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However, there is paucity in evidence supporting the efficacy of orthobiologic therapy. The blood-derived products, such as platelet-rich plasma (PRP), is one of the commonly used orthobiologic therapy for knee osteoarthritis. Several studies have shown that PRP is superior to other treatments, but the anatomic changes are scarce. Treatment with mesenchymal stem cells (MSCs) offers the greatest potential for curing degenerative disease due to their self-renewal ability, ability to migrate towards injured tissues (homing\/trafficking), and ability to promote repair and regeneration of osteochondral defects. However, ethical concerns and high costs remain major challenges associated with MSC therapy. Gene therapy, another promising orthobiologic therapy, is currently in phase II clinical trial and has shown promising results. The key factors for successful orthobiologic therapy include patient selection, appropriate dosing, treatment of underlying mechanical problems, age, severity, and cost-effectiveness.<\/jats:p>","DOI":"10.1007\/s00402-024-05310-9","type":"journal-article","created":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T10:03:07Z","timestamp":1713348187000},"page":"3937-3946","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Orthobiologics in knee osteoarthritis, dream or reality?"],"prefix":"10.1007","volume":"144","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0801-7400","authenticated-orcid":false,"given":"Nicolaas Cyrillus","family":"Budhiparama","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dananjaya","family":"Putramega","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imelda","family":"Lumban-Gaol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,17]]},"reference":[{"key":"5310_CR1","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1089\/hum.2016.036","volume":"28","author":"CJ Aalbers","year":"2017","unstructured":"Aalbers CJ, Broekstra N, van Geldorp M, Kramer E, Ramiro S, Tak PP, Vervoordeldonk MJ, Finn JD (2017) Empty capsids and macrophage Inhibition\/Depletion increase rAAV transgene expression in joints of both healthy and arthritic mice. 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