Regenerative medicine for sports injuries

Please note: We made this video before the COVID-19 pandemic. UI Health Care staff follow our most current guidance to wear the appropriate personal protective equipment when seeing patients. For more information about our safety efforts, please visit uihc.org.

Regenerative medicine offers sports medicine patients new options for nonsurgical treatment of common injuries. Most of these treatments use the patient’s own cells to stimulate healing in the injured area of the body.

If you have chronic pain from an injury, regenerative medicine may help you heal without having any surgery.

Regenerative medicine is not a single type of treatment. It’s a general name for many different types of medical treatments that use products made by the body, some of which have been used for many years. For example, organ and bone marrow transplants are forms of regenerative medicine.

Recent advancements in research and technology have led to a rapid growth in the number of different ways regenerative medicine can be used by doctors in many different areas of medicine.

In sports medicine, the most common types of regenerative medicine procedures include platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC), and microfragmented adipose tissue (MFAT). These treatments are used in treating conditions such as:

  • Chronic joint pain and osteoarthritis
  • Tennis elbow
  • Golfer’s elbow
  • Tendinitis in the Achilles tendon
  • Tendinitis in the rotator cuff of the shoulder
  • Meniscus tears
  • Labrum tears
  • Plantar fasciitis 
  • Certain tendon and ligament tears

A common misconception is that some of these regenerative medicine treatments for sports injuries are made from stem cells. The term “medicinal signaling cell” (MSC) is preferred and more accurately describes the cells used.

Platelet-rich plasma (PRP)

PRP is created from your own blood and gives a boost to your body’s natural healing process.

Platelets are the cells in your blood that heal and repair tissue. They stimulate cell growth, and they contain signaling molecules that instruct your body to heal. Plasma is the fluid part of your blood.

When you receive a PRP treatment, some of your blood is drawn and put into a machine that separates the platelets and plasma from the rest of your blood. This creates a fluid that is highly concentrated with platelets. That fluid is then injected into the damaged area of your body.

Your body already uses platelets to heal damaged tissue. PRP is a way of enhancing that process by placing far more platelets in the injured tissue than your body does normally.

Bone marrow aspirate concentrate (BMAC) and lipoaspirate

BMAC and lipoaspirate are similar to PRP. Specific types of cells and growth factors are collected from your body and then are injected into an injured area to stimulate healing.

BMAC uses MSCs collected from bone marrow in your pelvis, while lipoaspirate uses MSCs taken from fat in your abdomen or thighs.

Like PRP, BMAC and lipoaspirate use signaling molecules that stimulate healing. BMAC and lipoaspirate also contain MSCs, and this is where some of the misunderstanding related to stem cells occurs.

The MSCs in BMAC and lipoaspirate are true stem cells, but when those MSCs are injected near your damaged tissue, they “turn on” your own stem cells that were already naturally located in the area of the damaged tissue. The MSCs stimulate your local stem cells, encouraging them to heal and regrow tissue in the damaged area.

Microfragmented adipose tissue (MFAT)

MFAT uses your own adipose tissue, which is known more commonly as fat.

Adipose is a source of MSCs and other healing cells, along with growth factors and structural fibers. It helps to stimulate healing and can act as a cushion to provide support in the area where it’s used. MFAT can be particularly helpful for injuries in areas of the body that have limited blood flow.

The adipose tissue used in MFAT is easily withdrawn from just below the surface of the skin, usually from the abdomen or flanks. It’s a minimally invasive procedure that can be done in the doctor’s office.

After the adipose tissue is withdrawn, it is cleaned with saline and filtered in a way that retains the healing cells and removes other substances not useful in the healing process. This prepared adipose is the MFAT that is injected into the injured area of the body.

Deciding if regenerative medicine treatment is right for you

If you’re interested in learning more about nonsurgical options for chronic pain from an injury, ask your doctor. The University of Iowa Sports Medicine staff includes sports medicine doctors who have received specialized training in regenerative medicine and in other nonsurgical techniques for the treatment of injuries.

Resources for Referring Physicians

Orthobiologics at UI Health Care Orthopedics and Sports Medicine

Presenter: Ryan Kruse, MD

Last reviewed: 
August 2021

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