The role of orthobiologics in bone healing and joint and tendon degeneration in the upper limb.

This review article examines the role of orthobiologics, specifically platelet-rich plasma (PRP), mesenchymal stem cells (MSCs) and bone morphogenetic protein (BMP), in bone healing and the treatment of joint and tendon degeneration in the upper limb. The historical development, theorized mechanisms and clinical applications of these orthobiologics are explored, focussing on their effectiveness in fracture non-unions, osteoarthritis and tendinopathies. The evidence for bone healing shows promising results, particularly for MSCs and BMP in the treatment of non-unions. However, despite preclinical evidence of regenerative abilities of PRP and MSCs, the clinical trials do not support their use for tendinopathies or osteoarthritis. Before widespread clinical application of PRP or MSCs for upper limb degenerative conditions, their efficacy needs to be established through large, high-quality trials.