What Do Patients Know About Orthobiologics? Perceived Efficacy, Safety, and Factors Influencing Treatment Decisions

The use and research of orthobiologics have significantly grown in recent decades, yet patient understanding and perceptions remain largely unexplored. Widespread marketing and potentially misleading claims may skew public understanding of the efficacy and safety of regenerative and orthobiologic therapies.

The purpose of this study was to examine patient knowledge and perceptions of orthobiologics, identify misconceptions, and understand information sources. It was hypothesized that patients hold significant misconceptions about orthobiologic use and efficacy.

Cross-sectional study.

Between October 2023 and April 2024, a cross-sectional, single-center study was conducted at an orthopaedic clinic, engaging all English-speaking patients aged >18 years. A questionnaire was administered covering demographic information, attitudes toward orthobiologic therapies, medical history, and information sources. The survey included multiple-choice questions and Likert scales to assess participants' knowledge and perceptions of the safety and efficacy of orthobiologic treatments. Mean and standard deviation were calculated, and groups were compared using univariate analyses with unpaired t tests.

A total of 423 responses were obtained, of which 357 met inclusion criteria and were analyzed (response rate, 84.4%). Most respondents were female (56.6%; n = 202) and aged 25 to 34 (33.3%; n = 119), with ages ranging from 18 to 84 years. Among the respondents, 44.0% (n = 157) were familiar with orthobiologics. Within the entire cohort, patients most frequently indicated the belief that orthobiologics could manage pain and inflammation (70.9%; n = 253) and treat cartilage injuries (66.9%; n = 239). Among respondents aware of orthobiologics, the most recognized treatments were platelet-rich plasma (77.1%; n = 121), mesenchymal stromal cells (56.7%; n = 89), and bone marrow aspirate concentrate (38.2%; n = 60). Among these patients, 45.9% (n = 72) believed orthobiologics could reduce pain, and 36.3% (n = 57) believed they could enhance healing rates. Belief in current evidence was mixed, with 37.6% (n = 59) deeming it insufficient and 15.3% (n = 24) considering it adequate. The most influential factors in patients' decisions to use orthobiologics were cost (68.8%; n = 108), recommendations from orthopaedic surgeons (63.1%; n = 99), and potential side effects (57.3%; n = 90). Primary information sources were orthopaedic surgeons (38.2%; n = 60), other physicians (33.8%; n = 53), and friends or family (32.5%; n = 51).

This study demonstrated that patient familiarity with orthobiologics remains limited, with significant variation in understanding that highlights the need for improved education and communication. Physicians, as the primary source of information, play a critical role in bridging this gap. Financial considerations and potential side effects significantly influence patient decisions and should be emphasized during consultations to support well-informed choices.