Orthobiologics in Focus: Current Evidence, Clinical Applications, and Future Directions, A Scoping Review

Regenerative modalities are increasingly becoming part of orthopedic practice with the use of orthobiologic interventions. These interventions make use of biological approaches to help in repairing the tissues, mitigating nociception, and improving locomotor performance.

The current scoping review is a review of the modern literature as of 2020-2025 on orthobiologic therapies. It examines their clinical effectiveness, the strength of supporting evidence, and the development of new progress in musculoskeletal pathology regenerative management.

A systematic search in PubMed, Scopus, Embase, and WoS was done on the articles with their indexes dated between January 2020 and February 2025. The inclusion criteria were human and animal studies that utilized platelet-rich plasma (PRP), (MSCs), bone marrow aspirate concentrate (BMAC), and adipose-derived products strategies using a scaffold only. Synthesis and data extraction were conducted as per PRISMA-ScR standards.

Among the 1716 records that had been filtered, 81 studies met inclusion criteria. Most of them were randomized or comparative trials (77% Level I-II evidence), which are evidence of the high methodological quality. PRP was the most commonly researched modality, whereas MSC-based interventions were the most common.

PRP, MSCs, and BMAC are orthobiologic modalities, which are evidence-based and effective alternatives to promote musculoskeletal healing and regeneration. These interventions supplemented by conventional surgical procedures and rehabilitative interventions yield pain relief, functional restoration, and long-term joint maintenance in a spectrum of orthopedic complications.