Exploring regenerative medicine and orthobiologics has been a top priority at Chicago-based Midwest Orthopaedics at Rush, and it’s just the beginning for innovation, Brian Cole, MD, said.
Dr. Cole, managing partner, spoke with Becker’s about what he anticipates for orthobiologics in the coming year.
Note: This conversation was lightly edited for clarity.
Question: What research has Rush done this year? What will you be exploring in 2026?
Dr. Brian Cole: When it comes to research, we have 54 clinician scientists and 23 basic scientists. This year alone. We published in peer reviewed literature more than 500 articles, so it was a very productive year. We’ve done really well with funding, but there’s a lot that remains. There are people who are fully engaged and interested in performing research and demonstrating success, but there still is a tremendous shortfall, especially with what’s happening from the administration level and through the NIH. We struggle to get suitable funding for the stuff that we’re doing, but there’s a lot of things that are pretty interesting.
We’re looking at outcomes of surgical techniques to treat ACL injury and the Tommy John problem. We’re using three dimensional modeling to help develop patient-specific instrumentation for various surgical procedures. We’re interested in looking at the downstream consequences of ACL injury and preventing arthritis that can develop in our young people by using orthobiologics. We’ve made tremendous headway in looking at autologous products and agents and things that come from the patient, such as platelet rich plasma or PRP or bone marrow aspirations. These may have a few stem cells, but they also have growth factors that might change the environment following a surgical procedure, or even be utilized after an injury before surgery happens to prevent the downstream consequences.
In the joint replacement world, we’re using high level tools such as lasers and AI to help diagnose joint infection earlier and then get into the prevention mode. In the spine, there’s a new evolutionary trend towards minimally invasive spine surgery, borrowing from some of the things that we’ve done in sports medicine, using small cameras rather than larger incisions to treat spine problems. And now in an outpatient setting, we’re using a lot of 3D-printing techniques to customize or tailor surgical procedures to specific patients, rather than a one-size-fits-all model.
Q: What will the role of orthobiologics be 12 months from now?
BC: It has been hard to utilize the literature to make accurate decisions about the effects of orthobiologics or the use of agents that are often purported to stimulate a healing environment, and possibly, help regenerate tissue. The areas that we’ve demonstrated research success in and have published on include the use of orthobiologics to reduce rotator cuff re-tears following repair, help ACL grafts used for ligament reconstruction mature more rapidly, and to potentially minimize failure following cartilage transplantation. The most common orthobiologic investigated at our center includes bone marrow aspirate that is concentrated and utilized at the time of surgery or in the office setting.
One of our next initiatives is to capture virtually every patient who undergoes non-surgical symptom modifying treatment with the use of orthobiologics in the office setting. The literature often does not include an analysis or characterization of the substance that we are injecting. Having this information and understanding its correlation to patient reported outcomes might help us to nearly customize how we think about the use of orthobiologics in the future. This multi-center initiative (the BARB), centered at the Mayo Clinic in Arizona, involves up to 10 centers and will truly further our ability to provide predicable care and outcomes for our patients with greater precision.
