BACKGROUND Orthobiologics-biological substances like platelet-rich plasma(PRP),bone marrow aspirate concentrate,and stem cells-are increasingly used in musculoskeletal care to promote tissue repair and reduce reliance...BACKGROUND Orthobiologics-biological substances like platelet-rich plasma(PRP),bone marrow aspirate concentrate,and stem cells-are increasingly used in musculoskeletal care to promote tissue repair and reduce reliance on invasive surgery.Despite global momentum,India's clinical adoption remains underexplored.AIM To inform education,policy,and resource allocation for the safe and effective adoption of orthobiologics in musculoskeletal care.METHODS A cross-sectional electronic survey was conducted from January to March 2025 among orthopaedic surgeons,academicians,and trainees across India.The questionnaire assessed demographics,knowledge of orthobiologics,attitudes toward training and subspecialization,usage trends,regulatory awareness,and perceived barriers.Data were analyzed using descriptive statistics andχ2/Fisher’s exact tests,with P<0.05 considered significant.RESULTS A total of 1280 valid responses were collected.Awareness of orthobiologics was high(97%),with PRP being the most familiar and widely used(80%).Formal training was reported by only 31%,though 85%showed interest in structured education,and 68%supported orthobiologics as a subspecialty.Satisfaction with clinical outcomes averaged 6.5±2.3 out of 10 points.Barriers included high treatment cost(64%),poor patient awareness(90%),and limited access to biologics labs(18%).Regulatory understanding was moderate,with academic-affiliated clinicians more informed about stem cell guidelines.CONCLUSION Indian orthopaedic professionals demonstrate strong awareness and optimism toward orthobiologics,but widespread gaps in training,infrastructure,and regulation hinder broader adoption.Strategic investments in education,standardized protocols,and accessible facilities are essential to support safe and evidence-driven integration of regenerative therapies into clinical practice.展开更多
Molecular hydrogen(H2)demonstrates selective antioxidant and anti-inflammatory properties with therapeutic potential across musculoskeletal conditions including osteoarthritis,rheumatoid arthritis,exercise-induced mus...Molecular hydrogen(H2)demonstrates selective antioxidant and anti-inflammatory properties with therapeutic potential across musculoskeletal conditions including osteoarthritis,rheumatoid arthritis,exercise-induced muscle damage,chronic pain syndromes,tendinopathies,and muscle atrophy.This review critically evaluates preclinical and clinical evidence for H2 therapy and identifies research gaps.A comprehensive search of PubMed,EMBASE,and Cochrane Library(up to April 2025)yielded 45 eligible studies:25 preclinical and 20 clinical trials.Preclinical models consistently showed reductions in reactive oxygen species,inflammatory cytokines,and improved cell viability.Clinical trials reported symptomatic relief in osteoarthritis,decreased Disease Activity Score 28 in rheumatoid arthritis,and accelerated clearance of muscle damage markers.Delivery methods varied-hydrogen-rich water,gas inhalation,and saline infusion-hindering direct comparison.Mechanistic biomarkers were inconsistently reported,limiting understanding of target engagement.Common limitations included small sample sizes,short durations,and protocol heterogeneity.Despite these constraints,findings suggest H2 may serve as a promising adjunctive therapy via antioxidant,anti-inflammatory,and cytoprotective mechanisms.Future research should prioritize standardized delivery protocols,robust mechanistic endpoints,and longer-term randomized trials to validate clinical efficacy and optimize therapeutic strategies.展开更多
文摘BACKGROUND Orthobiologics-biological substances like platelet-rich plasma(PRP),bone marrow aspirate concentrate,and stem cells-are increasingly used in musculoskeletal care to promote tissue repair and reduce reliance on invasive surgery.Despite global momentum,India's clinical adoption remains underexplored.AIM To inform education,policy,and resource allocation for the safe and effective adoption of orthobiologics in musculoskeletal care.METHODS A cross-sectional electronic survey was conducted from January to March 2025 among orthopaedic surgeons,academicians,and trainees across India.The questionnaire assessed demographics,knowledge of orthobiologics,attitudes toward training and subspecialization,usage trends,regulatory awareness,and perceived barriers.Data were analyzed using descriptive statistics andχ2/Fisher’s exact tests,with P<0.05 considered significant.RESULTS A total of 1280 valid responses were collected.Awareness of orthobiologics was high(97%),with PRP being the most familiar and widely used(80%).Formal training was reported by only 31%,though 85%showed interest in structured education,and 68%supported orthobiologics as a subspecialty.Satisfaction with clinical outcomes averaged 6.5±2.3 out of 10 points.Barriers included high treatment cost(64%),poor patient awareness(90%),and limited access to biologics labs(18%).Regulatory understanding was moderate,with academic-affiliated clinicians more informed about stem cell guidelines.CONCLUSION Indian orthopaedic professionals demonstrate strong awareness and optimism toward orthobiologics,but widespread gaps in training,infrastructure,and regulation hinder broader adoption.Strategic investments in education,standardized protocols,and accessible facilities are essential to support safe and evidence-driven integration of regenerative therapies into clinical practice.
文摘Molecular hydrogen(H2)demonstrates selective antioxidant and anti-inflammatory properties with therapeutic potential across musculoskeletal conditions including osteoarthritis,rheumatoid arthritis,exercise-induced muscle damage,chronic pain syndromes,tendinopathies,and muscle atrophy.This review critically evaluates preclinical and clinical evidence for H2 therapy and identifies research gaps.A comprehensive search of PubMed,EMBASE,and Cochrane Library(up to April 2025)yielded 45 eligible studies:25 preclinical and 20 clinical trials.Preclinical models consistently showed reductions in reactive oxygen species,inflammatory cytokines,and improved cell viability.Clinical trials reported symptomatic relief in osteoarthritis,decreased Disease Activity Score 28 in rheumatoid arthritis,and accelerated clearance of muscle damage markers.Delivery methods varied-hydrogen-rich water,gas inhalation,and saline infusion-hindering direct comparison.Mechanistic biomarkers were inconsistently reported,limiting understanding of target engagement.Common limitations included small sample sizes,short durations,and protocol heterogeneity.Despite these constraints,findings suggest H2 may serve as a promising adjunctive therapy via antioxidant,anti-inflammatory,and cytoprotective mechanisms.Future research should prioritize standardized delivery protocols,robust mechanistic endpoints,and longer-term randomized trials to validate clinical efficacy and optimize therapeutic strategies.
