Mapping awareness and application of orthobiologics among orthopaedic professionals: A cross-sectional study

doi:10.5312/wjo.v17.i1.112738

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Jan 18, 2026 (publication date) through Jan 9, 2026

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World Journal of Orthopedics

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2218-5836

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World J Orthop. Jan 18, 2026; 17(1): 112738
Published online Jan 18, 2026. doi: 10.5312/wjo.v17.i1.112738

Mapping awareness and application of orthobiologics among orthopaedic professionals: A cross-sectional study

Madhan Jeyaraman, Naveen Jeyaraman, Swaminathan Ramasubramanian, Arulkumar Nallakumarasamy, Viji Devanand, Sathish Muthu

Madhan Jeyaraman, Naveen Jeyaraman, Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai 600077, Tamil Nadu, India

Madhan Jeyaraman, Naveen Jeyaraman, Sathish Muthu, Department of Orthopaedics, Orthopaedic Research Group, Coimbatore 641045, Tamil Nadu, India

Madhan Jeyaraman, Naveen Jeyaraman, Swaminathan Ramasubramanian, Arulkumar Nallakumarasamy, Sathish Muthu, Department of Regenerative Medicine, Agathisha Institute of Stemcell and Regenerative Medicine, Chennai 600030, Tamil Nadu, India

Arulkumar Nallakumarasamy, Department of Orthopaedics, Jawaharlal Institute of Postgraduate Medical Education and Research, Karaikal 609602, Puducherry, India

Viji Devanand, Department of Physiology, Sree Balaji Medical College and Hospital, Bharath Institute of Higher Education and Research, Chennai 600044, Tamil Nadu, India

Sathish Muthu, Central Research Laboratory, Meenakshi Medical College Hospital and Research Institute, Meenakshi Academy of Higher Education and Research, Kanchipuram 631552, Tamil Nadu, India

Co-first authors: Madhan Jeyaraman and Naveen Jeyaraman.

Author contributions: Jeyaraman M contributed to conceptualization, proofreading, administration; Ramasubramanian S and Muthu S contributed to acquiring clinical data and performing the data analysis; Jeyaraman N, Ramasubramanian S and Devanand V contributed to manuscript writing; Jeyaraman N, Nallakumarasamy A, and Muthu S helped in manuscript revision; Muthu S contributed for image acquisition; all authors have agreed to the final version to be published and agree to be accountable for all aspects of the work.

Institutional review board statement: The study was approved by the Institutional Ethics Committee of Sri Lalithambigai Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai.

Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement- checklist of items.

Data sharing statement: Contained within the manuscript

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Swaminathan Ramasubramanian, Department of Regenerative Medicine, Agathisha Institute of Stemcell and Regenerative Medicine, Chennai 600030, Tamil Nadu, India. swaminathan.ramasubramanian@outlook.com

Received: August 5, 2025
Revised: August 20, 2025
Accepted: November 18, 2025
Published online: January 18, 2026
Processing time: 157 Days and 16.9 Hours

Abstract

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 and χ²/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.

Keywords: Orthobiologics; Orthopaedics; Platelet-rich plasma; Bone marrow aspirate concentrate; Regenerative orthopaedics

Core Tip: Indian orthopaedic professionals demonstrate strong awareness and growing interest in orthobiologic therapies, especially platelet-rich plasma. Despite this enthusiasm, the availability of formal training and understanding of regulatory frameworks remains limited. Systemic challenges-including treatment costs, infrastructure constraints, and patient unfamiliarity-continue to hinder broader application of advanced biologics. These findings underscore the need for targeted education, standardized protocols, and enhanced facilities to promote safe, evidence-based integration of regenerative therapies in routine musculoskeletal practice.