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’s been hard to utilize the literature to make accurate decisions about the effects of orthobiologics or the use of agents that often will stimulate a healing environment, and in some instances, maybe even help regenerate tissue. The areas that we’ve had success in and and published in have included the use of orthobiologics as to reduce reinjury or retrains after a rotator cuff surgery to help an ACL reconstruction mature, the graft mature more rapidly, and in the area of cartilage transplantation to minimize failure after them. These are three areas that we’ve spent a lot of time on.
We’ve actually demonstrated that these agents, such as bone marrow aspirate that’s concentrated, has led to statistically significant improvements and at least three of our very large problems that we deal with. One is cartilage injury. The others are rotator cuff tears and ACL tears.
One of our next initiatives is actually to start to capture virtually every patient, typically in a non-surgical setting, who utilizes these ortho biologics, where we use it in the office setting, and start to quantify what’s in it. The literature right now doesn’t always include a full analysis of what we’re giving a patient because every patient may need a different orthobiologic in some capacity. Now we have the ability in the office to characterize what we’re giving back to the patient after we process it in the office setting, and then see how that tracks with their clinical outcome. That’s an enormous initiative. It’s a multicenter initiative. It will be up to 10 centers by the first quarter of 2026 as part of that effort.
Now besides just saying, “Well, how are you doing?” after a procedure, it’s getting much more granular and much more specific, so that at some point we might even be able to customize how we prepare solutions for a specific condition. Everything is getting much more granular, rather than going with what makes intuitive sense. Now we have the ability to analyze it actually and give us data that can hone in on our decision making, and again, become much more predictive in terms of what will lead to a successful outcome.
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