Regulatory and Ethical Aspects of Orthobiologic Therapies

the Biologics Association

Research output: Contribution to journalReview articlepeer-review


Orthobiologic therapies show significant promise to improve outcomes for patients with musculoskeletal pathology. There are considerable research efforts to develop strategies that seek to modulate the biological environment to promote tissue regeneration and healing and/or provide symptomatic relief. However, the regulatory pathways overseeing the clinical translation of these therapies are complex, with considerable worldwide variation. The introduction of novel biologic treatments into clinical practice raises several ethical dilemmas. In this review, we describe the process for seeking approval for biologic therapies in the United States, Europe, and Japan. We highlight a number of ethical issues raised by the clinical translation of these treatments, including the design of clinical trials, monitoring outcomes, biobanking, “off-label” use, engagement with the public, marketing of unproven therapies, and scientific integrity.

Original languageEnglish (US)
JournalOrthopaedic Journal of Sports Medicine
Issue number11
StatePublished - Nov 2022


  • biologics
  • orthobiologics
  • oversight
  • regeneration
  • regulation

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine


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