Editorial Commentary: Point-of-Care Harvest and Application of Resident Stem Are Practical and Cost-Effective.

Point-of-care harvest and application of residence stem cells are practical and cost-effective. Tissue formerly considered waste contains these biologically potent cells, and use of such tissue may represent a big part of biologics going forward. The practical application of orthobiologics has slowed because of 3 hurdles: the regulatory requirements of stem cell technologies; the energy, time, and money required to develop a clinical evidence base; and the expense that they present to patients and institutions. Orthobiologic technologies that are simple and cheap and that leverage tissues that are already readily available at the point of care (i.e., the surgical procedure) solve many of these challenges. Cell sources could include knee synovium, shoulder subacromial bursa, bone marrow aspirate, and anterior cruciate ligament injury effusion fluid and stump tissue. A current concern is that collagenase processing and culture expansion are steps resulting in regulatory hurdles in the United States.