Orthobiologic Research

• General PRP And Stem Cell Research
• Upper Extremity PRP, Stem Cell, and Laser Research
• Lower Extremity PRP, Stem Cell and Laser Research

In our research sections, we list published reports and current best practices on PRP, stem cell, and laser use in musculoskeletal conditions. These lists are periodically reviewed and updated as a reference sources to help guide our treatment recommendations for our patients.

How Orthobiologic Research Guides Patient Care

1. Review Scientific Literature. Evaluate peer-reviewed studies and published evidence.
2. Assess Clinical Outcomes. Analyze patient outcomes and treatment responses.
3. Determine Best Practices. Identify evidence-based treatment protocols.
4. Apply Research Findings. Integrate current research into individualized patient care.

Common questions

What are orthobiologics?

Orthobiologics are biological substances such as platelet-rich plasma, bone marrow concentrate, growth factors, and tissues used to support musculoskeletal healing and recovery.

What research topics are covered?

Research topics include PRP, bone marrow concentrate, stem cell science, orthopedic regenerative medicine, sports medicine, and musculoskeletal treatment outcomes.

Who leads orthobiologic research at Texas Orthobiologics?

Dr. Don Buford, a board-certified orthopedic surgeon specializing in sports medicine and regenerative medicine, oversees research initiatives and evidence-based treatment development.

Why is orthobiologic research important?

Research helps physicians evaluate safety, effectiveness, treatment indications, patient outcomes, and best practices for regenerative medicine therapies.

Selected work

Four publications that carry the most weight, ahead of the complete list below. Ordered by significance rather than by date.

• 2026
  Durable 8-year clinical and structural outcomes following ultrasound-guided autologous bone marrow aspirate concentrate injection for partial-thickness supraspinatus tearsBuford D, Murrell WDBiologic Orthopedics Journal. 2026;8(1):1–19The longest follow-up in the published literature with documented healing of the rotator cuff. First author. This is the practice's own outcome data, on the exact procedure it offers, using the exact imaging it uses.
• 2026 Systematic review
  Platelet-rich plasma outcomes in knee osteoarthritis are associated with the amount of total deliverable platelets: a systematic review and meta-analysisHooper N, Shapiro S, Paidsetty V, Azarpey A, …, Buford D, et al.PM&R. 2026;18(2):210–222A ten-author systematic review and meta-analysis establishing that PRP outcomes in knee osteoarthritis track with the total platelets actually delivered, not with the label on the syringe. Knee arthritis is this practice's highest-volume indication, and delivered dose is the variable it measures on every case — and the one most published trials do not report. See orthobiologics for the knee.
• 1994 Cited 470+ times
  The Buford complex — the “cord-like” middle glenohumeral ligament and absent anterosuperior labrum complex: a normal anatomic capsulolabral variantWilliams MM, Snyder SJ, Buford D JrArthroscopy. 1994;10(3):241–247An anatomic variant of the shoulder that carries Dr. Buford's name. First presented by him in 1992 and published in full here, it remains in shoulder textbooks and radiology references more than thirty years later. See SLAP tears and the Buford complex.
• 2025 Invited review
  Mesenchymal stem cell exosomes for the treatment of knee osteoarthritis: current clinical status and future potentialBuford DClinics in Sports Medicine. 2025;44(4):721–733Sole author, in a major review series. The person asked to review the state of exosome therapy is the same person whose practice explains why it is not legal for human use in the United States.
• 2000
  SLAP lesions: history, diagnosis, treatment, and resultsBuford D Jr, Karzel RP, Snyder SJTechniques in Shoulder & Elbow Surgery. 2000;1(4):202–208First author, written with the surgeons who named and classified the SLAP lesion in 1990.

Complete publication list

Peer-reviewed articles, reviews, consensus statements, letters, book chapters and conference abstracts, newest first. Each entry links to the abstract or the publisher's page. Compiled from PubMed and Google Scholar.

1. 2026 In my experience™… why a frozen shoulder doesn’t get better and what actually works to fix it
   Buford D
   Journal of Orthopaedic Experience & Innovation. 2026;7(1)
2. 2026 Durable 8-year clinical and structural outcomes following ultrasound-guided autologous bone marrow aspirate concentrate injection for partial-thickness supraspinatus tears
   Buford D, Murrell WD
   Biologic Orthopedics Journal. 2026;8(1):1–19
3. 2026 Intra-articular hyaluronic acid for osteoarthritis
   Devereaux J, Lakkaraju A, Sherif Z, Buford D, et al.
   Australian Prescriber. 2026;49(3):104
4. 2026 Therapeutic potential of extracellular vesicles: from biogenesis, isolation and molecular characterization to addressing translational gaps and regulatory barriers
   Primorac D, Brlek P, Bulić L, Hrvatin N, …, Buford D, et al.
   International Journal of Molecular Sciences. 2026;27(4):1676
5. 2026 Clinical applications of extracellular vesicles: promises and pitfalls
   Primorac D, Brlek P, Bulić L, Hrvatin N, …, Buford D, et al.
   International Journal of Molecular Sciences. 2026;27(3):1509
6. 2026 Platelet-rich plasma outcomes in knee osteoarthritis are associated with the amount of total deliverable platelets: a systematic review and meta-analysis
   Hooper N, Shapiro S, Paidsetty V, Azarpey A, …, Buford D, et al.
   PM&R. 2026;18(2):210–222
7. 2025 Mesenchymal stem cell exosomes for the treatment of knee osteoarthritis: current clinical status and future potential
   Buford D
   Clinics in Sports Medicine. 2025;44(4):721–733
8. 2025 Experts achieve consensus on a majority of statements regarding ethics, transparency, regulation, and best practices for the use of orthobiologics
   Gilat R, Muth SA, Hurley ET, Yazdi AA, …, Cole BJ; Biologic Association Member Organization Representatives
   Arthroscopy. 2025;41(9):3611–3621
9. 2025 Letter regarding “Platelet-rich plasma injections are inferior to corticosteroid injections for short-term pain relief: a prospective, double-blinded, randomized controlled trial” Letter
   Sussman WI, Buford DA, Bowers RL, Paul RV, et al.
   The Journal of Arthroplasty. 2025;40(8):e52–e54
10. 2025 Direct-to-consumer marketing: the ethics of snake oil sales? Letter to the editor Letter
    Sussman WI, Shapiro S, Demers A, Mautner K, …, Buford D, et al.
    The American Journal of Sports Medicine. 2025;53(9):NP18–NP22
11. 2024 In my experience… 15 data points to better evaluate platelet-rich plasma kits and protocols
    Buford D, Sherman N
    Journal of Orthopaedic Experience & Innovation. 2024;5(2)
12. 2024 Experts achieve consensus on a majority of statements regarding platelet-rich plasma treatments for treatment of musculoskeletal pathology
    Hurley ET, Sherman SL, Stokes DJ, Rodeo SA, …, Buford DA, et al.
    Arthroscopy. 2024;40(2):470–477.e1
13. 2023 Angiogenesis and tissue repair depend on platelet dosing and bioformulation strategies following orthobiological platelet-rich plasma procedures: a narrative review
    Everts PA, Lana JF, Onishi K, Buford D, et al.
    Biomedicines. 2023;11(7):1922
14. 2023 Determination of rotator cuff tear reparability: an ultrasound-based investigation
    Cox JL, Laughlin MS, Elkousy HA, Baker HM, …, Buford DA, et al.
    JSES International. 2023;7(1):21–24
15. 2021 Platelet-rich plasma injection vs sham injection and tendon dysfunction in patients with chronic midportion Achilles tendinopathy Letter
    Malanga GA, Mautner K, Buford D
    JAMA. 2021;326(19):1974
16. 2021 Letter to the editor in response to “The debit side of stem-cell joint injections: a prospective cohort study” by James Pritchett MD Letter
    Centeno CJ, Murrell WD, Buford D, Malanga G, et al.
    Current Orthopaedic Practice. 2021;32(6):631
17. 2020 Bone marrow aspirate concentrate is equivalent to platelet-rich plasma for the treatment of knee osteoarthritis at 1 year
    Malanga GA, Buford D, Murrell WD, Shiple BJ
    Orthopaedic Journal of Sports Medicine. 2020;8(10):2325967120960706
18. 2020 The Ortho Show podscript: an interview with Don Buford on orthobiologics Podcast transcript
    Buford D, Sigman S
    Journal of Orthopaedic Experience & Innovation. 2020;1(2)
19. 2020 The average level of evidence of papers published in six orthopedic journals
    Buford D, Tulpule S, Hyder J, Boot H
    Biologic Orthopedics Journal. 2020;2(1):e48–e50
20. 2020 Bone marrow concentrate (BMC) therapy in musculoskeletal disorders: evidence-based policy position statement of the American Society of Interventional Pain Physicians (ASIPP)
    Manchikanti L, Centeno CJ, Atluri S, Albers SL, …, Buford D, et al.
    Pain Physician. 2020;23(2):E85–E131
21. 2019 Welcome to the Biologic Orthopedics Journal Editorial
    Mishra A, Buford D, Murrell WD
    Biologic Orthopedics Journal. 2019;1(1):e1
22. 2015 Bone marrow concentrate and platelet-rich plasma acquisition and preparation: why technique matters
    Murphy MB, Terrazas JA, Buford DA
    Techniques in Regional Anesthesia and Pain Management. 2015;19(1–2):19–25
23. 2011 Rotator cuff healing with and without platelet-rich plasma application (SS-16) Conference abstract
    Buford DA
    Arthroscopy. 2011;27:e37–e38
24. 2010 The thirteen-point shoulder ultrasound examination (Poster 148) Conference abstract
    Buford D, DuBois B
    PM&R. 2010;2:S69
25. 2010 Restoration of the rotator cuff footprint after arthroscopic single-row repair (SS-01) Conference abstract
    Buford DA
    Arthroscopy. 2010;26(6):e1
26. 2003 Arthroscopic reduction and internal fixation of a greater tuberosity fracture of the shoulder: a case report
    Bonsell S, Buford DA Jr
    Journal of Shoulder and Elbow Surgery. 2003;12(4):397–400
27. 2003 Diagnostic shoulder arthroscopy: the 23-point arthroscopic evaluation with normal anatomical variants and pathology Book chapter
    Buford DA Jr, Snyder SJ
    In: Snyder SJ, ed. Atlas of Shoulder Arthroscopy. Martin Dunitz; 2003:71, 82–91
28. 2000 SLAP lesions: history, diagnosis, treatment, and results
    Buford DA Jr, Karzel RP, Snyder SJ
    Techniques in Shoulder & Elbow Surgery. 2000;1(4):202–208
29. 2000 Midterm results of arthroscopic co-planing of the acromioclavicular joint
    Buford D Jr, Mologne T, McGrath S, Heinen G, Snyder SJ
    Journal of Shoulder and Elbow Surgery. 2000;9(6):498–501
30. 1998 Intramedullary nailing of femoral fractures in adolescents
    Buford D Jr, Christensen K, Weatherall P
    Clinical Orthopaedics and Related Research. 1998;(350):85–89
31. 1994 The Buford complex — the “cord-like” middle glenohumeral ligament and absent anterosuperior labrum complex: a normal anatomic capsulolabral variant
    Williams MM, Snyder SJ, Buford D Jr
    Arthroscopy. 1994;10(3):241–247
32. 1992 The Buford complex — the loose anterior superior labrum / middle glenohumeral ligament complex: an anatomic variant Conference abstract
    Buford D, Snyder SJ, Veneziani S, Wuh H
    Arthroscopy. 1992;8(3):402