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ORTHOBIOLOGIC THERAPY FREQUENTLY ASKED QUESTIONS (FAQs)

What is orthobiologic therapy?

This refers to the use of biological substances to help musculoskeletal injuries heal quicker. Orthobiologics help to greatly reduce pain.

Orthobiologics are used to improve the healing of fractured bones and injured ligaments, muscles, nerves, and tendons.

Orthobiologics come from substances that are naturally found in our body.

What are examples of orthobiologic substances?

Platelet rich plasma (PRP) in our blood, bone marrow concentrate (BMC), and lipoaspirate (LA)

What is so important about IRAP and A2M?

IRAP and A2M are two very important heavily anti-inflammatory proteins.

IRAP is interleukin 1 receptor antagonist protein and A2M is alpha 2 macroglobulin protein. They counteract the negative effect of destructive inflammatory proteins in joints and soft tissue. IRAP is capable of slowing the osteoarthritic degenerative process. A2M prevents cartilage breakdown, promotes tissue growth, and supports the overall restoration of affected joints.

This is in contrast to steroids which are degenerative. Too many steroids over time contributes to brittle bone disease [osteoporosis], hypothyroidism [poorly functioning thyroid], diabetes, tearing of the tendons and ligaments etc.

Does orthobiologic therapy hurt?

No. Dr. Bethea walks you through the whole process so that there are not any surprises. She will tell you if you will feel some pressure or if you will feel some burning. The temporary burning sensation, which goes away in less than 60 seconds, is related to the acidic property of preservative free 1% lidocaine. Dr. Bethea decreases this sensation of burning from the 1% lidocaine by combining sodium bicarbonate with lidocaine. Sodium bicarbonate is really just glorified sterilized baking soda. This is a base. It neutralizes the acidity of 1% lidocaine.

Can I use another patient’s orthobiologic products?

No. This is not like blood transfusions done in the hospital.

If I am sick, can I still undergo orthobiologic therapy?

No.

How much orthobiologic substance is needed?

60 mL is the minimum in order to obtain the highest concentration of growth factors, IRAP, and A2M.

Is everything done the same day of my orthobiologic therapy?

Yes.

Do I need to drink a lot of water before coming in for my orthobiologic therapy?

Yes.

How do you get the growth factors, IRAP, and A2M from my orthobiologic product?

We use a special machine called a centrifuge. The centrifuge spins your 60ml of orthobiologic product down and separates out your dense growth factors, IRAP, A2M, and other important healing proteins.

How long does that take?

10 minutes.

How long overall does orthobiologic therapy take?

It depends on the number of locations to be addressed.

Do you mix anything else with my orthobiologic product?

No.

Do I need to bring anything for orthobiologic therapy?

Yes. We prefer to have imaging studies (x-rays, CT scans, MRIs, or ultrasound) of the respective joints and of the spine before orthobiologic therapy can take place. If you do not have any of these studies, these can be ordered at your initial consultation, or before coming in for your actual orthobiologic therapy. (Some new practice members BYPASS the consultation if they are 100% confident that want to directly proceed with orthobiologic therapy.)

Is orthobiologic consultation separate from the actual orthobiologic therapy?

Yes. Some practice members prefer to have their consultation first and then return on another day for their orthobiologic therapy. Some practice members are already prepared to undergo their orthobiologic therapy. They have their imaging studies already completed and they have stopped the respective pre-procedure items.

What is the orthobiologic 60 minute consultation health investment?

$385

How do I schedule an orthobiologics consultation?

Text or call us at 336.361.2396. You may use info@gsorejuvenation.com to email us. Call the main line, 336-501-3796 between the hours of 7:30 AM-4:00 PM Monday through Thursday. We are closed daily from noon to 12:30 PM for lunch. Phones are not answered during that 30 minute period of time. We are closed on Fridays, but you can still email, leave voice mail message, or text your request for an orthobiologic consultation appointment with Dr. Bethea.

Do I need to stop any medications or foods before or after orthobiologic therapy?

Yes. In order for you to have the best outcome, you need to stop the following for three days before and stay off of these three days after orthobiologic therapy:

ALL NSAIDs, which includes prescription as well as over-the-counter topical and oral forms, must be stopped. THE EXCEPTION IS MOBIC (MELOXICAM) AND CELEBREX ( CELECOXIB). These two have been found to NOT negatively affect orthobiologic therapy outcome. These CAN continue around orthobiologic therapy.

NSAIDs also includes natural based items, such as turmeric, OPC-3, etc.. It is best to stop anything that is stated to be an anti-inflammatory.

ALL vitamins, minerals, and other supplements must be stopped. This even includes your multivitamin.

Any aspirin containing products or blood thinners must be stopped (examples: Coumadin, Xarelto, Brilinta, Effient, Eliquis, Plavix, etc.). Some vitamins and supplements have blood thinning properties to them. These must be stopped.

If you’re taking any blood thinner greater than 325 mg of aspirin, then we will need written medical clearance from whoever prescribes your blood thinner. We have a special form that we send to your prescribing provider. We must have their approval to stop your blood thinner for the respective time frames. If they do NOT approve you, then you will NOT be able to undergo your orthobiologic therapy. IF you stop your respective blood thinner, on your own, without your prescribing provider’s permission, you will be doing so at your own risk. Stopping on your own is strongly discouraged. Look at other alternatives if your prescribing provider does not believe that you are safe to stop your blood thinner for x number of days pre and post orthobiologic procedure.

It is recommended that you stay away from green tea, wine, and other type of fluids that are known to have antioxidant properties to them. Any agent that contains antioxidant properties needs to be stopped.

Steroids must be out of your system for two weeks before and two weeks after treatment.

Can I drive to my orthobiologic therapy or do I need to have a driver?

You can drive to your orthobiologic therapy as long as you have not taken any type of pre-medication sedation agents. That’s medications such as Valium, Ativan, or Xanax. Valium is called in for some patients who undergo orthobiologic spine therapy. Valium is not prescribed for peripheral joints procedures, such as the knees or the shoulders.

What things would decrease my chances of the best outcome?

Not stopping the medications, vitamins, minerals, and supplements stated above.

Smoking, drinking, and using illicit (illegal) drugs.

If you cannot come off of steroids because of certain autoimmune or respiratory conditions, then, unfortunately, you are not an appropriate candidate for using the orthobiologic, PRP. You might be a candidate for another level of regenerative medicine therapy.

If you are taking immunosuppressants, such as methotrexate, you must be off of these for seven days before and seven days after your orthobiologic therapy.

Will I have restrictions after my orthobiologic therapy?

Yes. Reduce intensity of exercise activities by 50% by week five. Full intensity of activities by week six.

You will receive a detailed discharge instructions sheet which will spell out more specifics tailored to your joints or/and spine.

Can I go back to work the same day following my orthobiologic therapy?

If you have not taken any pre-procedure sedation, such as diazepam, you can return to work the same day.

When should I notice a difference in my pain reduction and improvement in my quality of life?

The first three days is the inflammatory phase. During this phase, you may experience increased pressure and throbbing as a result of the macrophages cleaning up the debris ( bad tissue and fluid in the respective locations). After these three days, starts the proliferative phase. This is where the growth factors, IRAP, and A2M exponentially increase. After six weeks is the remodeling phase. That’s when the tissue becomes more and more native to its location as A2M increases. By six weeks, practice members should start noticing improvements in their quality of life and in pain control. For some practice members, all symptoms resolve before 6 weeks. It is an individualized process. It may take others longer than six weeks. Growth factors don’t grow overnight. IRAP and A2M don’t sharply increase in a few hours or a few days. You must be patient with your body. If you are one who tends to be inpatient with the timing of therapy outcomes, you will need to ask yourself whether or not orthobiologic therapy is right for you. This is not like steroids. Everyone must have realistic expectations.

Will I need more than one orthobiologic therapy?

Some patients may need more than one session depending on the severity of their pathology.

Is orthobiologic therapy covered by insurance?

Contact your insurance carrier. In 2026, most commercial health and federal insurance carriers do not cover orthobiologic therapy.

That being said, many workers compensation companies have chosen to embrace orthobiologics so that their clients can avoid unnecessary surgeries, chronic opioid use with unwanted addiction, etc.

NEVERTHELESS, orthobiologic therapy remains affordable.

We offer Care Credit, which provides an 18 months interest-free program for repayment. Apply at home before your first visit with Dr. Bethea

Advance Care Card offers a 14 months interest-free program for repayment. Apply at home before your first visit with Dr. Bethea

HSA and FSA accounts can cover the health investment for orthobiologic therapies.

Am I responsible for my health investment payment up front?

Yes. Payment in full is due on the date of service, at check in, for orthobiologic therapies.