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Injections: Orthobiologics and the Power of Placebo

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Orthobiologics

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Abstract

Placebo effects have always aroused a strong interest in physicians and researchers, and their power in improving the symptoms of patients was addressed by several studies, with a debate on its efficacy that remains open to this day. The psychological mechanisms underlying the placebo effect, together with the potential neurological and physical responses, are being progressively clarified and quantified. Regardless of the specific placebo components, the relevance of the placebo effect in many medical fields is well recognized, and placebo effects play a major role in orthobiologics.

Musculoskeletal injections are undoubtedly influenced by the power of placebo effects, with some physicians still advocating that promising injectable drugs may be nothing more than expensive placebos. In fact, the response to the injection of a (theoretically) inactive solution has been documented in many double-blind randomized controlled trials, with placebos sometimes exceeding the efficacy of the active treatments. High level trials controlling for the many potential biases and influences of placebo effects are needed to define the true efficacy of orthobiologic injections in the musculoskeletal field.

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Author information

Authors and Affiliations

  1. Orthopaedic and Traumatology Unit, Ospedale Regionale di Lugano, EOC, Lugano, Switzerland

    Davide Previtali, Marco Cuzzolin, Giorgio Di Laura Frattura & Christian Candrian

  2. USI—Università della Svizzera Italiana, Faculty of Biomedical Sciences, Lugano, Switzerland

    Christian Candrian

  3. Rizzoli Orthopaedic Institute, Bologna, Italy

    Giuseppe Filardo

  4. Università della Svizzera Italiana, Ente Ospedaliero Cantonale, Lugano, Switzerland

    Giuseppe Filardo

Authors
  1. Davide Previtali
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  2. Marco Cuzzolin
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  3. Giorgio Di Laura Frattura
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  4. Christian Candrian
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  5. Giuseppe Filardo
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Corresponding author

Correspondence to Davide Previtali .

Editor information

Editors and Affiliations

  1. Rizzoli Orthopaedic Institute, Bologna, Italy

    Giuseppe Filardo

  2. Orthopaedic & Sports Medicine Group, Santa Monica Orthopaedic & Sports Medicine, Santa Monica, CA, USA

    Bert R. Mandelbaum

  3. Orthopaedic Surgery and Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA

    George F. Muschler

  4. Hospital for Special Surgery, New York, NY, USA

    Scott A. Rodeo

  5. Institute for Medical Science in Sports, Osaka Health Science University, Osaka, Japan

    Norimasa Nakamura

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Previtali, D., Cuzzolin, M., Frattura, G.D.L., Candrian, C., Filardo, G. (2022). Injections: Orthobiologics and the Power of Placebo. In: Filardo, G., Mandelbaum, B.R., Muschler, G.F., Rodeo, S.A., Nakamura, N. (eds) Orthobiologics. Springer, Cham. https://doi.org/10.1007/978-3-030-84744-9_29

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  • DOI: https://doi.org/10.1007/978-3-030-84744-9_29

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-84743-2

  • Online ISBN: 978-3-030-84744-9

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