Regenerative Medicine in Orthopedics: Evaluating PRP, MSC Therapies, BPC-157, TB-4/TB-500, CJC-1295, Retatrutide, and Osteostatin as Complements to Conventional Care: A Narrative Review

Abstract

Musculoskeletal disorders affect billions of individuals globally and are a leading cause of disability and healthcare expenditure. Regenerative medicine has emerged as a potential therapy, aiming to enhance tissue repair, improve functional outcomes, and delay the need for surgical intervention. This narrative review examines biologic therapies that aim to restore function and promote healing by leveraging the body’s intrinsic regenerative capacity. A comprehensive literature search was conducted using PubMed, Google Scholar, and various anthropological and orthopedic journals for studies published between 1990 and 2026. The review included clinical trials, observational studies, and preclinical investigations, with human data prioritized when available. Therapies evaluated included platelet-rich plasma (PRP), mesenchymal stem cell (MSC)-based therapies, and investigational peptides such as body protective compound-157 (BPC-157), thymosin beta-4 (TB-4), thymosin beta-500 (TB-500), CJC-1295, retatrutide, and osteostatin. PRP demonstrated the most consistent clinical benefit, particularly in knee osteoarthritis and tendinopathy. MSC-based therapies exhibit promising immunomodulatory and regenerative potential, largely mediated through paracrine signaling. Peptide-based therapies show encouraging preclinical effects in tissue repair, angiogenesis, and bone remodeling. Across all modalities, variations in study design and treatment protocols complicate reproducibility and cross-study comparison. Regenerative medicine is a rapidly expanding field and represents a potential adjunct in the management of musculoskeletal injury and degenerative disease. However, significant gaps remain in regulatory oversight, the standardization of treatment protocols, and, most importantly, clinical evidence. By carefully examining both the potential advantages and current limitations of these therapies, this review seeks to help bridge the gap between laboratory research and clinical application.