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Therapeutic Peptides in Orthopaedics: Applications, Challenges, and Future Directions.

This narrative review, published in the Journal of the American Academy of Orthopaedic Surgeons: Global Research & Reviews, surveys the mechanistic rationale for using therapeutic peptides — including BPC-157, TB-500, GHK-Cu, ipamorelin, CJC-1295, tesamorelin, sermorelin, semax, selank, and epitalon — in orthopaedic and musculoskeletal contexts. As a narrative review, it synthesises existing literature rather than generating new data; it carries no experimental controls, no patient cohort, and no statistical analysis of outcomes. Readers should weight it as an expert-curated overview, not as clinical evidence. The review's own authors acknowledge the central limitation plainly: preclinical findings are promising, but clinical trials are currently lacking. That candid admission matters. For most peptides covered — BPC-157, TB-500, ipamorelin, and epitalon in particular — the mechanistic picture is built almost entirely on rodent and in-vitro models. Tesamorelin is the notable exception, carrying FDA approval for HIV-associated lipodystrophy on the basis of Phase III RCT data, though that evidence does not transfer to orthopaedic applications. The review is useful as a...