Significant advances in regenerative medicine have developed over the past two decades, with some of the most cutting-edge technologies occurring within the realm of orthopaedics and musculoskeletal health. I have intently watched this development throughout the years and am convinced that a large part of orthopaedics will be centered around the use of biological and regenerative technologies in the future. While many new interventions truly remain experimental and lack the appropriate studies to justify their use, a cadre of well-established and proven treatments have emerged as invaluable tools for the treatment of musculoskeletal injuries.
The most common and well-established orthobiologic in-use in my practice is Platelet-Rich Plasma, or PRP. This is a compound derived from the plasma portion of your own blood that is harvested and prepared in our office (on the day of your visit) and injected into areas of injury. Its use has been proven to be effective in the treatment of knee osteoarthritis , exceeding the effectiveness of both placebo and hyaluronic acid (‘gel’) injections, and can help to delay the need for arthroplasty in many patients. I also employ PRP treatments for many shoulder problems including partial rotator cuff tears, biceps and labral injuries, as well as arthritis of the shoulder. There are also multiple applications in the hip, as well as muscle injuries throughout the body.
Another hot-topic in regenerative medicine is the use of stem cells. Although a lot of the literature on the use of stem cells is truly all over the map, there still exist some situations in which its use has been proven beneficial. In my practice, stem cells are utilized in chronic musculoskeletal conditions that have proven unable to heal with the body’s own mechanisms. Examples include severe tendinitis, non-union (lack of healing) of fractures, and revision bony and soft tissue surgery.
Other products that are in the pipeline for use in my practice include amnion (amnionic growth factors harvested from non-aborted umbilical tissue), peptide therapy, and naturopathic options for the treatment of orthopaedic injuries.
While most of these technologies have excellent scientific support for their use, nearly all insurance carriers will not reimburse us the cost of the products. Because of this, all regenerative and orthobiologic treatments are provided on a cash-only basis.