After word first broke out years ago about Platelet Rich Plasma (PRP) in the NY times following Super Bowl success story Hines Ward, the media has had a fascination & love hate relationship. As with any new therapy controlled trials are needed. However when looking at a lot of what we do in mainstream orthopedics , there is in fact very sparse data to rely on. Take for example epidural steroid injections for sciatica & low back pain. While tens of thousands are performed regularly to provide desperate relief, there limited studies if any verifying its use. Many studies have shown that there is no direct correlation with pain & the degree of x-ray findings. In fact often the less painful knee in a patient may look worse on radiographs. This goes back to the idea that the practice medicine is an art & a science.
Now Several years later hundreds of physicians are implementing biologic treatments on thousands and thousands of orthopedic injuries worldwide. Most can agree that our body contains the ingredients & capacity to self heal as it does so throughout our lifetime. However at times it gets stuck, when an otherwise healthy athlete or weekend warrior that has never had a setback can’t get over the hump.
Skeptics point out there are limited studies on treatments like PRP, however in reality this is simply not true. Every month in a listing of peer reviewed journals internationally at least 10 new published PRP Orthopedic articles emerge. For perhaps the most comprehensive listing of orthopedic publications on PRP click here.
Most studies have been positive refining this promising therapy that is by no means a panacea. Most likely however we will ultimately look back on PRP & Regenokine as the gateway to a new field: “Orthobiologics.”
Through the sensationilazation of athletes & success stories of dramatic results, comes motivation form pioneering patients to drive change in the stagnant realm of orthopedics. Many docs do not embrace change & are not staying current on the literature & discussions at the leading symposiums for their respected professional societies. Biologic medicine has become the hottest topic around. We are just beginning to understand osteoarthritis which appears to be centrally linked to the immune system which then triggers inflammatory proteins or cytokines. Many therapies like PRP, Bone Marrow Concentrate (BMC), Regenokine are geared towards blocking those cytokines and repairing tissue. While patients may be travelling overseas for regenerative therapies, we must not turn away from this field and ignore it. But rather as Physicians of United States, we have been looked to as leading the way & we are now falling behind quickly. Clearly some regulation is warranted to protect patients, manage their expectations & ensure safety.
Unquestionably are faced with an epidemic of increased arthritis with the boomer generation & increased activity & injuries. The status quo of cortisone, anti-inflammatories, and surgery if these fail just does not “cut” it.
Yes we must be optimistically guarded but we are beginning to better utilize our body’s natural potential to self repair. Treatments like PRP, Bone Marrow Concentrate, Regenokine are improving on a regular basis with sound fundamental science & a growing population of content patients.
This weekend some of the most respected physicians from around the world will gather in Los Angeles, CA for the 3rd annual Orthobiolgic Institute Regenerative Medicine Symposium. The community of pioneering patients and forward thinking physicians is growing. Agreed that more studies are needed before this therapy can be available more readily, but evidence is mounting every day.