My last Blog introduced the notion of earlier stem cell intervention than has been usual and customary in the informed patient. With the goals of pain relief, improved range of motion, better functional capacity, return to or maintenance of a recreational interest, limiting the progression of arthritis, and possibly regenerating cartilage, might an earlier stem cell intervention improve the chances of a patient reaching those goals? I committed November 14,15 and 16 to a Regenexx investigator meeting at the Broomfield headquarters and, introduced the notion of earlier interventions based on the following conclusions from navigating our outcomes data-base. At the outset, the practice had been to determine candidacy and success of a Bone Marrow Aspirate Concentrate procedure on the pretreatment and post treatment X-Ray and MRI. Two years of observation though has led me to conclude that equally if not of greater value is the Range of Motion of the arthritic joint as the predictor and determinant of a successful outcome.
Having dedicated more than 40 years of my professional life to the care and surgical treatment of the arthritic hip and knee by joint replacement, in addition to pain scoring, increased range of motion changes comparison before and after a total hip and total knee replacement is a major determining factor in patient satisfaction. Taking this fact to the world of stem cells, my outcomes data base causes me to reach the same conclusion; so much so that one wonders if range of motion is more important in determening stem cell candidacy than the X-ray and the MRI. Statisticians at Regenexx are at work this week in determining the statistical significance of this hypothesis. For me, an orthopedic surgeon, the measurement of range of motion of every new and returning patient is part of the patient monitoring program. I employ a physical therapist to maintain objectivity in assessment. If your physician doesn’t measure your range of motion with a goniometer, he or she is subjective and guessing as the measurements must be objective and reproduce able to have meaning. I will share the significance and power of findings by the Regenexx statisticians next week; Range of Motion monitoring may be of great import in maximizing the success and decision making and documenting outcomes for a stem cell intervention