TOBI is the largest yearly gathering of physicians, scientists and commercial interests in the emerging discipline of Orthobiologics. On the one hand, it is academic and advances the knowledge base of all participants and attendees. Clinicians present their outcomes of the many available approaches to deal with the painful osteoarthritic joint ranging from 20 or more varying Platelet Rich Plasma formulations, two different Bone Marrow aspiration and preparation options, and several Adipose Based methodologies. Next come the Growth Factor group categories of treatment and the individual Growth Factor possibilities. For the first time, the potential of Exosomes was highlighted while the Birth Tissue, Amniotic Fluid category almost ignored. The latter I assume owing to the recent actions by FDA and FTC in closing clinics that treat every imaginable malady without a scientific basis using Amniotic Fluid and Birth Tissue.
Given the above, what is on the horizon? It would seem that the Camp Followers and those offering “fake” news are finally being highly scrutinized by the FDA and FTC; in several settings even being criminally prosecuted. With the crackdown, a patient will no longer be recruited to attend a seminar with a free lunch and then be seduced into an amniotic fluid/stem cell scam. The overall quality and dependability of Regenerative Medicine will continue to evolve because of conferences such as TOBI. Another biologic option of particular interest to me are Exosomes. I recently dedicated a blog to the subject. The most recent advance is an Exosome recovered from voluntary Bone Marrow donors who are highly screened and that should eliminate or certainly reduce any inherent risks of using this Adult Mesenchymal derived cellular communication means.
This leaves us with a very exciting new approach to the subject of regenerative medicine, Personalized Stem Cells. As presented at the speakers’ podium, the initiative is waiting for FDA approval and it should be happening in weeks according to the PSC medial director. When approved, those who meet the inclusion criteria will be able to undergo a lipo aspiration and have that material sent to a laboratory in San Diego where it will be processed under stringent governmental oversight. The recovered stem cells and stromal vascular fraction will then be returned to the investigator clinician for injection into the arthritic joint. At the same time, an aliquot of the lipo aspirate will be placed in storage for subsequent use should there be said need. The processed will meet all FDA and FTC criteria and allow for injection of millions of cells rather than our present ability to provide thousands of stem cells. The announcement when the FDA approves the trial will appear on my web site and on this blog.
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