Regenerative Medicine for the Aging Athlete
It is increasingly apparent that we have to look at the whole patient and not just a single joint when considering Regenerative Medicine and its role in the care and treatment of osteoarthritis. A first stem cell intervention in a hip or knee may still leave some whole body pain and disability; but it might help a patient make incremental steps toward better health. Patients seeking Regenerative Medical alternatives through Cellular Orthopedics need to realize that until all the painful joints are addressed, not just one hip or knee, they’re not going to experience an optimal outcome. This is not an easy discussion; but you have to understand what may be necessary to maximize the outcome.
Let me sight a real patient example. A 68-year-old man presents with impairment of a wrist, both knees and his low back. The question is the staging of the interventions? Sure, he could give in and succumb to three joint replacements. The alternative is a staged Stem Cell Regenerative approach using Bone Marrow Concentrate for the wrist and knees and Plasma Lysate for the low back. The next decision has to do with staging versus a multiple joint same day alternative. The amount of bone marrow aspirate is usually 60ccs but as the need arises, it is possible to recover 90 and even 120ccs at times should the option become a multiple joint intervention in a single sitting.
To illustrate the dynamics of Cellular Orthopedics, I want to update you on a new debate pertaining to Non Steroidal Anti-inflammatory. Up until the present, the standard approach was that NASID’s are harmful to stem cells. Now it seems that not all families of anti-inflammatories are harmful; some may even be helpful to cartilage. The National Institutes of Health carried a scientific article last week published in the British Journal of Pharmacology indicating that Diclofenac, Aceclofenac and Meloxicam may exert a favorable effect. Because of the new debate and to assure the patient of the best recommendation, the upcoming TOBI (The Orthopedic Biological Institute) conference in Los Angeles next month, of which I am a member of the faculty, will feature an entire session on the subject of NSAIDS and Stem Cells.
Returning now to the 68-year-old patient, I cycled 35 miles with him this past Saturday and 40 more on Sunday following his Bone Marrow Aspirate Concentrate/Stem Cell interventions this past winter and three months of intensive core strengthening. There is no longer a brace on his wrist or the need to go slow or avoid hills because of knee pain. Where would he have been with a fused wrist and two knee replacements?