Several months ago, I was reading a scientific article in the orthopedic literature and I realized that much has changed in the field over the four years since I stopped doing joint replacement surgery. Then I wondered how much has changed in the other sub specialties within orthopedic surgery since I completed my residency training and received my orthopedic board surgical certification. After contacting, the American Academy of Orthopedic Surgery to determine the best way to assure that I was offering contemporary skeleto-muscular care to my patients, be it for regenerative medicine or the occasional second opinion for which a patient seeks consultation, I committed to the thousand page Orthopedic Knowledge Update, (OKU) dedicating several hours a day to each of the 64 chapters. Best stated in the Preface, “ We orthopedic surgeons face a challenging conundrum: we are driven to sub-specialize because of rapid technologic advances and patients seeking very specific expertise, yet we must remain knowledgeable across the full spectrum of orthopedics in order to deliver optimum patient care and pass certifying and recertifying examinations.”

Last week, I took the 200 question multiple-choice examination to measure competence and whether I had mastered the contents of the Orthopedic Knowledge Update initiative. Yesterday, I received notice of having passed the exam with flying colors. The material reward is 70 Continued Medical Education credits. The emotional and self-satisfaction reward is beyond description. The last multiple-choice test I had taken was when I passed my Boards in 1974. What does this have to do with Regenerative Orthopedics?

Again and again, the patients come to the office with pain, limited activity and altered life style with a diagnosis of osteoarthritis.  An orthopedic surgeon has told them: ”you have bone on bone; I am scheduling you for a joint replacement.” In my office, a full history, physical examination, and review of X-rays and MRIs are completed. It has been well established that the indication for surgery in arthritis is not an altered X-ray. The patient with Grade 2 or 3 osteoarthritis is then given an informed consent regarding Bone Marrow Aspirate Concentrate derived Stem cells.” I will call you to schedule” is a common response when the patients are really telling me that they intend to discuss stem cell intervention with their primary care physician or orthopedic surgeon. Why the subject matter of this Blog?  I can tell each and every patient that my recommendation is based on my knowledge, experience, credentialing, research and database. Ask your second opinion “expert” concerning Regenerative Orthopedics for his or her experience, credentialing, research, and data base after you receive the “it’s too early”; “that stuff doesn’t work”;” it’s ten years away” before making your decision.

 

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