Most patient educational initiatives centered on Regenerative Medicine are based on positive reports of patient satisfaction. The truth be told, never say “always” in medicine. Outcomes surveillance leads to a better understanding of the who, what, when, where and how of PRP and Stem Cells. There is a particular role and place for all medical alternatives; to assure a best chance of success, the treatment must be tailored to a diagnosis. I am an orthopedic surgeon by training and an extensive surgical experience; Regenerative Medicine has little chance of success for the treatment of musculoskeletal pain unless causation is established. PRP and Stem Cells won’t work when they are not indicated.
A 45-year-old man came to my office for a consultation regarding pain in his lower extremities. Up until two years ago, he had run marathons, completed triathlons and skied in the winter. Because of musculoskeletal pain and progressive loss of his ability to enjoy his recreational endeavors, he sought out multiple Regenerative Medicine practitioners. He had undergone multiple Prolotherapy treatments, PRP spinal interventions, so on and so forth. I began our encounter by listening to him as he summarized his symptom progression. It took one step in the physical examination to establish causation; a disease entity that requires standard anti-inflammatory management. I took a tape measure and recorded his chest circumference during maximum inspiration and then expiration. Normal chest excursion averages two inches, significantly more in an athlete. Less than one inch chest excursion in an adult male points to Ankylosing Spondylitis, an inflammatory spondyloarthropathy. On further examination, he had a “poker” spine; no side-to-side bend or forward flexion. My orthopedic approach was not one of Regenerative Medicine but referral to the rheumatologist who is best equipped to manage this entity
There is a time and place for all things; beware and take care that the approaches with Regenerative Medicine are causally connected.
Mitchell B. Sheinkop, M.D.
1565 North LaSalle Street . Chicago . Illinois . 60610