Do you have joint pain or arthritis? Are you caught in the “treatment gap”? Not ready for surgery? Interested in evidence-based treatment options? 

Regenerative medicine, also known as “cell restoration” or “cell therapy”, may be an option for you.
By: Heather Hammonds, MD,CAQSM, DipABLM

Before you allow someone to put a needle in you, find a physician who uses best practices in this promising new field of medicine. Here are some questions to consider:

1.    Does the regenerative medicine physician have the necessary skill level and training?  
These are physicians who have extensive training in diagnosis and management of musculoskeletal problems. You want to look for a board-certified physician in sports medicine, interventional radiology, orthopedic medicine, physical medicine & rehabilitation, rheumatology or interventional pain medicine. A typical assessment involves a thorough history and physical exam as well as a review of appropriate imaging (X-ray, ultrasound and/or MRI) to determine the likely source of your pain. These tools will help physicians to determine if regenerative medicine is a reasonable course of treatment for you.
    
2.    Will the physician perform the injections under imaging guidance (ultrasound or fluoroscopy)? 
Putting gas outside the tank won’t fuel the car. Likewise, when receiving injections, using imaging is essential to ensure that it reaches the right location to maximize the potential for healing. If your physician is not using guided imaging (either ultrasound or fluoroscopy), they are going in blind and are unlikely to successfully treat your pain. Learning how to accurately and precisely perform regenerative injections requires extensive training. Be sure to ask your physician how they will perform their injection(s) (with or without guidance) and what training they have undergone to learn how to ensure injections address the target area.

3.    What is being injected?  
Best evidence currently only supports use of autologous (from you) products for injection therapies. Examples of these are: Platelet-Rich Plasma (PRP), Bone-Marrow Aspirate (BMAC) and Adipose-Derived. Most insurance companies consider these treatments experimental and do not pay for them. There are many “stem cell clinics” falsely advertising the benefits of their treatments and what they are injecting. Many of these clinics use birth products or allograft tissue (i.e.: amniotic fluid, umbilical cord tissue, placental products, Wharton’s jelly tissue) which after the cleansing process do NOT CONTAIN ANY LIVE STEM CELLS IN THEM. To date, no such product has been licensed for musculoskeletal use. Owing to regulatory restrictions and a lack of clinical data, these interventions are not recommended for clinical use in musculoskeletal at this time.

4.    Is Regenerative Injection Therapy right for you? 
Your physician should have a conversation with you about the likelihood that these treatments will be successful in relieving your pain. There is a risk of failure with any procedure and a physician who guarantees you these injections will eliminate your pain permanently is not to be trusted. Your doctor should have a conversation with you about all possible outcomes, including ones that don’t result in 100 percent pain relief. Recent news coverage about unqualified providers harming patients with risky, unproven procedures highlights the need for patients to ensure they are receiving care from reputable physicians before undergoing PRP (platelet-rich plasma) or any regenerative injection treatments. The FDA has stepped in to regulate rogue clinics and product manufacturers.

Regenerative medicine procedures like PRP and BMAC therapy are medical procedures with growing evidence of benefit and selecting a physician to perform these procedures requires the same level of care as selecting any other medical provider. With many clinics falsely advertising expertise and procedure benefits, it’s important to do your research before paying for and undergoing any regenerative medicine procedures. 

At Restore Sports Medicine, our board-certified sports medicine physician, Dr. Heather Hammonds, is dedicated to providing the highest level of patient care to ensure the best, cost-effective outcomes by staying up to date with the latest research. We work with each patient to listen to their concerns, develop a customized treatment plan and carefully treat your pain, injuries and medical concerns to allow you to get back to living pain free or to your sport on a timely basis. Give us a call   at: (870) 425-5464 to schedule a consultation.