David Tietze, M.D. Answers Questions On: Regenerative Medicine

The easiest way to describe it is a field of medicine that uses your body's own healing processes in the area that's causing the ailment. Basically, it involves using your own tissue and leveraging your own healing capabilities, applying them in a spot where they don't usually go, and creating a healing response in that area that would not normally heal on its own. In a lot of cases, regenerative medicine can be used as an alternative to surgery. 

Some examples of regenerative medicine are stem cell therapy, platelet-rich plasma therapy, and cartilage regeneration procedures. It can be used to treat a variety of ailments in the tendons, ligaments, and cartilage tissue in the knees, elbows, shoulders, and hips.

Mainly because it's minimally invasive. If it's used as an alternative for surgery, people are able to return faster to the same level of activity or play, when they otherwise would have required surgical intervention. The recovery is a lot easier and better tolerated.

The techniques that we use are the Arthrex Angel® System, which lets us do customized platelet-rich plasma (PRP) formulations, and the adipose tissue transfer for stem cell treatments.

Anytime we use a regenerative medicine option, we start with an ultrasound to identify where the injury is that we're treating. Then, our treatment plans are very specific to the needs of the athlete. We're probably going to be more aggressive for an in-season athlete, trying to get him or her back into play faster. But, if it’s their off season, when we have more time, we'll probably be more conservative in our approach.

We might end up using regenerative medicine as a first-line treatment for a lot of ailments, which can provide better healing response than traditional modalities, such as steroid injections. Physicians are also starting to use leading-edge treatments such as placental tissue grabs. And with ultrasound, we'll be able to do more minimally invasive surgical techniques. For example, there are case studies with patients who need their bicep tendons released because it's very painful and they can't have surgery. Because patients don't need sedation under ultrasound, we could locally anesthetize them and do it right there in the clinic.

What I'm excited about is the possibility of replacing surgical procedures from the past with this type of procedure, which ultimately will result in faster recovery for the patient and better outcomes. It's gradually evolving the way we approach orthopaedic medicine.