I recently reviewed an interesting article that presented a 54-year-old male with moderate-grade knee osteoarthritis who was healthy and active. The article argued the points for total knee arthroplasty (TKA) versus regenerative medicine therapy. An orthopedic surgeon was making the argument that TKA was a safe and successful surgery and that the patient should be able to return to a high level of functioning, such as golfing and skiing. He also mentions that the joint prosthesis should have a life of about 15 years. The physiatrist made several arguments, instead, for consideration of regenerative medicine therapy, including either platelet-rich plasma (PRP) or autologous stem cells. He states that the process of both blood aspiration (for PRP) and bone marrow aspiration (for stem cells) techniques are efficient and safe. The safety profile for regenerative medicine treatments, a single or limited number of injections, is also extremely preferred to the potential risks that are seen with TKA, such as infection, rejection, deep vein thrombosis and pulmonary embolus. Also extremely important is the cost of these two opposing options. The total cost of a TKA today is said to be around $52,000, and with many new insurance policies, a patient may be responsible for up to 20% of this value. Stem cell therapy provided in the office by SJS typically ranges from $1,800 to $3,000, depending on the product chosen, amount used and number of areas treated. This 54-year-old will require one to two prosthetic revisions due to his age and the average life of a knee prosthesis, and research does not show that individuals are typically able to return to a high level of activity following TKA. Most research suggests that patients return to activities of daily living after a TKA for the most part. In contrast to this, the goal of providing regenerative medicine therapy would be to not only return an individual to do her activities of daily living, but also to most extracurricular activities that would want to be pursued. Bottom Line: It is imperative that the general public be aware of regenerative medicine as a viable treatment option instead of more invasive measures. Any physician treating musculoskeletal and spine conditions needs to be educated, fair and honest with patients regarding their options.
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