Regenerative & Orthobiologic Medicine
Exciting, new advances in diagnostic medicine are helping our Precision Sports & Ortho physicians treat pain caused by joint or soft tissue problems. Through the use of diagnostic and interventional ultrasound, our orthopaedic specialists are combining technology with the body’s natural ability to heal itself to help competitive athletes and weekend warriors reduce pain and remain active.
Traditionally, the success of injection procedures such as office-directed cortisone injections was limited according to the clinician’s anatomical impression and the patient’s feedback. There was no way to actually observe the position of the needle in relation to the diseased tissue at the time of injection. Some of these “blind” injections worked well but some were less successful, creating the necessity for doctors to use ultrasound-guided injections to improve results.
Physicians were also limited to the use of corticosteroid injections, which at times would provide a fairly rapid short-term response, due to their potential anti-inflammatory properties. These injections do not treat the actual cause of the problem, though; only the symptoms. Repeated cortisone injections over time may also have a negative effect on tendon and muscle tissue. If a patient has had one or two blind cortisone injections with limited relief, an ultrasound guided approach may help provide greater accuracy thanks to its real-time imaging capability. The procedure is also typically covered by insurance.
Another recent interventional option includes the expanding field of regenerative injections. This approach has drawn the attention of college and professional athletes alike who want to optimize their return to competition after an injury. The premise is to stimulate migration or actually inject one’s own growth factors, including platelet rich plasma (PRP), autologous whole blood, or mild proliferants like dextrose or sodium morrhuate, in diseased tendons or ligaments under direct visualization (ultrasound) where the structure has become stagnant and insufficient.
Regenerative treatment takes time to work effectively, especially in chronic conditions, so patience is a pre-requisite for success. Although controversial in many circles, the use of musculoskeletal ultrasound combined with regenerative treatment trials may be worth a try if traditional nonsurgical options have been exhausted and an athlete is still unable to return to their sport or exercise. Even though regenerative procedures are generally not covered by insurance, they carry a reasonable cost and may provide a good option for those serious about returning to a demanding physical regimen. For those dedicated to fitness, it should be considered hopefully as a natural step and investment in exchange for years of continued health and activity.