Regenerative Medicine: Unproven or Unprovable

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Which of the following statements best describes your opinion about Regenerative Medicine?

  • It is unproven: More evidence is needed to determine whether it works.

    Votes: 18 100.0%
  • It is unprovable: There is no way to demonstrate by evidence or argument that it works.

    Votes: 0 0.0%

  • Total voters
    18
  • Poll closed .
ampaphb. From the study you just quoted 'Both treatments proved to be effective in improving knee functional status and reducing symptoms'. If I was to charge $150 for PRP after discussing pro and cons with the patient or do it for free would you support it? Why not try PRP for patients who have failed all conservative management and headed towards surgery?

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Those studies are unlikely to be done.

Then again, how many of the standard treatments for outpatient spine/MSK/pain management are backed by large, multicenter RCTs?

It all depends on where we want to set the bar for level of evidence before utilization.

But that is our own fault. We perpetually let the cat out of the bag before we know what we are doing. And we (as a profession) don't learn from it.

Our relationships to industry, and the desire for increasing reimbursements are the problem. If it was not profitable, why would there have been so many booths at the Academy meeting pushing this stuff?
 
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Again, PRP alone in an osteoarthritic knee only works in young patients. We already know that PRP does not work well in stem cell poor environments. No wonder you think it doesnt work.

It works, cause I said it works. Young patients with osteoarthritic knees. Oxymoron? Or just *****?
 
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Again, PRP alone in an osteoarthritic knee only works in young patients. We already know that PRP does not work well in stem cell poor environments. No wonder you think it doesnt work. Poorly designed studies work poorly.

once again, show the rest of us some good, well studied protocols.

Obviously, I'm not a smart man and can't read good. So break it down for me.

When does it work? What type of protocol works? What are the age groups that it works on? What kind of cellular prep is most effective? How are the stem cells best delivered to the target organ? What kind of scaffolding is needed?

And please show the data for this.
 
It works, cause I said it works. Young patients with osteoarthritic knees. Oxymoron? Or just *****?

I had it at 23. It happens more often than you think.
 
It works, cause I said it works. Young patients with osteoarthritic knees. Oxymoron? Or just *****?
Are you kidding me. So living in Georgia you have never seen a young patient with knee OA? I consider anyone less than 45 years old to be young. What about all the unfortunate patient who had meniscectomies in the 80's and 90's?
 
It works when I say it works, or only in the patients I remember it works for.

The bias is so strong here it makes the merit murkier than a Georgia swamp.
 
I forgive Steve....he's just having a bad day or something.

Im in solo private practice.....no time or desire to do research. I will leave that to the guys in academia. There isnt much research proving steroid injections or fusions for long term benefit either.
 
Are you kidding me. So living in Georgia you have never seen a young patient with knee OA? I consider anyone less than 45 years old to be young. What about all the unfortunate patient who had meniscectomies in the 80's and 90's?

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Im in solo private practice.....no time or desire to do research. I will leave that to the guys in academia. There isnt much research proving steroid injections or fusions for long term benefit either.
so what is your protocol? How do you choose your patients? Gut feeling? Or is it just that you will try it on anyone (provided they can pay) and explain that it might not work?
 
Yeah I'm sorta naive enough to think you can inject me with stuff that came from me, that said, just being poked with a needle carries risk. And it comes from me but that doesn't mean I should eat my own **** or have it injected in me.

Sigh, I guess maybe it could upset my body to jam a needle into my ovaries, try to suck out some eggs, or grab some bone marrow, and then inject try to that into my epidural space. Back to torturing lab rats I guess. At least until I have a miscarriage and can... OK, no more mad science.

No, really, from an immunological standpoint working with autologous tissue is pretty much going to be better than any other source, but you can't just start rearranging the furniture.

But yeah, I'd love it if we could just draw my blood and grow me a knee replacement, but it's going to take more than that.

Question, I heard about some sort of magnet/electric device you wear next to a degenerated joint and it regenerates? Anyone know about this? I know a terribly disabled physician (non-quack) that did this for their non-replaceable joint and had miraculous results... they weren't trying to promote it, just something they did to salvage their own life and claimed it worked

it's nice to have some of those "seemingly" harmless unproven therapies in mind to try when you become so desperate you're thinking "I wear this magnet bracelet or it's time to euthanize". In that way is the only way I sorta support the earlier poster saying sometimes the FDA should let people inject themselves with their own stuff, like some form of medicalized autosarcophagy harm reduction model, because that's better than total despair? then again helping a patient pursue potentially useless or harmless treatment because they aren't getting benefit from being counseled acceptance.... is bad. And it makes sense that's it bad. And we try to help patients see "reason." And it doesn't work.

But then again given no proven benefit, why would MS patients refuse to stay in the US and accept their symptoms versus pay thousands of dollars to fly south of the country for some weird spine injections that they think work but stymies science. Why can't they do nothing for the same result?

Our patients will demand treatment. We must offer them safe placebo if nothing else, and if not proven safe placebo or treatment, have no part of it. Which they will find cruel. We are holding out on them.

I'm trying to find the various things I've read about how shamanism only works and has value if it comes at great cost

So we may continue to sell snakeoil, magnetic bracelets, but only as a last resort when pressed, it can't be free, but at least shouldn't be prohibitive, but should not be doing crazy wild joint stem cell injections for thousands of dollars. There must be a middle ground. A magnetic bracelet for hundreds of dollars instead? and donate the money to researching the injections

Injecting ****ty water into joints...now we are talking cutting edge. I suppose that the fear of septic arthritis would be a deterrent...but perhaps not worse than cancer or teratoma. ****ty water vs MSC/PRP in a RCT...I'll run it by Dr. Jay Smith next year. ;)
 
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Have there been any studies done to determine what is so damn special about the lateral epicondyle/musculature or the studies performed on the topic. I'm guessing that there is nothing mystical about the anatomy...and it has much more to do with the study designs. Am I wrong?
 
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