Replacement medicine vs. regenerative medicine

Joint replacement surgery is becoming more common, with knees and hips replaced most often. As of 2009, about 773,000 Americans have a hip or knee replaced each year.

by Dr. Fred G. Arnold — 

Far too often, I hear from a patient that he or she was never told that there was an alternative — such as regenerative medicine — to surgery and joint replacement. It is particularly sad when a patient has had replacement medicine and is still in pain. This article explains the difference between replacement medicine and regenerative medicine.

Replacement medicine 

Replacement medicine is what I refer to as the process of replacing damaged and degenerative joints with prosthetics. A prosthetic joint is made of a metal such as titanium and is designed to replace the involved joint. Joint replacement surgery is an orthopedic treatment performed when severe joint pain or dysfunction is not alleviated by less-invasive therapies. The purpose of this surgery is to relieve pain, to restore range of motion and to increase ability, leading to the improvement of muscle strength.

Joint replacement surgery is becoming more common, with knees and hips replaced most often. As of 2009, about 773,000 Americans have a hip or knee replaced each year.

Some of the associated risks and complications of joint replacement therapies include heart attack, stroke, blood clots, infections, fracture of the adjacent bone, nerve damage, damage to blood vessels and persistent post-surgical pain.

The success of prosthetic joint replacement has improved over the years as medical knowledge, techniques and materials have improved. Joint replacement has truly changed the lives of thousands of patients suffering from chronic joint pain.

Regenerative medicine 

Although joint replacement is an accepted form of medical care, in my opinion it should only be considered after a conservative trial of regenerative medicine. Regenerative medicine is a far less invasive medical treatment for patients suffering from chronic joint pain, including bone-on-bone conditions. Regenerative medicine is the process of replacing or regenerating human cells and tissues to restore or establish normal function.

In the treatment of chronic joint pain, regenerative medicine regenerates damaged ligaments, tendons and cartilage by stimulating the body’s own repair mechanisms to heal these weakened and painful tissues. Although this field holds the promise in the future to grow complete organs in laboratories, the current state of regenerative medicine allows for the body to heal painful joints on its own.

Some of the current and effective regenerative injection medicine techniques include prolotherapy, prolozone, platelet-rich plasma (PRP) and stem-cell therapy.

• Prolotherapy is the oldest and most widely used form of regenerative therapy. A natural substance, such as dextrose, is injected with an anesthetic to purposefully provoke mild localized inflammation. This increases the blood supply and flow of nutrients to the area, and the body responds by regenerating the damaged structures.

• Prolozone, developed by Dr. Frank Schallenger, is a regenerative therapy that uses ozone, a naturally occurring form of oxygen and an anesthetic, such as procaine. Prolozone injections work by increasing circulation and oxygen to the damaged areas. In addition to strengthening ligaments and tendons, prolozone may also help rebuild cartilage in the treated joint.

• PRP uses the body’s own platelets and growth factors to stimulate healing. A small amount of blood is drawn and centrifuged to separate out the platelets and growth factors. The high concentration of platelets is then injected in and around the involved joints to accelerate tissue repair and regeneration. PRP is rapidly gaining popularity among professional athletes.

• Stem-cell therapy is probably the most complicated regenerative procedure that involves the collection of adult stem cells, usually from the abdomen adipose (fat) tissue or bone marrow contents, frequently from the knee. The stem cells are processed from each of these areas and then injected in and around the involved joints.

Joint replacement statistics

The following statistics are from  beckersorthopedicandspine.com.

• Hospital discharges for total hip replacement increased by one-third and knee replacements by 70 percent from 1996-2006.
• The most common reason for joint replacement is pain and decreased quality of life from osteoarthritis.
• Partial hip procedures, often used to treat fractures, are about twice as common among women than men, 45 years of age and older.
• Knee replacements are also more common among women than men, 45 years of age and older.

Summary 

Regenerative medicine should be a consideration when joint replacement therapy is recommended. The above regenerative medicine procedures have an excellent safety and success record and are considered state-of-the-art treatments for chronic joint pain.

Receiving regenerative medicine before a joint replacement can even help to improve the post-surgical outcome by strengthening the involved joint, should regenerative medicine fail to provide optimum results.

References 

“Joint Replacement Surgery and You,” April 2009. National Institute of Arthritis, Musculoskeletal and Skin Disease.  www.niams.nih.gov/#.

Fred G. Arnold, D.C., N.M.D., has more than 20 years of clinical experience and specializes in pain rehabilitation services. He is a Diplomate of the American Academy of Health Care Providers, member of American Academy of Pain Management and is one of the few physicians in the nation with both a naturopathic medical degree and chiropractic degree (licensed in Texas). 602-292-2978, phoenixpainrehabilitation.com or prolotherapyphoenix.com.

Reprinted from AzNetNews, Volume 32, Number 1, February/March 2013.