Articles by Dr. Arnold

Articles by Dr. Arnold

Small RhombusHealth articles by Dr. Fred Arnold focus on prolotherapy, pain rehabilitation and natural healing.

Articles by Dr. Fred Arnold

Dr. Fred Arnold

REPLACEMENT MEDICINE VS REGENERATIVE MEDICINE

BY FRED G. ARNOLD, NMD

It is far too often I hear from a patient that they were never told that there was an alternative, such as regenerative medicine, to surgery and joint replacement. It is particularly sad when a patient had replacement medicine and they are still in pain. This article to explain 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 prosthetic joints. A prosthetic joint is made of some 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 doing this surgery is to relieve pain, to restore range of motion and to improve 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 includes: heart attack, stroke, blood clots, infections, fracture of the adjacent bone, nerve damage, damage to blood vessels, post surgical persistent 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 from of medical care, it is my opinion it should 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 regards to 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 the laboratory, the current state of regenerative medicine today allows for the body to heal painful joints itself naturally.

Some of the current and effective regenerative, injection medicine techniques includes 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, is a regenerative therapy developed by Dr. Frank Schallenger 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.
  • Platelet Rich Plasma (PRP) use the bodies own platelets and growth factors to stimulate healing. A small amount of blood is withdrawn 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.

SUMMARY
Regenerative medicine should be a consideration when joint replacement therapy is being considered. The above regenerative medicine procedures has an excellent safety and success record and are state of the art treatment for chronic joint pain. Receiving regenerative 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:

  1. Joint Replacement Surgery and You. (April, 2009) In Arthritis, Musculoskeletal and Skin Disease online. Retrieved from http://www.niams.nih.gov/#