| 1 | Black Stone Physical Medicine | Latest & Greatest Advances In Regenerative Medicine | 342 | 10 | 2 | 71.9 | positive | 4:35 | Today we're going to talk about the top new advances in regenerative medicine. My name is Mark Musa and I'm an interventional pain physician. This last weekend there was a conference out in Florida, this Toby conference. It's a regenerative medicine conference. We have people come from all over the world sharing their research to do with regenerative medicine. This Toby conference in my opinion is probably one of the best in the nation. They have it every year. There's a couple other really good regenerative medicine conferences like the go-to-to but this is one of my preferred ones. So we flew out to Florida this weekend for the conference. Many of the things discussed the conference were not new. As new things are seen in regenerative medicine we kind of continue talking about them subsequent conferences. But there are two new regenerative medicine procedures that I want to discuss. The first one was the inner osseus regenerative treatments. So I've seen this coming around the last few years as we go to these conferences. Inner osseus is essentially where you take something and you inject it into the bone. This has been used for years by paramedics. If they need to give IV access and they can't get into vein they'll put it right in the bone and they can put you can put IV fluids into the bone. So over the years as we've looked at osteoarthritis first we would inject things into the joint like platelet-rich plasma or bone marrow concentrate some stem cells from the bone marrow. And then with a little bit more time we saw people treating the ligaments in addition to the joint itself and we saw better improvement. We know from physiology that the pain from an arthritic joint comes from the joint capsule as well as the bone. We call this sub-control bone so the layer kind of underneath the cartilage. And we've seen that if the arthritis gets severe enough there are some changes in the bone marrow. We call it bone marrow dima, essentially bone bruises. And there's been over the last handful of years more docs looking at this doing studies where they have been treating these bone marrow lesions. So I was initially skeptical so I've been watching to see what kind of results we saw over the years and it really keeps getting better and better. In this year they dedicated almost seem like a quarter of the conference to interosseous treatments. So what they do is they essentially stick a needle into the bone either through a crack or they drill into the bone and inject either play the rich plasma or a bone marrow concentrate right into the bone marrow lesion. And these studies showed pretty significant improvement in the patient's pain and function. So pretty dramatic improvement. And I imagine as we go forward this will be become part of a routine regenerative medicine option in addition to intradicular or directly injecting into the joint. The other new regenerative medicine technique that I want to talk about was something that I've been keeping my eye on for years. Nerve pain or neuropathy is always a challenge to treat an impain management. Not a lot of great treatments like for example peripheral neuropathy. Not a lot of great treatment options for that. Years ago there was an animal study that we saw where they injected directly into the nerve of an animal with this nerve lesion or nerve injury. Some play the response and we're right into the nerve and I thought that was pretty wild because we try to avoid injecting the nerve at all costs. So there's one presenter, one researcher at this last conference that studied actually that in humans which is the first time I think I've seen it in humans where they he would inject directly into the nerve with play the rich plasma and saw some significant recovery in nerve pain. So over the years we've seen most commonly done was something called hydro dissection where you inject around the nerve and separate it with the fluid you inject from the surrounding tissue. So many we've seen improvement with that. Often we'd use play the rich plasma for that as well or maybe something like a steroid or dextrous solution. And so this is taking that to the next level. You know I would imagine they'd do this if they had saw actual nerve fiber damage which you can see on an EMG. Interesting studies with that. I don't think I have a point where I would want to try injecting into the nerve quite yet. I'd want to see give this a bit more time, a couple more years and see what continues to show up with the research before I feel confident in doing this on a patient. And it'd have to be a pretty carefully selected patient with a specific type of nerve injury like a crush injury or something along those lines where we could easily do that. So it's really exciting to see these advances in and pain management really getting people feeling better so they can get back to doing what they want to do. Make sure to subscribe. Until next time. | ↗ |