true. I know one very prominent researcher/clinician in stem cells/prp who believes we could take over 50% of the work away from orthopedic surgeons, once stem cell/prp protocols are optimized and every pain fellowship includes adequate training in peripheral nerve RF ablation for the shoulder/knee/hip, etc.
Its all about branding, treating every joint in the body, and convincing the local PCPs to just send every musculoskeletal case to you first, and not to ortho. This is how cardiology took the market away from cardiac surgery, because #1 they always see the patient first and #2 they developed lower risk interventional procedures compared to cardiac surgery.
We all know there are too many spine surgeries, particularly fusions, but multiple studies have also demonstrated that a significant percentage of shoulder, hip, and knee arthroscopies are unnecessary and often counterproductive for the patient. Even arthroplasty, while great for old patients with end stage DJD, shouldn't be the first choice for younger patients (under 55) with moderate-severe OA, as surgically revising their implant 2-3 times over their lifetime carries plenty of additional risks both to relative pain control of the joint and general medical risks of infection, PE, anesthesia, etc.
I have personally seen many patients under 30, 40, or 50yrs with significant persistent joint pain s/p arthroplasty/arthroscopy. Unfortunately, many of these surgeries often took place after the patient only failed PT. Sometimes the patients are offered one steroid injection before the orthopod goes right to surgery. Viscosupplemention is often not offered, the quality of PT is generally not properly evaluated, bracing is often not considered, prolo/stem cells/PRP are never mentioned, nor is peripheral joint RF ablation. This why we need to see patients first, and if it angers some orthopedists I don't care.