Pain fellowship programs that practice regenerative medicine?

[oreosandsake]

I know of attendings in the community that practice this way.

I'm interested in BMAC and PRP

would like to follow enough of a N to observe how these patients do long term
(i.e. develop my own biased perspective)

any program work like this?

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[oreosandsake]

bumpity

is this something only to be found in the un-accredited fellowship world?

 

[101N]

bumpity

is this something only to be found in the un-accredited fellowship world?

This is something that you'd explore in a weekend course and through journal club. There isn't enough good data to devote a lot of curriculum time to it at this point.

 

[Gauss]

pure cash, no insurance will reimburse this. Medicare slammed T codes on it long ago. so to do it you gotta invest capital and market it, be concierge/boutique. No ACGME fellowship is gonna get heavily into this

 

[nvrsumr]

I have been paid for PRP by a WC carrier for epicondylitis

 

[Gauss]

yes I used to as well. but last year it started trailing off and getting denied more and more

 

[PinchandBurn]

bumpity

is this something only to be found in the un-accredited fellowship world?

yes

 

[oreosandsake]

thanks for the responses!

 

[ampaphb]

I have been paid for PRP by a WC carrier for epicondylitis

Treatment of Lateral Epicondylitis With Platelet-Rich Plasma, Glucocorticoid, or Saline: A Randomized, Double-Blind, Placebo-Controlled Trial.
Krogh TP, Fredberg U, Stengaard-Pedersen K, Christensen R, Jensen P, Ellingsen T.
Am J Sports Med. 2013 Jan 17. [Epub ahead of print]

METHODS:A total of 60 patients with chronic LE were randomized (1:1:1) to receive either a blinded injection of PRP, saline, or glucocorticoid. The primary end point was a change in pain using the Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire at 3 months. Secondary outcomes were ultrasonographic changes in tendon thickness and color Doppler activity.

RESULTSain reduction at 3 months (primary end point) was observed in all 3 groups, with no statistically significant difference between the groups; mean differences were the following: glucocorticoid versus saline: -3.8 (95% CI, -9.9 to 2.4); PRP versus saline: -2.7 (95% CI, -8.8 to 3.5); and glucocorticoid versus PRP: -1.1 (95% CI, -7.2 to 5.0). At 1 month, however, glucocorticoid reduced pain more effectively than did both saline and PRP; mean differences were the following: glucocorticoid versus saline: -8.1 (95% CI, -14.3 to -1.9); and glucocorticoid versus PRP: -9.3 (95% CI, -15.4 to -3.2). Among the secondary outcomes, at 3 months, glucocorticoid was more effective than PRP and saline in reducing color Doppler activity and tendon thickness. For color Doppler activity, mean differences were the following: glucocorticoid versus PRP: -2.6 (95% CI, -3.1 to -2.2); and glucocorticoid versus saline: -2.0 (95% CI, -2.5 to -1.6). For tendon thickness, mean differences were the following: glucocorticoid versus PRP: -0.5 (95% CI, -0.8 to -0.2); and glucocorticoid versus saline: -0.8 (95% CI, -1.2 to -0.5).

CONCLUSION:Neither injection of PRP nor glucocorticoid was superior to saline with regard to pain reduction in LE at the primary end point at 3 months. However, injection of glucocorticoid had a short-term pain-reducing effect at 1 month in contrast to the other therapies. Injection of glucocorticoid in LE reduces both color Doppler activity and tendon thickness compared with PRP and saline.