regenerative medicine key papers

[bedrock]

I"m getting some pushback from my orthopedic partners regarding PRP and I need to summarize the current data for them.

There are so many papers out on PRP. I would appreciate your help if you could guide me to the seminal papers, or rather key papers with the best statistical evidence for PRP with key peripheral joint/tendon issues. (For knee OA, lateral epicondylitis, rotator cuff, etc). Key papers using PRP for other pathology, are also appreciated

Thank you

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[drusso]

I"m getting some pushback from my orthopedic partners regarding PRP and I need to summarize the current data for them.

There are so many papers out on PRP. I would appreciate your help if you could guide me to the seminal papers, or rather key papers with the best statistical evidence for PRP with key peripheral joint/tendon issues. (For knee OA, lateral epicondylitis, rotator cuff, etc). Key papers using PRP for other pathology, are also appreciated

Thank you

I'm curious what the pushback is: "We don't want to do this because it works?"

Orthopedic surgeons do all kinds of things that don't work so it can't because they don't think it works.

 

[bedrock]

I'm curious what the pushback is: "We don't want to do this because it works?"

Orthopedic surgeons do all kinds of things that don't work so it can't because they don't think it works.

Exactly. I’m rolling my eyes at the entire thing, though all of them have been practicing for 15+ years and so are a bit out of date.

Can you help me out Russo? You’re always posting Regen Med literature. I don’t mind googling but I’m trying to narrow things down to the papers with the best statistical evidence.

 

[drusso]

Exactly. I’m rolling my eyes at the entire thing, though all of them have been practicing for 15+ years and so are a bit out of date.

Can you help me out Russo? You’re always posting Regen Med literature. I don’t mind googling but I’m trying to narrow things down to the papers with the best statistical evidence.

This can get you started...

PRP Research: Platelet Rich Plasma Randomized Controlled Trials

Dr. Centeno reviews almost 70 randomized controlled trials on platelet rich plasma (PRP) used to treat orthopedic problems.

regenexx.com

2021 Bone Marrow Research Infographic - Regenexx

Dr. Centeno's 2021 bone marrow stem cell research infographic.

regenexx.com

Published Peer-Reviewed Research - Regenexx

Regenexx procedures have been studied extensively for more than a decade. This page lists all published peer-reviewed research to date.

regenexx.com

 

[Nodolor]

Anything other than Dr. Centeno? We know he has no bias or skin in the game

 

[lobelsteve]

Is the pushback medically related or cost related?

 

[drusso]

Anything other than Dr. Centeno? We know he has no bias or skin in the game

There are a lot of non-Centeno articles in there. The problem with Regen research is there are no deep pockets to fund it because there is no intellectual property to monetize. Autologous platelets and bone marrow are not patentable.

 

[Ferrismonk]

I'm curious what the pushback is: "We don't want to do this because it works?"

Orthopedic surgeons do all kinds of things that don't work so it can't because they don't think it works.

Well we know that steroid injections into joints hastens deterioration. Perhaps they would rather inject steroids over and over until they can the do the TKA/THA/Total shoulder.

 

[SSdoc33]

Well we know that steroid injections into joints hastens deterioration. Perhaps they would rather inject steroids over and over until they can the do the TKA/THA/Total shoulder.

this is actually closer than you think.

its not so much that the steroids hasten deterioration, its that they dont want another option other than surgery. they think it will cut down their numbers. i have an ortho that i work with who gets pissed off if a patient gets a genicular RF instead of a TKA. he doesnt hesitate to send the patients to back to me after their knee hurts post TKA

 

[Dr. Ice]

One of my Ortho partners has warmly embraced prp..he loves them so much he does them blind and then when it doesn’t work, he operates. Best of both worlds. Scum of the earth..be thankfully that your ortho guys are at least not doing this bs..

 

[Ferrismonk]

One of my Ortho partners has warmly embraced prp..he loves them so much he does them blind and then when it doesn’t work, he operates. Best of both worlds. Scum of the earth..be thankfully that your ortho guys are at least not doing this bs..

I see this as well, but he uses $5K LipoGems instead of PRP.

 

[Dr. Ice]

My guy was using fluid flow for awhile but then aborted

 

[bedrock]

Thank you drusso for the regenex links.

To the rest of you- can we please come back onto the topic of this thread, which is the key papers with best statistical evidence using PRP for MSK applications?

 

[SSdoc33]

Thank you drusso for the regenex links.

To the rest of you- can we please come back onto the topic of this thread, which is the key papers with best statistical evidence using PRP for MSK applications?

so... you are mad at us for not doing your homework for you? o..........k

i could find these papers in 5 minutes. then again, so could you

 

[bedrock]

so... you are mad at us for not doing your homework for you? o..........k

i could find these papers in 5 minutes. then again, so could you

You can find the PRP papers on multiple body parts (with the best statistical evidence) in 5 min…….right

I know liberal elites are always “right” but give me a break.

I started this thread and Im simply asking for us to stay on topic.

 

[Tboned]

I guess my other post was blocked or something….but you should already know the evidence base for what procedures you do/offer

 

[bedrock]

I guess my other post was blocked or something….but you should already know the evidence base for what procedures you do/offer

wow, whatever buddy. This board is about helping our fellow pain physicians.
You have all of 30 posts, so clearly you're not contributing anything positive to the discussion, so why don't you go check out cnn like the rest of the sheep.

 

[SSdoc33]

wow, whatever buddy. This board is about helping our fellow pain physicians.
You have all of 30 posts, so clearly you're not contributing anything positive to the discussion, so why don't you go check out cnn like the rest of the sheep. "Liberal Elites"

you catch more flies with honey.

id be much more inclined to do a little digging if you didnt repeatedly disparage half of the political spectrum with your posts.

 

[bedrock]

id be much more inclined to do a little digging if you didnt repeatedly disparage half of the political spectrum with your posts.

Because you were so willing to help out initially?
Or did you feel the need to mock me, which is why I posted the reply I did???

And thankfully on a physician forum, less than 50% of the docs are liberals, because medicine requires you to work hard and earn what you get, and not just expect handouts from the government.

Just baffles me why any physician would be a socialist.
Possibly more likely in those that came from family money/connections and so they didn’t have to earn and fight for everything themselves along the dozen year journey to become a physician.

 

[SSdoc33]

Because you were so willing to help out initially?
Or did you feel the need to mock me, which is why I posted the reply I did???

And thankfully on a physician forum, less than 50% of the docs are liberals, because medicine requires you to work hard and earn what you get, and not just expect handouts from the government.

Just baffles me why any physician would be a socialist.
Possibly more likely in those that came from family money/connections and so they didn’t have to earn and fight for everything themselves along the dozen year journey to become a physician.

some folks just don't learn......

“Insanity is doing the same thing over and over and expecting different results.” That witticism—I'll call it “Einstein Insanity”—is usually attributed to Albert Einstein.

 

[Nodolor]

Because you were so willing to help out initially?
Or did you feel the need to mock me, which is why I posted the reply I did???

And thankfully on a physician forum, less than 50% of the docs are liberals, because medicine requires you to work hard and earn what you get, and not just expect handouts from the government.

Just baffles me why any physician would be a socialist.
Possibly more likely in those that came from family money/connections and so they didn’t have to earn and fight for everything themselves along the dozen year journey to become a physician.

Who says more than 50 % agree with you ? just because some on your side are the loudest and most obnoxious?
Your silly comment that Liberals don't work hard is as ridiculous.
I know plenty of liberals including myself that have started our own practices and have done well.

Some us think we are successful without driving a fancy car and dating a "movie star"

 

[Doctodd]

Hernigou has strong research on hips....and he is ortho

hernigou hip osteonecrosis - Search Results - PubMed

hernigou hip osteonecrosis - Search Results - PubMed

pubmed.ncbi.nlm.nih.gov

 

[Agast]

Why does every interesting thread have to be ruined with a flame war….seriously, no other specialty forum is like this. Except maybe EM and Anesthesiology. We must be the doctors with the most free time on our hands.

My ortho group is fine with PRP but most of them can’t be bothered with the logistics. One guy will use it in the OR with his knee scopes which is probably verboten.

Drusso posted a bunch of studies, I think it was to the Adding Regenerative Medicine to Your Practice thread.

Tell the guys that it’s a great marketing tool and it draws the patients still working with cash to your group, which is especially important as Medicare cuts reimbursements further.

Also when I don’t feel like working hard, it’s not because of my feelings on civil rights and women’s health. It’s because I’m fncking tired and drained from being around Pain all the time.

 

[BobLoblaw78]

Because you were so willing to help out initially?
Or did you feel the need to mock me, which is why I posted the reply I did???

And thankfully on a physician forum, less than 50% of the docs are liberals, because medicine requires you to work hard and earn what you get, and not just expect handouts from the government.

Just baffles me why any physician would be a socialist.
Possibly more likely in those that came from family money/connections and so they didn’t have to earn and fight for everything themselves along the dozen year journey to become a physician.

Is there a stat that 50% of docs are liberals. Truly curious bc it doesn't seem that way. It seems heavily weighted the opposite direction from my experience.

Who says more than 50 % agree with you ? just because some on your side are the loudest and most obnoxious?
Your silly comment that Liberals don't work hard is as ridiculous.
I know plenty of liberals including myself that have started our own practices and have done well.

Some us think we are successful without driving a fancy car and dating a "movie star"

So bedrock is dating a movie star? That seems like it would be against a conservative's principles.

 

[Nodolor]

Think Specialists lean Republican and Primary care Dem...which makes sense

 

[drusso]

Think Specialists lean Republican and Primary care Dem...which makes sense

I wonder why this "makes sense."

 

[Ducttape]

Is there a stat that 50% of docs are liberals. Truly curious bc it doesn't seem that way. It seems heavily weighted the opposite direction from my experience.

So bedrock is dating a movie star? That seems like it would be against a conservative's principles.

because you are in an exclusive group of physicians, who are surgical subspecialists.

as a whole, most physicians are primary care - internal medicine, family medicine and if i may add, emergency medicine. they do not make bank, they are not looking at FIRE, they are working a lot harder than you and i to make significantly less pay. they are also seeing people many of us dont see because many of us do not accept Medicaid. they see "how the other half lives".

look at your last 10 patients. count the number of medical problems they have total. i bet that my 1pm patient has more medical problems than your last 10 patients combined.

 

[BobLoblaw78]

because you are in an exclusive group of physicians, who are surgical subspecialists.

as a whole, most physicians are primary care - internal medicine, family medicine and if i may add, emergency medicine. they do not make bank, they are not looking at FIRE, they are working a lot harder than you and i to make significantly less pay. they are also seeing people many of us dont see because many of us do not accept Medicaid. they see "how the other half lives".

look at your last 10 patients. count the number of medical problems they have total. i bet that my 1pm patient has more medical problems than your last 10 patients combined.

So are you saying majority of physicians are liberal or conservative?

40-60% of my patients are Medicare or Medicaid. I get excited if my patient only has 10 legit medical problems. Literally last patient- pulm HTN, HTN, CHF, aortic stenosis, dislocated hip, afib RVR 130’s, UTI, chronic cholecystitis, LBP, CKD, COPD on O2, OSA, morbid obesity, CAD, angina, HLD, DM, hepatitis and hangnail.

 

[BobLoblaw78]

If I’m making generalizations, the vast majority of my Medicare patients are conservative. Medicaid are liberal.

 

[cowboydoc]

So are you saying majority of physicians are liberal or conservative?

40-60% of my patients are Medicare or Medicaid. I get excited if my patient only has 10 legit medical problems. Literally last patient- pulm HTN, HTN, CHF, aortic stenosis, dislocated hip, afib RVR 130’s, UTI, chronic cholecystitis, LBP, CKD, COPD on O2, OSA, morbid obesity, CAD, angina, HLD, DM, hepatitis and hangnail.

This has been referenced here multiple times.

Your Surgeon Is Probably a Republican, Your Psychiatrist Probably a Democrat (Published 2016)

 

[drusso]

This has been referenced here multiple times.

Your Surgeon Is Probably a Republican, Your Psychiatrist Probably a Democrat (Published 2016)

...but "why?" Why is it that I can sit across from a progressive FP who can't decide what pronouns to use and ze have such different values from a conservative cis-gendered orthopedic surgeon who is at the sidelines every home game, even post-call, and we all the same four years of medical training?

 

[crunchymedicine]

Does anyone make their own prp with just a centrifuge and no expensive kit? Is it legal to spin your own?

 

[Agast]

...but "why?" Why is it that I can sit across from a progressive FP who can't decide what pronouns to use and ze have such different values from a conservative cis-gendered orthopedic surgeon who is at the sidelines every home game, even post-call, and we all the same four years of medical training?

What do you think the end result of medical training is supposed to be? Everyone should be able to identify the same spleen, not agree on how much taxes the spleen owner should pay. You can even go to the same church as another doctor for 4 years and find out he cheats on his wife.

 

[Doctodd]

My wealthy country club patients all use Medicare….they worked and paid into it for decades. They will be damned if the govt gets to squander it somewhere. They are almost all republicans….. because too many Democrats have radical views.

 

[lobelsteve]

Does anyone make their own prp with just a centrifuge and no expensive kit? Is it legal to spin your own?

Yes. 10 min spin in edta tube. It is a blue top. I think it is citrate.

Development of a cost-effective method for platelet-rich plasma (PRP) preparation for topical wound healing - PMC

Platelet-rich plasma (PRP) is a volume of plasma fraction of autologous blood having platelet concentrations above baseline whole-blood values due to processing and concentration. PRP is used in various surgical fields to enhance soft-tissue and ...

www.ncbi.nlm.nih.gov

 

[bedrock]

some folks just don't learn......

“Insanity is doing the same thing over and over and expecting different results.” That witticism—I'll call it “Einstein Insanity”—is usually attributed to Albert Einstein.

as you wisely said in a post a few months ago, you stated my medical thoughts were usually "spot on" while you disagreed with my political posts.

I appreciate your medical posts, but I don't depend on them and I certainly won't beg you for your medical opinion if you're being a a$$ about it.

 

[bedrock]

Who says more than 50 % agree with you ? just because some on your side are the loudest and most obnoxious?
Your silly comment that Liberals don't work hard is as ridiculous.
I know plenty of liberals including myself that have started our own practices and have done well.

Some us think we are successful without driving a fancy car and dating a "movie star"

Wake up, because being woke is wandering around blinders on, which you are clearly doing. Far less than 50% of medical specialists are democrats. As others have mentioned, PCPs are mostly liberal, while specialists are overwhelming Republican, (or Independent) in my experience. This difference becomes even more stark when comparing political persuations of specialists who went out and started their own medical practices, as liberals are clearly in the minority of physician specialists who own their own medical practice. Please try to post data proving me wrong.

In general, liberals/socialists definitely don't work as hard as Independents/Republicans, that is clear as day to anyone with a brain. I'm not referring to physicians here, but to society as a whole. There are exceptions of course, but Liberal/Socialist policies are all about handing out money to those who can't be bothered to work, by taking it from those who do work, build, and contribute to society.

I also find it interesting that you can remember from previous posts that I drive a Porsche and previously dated a known television actress, but you can't remember that in the past year I posted a dozen times on SDN that I AM AN INDEPENDENT. Again this goes back to my first sentence of being woke is wandering around with blinders on, seeing only what you want to see.

Your other posts in your short time on SDN suggest that you are either blind or stupid, hopefully not both.

 

[Nodolor]

I also find it interesting that you can remember from previous posts that I drive a Porsche and previously dated a known television actress, but you can't remember that in the past year I posted a dozen times on SDN that I AM AN INDEPENDENT. Again this goes back to my first sentence of being woke is wandering around with blinders on, seeing only what you want to see.

LMAO, really hard to remember you drive a Porsche as you post it in Car thread and it is your Picture.
The the fact you posted about dating a "known television actress" was such a pompous statement how could one forget


You can say you are an Independent but your posts definitely speak otherwise

 

[Ferrismonk]

Yes. 10 min spin in edta tube. It is a blue top. I think it is citrate.

Development of a cost-effective method for platelet-rich plasma (PRP) preparation for topical wound healing - PMC

Platelet-rich plasma (PRP) is a volume of plasma fraction of autologous blood having platelet concentrations above baseline whole-blood values due to processing and concentration. PRP is used in various surgical fields to enhance soft-tissue and ...

www.ncbi.nlm.nih.gov

Not EDTA, but yes Citrate (Blue). EDTA (lavender tube) often uses Potassium as the cation, and you don't want to reinject too much of that...

 

[Ducttape]

...but "why?" Why is it that I can sit across from a progressive FP who can't decide what pronouns to use and ze have such different values from a conservative cis-gendered orthopedic surgeon who is at the sidelines every home game, even post-call, and we all the same four years of medical training?

because some people get enamoured by the $$$.

My wealthy country club patients all use Medicare….they worked and paid into it for decades. They will be damned if the govt gets to squander it somewhere. They are almost all republicans….. because too many Democrats have radical views.

thats because they are over 65. every American automatically qualifies for Medicare at age 65, in case you forgot.

they also have a term for this: Country Club Republican. Country club Republican - Wikipedia

In general, liberals/socialists definitely don't work as hard as Independents/Republicans, that is clear as day to anyone with a brain. I'm not referring to physicians here, but to society as a whole. There are exceptions of course, but Liberal/Socialist policies are all about handing out money to those who can't be bothered to work, by taking it from those who do work, build, and contribute to society.

I also find it interesting that you can remember from previous posts that I drive a Porsche and previously dated a known television actress, but you can't remember that in the past year I posted a dozen times on SDN that I AM AN INDEPENDENT. Again this goes back to my first sentence of being woke is wandering around with blinders on, seeing only what you want to see.

Your other posts in your short time on SDN suggest that you are either blind or stupid, hopefully not both.

i call that first statement \biased political misinformation. this is not the kind of comment an independent would make. it is the type of comment from someone who identifies primarily as conservative..


in addition, how hard one works and whether one is concerned about equity in life are not interconnected. i think it is called False Cause Fallacy...

 

[cowboydoc]

LMAO, really hard to remember you drive a Porsche as you post it in Car thread and it is your Picture.
The the fact you posted about dating a "known television actress" was such a pompous statement how could one forget


You can say you are an Independent but your posts definitely speak otherwise

Which political party has a monopoly on fancy cars and actors? I'm not really that in to politics, cars or actors.

 

[SSdoc33]

Wake up, because being woke is wandering around blinders on, which you are clearly doing. Far less than 50% of medical specialists are democrats. As others have mentioned, PCPs are mostly liberal, while specialists are overwhelming Republican, (or Independent) in my experience. This difference becomes even more stark when comparing political persuations of specialists who went out and started their own medical practices, as liberals are clearly in the minority of physician specialists who own their own medical practice. Please try to post data proving me wrong.

In general, liberals/socialists definitely don't work as hard as Independents/Republicans, that is clear as day to anyone with a brain. I'm not referring to physicians here, but to society as a whole. There are exceptions of course, but Liberal/Socialist policies are all about handing out money to those who can't be bothered to work, by taking it from those who do work, build, and contribute to society.

I also find it interesting that you can remember from previous posts that I drive a Porsche and previously dated a known television actress, but you can't remember that in the past year I posted a dozen times on SDN that I AM AN INDEPENDENT. Again this goes back to my first sentence of being woke is wandering around with blinders on, seeing only what you want to see.

Your other posts in your short time on SDN suggest that you are either blind or stupid, hopefully not both.

if you make a claim, it is your responsibility to back up that claim with data. it is not our responsibility to prove you are wrong. especially when saying something like "liberals don't work as hard as republicans".

for someone who takes pride in working so hard, you definitely want others to do your work for you. ironic, isnt it?

 

[Doctodd]

Which political party has a monopoly on fancy cars and actors? I'm not really that in to politics, cars or actors.

most of hollywood is subsidized by govt/democrats and get big tax breaks by prominent California politicians who are Democrat. It is pretty clear that California is a blue state....they seem to all get invited to Obama's birthday partys, and play free concerts at their reelection campaign parties. Id say James Woods, Clint Eastwood, John Voigt, and some others are vocal about their disdain for government overreach and have no fear of being blackballed by Hollywood, so they are not Democrat supporters. The bigwigs in Hollywood like Harvey Weinstein are Democrat.