If you read this blog, you know I love the holidays. It’s a time of year that I can shift into low gear, which for me is saying something. It’s also a time of year I can give back to our employees who work hard all year. This weekend at our party, an ACL stem cell story emerged that typifies what’s likely to happen as we innovate more and more using advanced interventional orthopedics. Resistance to change and an orthopedic surgeon acting out against a college offensive lineman is what this story is all about.
70% of All Patients Who Currently Get ACL Surgery Don’t Need It
If you read this blog carefully, I have always hedged the above statement in some way. I have usually placed the word “likely” in front of the statement. However, at the turn of the year, we will have been performing our precise ACL stem cell injection procedure for about seven years. At this point, I have seen enough to know that the above statement is true. However, that doesn’t mean that we still don’t have much to prove. We do. We have a second research paper that has still to be published. We have the first part of our ACL stem cell randomized controlled trial (RCT) to publish. We also have yet to complete the full RCT which is still recruiting.
Brendan is the son of our bookkeeper. He was born to play offensive line in football, as his six and a half feet and size make him a formidable tight end. Hence, he quickly bagged a scholarship to play college football as he graduated high school. In addition, he has also been at almost all of our holiday parties from the age of about eight through this year.
As is common in college football, he eventually sustained an ACL injury. Since his mother knew us well, she asked if we could use our then new ACL stem cell procedure to help her son. Why? She knew from my writings that ACL surgery wasn’t all it was cracked up to be. That the ACL graft weakens the muscle from which it’s taken. That the new graft goes in at too steep an angle to be an effective protection system for the knee. Finally, that the new and very artificial ligament has none of the position sense capability it requires to fire muscles to protect the knee.
We treated Brendan’s ACL and it healed. We then treated a second ACL tear on the other side and it healed. His MRI images are below:
A Backward Orthopedic Surgeon
Like most college teams, Brendan’s had an orthopedic surgeon as its team physician. He wanted to operate on Brendan’s knees, and he was politely told no. After his MRIs showed that his ACLs had healed, the surgeon continued to block Brendan’s return to the field. This was even after Brendan demonstrated 700+ pound squats and his physical exam was normal. The surgeon refused to acknowledge that a stem cell procedure like an injection could have allowed this player to avoid surgery.
As life would have it, Brendan eventually became an assistant offensive line coach at the school, taking his fate and making lemonade out of lemons. However, over the last five years, many orthopedic surgeons who considered stem cell procedures to be voodoo have begun to use them in their practices. We also now have orthopedic surgeons retraining in interventional orthopedics, seeing the handwriting on the wall. Finally, the evidence base that supports what orthopedic surgeons do every day has cratered, with study after study showing that most common orthopedic surgical procedures are no better than sham surgeries.
How are Brendan’s knees? They’re 100%. As I learned at our Christmas party, he never looked back. He does everything he wants to do and now is coaching kids. He knows he would have had no issues playing his last two seasons as a tight end, but this kid doesn’t hold a grudge, He’s just thankful that he doesn’t have surgically implanted artificial ligaments.
The upshot? The world is changing. Most of elective orthopedic surgery will be replaced by precise image-guided interventional orthopedics without surgery. By the way, if you’re an orthopedic surgeon in Aberdeen, South Dakota, you were an idiot. If you’ve grown an open mind in the past few years, we would be happy to retrain you in what will replace most of your specialty over the next 1–2 decades.