I’ve been blogging now for more than a decade. Every year I try to find the 10 blogs that were my favorites for my readers to review in case they missed them. Let’s dig in.
First, why do I take the time to blog? It’s really a form of educational catharsis. What we do is disruptive. It dramatically changes the normal care pathway for orthopedic surgery and disrupts many different industries that are very profitable. At the same time, given that what we do is difficult to perform correctly but easy to fake, we’re in a situation where fake orthobiologic treatments are now common and need to be exposed. At the same time, the providers who are working hard to build a new medical specialty called interventional orthopedics (or interventional orthobiologics) need to be hat tipped. I also need to keep up with this rapidly exploding field. Hence, this blog serves a very real purpose.
It’s hard to believe that my first blog post was on September 3rd, 2008. That’s more than eleven years ago. Since then, I’m approaching 3,000 posts, which I should hit sometime in spring!
My 2019 Top 10
2019 was an interesting year for orthobiologics. We saw the FDA crackdown on numerous bad actors, but despite that, we saw more scams explode into the field. Despite all of this, the research in orthobiologics has continued to evolve.
10. Our Research Team Published a New Paper on PRP and Tendons- The conventional wisdom, based on a few poorly done papers, what that higher concentrations of PRP were a problem for tendon cells. Hence, using a lower concentration of PRP was better for tendons. The problem? When you correct the poor experimental design of the prior papers and redo the experiment in the lab, the opposite is true. A higher concentration of PRP benefits older tendon cells. This is our scientific publication on that matter. So go big or go home with PRP concentration in tendon therapies!
9. Honored to Be Honored by My Colleagues– At the 2019 edition of the Interventional Orthopedics Foundation conference, I turned over the reins of the organization to Gerry Malanga, M.D. and as a surprise, my colleagues made me a very touching good-bye/retirement video.
8. Consensus Document on Amniotic and Umbilical Cord Scams-This document marks the beginning of legitimate physicians pushing back against chiropractors and other providers who are offering dead stem cell products to their patients while claiming these are actual stem cell procedures with millions of live and highly vital stem cells.
7. Naturopaths and Regenerative Medicine: The Utah Example– This was a deep dive into the exploding trend of naturopaths performing procedures that they aren’t licensed to undertake. In fact, most are only licensed for minor in-office procedures but are violating their practice acts by performing image-guided minimally invasive spinal procedures using stem cells. Here I dig into the case of Harry Adelson, who is a naturopath in Utah, who in my opinion, should not be permitted to perform the procedures he offers.
6. Is ACL Surgery a Second Hit to the Joint Cartilage? In May I was invited to attend the CSU Havemayer Symposium on the orthopedic uses of stem cells. A very interesting talk was given about how ACL surgery itself is a second hit to the joint cartilage. This created yet another reason to support the use of our Prec-ACLR procedure that’s capable of repairing the damaged ACL ligament with ultra-precise injections of the patient’s own bone marrow concentrate.
5. Judge Rules in FDA’s Favor Against Fat Stem Cell Clinic Chain-The FDA got a win in court against US Stem Cell, a chain of clinics using fat-based SVF, a type of stem cell therapy the FDA had long stated was not legal without first being approved as a drug. My problem with this organization was that they used SVF to treat a variety of incurable diseases without any evidence that this procedure worked. Hence, in my opinion, the company was making the stem cell wild west worse and not better.
4. How to Chose the Right Stem Cell Clinic: Who, What, Where, When, and How-I created a little blook to help patients decide how to make sure they’re getting high-quality orthobiologics care versus something that costs an arm and a leg but is a poor fake of the original. This book is critical since the number of scam clinics out there has exploded over these past few years. Hence, if you have a friend considering a regenerative medicine procedure for their hip, knee, shoulder, or spine, please send them the link to this quick read to make sure they don’t get scammed.
3. New Version of Orthopedics 2.0! I first wrote Orthopedics 2.0 way back in 2009. It’s about how regenerative medicine and highly precise image-guided orthobiologic injections will replace much of elective orthopedic surgery. However, as the field evolved and also began to spin out of control, it was essential to issue multiple versions of the book to keep up. This is the 4th edition. So if you haven’t read this before or read it a while back, please download another copy to get the latest and greatest on how legitimate orthobiologics are changing everything!
2. My 2019 Orthopedic Bone Marrow Stem Cell Research Infographic-Every year I summarize the bone marrow stem cell research that got published the prior year. This year’s edition covers 32 years of data on more than eleven thousand patients. So if you hear we have little research on the use of bone marrow stem cells in orthopedics, that’s just someone who has never taken the time to review the massive amount of published research on the topic.
1. My PRP Injection RCT Infographic: Google Screwed Up– Here I looked up all 67 Randomized Controlled Trials on Platelet-Rich-Plasma use in orthopedics. What I found was that PRP use in orthopedics has a huge and convincing dataset to support its use. This is despite the fact that bench scientists recently convinced Google to get rid of PRP advertising. This decision wasn’t science-based, but political.
The upshot? I enjoy blogging several times a week because it’s my catharsis. It also keeps me up to date on the evolving science in this area and what everyone else is doing. Finally, I’ll soon hit three thousand posts. That’s almost three times the page count of War and Peace! Hence, keep coming back here several times a week for the latest and greatest (or worst) in orthobiologics!