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Progression of Thought

Image of Dr. Dan Levesque, DC
Dr. Dan Levesque, DC
severe-oa-damage-knee

     Even though it’s been practiced for numerous years now, regenerative medicine is considered a new(er) branch of medicine. While treating joint problems with allografts and regenerative tissue products have been deemed safe and effective by the FDA, the science has not been around long enough for standard treatment protocols to have been established. Just as there are new products constantly coming out that are better and more advanced than the last, the same goes for the understanding and application of treatment. At Solutions, we have also been through a progression of understanding of just how these products work and what works best. 

     At first the regenerative medicine products available were allotments of allograft tissue cells consisting entirely of undifferentiated mesenchymal cells. When injected into a damaged joint, a large percentage of the patients experienced great results including reduced pain, better function and improved joint space (confirmed by post x-rays). However, there was still a percentage of patients who did not respond. Their x-rays showed no improvement and their symptoms either changed very little or not at all. This suggested that perhaps the regenerative medicine treatments were hit and miss, and so we began warning potential patients of this; that one of the risks of this type of treatment is it may not work.

     However, there was also a percentage of patients who got good results from regenerative medicine, but less than miraculous; they did better, just not completely well. For example, their pain levels and range of motion improved 50%, but had no noticeable changes on x-ray. For many of these patients, this was the only treatment that had made any difference in their condition, so they were pleased but of course wanted more. After receiving another injection, their condition improved even further, some reaching 90%+ (with changes on x-ray), while others required yet another injection to take them the rest of the way.

     What this taught us was that not all patients respond to one injection. It was not that the results of regenerative medicine were hit and miss (only working on some patients and not on all), it was that some patients simply require more than others to respond. We discovered that joints with excessive amounts of deterioration may take several rounds of regenerative medicine for the patient to regain function and feel better. This progression of understanding has helped us provide better recommendations with more realistic treatment expectations and ultimately better patient results.


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