Regenerative Medicine Part I :
Osteoarthritis (wear and tear arthritis) is something we see on a daily basis. Physicians have multiple choices on how to educate and treat their patients. Some conservative treatment methods are rest, ice, compression, elevation and non-steroidal anti-inflammatories. Steroid injections are a minimally invasive way to decrease the inflammatory response and reduce swelling. I usually give a steroid injection in the joint every six months if needed. I don’t like to inject the same joint earlier than this. JAMA published a study last year about the frequency of injections done in a knee joint. Patients were given a steroid injection every 3 months for two years. An MRI was done prior to the study and one after two years. This was compared to saline injections in patients over two years as well. The patients receiving the steroid injection quarterly, had their cartilage decrease 2 times as quickly as those with saline injections. Steroid injections can be very helpful for immediate pain relief and to specify the location of pathology. The frequency of the injection is what patients need to be educated on. Too frequent of steroid injections according to this study can have a negative effect on the cartilage in the joint. Regenerative medicine like platelet rich plasma, umbilical cord blood, umbilical cord matrix, bone marrow aspirate and adipose extraction are all options to decrease inflammatory factors in the joint and optimize healing without causing an increase in harm to the cartilage. These can be done frequently if needed and have had long term benefits as well. We will learn about different regenerative medicine options in following posts.