Regenerative medicine started to take its first steps in the early 20th century with the successful transplant of bone, soft tissue and cornea transplants. Since then it has developed to include stem cell and platelet-rich plasma treatments.
Regenerative medicine is categorized as the use of living tissue to repair damaged, dying or diseased tissue, according to the National Institute of Health.
The demand for regenerative medicine also is anticipated to grow as the aging baby boomer generation needs more medical care. About half a million people get organ transplants each year, and new developments in platelet-rich plasma and stem cells can help prevent the need for a transplant to begin with, according to the Mayo Clinic and the National Institute of Health.
This is because when injected, stem cells which are harvested from a patient’s hip bone marrow can turn into the type of cell needed to repair the damaged tissue, said Dr. Sarah Vlach, a physiatrist at Eastern Idaho Spine, Sports and Rehab Center.
Vlach said to think of stem cells as little repairmen that can go into tissue and have paracrine functions, which means they can talk to other cells to figure out what’s wrong.
Vlach offers stem cell injections and platelet-rich plasma injections as part of the regenerative medicine at her clinic.
Doing a stem cell procedure is a three-part, intensive process for Vlach. The patient first has to get a prolotherapy injection, which is an irritation solution to turn on the inflammatory process.
Then patients get their stem cells harvested in the morning and, in the afternoon, Vlach injects the live stem cells. After three to five days the patient comes in for a final platelet injection.
Because stem cell procedures are time consuming and harder on patients, Vlach likes to use them sparingly, only on cases where regular platelet treatments won’t work.
Stem cells also can be programmed by scientists to turn into specific cells, according to the Mayo Clinic. The doctors harvest cells called fibroblasts from patients’ skin and reprogram the cells to pluripotent stem cells that can be taught to grow into a variety of other cells and tissues.
This allows the doctors to control the stem cells to directly address the needs of the patients.
Platelet-rich plasma also contains growth factors, that can help heal damaged or degenerative ligaments and tendons. This works by remodeling the ligament or tendon, not regrowing cartilage which is a common misunderstanding, Vlach said.
Every time Vlach sees a patient, they undergo a thorough physical exam to determine the location of their pain. The physical exam is important because sometimes MRI results can be misleading.
A New England Journal of Medicine study found that people that didn’t have back pain even though MRI results showed abnormal or degenerative back discs. There wasn’t a correlation between back pain and the MRI imaging.
This is why Vlach insists on the “art of the physical exam” which she thinks most doctors have lost. She said the physical exam portion of her patient evaluations are critical for diagnosing pain.
Vlach still uses MRI imaging, but those images work with the physical exam to draw a whole picture of the patient’s health. One doesn’t work without the other.