Regenerative Medicine

What is Regenerative Medicine?

Regenerative medicine is a medical specialty that focuses on the human body’s innate ability to heal itself. When our skin is cut, it will heal. When our bone is broken, it will mend. Sometimes the body doesn’t heal as well or as fast as we would like. Often this is due to the limitations with the specific site of injury, which may be due to poor availability of healing nutrients like growth factors. Regenerative medicine optimizes the body’s own healing process. Often this can simply be isolating the lacking healing factors and placing them where needed, so the injured tissue can have a better chance of recovery. This is a young field of medicine with significant exciting advancements every year. The way we practice regenerative medicine today may be significantly different than a year from now.

What is Platelet-Rich-Plasma (PRP) Therapy?

Platelet rich plasma (PRP) is a solution that is obtained from a patient’s blood. This blood is centrifuged to separate the red blood cells from the plasma. A layer of plasma that is rich in platelets is then isolated from this blood sample.

PRP has been studied for years for its use in a variety of orthopedic conditions including tendon injuries, osteoarthritis, plantar fasciitis, and ligament sprains. The theory behind PRP is that these platelets release a variety of growth factors and cytokines, which then in turn stimulate the healing process. Some of these growth factors include platelet derived growth factor (PDGF), insulin-like growth factor (IGF), vascular endothelial growth factor (VEGF), and epidermal growth factor (EGF).

This process mimics the natural injury model where a tissue is damaged and bleeds, bringing the needed healing factors to the site of injury. Inflammation occurs and the healing process ensues. PRP can help stimulate this process when an injured area isn’t recovering as well as we would like.

PRP has been used for many years on athletes with sporting injuries as well as on patients with chronic pain. Often standard of care procedures used to treat pain involve corticosteroids (cortisone) which, although temporarily helpful, can cause long term consequences to the patient and area being treated.

What is Bone Marrow Aspiration Concentrate (BMAC) Therapy?

Regenerative medicine has studied for years for managing pain from osteoarthritis. The knee is the most extensively studied due to it being the joint commonly most affected by osteoarthritis. Studies have demonstrated improvement in a patient’s pain, activity levels, and quality of life with these interventions. Platelet rich plasma (PRP) has been studied for soft tissue injuries, including ligaments and tendons, and for joint pain from mild osteoarthritis. With moderate or severe osteoarthritis, PRP has been shown to not be as helpful as other interventions such as bone marrow concentrate.

What is Alpha-2-Macroglobulin (A2M) Therapy?

Alpha-2-macroglobulin (A2M) is a protein found in blood. This protein inhibits certain enzymes. This protein has become an area of interest in the regenerative medicine field with recent studies showing that this A2M protein also inhibits the activity of some ADAMTS enzymes in joints. These particular ADAMTS enzymes play a role in the breakdown of cartilage in arthritis. This protein is found in normal, healthy joints.
There have been studies investigating the benefit of A2M in preventing OA. These studies have been done only in animal models up to this point.

The researchers typically induce trauma to a rat knee and compare a placebo injection to A2M injection. The A2M treated animals demonstrate a cartilage sparing effect and slowing of the arthritis process.