Regenerative Medicine


Many people know me from my blogs that I write on the website. Unlike most people, I do not use ghost writers. I write my own material. There is another group of people who know me from my comments on LinkedIn. The above represents one of the articles I recently commented upon on LinkedIn. What I find interesting is that the above article gives a glimpse into my journey in Regenerative Medicine. As I stated, many years ago when I became involved in Regenerative Medicine, it was the dogma that Mesenchymal Stem Cells were the only cells that accomplished repair. Well, that certainly has changed, as can be seen by the 1900+ hits this short article has gotten. We now know that a symphony of cells accomplish repair.  

This article reminded me of my journey into the field of Regenerative Medicine. The groundwork for my journey began as a typical Orthopedic surgeon. I was seeing patients in the office, and at the same time having a very busy operative practice. My week would consist of performing total joint replacements, performing arthroscopies, and doing spinal laminectomies. Of course, my occasional weekend was involved in repairing hip fractures and a variety of other fractures. In those days, there was not the specialization in Orthopedics as there is today. I did many of these surgeries, but at the same time I thought that these were rather barbaric operations.  I was basically doing carpentry on patients. When I finished my residency, the field of Arthroscopic Surgery was just getting started. I remember some of the more “seasoned” orthopedic surgeons that I met in private practice said to me that arthroscopy was just a fad that would die out in a few years. Initially, they looked at me in scorn thinking I was doing some type of quackery surgery. Well, I guess they were wrong! I became very proficient with the arthroscope, and did many surgeries, as did the rest of the Orthopedic community. Although the initial results in arthroscopic surgery were excellent, later on in my career I realized that these surgeries were actually causing patients to develop osteoarthritis at a young age, and this concept is now supported in the literature. I started to become disillusioned with this treatment protocol, but at the time did not know what could be a better option.     

I would go to conferences to learn the latest techniques which, when all was said-and-done, was not much different from older techniques. One thing I was always drawn to was the cutting-edge techniques. I was at one time involved with injecting chymopapin into herniated discs. Chymopapin is the enzyme found in meat tenderizers. In this case, it would disolve the herniated disc. The results we obtained were very good. After this technique, I moved on to laser discectomies.  Both of these methods gave excellent success in the right patient. I would call these episodes my springboard for regenerative medicine.  

Total joint replacements were my formal indoctrination to the world of Regenerative Medicine. I was doing joint replacements, and I went to a conference where they discussed a “new technique” called PRP or Platelet Rich Plasma. They said that this helps the joint replacement patient heal quicker and, in general, have less pain. I started using this “new technique” with excellent success. I started studying more about PRP, and realized that this is the way nature heals itself. This was my “A-ha!” moment. I realized that the PRP technique could be used in many other applications besides total joints. My second “A-ha!” moment was that perhaps this might eventually replace the joint replacement itself.

I was now at the fork in the road. I could continue doing everyday orthopedics, or I could get more involved in the path that led to the use of biologics for orthopedic conditions. I went down this path when few people even knew what a PRP was. Those that knew about a PRP typically did not know much about bone marrow aspirate or adipose tissue. Bone marrow and adipose were my next targets to learn and study. They fell into place quickly. This time period reminded me of the time when I first went into private practice, and began doing arthroscopic surgery.  The more established orthopedists said this was a fad and recommended against it. Well, fast-forward twenty years and the same comments were being made by the Orthopedic community about PRP. They said that PRP and Regenerative medicine was “Hocus Pocus Surgery.” They said that it was a fad with no scientific basis, and the talk behind my back was causing my ears to burn.

I stood steadfast in my convictions and I am so happy I did.  Slowly, more acceptance crept into the field. I was eventually lecturing all over the world, and continue to do so. As a matter of fact, I leave tonight for a quick teaching trip to Brazil. I will be there for about a day and a half and then return to the USA. In that time, I will talk about the basic science of stem cells and regenerative medicine. This is interesting, in that, most clinicians try to disregard basic science and usually are not involved in teaching. Well, low and behold, I now find myself teaching of all things about the basic science of stem cells and Regenerative Medicine. As a matter of fact, I have taught on all six continents. If someone would have told me this twenty years ago, I would have bet the farm against it. It is interesting how life takes some unexpected turns.  I realized that in order to become proficient in anything, one must learn to master the basics. 

Every day, I try to learn more basic science in the field of Regenerative Medicine. It reminds me of one of my slides in my talks, “the more you know the more you don’t know.” That is actually a profound statement because of its simplicity. Using this knowledge of basic science has allowed me to expand the horizons and successes of our clinics.  We are involved in cutting-edge aspects of anti-aging medicine that down the road will become building blocks of mainstream medicine. I have learned that the way stem cells age is how we age. These aging pathways include eliminating senescent zombie cells and stimulating gene pathways to improve the health of our mitochondria. I have realized that Anti-Aging, Stem cells and Regenerative Medicine have a strong bond that ties all of them together. It has been an exciting journey that I look forward to continuing. 


– Dr. P


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