Did you know?

A few important takeaways:

• Make sure your clinician offers you all the types of treatments that are currently available and not just the ones your insurance carrier pays for. You need to be able to make the decision based on all the treatments that are currently available. Be aware that if a clinician does not do certain procedures, oftentimes, they will not be offered to you. Generally, people are down on what they are not up on. 
• The FDA only allows PRP, BMAC and Micro-Fat and any umbilical cord blood, amniotic or Warton’s Jelly or other embryonic cells are illegal.
• Remember all PRP is not created equal and the proper centrifuge will be needed to concentrate your platelets in certain ranges to get the best results.
• PRP since 2018 is no longer considered “experimental” so don’t let anyone tell you it is.
• Longer results are seen with PRP when combined with the correct exercises.
• BMAC and Micro-Fat are still considered experimental but still allowed by the FDA. These procedures will in all likelihood be proven, like PRP, to be efficacious and soon will no longer be considered experimental.
• All injectable steroids and local anesthetics are toxic to joint cartilage and should not be used except in a wet joint (synovitis) once but certainly not multiple times per year.
• Systemic absorption occurs with steroid injections and if given more than 2 per year will contribute to systemic osteoporosis. 
• For each steroid injection received in a joint there is a 9.4% increase in an earlier joint replacement in the next 9 years.
• Clinicians in New York State (NYS) that cannot inject—but employ other clinicians to perform injections—must have certain criteria met to make this relationship legal. For example, if a Chiropractor, who cannot inject a patient in NYS, hires a physician (DO or MD), nurse practitioner or physician assistant, who legally can inject a patient establish this relationship certain criteria must be met. In NYS this relationship is allowed. However, if the evaluation and determination of whether an injection is needed and to be performed by one of these clinicians and the examination is not done by the injecting clinician and that clinician relies solely on the chiropractor’s assessment, then this is illegal in NYS. In the Buffalo area, several of these relationships exist in certain clinics and not surprisingly these same clinics perform illegal injections of non-FDA allowed products such as umbilical cord, amniotic, Warton’s Jelly and other products that are illegal.

Other Articles in the “Use of Biologics for Treatment of Musculoskeletal Conditions” Series:

• Understanding Biologics
• The Current Landscape
• Biologics as Regenerative Medicine
• The Healing Potential of Platelet-Rich Plasma
• Challenges Facing the Use of Biologics
• The Role of Exercise

Article Series: Use of Biologics for Treatment of Musculoskeletal Conditions
From your spine and sports medicine expert Dr. Michael C. Geraci, Jr., MD PT.