As Dr. Centeno puts it, we basically can devide orthopedic surgeons into two groups:

a) Forward thinking open minded orthopedic surgeons that have seen the light and have embraced Orthobiologics. These don’t feel threatened by the idea that Platelet Rich Plasma (PRP) or Bone Marrow Concentrate (BMC) procedure may take the place of some surgical procedures. These surgeons offer PRP and BMC to their patient. They are the exception.

b) Close minded, not forward thinking orthopedic surgeons that feel very theartened by regenerative medicine. They like to say that the only way for them to embrace regenerative procedures, is that level one evidence needs to exist. However, they conveniently forget that many of the orthopedic surgical procedure they already perform, do not have that level one evidence. In fact, orthopedic surgery is one of the most poorly studied disciplines.
Presently, to the surprise of this second group of orthopedic surgeons, there is a study by a prominent orthopedic surgeon in Dallas Texas by the name of Dr. Don Buford, who himself embraces the use of Orthobiologics. Dr. Buford’s study brings to light that the average level of evidence available for traditional orthopedic surgery is a level 3. Think about that for a minute! Getting a new drug approved so that it can be used by an internist requires level 1 evidence! A new surgical procedure? Only a level 3 or less!! Follow this link to read Dr. Buford study:

“Here’s my thesis. Orthopedic surgeons have long been kings of the hill when it comes to the definitive treatment of musculoskeletal problems. In a world where the conservative treatment options are steroid injections or physical therapy, that makes sense, as only orthopedic surgeons could deploy solutions that made an attempt at repairing or restructuring bones, cartilage, ligaments, muscles, or tendons. However, with the advent of orthobiologics, all of that dramatically changes. Let’s explore why.

If substances exist that can be precisely injected with imaging guidance, that can help tissues heal and reduce the need for surgery, then surgical rates begin dropping, and the status of orthopedic surgery changes. We know this because this is what has already happened in cardiothoracic surgery. For example, as interventional cardiology solutions like x-ray-guided and catheter-deployed stents came into common use, open heart surgery rates plummeted. The cardiothoracic surgeons went from kings of the proverbial heart care hill to only treating severe cardiac disease, with interventional cardiologists supplanting them as the primary providers for cardiac care.

To explore the disruptive impact of interventional orthobiologics further, let’s look at just three of about 100 orthopedic surgical procedures that will soon compete head to head with Interventional orthobiologics. First, let’s take the results of our Perc-ACL injection procedure Randomized Controlled Trial (RCT) and imaging case series (1-3). Based on an analysis of the data, I would estimate that somewhere between half to 2/3rds of every patient in the US who currently now gets an ACL reconstruction can be treated with a precise injection of bone marrow concentrate instead (1). Our case series and RCT data show the same for rotator cuff tears and the need for surgical repair (4,5). Finally, it’s clear based on our published knee arthritis case series and RCT and two RCTs published by Herigou that some percentage of knee replacements could be pushed off many years or not needed at all (6-8,13,14).

Let’s now explore how that impacts surgical rates by looking at how many of these orthopedic procedures are performed annually. On an annual basis, there are now approximately 100K ACL reconstruction procedures, 460K rotator cuff procedures, and 800K knee replacement surgeries that would be impacted. If half of those surgeries are no longer needed, that’s a drop in about 700,000 procedures annually. If you add in the dozens of orthopedic surgeries that would be prevented by the widespread adoption of interventional orthobiologics, millions of surgeries will no longer be needed.

Hence, interventional orthobiologics presents a first-in-history threat to the orthopedic surgery hegemony. On the one hand, it’s potentially devastating. On the other, if this is going to happen, then if you’re an orthopedic surgeon, you need to get a handle on this phenomenon and control it.”

For a consultation with Dr. Dieguez for him to evaluate your conditon and see if you are a candidate for any of these advanced procedures, please call our office in at (904) 824-0955. For additional information about our practice please visit our website at www.TheOrthobiologicClinic.com. You may also want to follow office Facebook page at https://www.facebook.com/TheOrthobiologicClinic .