As a result of evolving technology and knowledge growth, regenerative orthopedics helps restore damaged tissue using platelets, mesenchymal stem cells, plasma proteins, and growth factors from your body. When traditional methods such as rehabilitation aren’t working on their own, regenerative medicine can help promote the healing process to heal a variety of musculoskeletal injuries without turning to surgery.
Through years of research, practice, and teaching, Dr. Khadavi at APEX Orthopedics has become a leading physician in regenerative medicine in the Kansas City community (and even beyond). In fact, patients travel from across the Midwest to seek treatment at our clinic because of his high regard in the field of advanced orthobiologics (the use of regenerative medicine in orthopedic applications).
After thousands of successful procedures, Dr. Khadavi has found that high-quality regenerative orthopedics can enhance a patient’s mobility and decrease the occurrence of pain.
Read on to learn more about regenerative orthopedics and how these treatment options could help you recover.
What is regenerative medicine?
Regenerative medicine, or orthobiologics, uses live cells, platelets, and growth factors to repair or replace damaged tissue. For orthopedics specifically, regenerative treatments can heal and/or improve:
- Tendon tears
- Ligament tears
- Arthritis
- And more
The most effective regenerative medicine comes from your own body rather than an outside source. Oftentimes, doctors will promote their regenerative treatments such as an allograft (cells or tissues transplanted from one person to another). An example would be amniotic fluid. These treatments are made from outside cells that become non-viable after they are frozen, thawed, and stored. While both options can help an injury or damaged tissue (due to growth factors), the results are dampened compared to treatments derived from your own cells.
Whenever you’re seeking regenerative treatment options, make sure you talk to different physicians about what they provide.
Types of treatments in regenerative orthopedics
There are a variety of regenerative treatment options to help repair musculoskeletal conditions that could affect your daily life. We will talk about two common treatments:
- Stem cell treatments
- Platelet-rich plasma
Stem cell treatments
The most effective stem cell treatments, like Dr. Khadavi’s treatments, utilize the stem cells in your body. Therefore these treatments take time and require more expensive materials. In fact, some stem cell treatments on the market come from outside sources, even though hundreds of studies have shown that those products don’t have viable stem cells in them.
Let’s step back for a moment and talk about what stems cells are. Every tissue in your body has stem cells that live on the surfaces of your blood vessels, waiting to be activated and released to a site of injury. Unlike other cells, stem cells are unspecialized, meaning they don’t have a specific function. Stems cells can either divide into more stem cells (without limit) or they can become specialized through cellular differentiation.
The cellular differentiation process changes the function of the cell to meet the body’s needs. For example, the process could change a stem cell into a myocyte (muscle cell) and function in the same way. In various parts of the body, stem cells also act as regenerative measures to replenish damaged cells.
Because of their versatility, researchers have long studied stem cells and how they could be used in modern medicine. As a result, research physicians like Dr. Khadavi have found that stem cell injections can induce cell division in damaged areas to replace old, worn out, or injured tissue.
How does a stem cell treatment work?
A doctor will first take stem cells from either your bone marrow or your fat. Bone marrow has a large concentration of stem cells, and unlike fat, the process of harvesting does not require enzymes to break them down—a process that is not legal in the United States. For this reason, bone marrow is the preferred stem cell source at Apex Orthopedics.
Dr. Khadavi will utilize several techniques to maximize stem cell concentrations, such as pulling bone marrow from four to six different sites rather than the more common technique that utilizes just one site.
From there, Dr. Khadavi runs the bone marrow through a centrifuge to isolate stem cells, platelets, growth factors, plasma proteins, and sometimes white blood cells. This leaves behind red blood cells and other unnecessary proteins. The centrifuge process takes about 25 to 45 minutes.
Keep in mind that the precise formulation of stem cells, platelets, white blood cells, and other components is customized to the specific condition and patient.
Over time, stem cells replenish old or damaged tissue with easier recovery and less pain than surgery.
Platelet-rich plasma (PRP)
You may have heard of platelet-rich plasma or “PRP” some way or another. PRP is an advanced method to restore damaged tissue. Benefits of PRP span across a variety of medical branches such as dermatology, sports medicine, orthopedics, and more.
PRP is derived from your blood, which has four main components:
- Plasma
- Red blood cells
- White blood cells
- Platelets
Platelets are key for the wound healing process since they promote blood clotting. However, they also carry growth factors that can enhance the function of cells with which they come into contact. As a result, when you receive PRP injections for sports-related injuries, arthritis, or even ligament tears, the platelets can promote cellular growth to reduce pain and increase mobility.
How does a PRP treatment work?
To obtain your platelet-rich plasma, your doctor must start by drawing your blood. Much like stem cells, the platelets are then isolated using a centrifuge. The process could take around 25 to 45 minutes.
Often used in conjunction with stem cell treatments, PRP can alleviate joint and muscular pain while promoting cellular growth.
PRP or Bone Marrow Concentrate →
How do I know if regenerative orthopedics is right for me?
To be fully transparent, regenerative orthopedics does not work for everyone. About 1 out of 4 patients that visit Dr. Khadavi are candidates for PRP or stem cell treatments to begin with.
As an expert in the field, Dr. Khadavi considers four main factors when choosing whether a regenerative treatment would best suit a patient. These factors are:
- Diagnosis
- Age
- Activity level
- Patient goals
Diagnosis
What many people fail to realize is that determining a precise diagnosis is the first and most crucial step in determining whether or not regenerative orthopedics is right for you. There are many instances where a regenerative treatment simply won’t be beneficial, and Dr. Khadavi will be sure to be transparent about this.
You may be surprised to find out that many other orthopedists in Kansas City would utilize it anyway. Here are a few examples of conditions that haven’t shown much results from regenerative orthopedics:
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- Large and retracted tendon tears
- Very severe arthritis
- Acute meniscus tears
- Alignment and biomechanical abnormalities (such as patellofemoral pain)
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Therefore the key is proper diagnosis to find the right treatment. If you’re in the Kansas City area, we highly recommend you visit Dr. Khadavi rather than trying to diagnose yourself.
Age
Your age isn’t going to deter you from getting a regenerative treatment if the diagnosis calls for it. However, it can change the process. Since Dr. Khadavi is a national consultant and educator for regenerative orthopedics, he makes it a top priority to stay on top of the latest research, keeping him years ahead of the curve and other physicians in the country. Because of this, he is constantly changing his practice to uphold the highest standards, and that includes accommodating for age.
A recent 2019 study showed that individuals over the age of 50 require higher concentrations of platelets to achieve good outcomes. This means that during a regenerative treatment at Apex Orthopedics, Dr. Khadavi will draw more blood and bone marrow and put it through a more extreme concentration process to get you better results. (consider hyperlinking to blog about how to choose a regenerative provider, or why regenerative procedures at Apex are better than others)
Lastly, between 70 and 80 years old the number of stem cells in your bone marrow decreases. As a result, for patients over the age of 80, multiple PRP injections may be more beneficial and cost-effective than a bone marrow stem cell treatment.
Learn more about age and regenerative medicine. →
Activity level
Your activity level plays a large role in how much pain you can tolerate and how much motion you require. If someone with a large tendon tear is only moderately active and simply wants to return to normal daily activities, then regenerative orthopedics may be sufficient. However, for someone with a large tendon tear who plans to go back to sports or take part in a highly active lifestyle, regenerative medicine may not suffice and we may discuss other alternatives such as surgery.
Patient goals
At the end of the day, these three factors combined with your long-term goals determine whether or not regenerative orthopedics at APEX would be the right choice.
Regenerative orthopedics with other treatment methods
Regenerative orthopedics works best in conjunction with other methods such as physical therapy, bracing, pain medication, or even surgery. Something that APEX offers that other clinics in Kansas City doesn’t is to provide regenerative treatments such as PRP at the same time as surgery.
Adding a regenerative treatment to your surgery, either during or after the procedure, comes with many benefits. For example, studies have shown that PRP along with a rotator cuff surgery can decrease the retear rate. Similarly, a patellar tendon tear or severe tendinosis may benefit from a surgery that is augmented with PRP. That means you get more value out of your treatment because it is less likely that you will have to come back.
Does insurance cover regenerative medicine?
For an overwhelming majority of cases, insurance companies do not cover regenerative medicine. Therefore for many patients, it is up to them and their budget if they want to add a regenerative treatment to their recovery plan.
One reason for this is because two physicians can charge the same price for stem cells, yet one physician only achieves 1/10th of the concentration. Either way, the insurance companies would pay the same amount regardless if one was a higher quality. In that case, there is no incentive to provide high-quality stem cells or other regenerative treatments. In other words, there is no uniformity, and many physicians don’t provide the same effective treatments as the ones Dr. Khadavi provides at APEX.
A second reason insurance companies are not yet covering these procedures is the strong lobbyists that surgical device companies employ. No matter how expensive regenerative procedures may seem, they are a small fraction of surgical costs.
Keep in mind that this does not mean regenerative medicine will never be covered. A time will come when more insurance companies will hop on the bandwagon and when that occurs, hopefully a process is in place to ensure. This will not, however, change the quality of the treatment you receive. That is why it is important to talk with a physician about the techniques he or she uses and the success rate.
While many continue to question the “experimental” nature of orthobiologic injections, for most conditions and procedures this is no longer the case. By now, thousands of high level studies, including randomized control trials, systematic reviews, and meta-analyses have been performed confirming their efficacy. Dr. Khadavi would be happy to discuss what is currently known in the literature and share the most respected research studies for your specific condition.
Get to know Dr. Khadavi at APEX Orthopedics & Sports Medicine
Dr. Khadavi is the only physician in the Kansas City area who is triple board certified in Sports Medicine, Physical Medicine and Rehabilitation, and Musculoskeletal Ultrasound (RMSK). He not only specializes in regenerative medicine, he is also a field leader who teaches best practices to other physicians across the country.
As a result, patients receive treatments that are most likely to work in comparison to cheaper alternatives. With the help of APEX’s private practice model, Dr. Khadavi ensures each patient receives the most value that doesn’t involve hidden fees or outlandish pricing.
The core of his success lies in proper diagnosis. An appointment with Dr. Khadavi includes the highest quality technology to pinpoint a patient’s underlying musculoskeletal conditions. From there, he can better understand whether his advanced regenerative medicine techniques would be the best solution.
For a thorough evaluation with Dr. Khadavi or his physician’s assistant Stephanie Shull, call us at 913-642-0200 or schedule an appointment today.
