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Dr. Ice said:
My linked in page is telling me Joann borg stein and Spaulding has jumped way onto the prp bandwagon..as has mayo, Kessler, etc

Must be something to that “secret” sauce
Click to expand...

I was at Mayo during the early days of using the secret sauce.
Members don't see this ad.
 
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ill repeat, the rinky-dink clinics are doing prp and billing medicare
 
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Members don't see this ad :)
bedrock said:
How are they billing Medicare?
Click to expand...
i havent seen an eob, but there are only 2 possibilities. They are eating the cost in exchange for a visit and joint injection(they dont have imaging), or they are billing the tissue transplant code fraudulently.
 
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Work Comp pays for it. If they're billing Medicare they're doing exactly what everyone did with AmnioFlow.
 
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Role of platelet rich plasma in management of early knee osteoarthritis pain: A retrospective observational study​

Author links open overlay panelSandeep Khuba a, Dheeraj Khetan b, Sanjay Kumar a, Keshav Kumar Garg c, Sujeet Gautam a, Prabhaker Mishra

Abstract​

Introduction​

Knee joint osteoarthritis is a well-known cause of pain and disability in patients above 40 years of age. It is treated by use of non-steroidal inflammatory drugs, corticosteroids, glucosamine, chondroitin sulfate, physiotherapy with limited success. The platelet rich plasma (PRP) contains a large amount of platelet derived growth factors, cytokines and anti-inflammatory molecules which showed promising results in recent studies to relieve pain of knee joint osteoarthritis. The present study aims to determine the efficacy of intraarticular PRP for pain relief and functional improvement in patients with early knee joint osteoarthritis.

Methods​

It is a retrospective observation study involving patients who underwent single intraarticular administration of PRP for knee pain with Kellgren-Lawrence (KL) grades I or II knee joint osteoarthritis. The Visual analogue scale (VAS) score and Oxford knee score (OKS) were recorded pre-procedure and at 1- and 6-month post-procedure.

Results​

A total of 31 patients (20 females, 11 males) underwent PRP therapy for knee pain (16 kL grade I, 15 kL grade II). The mean age and duration of symptoms were of 53.9 years (range: 79–42 years) and 5.53 ± 2.35 years respectively. There was a significant reduction (p < 0.05) in VAS scores from pre-procedure (68.06 ± 8.33) to post procedure at 1 month (37.74 ± 11.16) and 6 months (54.52 ± 11.78). There was also significant improvement (p < 0.05) in OKS score from pre-procedure (31.1 ± 3.47) to post-procedure at 1 month (39.06 ± 3.37) and 6 months (34.10 ± 3.75). No adverse effects were reported in patients during the study period.

Conclusion​

This small retrospective study suggests that a single administration of intraarticular PRP may be safe and effective for pain relief and functional improvement for up to 6 months in patients of early-stage osteoarthritis.
 
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PRP should be covered for the knees over HA.

If PRP, steroids, and HA, were all equally covered by insurance, I would start with a PRP knee injection, 95% of the time.
 
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Ducttape said:
retrospective.

small group.

no comparison.

adds nothing to the volume of literature out there.
Click to expand...

It does add to the literature. It all harmonizes to one singular Truth. You build Truth based upon a hierarchy of evidence from the bottom up, not the top down.

1703195700971.png
 
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drusso said:
It does add to the literature. It all harmonizes to one singular Truth. You build Truth based upon a hierarchy of evidence from the bottom up, not the top down.

View attachment 380035
Click to expand...
I 100% disagree with this. In NO WAY is meta-analysis high quality evidence.

That is like taking the top 10 Lasagnas and mixing them all together and saying that is better than the original - well maybe that isn't a great analogy but shucks...meta-analysis really suck most times.
 
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epidural man said:
I 100% disagree with this. In NO WAY is meta-analysis high quality evidence.

That is like taking the top 10 Lasagnas and mixing them all together and saying that is better than the original - well maybe that isn't a great analogy but shucks...meta-analysis really suck most times.
Click to expand...

Completely agree.
A certain forum member frequently posts meta analysis papers and I ignore every post.

No study means anything other than a randomized controlled trial.
 
drusso said:
It does add to the literature. It all harmonizes to one singular Truth. You build Truth based upon a hierarchy of evidence from the bottom up, not the top down.

View attachment 380035
Click to expand...
It adds nothing and I did not think I would have to explain, but I frequently seem to underestimate the audience....

First, the study is crap design. Second, there is already a volume of literature out there already that is much better done, with larger groups and even with blinding.
 
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Ducttape said:
It adds nothing and I did not think I would have to explain, but I frequently seem to underestimate the audience....

First, the study is crap design. Second, there is already a volume of literature out there already that is much better done, with larger groups and even with blinding.
Click to expand...

You don't understand how knowledge works...

Epistemology | Internet Encyclopedia of Philosophy

iep.utm.edu iep.utm.edu
 
Ducttape said:
It adds nothing and I did not think I would have to explain, but I frequently seem to underestimate the audience....

First, the study is crap design. Second, there is already a volume of literature out there already that is much better done, with larger groups and even with blinding.
Click to expand...

You've got an organic intelligence version of the same problem Chris points out in this article...you're limited by your own lack of knowledge and personal experience in the domain.

regenexx.com

Can You Use Chat GPT to Write Scientific Papers? - Regenexx

Regenexx offers non-surgical, regenerative orthopedic treatment options for pain related to osteoarthritis, joint injuries, overuse conditions, spine pain, and common sports injuries.
regenexx.com regenexx.com
 
My take from that article is that chatGPT cannot filter out or evaluate studies and data as succinctly and clearly as humans.

And that's true. It is only as good as the data that it is given and it cannot independently assess the quality of data that it can draw upon.

I would argue, however, having had to read and evaluate every single article you and Centeno have posted about PRP, with the human ability to evaluate each and every study, that I do not have the organic problem that he is critiquing chat GPT and you are criticizing me of having.


Much to your credit, I do not have the limitations that Centeno states regarding chatGPT.



To answer your first comment:

Imagine that what you have previously posted is akin to a clock that is linked to the NIST cesium atomic clock in Boulder Colorado.

Using this analogy, this article you just posted is akin to a sundial in downtown Seattle Washington on a typical cloudy evening.
 
If you believe that PRP's treatment effects are placebo, do you also believe that potential complications are nocebo? Why or why not? Can a placebo be "not biologically active" but simultaneously cause objective tissue changes?

If you told me that my regen complications were all in my head, I'd be pissed...

pubmed.ncbi.nlm.nih.gov

Heterotopic Ossification and Platelet-Rich Plasma in Core Muscle Injuries: A Single-Institution Experience Over 6 Years - PubMed

The present, more comprehensive study confirms the previous preliminary analysis that treating CMIs with PRP may be associated with HO.
pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov


Am J Sports Med
2024 Jan;52(1):54-59.
doi: 10.1177/03635465231209509.

Heterotopic Ossification and Platelet-Rich Plasma in Core Muscle Injuries: A Single-Institution Experience Over 6 Years​

Alexander E Poor 1 2 3, Adam C Zoga 2, Alec Warren 1, Leigh C Waters 1, Louis Vilotti 1, Garrison P Bentz 1, William C Meyers 1 2 3 4
Affiliations expand

Abstract​

Background: A 2015 study of platelet-rich plasma (PRP) for groin injuries in National Football League (NFL) players alerted the authors to the possibility that PRP is associated with heterotopic ossification (HO). The current study of athletes seen between 2014 and 2019 provides a more comprehensive analysis of that observation.
Purpose/hypothesis: This report describes the early results of groin surgery for athletes who had experienced failed PRP therapy performed by different practitioners and with an assortment of PRP techniques. The primary goal of this cohort study was to determine short-term clinical outcomes after surgery of PRP-treated patients. It was hypothesized that previous PRP treatment would be associated with the presence of HO among patients with core muscle injuries (CMIs).
Study design: Cohort study; Level of evidence, 3.
Methods: All athletes seen at 1 institution and identified at their first visit as having received PRP for a CMI were followed and compared with patients with a CMI who had not previously received PRP. Although in many cases HO was observed on clinical examination or imaging, HO was identified intraoperatively in all surgical cases and confirmed pathologically. Successful surgery was defined as return to play at previously high levels of performance or greater as determined by the athletes' own assessments. All patients who had received PRP were followed for ≥2 years.
Results: Among 3642 patients with a new CMI seen between 2014 and 2019, 68 (1.9%) patients developed HO within the core muscles and/or adjacent soft tissues. Of the 68 patients, 60 (88.2%) were men, and the mean age was 34.5 years. Of the 68 patients, 62 (91.2%) were athletes and 44 (64.7%) had been treated previously with PRP. HO was observed in 24 (0.7%) patients without previous PRP treatment. Three athletes who received PRP retired early from sports because of HO and scar issues. In total, 22 of 28 (78.6%) NFL players who received PRP developed HO, compared with 0 (0%) of 28 randomly selected, age-, position-, and injury-matched NFL players. After surgical repair, 3-month success rates were 67.9% and 96.4%, respectively, in the PRP and non-PRP groups (P = .006). By 6 months postoperatively, PRP-treated patients were back to similarly high success rates compared with the non-PRP cohort. Scar tissue issues played a prominent role in the relative delay in definitive success.
Conclusion: The present, more comprehensive study confirms the previous preliminary analysis that treating CMIs with PRP may be associated with HO.
Keywords: core muscle injuries; heterotopic ossification; platelet-rich plasma.


This study investigates the relationship between platelet-rich plasma (PRP) treatment and the development of heterotopic ossification (HO) in patients with core muscle injuries (CMIs). HO involves abnormal bone growth within muscles and other tissues. The study, conducted over 6 years at a single institution, focused on athletes, many from the NFL, who had failed PRP therapy for groin injuries and then underwent surgery.

Key findings include:

  1. Out of 3642 patients with CMIs, 68 (1.9%) developed HO. Among these, 44 (64.7%) had received PRP treatment.
  2. The study observed a higher incidence of HO in patients treated with PRP than those without PRP (40.7% vs. 0.7%).
  3. Post-surgery, PRP-treated patients initially had lower success rates at three months than non-PRP patients, but success rates evened out by six months.
  4. PRP treatment was associated with delayed rehabilitation due to issues like scarring and thickening of muscle tissue.
  5. The study suggests a potential link between PRP treatment and the development of HO in patients with CMIs, particularly among athletes. However, it also notes the limitations of its findings due to the non-randomized, retrospective nature of the study and the potential bias from focusing on patients who had unsuccessful PRP treatments. The researchers caution against concluding that PRP directly causes HO, but the association they observed suggests the need for further investigation and careful consideration before using PRP for CMIs.
 
drusso said:
If you believe that PRP's treatment effects are placebo, do you also believe that potential complications are nocebo? Why or why not? Can a placebo be "not biologically active" but simultaneously cause objective tissue changes?

If you told me that my regen complications were all in my head, I'd be pissed...

pubmed.ncbi.nlm.nih.gov

Heterotopic Ossification and Platelet-Rich Plasma in Core Muscle Injuries: A Single-Institution Experience Over 6 Years - PubMed

The present, more comprehensive study confirms the previous preliminary analysis that treating CMIs with PRP may be associated with HO.
pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov


Am J Sports Med
2024 Jan;52(1):54-59.
doi: 10.1177/03635465231209509.

Heterotopic Ossification and Platelet-Rich Plasma in Core Muscle Injuries: A Single-Institution Experience Over 6 Years​

Alexander E Poor 1 2 3, Adam C Zoga 2, Alec Warren 1, Leigh C Waters 1, Louis Vilotti 1, Garrison P Bentz 1, William C Meyers 1 2 3 4
Affiliations expand

Abstract​

Background: A 2015 study of platelet-rich plasma (PRP) for groin injuries in National Football League (NFL) players alerted the authors to the possibility that PRP is associated with heterotopic ossification (HO). The current study of athletes seen between 2014 and 2019 provides a more comprehensive analysis of that observation.
Purpose/hypothesis: This report describes the early results of groin surgery for athletes who had experienced failed PRP therapy performed by different practitioners and with an assortment of PRP techniques. The primary goal of this cohort study was to determine short-term clinical outcomes after surgery of PRP-treated patients. It was hypothesized that previous PRP treatment would be associated with the presence of HO among patients with core muscle injuries (CMIs).
Study design: Cohort study; Level of evidence, 3.
Methods: All athletes seen at 1 institution and identified at their first visit as having received PRP for a CMI were followed and compared with patients with a CMI who had not previously received PRP. Although in many cases HO was observed on clinical examination or imaging, HO was identified intraoperatively in all surgical cases and confirmed pathologically. Successful surgery was defined as return to play at previously high levels of performance or greater as determined by the athletes' own assessments. All patients who had received PRP were followed for ≥2 years.
Results: Among 3642 patients with a new CMI seen between 2014 and 2019, 68 (1.9%) patients developed HO within the core muscles and/or adjacent soft tissues. Of the 68 patients, 60 (88.2%) were men, and the mean age was 34.5 years. Of the 68 patients, 62 (91.2%) were athletes and 44 (64.7%) had been treated previously with PRP. HO was observed in 24 (0.7%) patients without previous PRP treatment. Three athletes who received PRP retired early from sports because of HO and scar issues. In total, 22 of 28 (78.6%) NFL players who received PRP developed HO, compared with 0 (0%) of 28 randomly selected, age-, position-, and injury-matched NFL players. After surgical repair, 3-month success rates were 67.9% and 96.4%, respectively, in the PRP and non-PRP groups (P = .006). By 6 months postoperatively, PRP-treated patients were back to similarly high success rates compared with the non-PRP cohort. Scar tissue issues played a prominent role in the relative delay in definitive success.
Conclusion: The present, more comprehensive study confirms the previous preliminary analysis that treating CMIs with PRP may be associated with HO.
Keywords: core muscle injuries; heterotopic ossification; platelet-rich plasma.


This study investigates the relationship between platelet-rich plasma (PRP) treatment and the development of heterotopic ossification (HO) in patients with core muscle injuries (CMIs). HO involves abnormal bone growth within muscles and other tissues. The study, conducted over 6 years at a single institution, focused on athletes, many from the NFL, who had failed PRP therapy for groin injuries and then underwent surgery.

Key findings include:

  1. Out of 3642 patients with CMIs, 68 (1.9%) developed HO. Among these, 44 (64.7%) had received PRP treatment.
  2. The study observed a higher incidence of HO in patients treated with PRP than those without PRP (40.7% vs. 0.7%).
  3. Post-surgery, PRP-treated patients initially had lower success rates at three months than non-PRP patients, but success rates evened out by six months.
  4. PRP treatment was associated with delayed rehabilitation due to issues like scarring and thickening of muscle tissue.
  5. The study suggests a potential link between PRP treatment and the development of HO in patients with CMIs, particularly among athletes. However, it also notes the limitations of its findings due to the non-randomized, retrospective nature of the study and the potential bias from focusing on patients who had unsuccessful PRP treatments. The researchers caution against concluding that PRP directly causes HO, but the association they observed suggests the need for further investigation and careful consideration before using PRP for CMIs.
Click to expand...
Did research for Stryker years ago. BMP injected into knee joints. If you missed the joint, you got HO.
PRP is biologically active.
 
it is an interesting question. it depends on the definition of placebo. i would argue your article is meaningless to this question.

the definition of placebo is something that is only psychological ie chemically inert to an individual. a nocebo is also a chemically inert substance that causes negative psychological effects.

this article shows that the substance is not inert, so by definition it is not applicable. it technically cannot be considered a placebo and technically cannot be considered nocebo.


btw, if one is disparaging biologics, the technically most appropriate statement is to say that a biologic is no better than placebo. a reason why quality testing should include an arm that incorporates a placebo with it (such as a sham injection)
 
For some reason I can't log on and read the actual article. I need a new phone.

1000026651.jpg
 
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Baria M, Barker T, Durgam S, et al. Microfragmented Adipose Tissue Is Equivalent to Platelet-Rich Plasma for Knee Osteoarthritis at 12 Months Posttreatment: A Randomized Controlled Trial. Orthopaedic Journal of Sports Medicine. 2024;12(3).


Microfragmented Adipose Tissue Is Equivalent to Platelet-Rich Plasma for Knee Osteoarthritis at 12 Months Posttreatment: A Randomized Controlled Trial

Michael Baria, MD, MBA [email protected], Tyler Barker, PhD, […], and Robert Magnussen, MD, MPH+5View all authors and affiliations

Abstract

Background:
Platelet-rich plasma (PRP) is an effective treatment for knee osteoarthritis (OA). Microfragmented adipose tissue (MFAT) is another orthobiologic that holds promise, but data supporting its use are limited. Previous studies showed that MFAT created using the Lipogems device was equivalent to PRP created via noncommercial laboratory-based processes.

Purpose:
To perform a comparison of commercially available MFAT and PRP systems for treatment of knee OA.

Study Design:
Randomized controlled trial; Level of evidence, 2.

Methods:
A total of 71 patients with symptomatic knee OA (Kellgren-Lawrence grades 1-4) were randomized to receive a single injection of either leukocyte-rich PRP (Angel; Arthrex) or MFAT (Lipogems) under ultrasound guidance. Patient-reported outcomes (Knee injury and Osteoarthritis Outcome Score [KOOS], visual analog scale for pain with activities of daily living [VAS pain], and Tegner activity level) were recorded at baseline and at 1, 3, 6, and 12 months after injection. The primary outcome was the KOOS-Pain subscale score at 12 months after injection.

Results:
Overall, 49 patients completed their 12-month follow-up (PRP group, n = 23; MFAT group, n = 26). All demographic features were similar between groups, except that more men were randomized to the PRP group and more women to the MFAT group. At 12 months posttreatment, KOOS-Pain scores improved in both groups, with no significant group difference (PRP, 78 ± 17.9 vs MFAT, 77.8 ± 19.3; P = .69). Similarly, other KOOS subscales, VAS pain scores, and Tegner scores improved at 12 months, with no differences between treatment groups.

Conclusion:
Both PRP and MFAT injections for knee OA resulted in improved patient-reported outcomes at 12 months posttreatment, with no differences found between treatments.

Registration:
NCT04351087 (ClinicalTrials.gov identifier).
 
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drusso said:
Baria M, Barker T, Durgam S, et al. Microfragmented Adipose Tissue Is Equivalent to Platelet-Rich Plasma for Knee Osteoarthritis at 12 Months Posttreatment: A Randomized Controlled Trial. Orthopaedic Journal of Sports Medicine. 2024;12(3).


Microfragmented Adipose Tissue Is Equivalent to Platelet-Rich Plasma for Knee Osteoarthritis at 12 Months Posttreatment: A Randomized Controlled Trial

Michael Baria, MD, MBA [email protected], Tyler Barker, PhD, […], and Robert Magnussen, MD, MPH+5View all authors and affiliations

Abstract

Background:
Platelet-rich plasma (PRP) is an effective treatment for knee osteoarthritis (OA). Microfragmented adipose tissue (MFAT) is another orthobiologic that holds promise, but data supporting its use are limited. Previous studies showed that MFAT created using the Lipogems device was equivalent to PRP created via noncommercial laboratory-based processes.

Purpose:
To perform a comparison of commercially available MFAT and PRP systems for treatment of knee OA.

Study Design:
Randomized controlled trial; Level of evidence, 2.

Methods:
A total of 71 patients with symptomatic knee OA (Kellgren-Lawrence grades 1-4) were randomized to receive a single injection of either leukocyte-rich PRP (Angel; Arthrex) or MFAT (Lipogems) under ultrasound guidance. Patient-reported outcomes (Knee injury and Osteoarthritis Outcome Score [KOOS], visual analog scale for pain with activities of daily living [VAS pain], and Tegner activity level) were recorded at baseline and at 1, 3, 6, and 12 months after injection. The primary outcome was the KOOS-Pain subscale score at 12 months after injection.

Results:
Overall, 49 patients completed their 12-month follow-up (PRP group, n = 23; MFAT group, n = 26). All demographic features were similar between groups, except that more men were randomized to the PRP group and more women to the MFAT group. At 12 months posttreatment, KOOS-Pain scores improved in both groups, with no significant group difference (PRP, 78 ± 17.9 vs MFAT, 77.8 ± 19.3; P = .69). Similarly, other KOOS subscales, VAS pain scores, and Tegner scores improved at 12 months, with no differences between treatment groups.

Conclusion:
Both PRP and MFAT injections for knee OA resulted in improved patient-reported outcomes at 12 months posttreatment, with no differences found between treatments.

Registration:
NCT04351087 (ClinicalTrials.gov identifier).
Click to expand...
So now I need a ninja blender and a centrifuge?
Also, will it make my knees look fat?
 
Ducttape said:
thedaily.case.edu

Stopping heavy bleeding with next-generation artificial platelets

Biomedical researchers at Case Western Reserve University report that their latest innovation in developing synthetic platelets could help save lives by rapidly stabilizing clots to reduce blood loss from traumatic injuries.
thedaily.case.edu thedaily.case.edu
Click to expand...

That would be a good comparator because it would mimic the biological function of platelets but would not contain alpha-granules, PDGF, etc.

www.ncbi.nlm.nih.gov

Platelet Rich Plasma: a short overview of certain bioactive components

Platelet rich plasma (PRP) represents a relatively new approach in regenerative medicine. It is obtained from patient’s own blood and contains different growth factors and other biomolecules necessary for wound healing. Since there are various ...
www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov
 
drusso said:
That would be a good comparator because it would mimic the biological function of platelets but would not contain alpha-granules, PDGF, etc.

www.ncbi.nlm.nih.gov

Platelet Rich Plasma: a short overview of certain bioactive components

Platelet rich plasma (PRP) represents a relatively new approach in regenerative medicine. It is obtained from patient’s own blood and contains different growth factors and other biomolecules necessary for wound healing. Since there are various ...
www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov
Click to expand...
www.ncbi.nlm.nih.gov

Platelet α–granules: Basic biology and clinical correlates

α–Granules are essential to normal platelet activity. These unusual secretory granules derive their cargo from both regulated secretory and endocytotic pathways in megakaryocytes. Rare, inheritable defects of α–granule ...
www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov

Love me some alpha granules in my cereal....
 
The most recent PRP research is in the Journal of Arthroscopy from orthopedic surgeons!
A review of level 1 studies evaluating PRP outcomes for knee osteoarthritis was just published March 19, 2024. When you look at the 18 studies that followed patients for a year AND that reported PRP dosing data, the mean platelet dose in the 16 studies with statistically significant outcomes at 1 year was 5.5 billion. In the 2 studies that did not show statistically significant outcomes at one year the mean dose was 2.3 billion.


View attachment 384505View attachment 384505
1711283905802.png
1711283905802.png
 
Last edited:
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Doctodd said:
The most recent PRP research is in the Journal of Arthroscopy from orthopedic surgeons!
A review of level 1 studies evaluating PRP outcomes for knee osteoarthritis was just published March 19, 2024. When you look at the 18 studies that followed patients for a year AND that reported PRP dosing data, the mean platelet dose in the 16 studies with statistically significant outcomes at 1 year was 5.5 billion. In the 2 studies that did not show statistically significant outcomes at one year the mean dose was 2.3 billion.
View attachment 384505View attachment 384505
View attachment 384506View attachment 384506
Click to expand...
Thanks for this.
 
a study that the researchers acknowledge cannot rise to the level of a true meta-analysis.

what did someone say about meta-analyses?

fwiw, it seems they got 882 studies, and then narrowed that down to 29. a lot of weeding.

then they end up comparing several studies with higher platelet counts and compared them to 3 studies with lower platelet counts.

they in fact did document this as a limitation.

Third, there is a predominance of positive PRP studies with fewer negative trials. The number of positive versus negative studies limits our ability to compare the two groups. It also suggests the likelihood of publication bias that may skew the overall assessment of PRP's efficacy. Studies with negative outcomes may be underrepresented in the literature, potentially affecting the application of our findings.
Click to expand...
 
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Ducttape said:
a study that the researchers acknowledge cannot rise to the level of a true meta-analysis.

what did someone say about meta-analyses?

fwiw, it seems they got 882 studies, and then narrowed that down to 29. a lot of weeding.

then they end up comparing several studies with higher platelet counts and compared them to 3 studies with lower platelet counts.

they in fact did document this as a limitation.
Click to expand...

The evidence is overwhelming.
 
lobelsteve said:
No, it is not.
We need a less expensive, non franchised method of producing reliable PRP (5x) with a CPT code and reasonable costs for patients and insurers.
Click to expand...

Home

regenexxcorporate.com regenexxcorporate.com

Insurance coverage for interventional orthopedics with a national network, registry, and almost two decades of established best practices. Why re-invent the wheel instead of just following the leader—especially at your career stage?

CPT codes already exist. RUC has already signed off.
ICD-10 codes already exist.

Your issue is that individual health plans don't have medical policies for regen, but that's a local state and market issue. Medicare/tricare already has codes.

1711469585811.png
 
lobelsteve said:
You are ranked #4 on the map....

$ell more $tem$ell$$ to rank up.
Click to expand...

No. There are 4 locations in that region. If I were #4 in Regen I'd be eating at French Laundry, running ultra-marathons in my spare time, and showing off my pointy shoes to all my Insta fans.
 
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drusso said:
No. There are 4 locations in that region. If I were #4 in Regen I'd be eating at French Laundry, running ultra-marathons in my spare time, and showing off my pointy shoes to all my Insta fans.
Click to expand...

Ducttape said:
wait...that guy im following who does that is not you?
Click to expand...
Nope, this guy looked stoned on It's a Small World Ride at Disneyland.
 

I told you so...

EDITORIAL COMMENTARY|ARTICLES IN PRESS

High Platelet Dose PRP May be the Nonoperative Treatment of Choice for Knee Osteoarthritis
Published:April 08, 2024DOI:Redirecting

Abstract​

Knee osteoarthritis (OA) affects 30% of individuals over 60 and 40% over 70 years old. The incidence of radiological knee OA is 373 per 10,000 person-years, but symptomatic knee OA registers as a considerably lower rate of 50 per 10,000 person-years. For symptomatic cases that are not candidates for surgical intervention, various treatment options include exercise, weight loss, pharmacological management, bracing, physical therapy, oral supplementation, and intra-articular injection with corticosteroids, hyaluronic acid, or orthobiologics such as platelet-rich plasma (PRP). Recent network meta-analysis has affirmed superiority of PRP over the other alternatives. It appears that a mean absolute platelet count in the final product of below 2500 x106 is not effective, whereas an average platelet count of above 5000 x106 displays a positive clinical effect at both six and twelve months. Yet, aspects like the definition of PRP, whether activation is necessary, the frequency of injections, the optimal dosage, and the preparation method remain unclear.
 
drusso said:

I told you so...

EDITORIAL COMMENTARY|ARTICLES IN PRESS

High Platelet Dose PRP May be the Nonoperative Treatment of Choice for Knee Osteoarthritis
Published:April 08, 2024DOI:Redirecting

Abstract​

Knee osteoarthritis (OA) affects 30% of individuals over 60 and 40% over 70 years old. The incidence of radiological knee OA is 373 per 10,000 person-years, but symptomatic knee OA registers as a considerably lower rate of 50 per 10,000 person-years. For symptomatic cases that are not candidates for surgical intervention, various treatment options include exercise, weight loss, pharmacological management, bracing, physical therapy, oral supplementation, and intra-articular injection with corticosteroids, hyaluronic acid, or orthobiologics such as platelet-rich plasma (PRP). Recent network meta-analysis has affirmed superiority of PRP over the other alternatives. It appears that a mean absolute platelet count in the final product of below 2500 x106 is not effective, whereas an average platelet count of above 5000 x106 displays a positive clinical effect at both six and twelve months. Yet, aspects like the definition of PRP, whether activation is necessary, the frequency of injections, the optimal dosage, and the preparation method remain unclear.
Click to expand...
Yet, aspects like the definition of PRP, whether activation is necessary, the frequency of injections, the optimal dosage, and the preparation method remain unclear.
 
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