For quite some time I have promoted the idea that the most effective way to learn MSK diagnostic and interventional skills is for it occur on an individual’s “home turf”. Conferences and cadaver workshops do not compare to presentation of succinct, straightforward scan protocols… in your office… on your patients. I observe a visible increased acuity in every doctor, without exception.
In the months of September and October 2017 I very much enjoyed presenting and demonstrating the idea and technique of “comprehensive and targeted” biocellular procedures. There is a common practice within regenerative medicine practices to provide a “one and done” service. By that I mean the patient receives in a single intra-articular injection. The entire focus of the treatment is the “arthritis”. This thinking is akin to the rationale employed in arthroplasty of knee and hip. The new joint is supposed to fix everything. It simply does not occur. Nor will the patient receive the full benefit of a biocellular/regenerative treatment with a single intra-articular injection. It is just one portion of a comprehensive and targeted treatment.
For example, a typical biocellular shoulder treatment includes the following treatment sites as well as a Gleno-Humeral injection (by the way… the Rotator Interval is an excellent access to the shoulder joint space).
- Biceps tendon
- AC joint ligament/capsule complex and intra-articular (common site of impingement)
- Supraspinatus (intra-substance and insertion)
- Intra-tendon areas of calcific tendinosis.
- Sub-Acromial/Sub-Deltoid Bursa
Targeting specific sites requires pre-treatment imaging, and determining volumes for each site, but the full spectrum… comprehensive and targeted… ultrasound guided treatment delivers the product precisely and gives the patient the best opportunity for remodeling response to the biocellular treatment.
Cells and/or biocellular product will not “migrate to where they are needed”.