• Dr. Timothy Mazzola

Regenerative Medicine in Orthopedics

Updated: Feb 25, 2021

Separating MYTHS from TRUTH in REGENERATIVE ORTHOPEDICS


What does the DATA tell us about the EFFECTIVENESS and SAFETY of REGENERATIVE treatments in Orthopedics?

As of April 2020, we have Level 1 or 2 evidence (considered an acceptable level to establish of treatment as appropriate for implementation) for certain applications of both Dextrose Prolotherapy and Platelet Rich Plasma.


Evidence for Dextrose Prolotherapy


LEVEL 1 EVIDENCE OF EFFICACY:

  • Rotator Cuff Tendinopathy (Bertrand 2015)

  • Knee Osteoarthritis (Rabago 2013, Dumais 2012)

  • Osgood Schlatter Disease (Patellar tendinosis) (Topol 2011)

  • Hand Osteoarthritis (Jahangiri 2014, Reeves 2000)

  • Lateral Epicondylosis (Scarpone 2008)


LEVEL 2 EVIDENCE OF EFFICACY:

  • Rotator Cuff Tendinopathy (Lee 2015)

  • SI Joint Dysfunction (Kim 2010)

  • Lateral Epicondylosis (Rabago 2013)

  • Low Back Pain (Yelland 2004)

  • Achilles Tendinosis (Yelland 2011)

  • (Sports Hernia) Adductor/Rectus Abdominis Tendinosis (Topol 2008)

  • Knee Osteoarthritis (Reeves 2000)


Evidence for Platelet Rich Plasma


For Platelet Rich Plasma, the strongest Level 1 and Level 2 evidence is found in these studies:

  • Knee Osteoarthritis (2 Meta-Analyses reviewing many studies: Shen 2017, Xie 2014)

  • Lateral Epicondylosis (Peerbooms 2010, Mishra 2013)

  • Chronic Plantar Fasciitis (Othman 2015)

  • Gluteal Tendinopathy / Trochanteric Bursitis (Fitzpatrick 2019)


As you can see, there is a significant body of literature that demonstrate the HIGHEST LEVELS of EFFECTIVENESS for both dextrose prolotherapy and platelet rich plasma. The most common ailments that we treat on a regular basis are Osteoarthritis and Chronic Tendonitis or Tendinopathy.

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