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It’s always good to understand what is meant by a good response to a regenerative medicine treatment. Sometimes, from the physician’s end what can mean a good response can be different than what it means from the patient’s standpoint. So it’s always helpful to make sure that when we say good response, we’re presenting it from the perspective of the patient.

As an example, I have a new patient that I saw recently who has a left shoulder pain. She is a 70-year-old woman, very high-functioning, and that includes swimming, low-level weights, and cardio three to four times per week. She had an injury to her left shoulder roughly five years ago. She has, at baseline, some mild degenerative rotator cuff tendinopathy and arthritis as well. At the time of her injury five years ago she developed a high-grade partial thickness tear of her supraspinatus tendon. She was treated by a colleague of mine at that time with bone marrow-derived stem cells. She did well for about a year and a half at which time she started to develop early signs of pain again. She had a repeat platelet rich plasma treatment and essentially did well for about three more years.

Currently she is presenting to me now as she has redeveloped discomfort in the left shoulder. She is still very high-functioning, still doing all of her exercises. On her ultrasound examination she still has that high-grade partial thickness tear, it has not gotten worse and might be slightly better. She also has mild inflammation in the biceps tendon, but essentially stable imaging of her left shoulder. The plan for her is to repeat platelet rich plasma treatment because she’s done very well with that a few years ago.

The goals here are can we keep this individual at a very high level of function, with significant pain relief, and not requiring pain medication. If we can keep the imaging look stable or better that’s great, but that’s really a secondary issue. Realistically we are not going to dramatically change how her imaging looks. If it stays stable, as it has over the last five years, that is a successful outcome. But, more than anything else, improving pain, allowing her to stay very physically active at a high level at the age of 70, and avoiding pain medications that is a great outcome. From her perspective that is a great outcome, from the physician’s side that is a great outcome as well. It’s a nice merging of our expectations, and I think she has a good chance of doing really well.

 

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