Pitchers Opt for Stem Cell Therapy, No Surgery

Dr. Henry Stiene of Beacon Orthopaedics and Sports Medicine works with professional, collegiate, and high school athletes.  The Cincinnati based orthopedist specializes in regenerative medicine, meaning he helps athletes use the body’s ability to heal itself to avoid open surgery.  One of these ways is through stem cell therapy, which  Dr. Stiene believes will drive the “epitome” of sports medicine advancement.

But the future is here today in some cases.  The Angels placed dead last, a far cry from winning the division in 2014.  At 17.5 games behind the Texas Rangers, though, the Angels have a long way to go within the American League West.  A big contribution to the less-than-outstanding season has been the disabled list.  Two of the Angels’ top starters have been restricted to the bench while they wait for ligaments regenerate.

Stem cell therapy isn’t like Tommy John surgery.  With nearly 40 years of data on Tommy John cases in professional baseball players, it’s easy to approximate the recovery time.  It is also much simpler to benchmark progression against similar cases.  For the new, non-surgical approach, there is far less data. This is exacerbated by the uncertainty of applications of stem cell therapy in certain situations. For example, some research indicates that it cannot heal full tendon tears.

There is a full year of recovery after stem cell treatment, which is still less than Tommy John.  Less, that is, if the stem cell therapy works.  Many players see Tommy John surgery as a sure thing: have a ligament replaced and be back on the mound in 18 months.  Stem cells, on the other hand, are more of a gamble.  Garrett Richards, the 28-year-old right handed pitcher for the Angels, struggled with this decision.

To a limited extent, ultrasounds will show the extent and speed of healing within a treated area.  Unfortunately, the amount of partial tears in the ligaments that stem-cell therapy will really repair is unknown at this point in time.

Dr. Frederick Purita, who has treated two dozen professional pitchers with stem cell therapy acknowledges the procedures shortcomings, but also its great promise.  He seeks to always provide the absolute best care for each patient, but he struggles with the moral dilemma of which route of treatment to suggest.  “It’s a genuine moral dilemma for me,” Purita comments.

Dr. Henry Stiene, who works on the medical team for the Cincinnati Reds, explains that stem cell treatments may have a bigger impact on torn labrums in dominant shoulders, which are usually more difficult to repair with surgery.

On two separate occasions, doctors have performed ultrasound screens on Andrew Heaney’s arm to monitor progress.  This involves using a gel to take contrast photos, then pulling them up on a screen.  The good news is that the ligaments are healing.  The bad news is that the degree to which they are healing is relatively unknown and difficult to discern.  In fact, it really won’t be known until they start throwing again.

Richards observed, “If it ever becomes conclusive that the own stem cells will help you regenerate ligaments, then why wouldn’t you’re doing so every off-season?”  He thinks clubs will invest in treating their players as a preventative measure.  Why wait until a tendon is causing pain when a simple therapy can reduce tiny, insignificant tears with no obstruction of normal function?

“The trouble with partial tears,” Dr. Stiene stated, “is they’re not symptomatic until they get about 75% effort level.”

It will take time and research to develop.  In 1974, the first widely publicized ulnar collateral ligament surgery was performed on Dodgers pitcher Tommy John.  Thirty-five years later, players, doctors, trainers, managers, and even fans know what to expect.  Stem cell therapy will prove to be the same, but it may take several years for that to happen.  Tommy John wasn’t perfected overnight, and neither are other new technologies.

 

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