Dr. Penello on what lies ahead for regenerative medicine in orthopedics

Biologics

Daniel Penello, MD, of Alexander Orthopaedic Associates in St. Petersburg, Fla., is a fellowship-trained orthopedic surgeon who specializes in hand and upper extremity surgery.

Dr. Penello recently implanted a custom 3D-printed finger bone in an iron worker who was facing amputation after a heavy steel beam crushed his finger.

Here, Dr. Penello shared his insight on how regenerative medicine will develop in orthopedics.

Q: What do you see as the next big trend in orthopedics?

DP: I think it will be regenerative medicine. Robotics have not necessarily improved a lot of outcomes, at least not in orthopedics. In other areas, I think robots have helped but in orthopedics I don't think it has been definitively proven that the outcomes are much better. With regenerative medicine there's the potential to revolutionize the way injuries are dealt with. It's going to be akin to introducing anesthesia and sterility into surgery and the development of arthroscopy for treating a lot of joint problems. 

Right now what researchers are harvesting growth factors from the patient's own bone marrow or fat cells or amniotic tissue. They're injecting them into an injured structure like an arthritic knee or badly inflamed tendon and hoping that the growth factors do their thing. I think that has to be refined. I think the future of orthopedics is going to be okay. When the body heals it follows a particular sequence of events and there's a cascade of things that happen like a domino effect. I think the future is going to involve a sequence of treatments where first the growth factors are injected, then two weeks later we have to inject different growth factors and mimic what the body is doing naturally as it's trying to heal tissue, as opposed to the shotgun approach where we're sticking a needle in the knee, injecting it with growth factors and hoping some of these things do something for the patient. 

 

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