When Claude Moorman, MD, looks at the future of orthopedics, he doesn’t see replacement — he sees regeneration.
“Sports medicine has been a sort-of ‘space program’ for orthopedics,” said Dr. Moorman, president of the Musculoskeletal Institute and chair of orthopedic surgery at Charlotte, N.C.-based Atrium Health. “Athletes push us to innovate — to shorten recovery times and improve outcomes — and that progress ultimately benefits everyone.”
That pursuit of faster recovery times and lasting mobility has made regenerative medicine one of orthopedics’ most promising frontiers. The focus has shifted from extending life span to extending “health span” — the years people can stay active and engaged, Dr. Moorman said.
His work in the field began nearly a decade ago. In 2016, while on the faculty at Durham, N.C.-based Duke University, he performed the first microfragmented fat procedure in North America with Carlo Tremolada, MD, a plastic surgeon from Milan, Italy, who helped develop the technology.
Later, he and colleagues traveled to Italy to study regenerative innovations, learning from programs already ahead of those in the U.S.
Since then, he said, tighter FDA oversight has helped legitimize the field.
“A few years ago, groups and practitioners were making sensational claims and charging patients huge amounts,” he said. “That’s been cleaned up quite a bit. Now there’s more standardization and affordability.”
Some regenerative treatments, such as platelet-rich plasma and microfragmented fat injections, are now FDA approved and more affordable for patients. Still, most remain cash-based, as insurers have been slow to support coverage.
“The breakthrough will come when there’s enough high-level evidence that payers won’t be able to ignore it,” he said.
He believes that proof will come from what he calls the “treatment gap” — patients whose pain persists despite injections, therapy or minor procedures, yet who aren’t ready for joint replacement. Many are younger, active individuals seeking ways to stay in motion without major surgery.
The changing business landscape has added another layer of complexity. Atrium Health operates a hybrid model, collaborating with large independent orthopedic and neurosurgery groups through its Musculoskeletal Institute.
“When you’re on different business platforms, it can be difficult to create a completely aligned experience for patients,” Dr. Moorman said.
He also pointed to state policy shifts that could reshape care delivery.
“With North Carolina ending its certificate-of-need requirements for ASCs — and soon MRIs — we’ll likely see new opportunities for practices,” he said. “At the same time, more orthopedic care is moving to outpatient settings. We can do more safely and efficiently in ASCs, often with higher patient satisfaction.”
Looking ahead, Dr. Moorman believes regenerative biology could redefine joint preservation.
“We’re developing cellular therapies that reduce inflammation and stimulate cartilage growth,” he said. “That work could fundamentally change how we approach mobility and aging.”
He views mobility itself as a vital measure of health.
“When you think about Alzheimer’s, metabolic disease, heart disease and cancer — the ‘four horsemen’ of aging — I’d add a fifth: mobility,” he said. “Good health doesn’t mean much if you can’t move, walk or lift your grandchild.”
For Dr. Moorman, the mission is clear: to help people stay active, independent and engaged for as long as possible.
“It’s a really exciting time to be in orthopedics and in Charlotte,” he said.
