The new year provides new opportunities for orthobiologics, but some obstacles in the healthcare landscape also loom, Jason Koh, MD, said.
Dr. Koh, of Skokie, Ill.-based Endeavor Health, joined the "Becker's Spine and Orthopedic Podcast" to discuss his outlook on regenerative medicine and challenges ahead in 2025.
Note: This is an edited excerpt. Listen to the full conversation here.
Question: Can you share insight into recent advancements in regenerative medicine like cartilage regrowth? How do you integrate procedures like this in terms of meniscus transplants?
Dr. Jason Koh: What's happened over the years, and I've been involved with cartilage transplantation research for over close to 30 years at this point, is we're getting more and more different tools. Historically, some of the techniques involved harvesting cells and then placing it under some sort of periosteal patch, which had to be sutured in place with very technically tedious and difficult procedures.
Things have evolved to more use of donated cartilage tissue or other systems where there are scaffolds that help promote cartilage regrowth, or the use of transplants that have scaffolds now that can be transplanted very minimally invasively. This has enhanced our ability to heal this articular cartilage with the meniscus cartilage we're getting much more comfortable with doing meniscus transplantation. And there are techniques we're evolving and testing around partial meniscus transplantation. We've done some specific biomechanics work around that, and it might be able to help restore the meniscus, which functions as a shock absorber for the knee. So it's an exciting period of time.
Q: What are the biggest headwinds, the biggest challenges that you're planning for in 2025
JK: I think there's a couple of issues, some of which have been around for a while. I think everybody in healthcare is aware of the fact that there continues to be declining reimbursement for the work that we do, and the cost of delivering care has continued to increase. Everybody's going to have to become more efficient in order to survive. Another area of significant uncertainty is around what healthcare is going to look like in the new [Trump] administration. There have been statements that things will be different. But how different, what the pace of change will be and what those ultimate differences will be remains unknown. So this is something that I think we're going to have to be prepared for on many fronts. The other area is increasing issues with authorization of services. There's a recent paper from The JAMA Network, saying that about a third of patients on Medicare Advantage have experienced some sort of denial over the past year. Rates of denials or issues with authorization of necessary services, whether it's imaging or procedures or medications, continue to increase, and I think everybody's feeling that. How we can deal with that is going to be an ongoing issue, and I think that's an area of concern for many patients as well as providers.