From the use of regenerative medicine products to new ways of looking at inflammation, the most contentious issues in the field of sports medicine are discussed by five specialists.
Question: What is the most contentious trend in sports medicine today?
Jorge Chahla, MD, PhD. Midwest Orthopaedics at Rush (Chicago): One of the most contentious trends in sports medicine is the use of biologics as a form of conservative treatment of pain both intra- and extra-articularly. There is a wide spectrum of opinions when it comes to this debate. On one end, there are physicians that advocate for their use in almost any indication. On the other end, there are physicians that disregard them as a viable treatment option, questioning their efficacy and the presence of supporting literature. Still, there are some physicians that find themselves in the middle of the controversial spectrum. The truth of the matter is that there is a plethora of evidence to suggest biologics can be beneficial in certain pathologies with the appropriate indications.
Scott Sigman, MD. Orthopedic Surgical Associates (Chelmsford, Mass.): Regenerative medicine: Does it work and is it worth the cost to the patient?
Alexis Colvin, MD. Mount Sinai Hospital (New York City): One of the most contentious trends in sports medicine today is the appropriate use of biologics. This is due to several factors, including the application of biologics to a host of diagnoses with limited to no evidence of therapeutic benefit and direct to consumer marketing.
James Gladstone, MD. Mount Sinai Hospital (New York City): While some biologic products may be beneficial in certain circumstances, they are by no means a panacea and should therefore be used judiciously and with full disclosure, particularly as many of them are not covered by insurance.
Richard Spelts, DO. Southern California Orthopedic Institute (Los Angeles): For years, we have always been taught that inflammation is bad, and we should take antiinflammatories and ice our injuries to help them heal. However, for most soft tissue injuries in modern sports medicine, we are finding that it is the inflammation that helps us heal more quickly. We are doing more things in sports medicine to increase inflammation in order for the athletes to heal faster: platelet rich plasma, ASTYM physical therapy, eccentric exercises, etc. Currently, we are trying to find a new mnemonic instead of RICE for patients to follow after their injuries.