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PainExam Podcast Show
Episode Title: Exploring PRP and BMAC in Pain Managemen
Host: David Rosenblum, MD
Release Date: November 27, 2024
Episode Overview:
In this episode of the PainExam Podcast, Dr. David Rosenblum, a New York-based pain physician, examines the latest research surrounding Platelet-Rich Plasma (PRP) and Bone Marrow Aspirate Concentrate (BMAC) in pain management for the knee, shoulder, and spine. Dr. Rosenblum reviews several key studies, providing insights into the efficacy of these regenerative treatments and their implications for clinical practice.
Featured Studies:
1. A Comparison of Functional Outcomes in Rotator Cuff Repairs Using Adjunctive Bone Marrow Aspirate Concentrate vs. Bone Marrow Aspirate Concentrate With Platelet-Rich Plasma: A Systematic Review and Meta-Analysis**
- Authors: Seth J. Spicer, Sara Soliman, Robert Malek, Mitchell Kaplan, Jensen Clark, Nicholas Averell, Brandon Goodwin, Richard Jermyn
- Published in: Cureus. 2024 Aug 23;16(8):e67594. doi: 10.7759/cureus.67594
- Summary: This systematic review evaluates the outcomes of rotator cuff repairs (RCR) using BMAC alone versus BMAC combined with PRP. The analysis included three studies and found no significant difference in functional outcomes between the two groups, suggesting that BMAC alone may be adequate, potentially reducing costs and resource use.
2. Bone Marrow Aspirate Concentrate Versus Platelet-Rich Plasma for Treating Knee Osteoarthritis: A One-Year Non-Randomized Retrospective Comparative Study
- Authors: Abed El-Hakim El-Kadiry, Carlos Lumbao, Natasha Salame, Moutih Rafei, Riam Shammaa
- Published in: BMC Musculoskeletal Disorders, 2022.
- Summary: This study compared the effectiveness of intra-articular BMAC and PRP injections in patients with knee osteoarthritis (OA). Results indicated that patients receiving BMAC experienced significant improvements in pain and functionality scores over 12 months, while the PRP group showed nonsignificant improvements. BMAC was found to be more effective than PRP in managing knee OA symptoms.
3. Patients With Knee Osteoarthritis Who Receive Platelet-Rich Plasma or Bone Marrow Aspirate Concentrate Injections Have Better Outcomes Than Patients Who Receive Hyaluronic Acid: Systematic Review and Meta-analysis**
- Authors: John W. Belk, Joseph J. Lim, Carson Keeter, Patrick C. McCulloch, Darby A. Houck, Eric C. McCarty, Rachel M. Frank, Matthew J. Kraeutler
- Published in: World Journal of Stem Cells, 2021.
- Summary: This systematic review assessed the efficacy of PRP and BMAC compared to hyaluronic acid (HA) injections for knee OA. The findings demonstrated that both PRP and BMAC led to significantly better patient-reported outcomes (PROs) compared to HA, with no significant differences between PRP and BMAC in terms of effectiveness.
4. Platelet-Rich Plasma vs Bone Marrow Aspirate Concentrate: An Overview of Mechanisms of Action and Orthobiologic Synergistic Effects
- Authors: José Fábio Santos Duarte Lana, Lucas Furtado da Fonseca, Rafael da Rocha Macedo, Tomas Mosaner, William Murrell, Ashok Kumar, Joseph Purita, Marco Antonio Percope de Andrade
- Published in: World Journal of Stem Cells, 2021.
- **Summary:** This overview discusses the mechanisms of action for PRP and BMAC and their potential synergistic effects in musculoskeletal healing. The authors highlight that while both therapies show promise, further research is needed to standardize treatment protocols and fully understand their combined effects on healing processes.
5. PRP and BMAC for Musculoskeletal Conditions via Biomaterial Carriers*
- Authors: Fabio S. M. Yamaguchi, Shahin Shams, Eduardo A. Silva, Roberta S. Stilhano
- Published in:** International Journal of Molecular Sciences, 2019.
- Summary: This review focuses on the use of biomaterial carriers in conjunction with PRP and BMAC to enhance regenerative processes for musculoskeletal injuries. The authors emphasize the growing interest in these therapies as alternatives for treating cartilage, muscle, and bone injuries, and discuss the various biomaterials used in clinical trials.
Key Takeaways:
- The efficacy of BMAC compared to PRP in various orthopedic applications.
- Insights into the mechanisms of action and potential synergistic effects of PRP and BMAC.
- The importance of research in optimizing treatment protocols for knee osteoarthritis and other musculoskeletal conditions.
Upcoming Events:
Visit NRAPpain.org to learn about the virtual pain fellowship and other educational resources. Additionally, check out our live courses designed for healthcare professionals looking to enhance their skills in pain management and regenerative therapies.
Listen to the Episode:
Join Dr. Rosenblum as he provides expert analysis on these studies and discusses the implications for pain management and regenerative medicine.
Connect with Us:
For more information, resources, and to access past episodes, visit our website or follow us on social media. Your feedback and questions are always welcome!
Disclaimer
The content of this podcast is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider for any medical concerns.
Podcast Show Notes
Episode Title: Optimizing Genicular Nerve Chemical Ablation: Insights from Dr. David Rosenblum
Episode Summary:
In this episode, we are joined by Dr. David Rosenblum, a New York-based interventional pain physician, who discusses optimizing genicular nerve chemical ablation. Dr. Rosenblum shares insights as well as his upcoming ultrasound course schedyke in New York City, focusing on regional anesthesia, interventional pain, and IV ultrasound placement. He emphasizes the significance of ultrasound in enhancing pain management procedures and the latest advancements in the field.
For PM&R Board Prep, go to NRAPpain.org
Key Topics Discussed:
- Overview of Dr. Rosenblum's upcoming ultrasound courses in NYC, including regional anesthesia and IV ultrasound placement. More information can be found here or at NRAPpain.org.
- The role of ultrasound in interventional pain management, specifically in optimizing genicular nerve chemical ablation.
- Discussion on the recent study comparing genicular nerve phenol neurolysis and radiofrequency ablation.
- Importance of updating anatomical targets for pain management.
- Recommendations for expanding the number of targets in pain interventions.
- Insights on the safety and efficacy of chemical neurolysis versus radiofrequency procedures.
- Challenges and considerations in performing neurolytic blocks.
- Future directions in personalized treatment for chronic pain patients.
For Anesthesia Board Prep go to AnesthesiaExam at NRAPpain.org
Featured Article:
Dr. Rosenblum references an article from The Korean Journal of Pain discussing the optimization of genicular nerve chemical ablation. Key takeaways include:
- The evolution of anatomical understanding related to genicular nerves.
- The recommendation to consider multiple targets for pain management instead of the traditional three.
- The need for careful patient examination to map pain effectively before intervention.
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Discussion on Knee Pain Management
• ArticlebyAndresRochaRomero:
• Discussion on knee pain targeting genicular nerve ablation.
• Co-authored by Tony Ng and King K Stanley Lam.
• Published in Korean Journal of Pain.
• Highlights differences in pain management practices outside the U.S.Other Points on Genicular Nerve Chemical Ablation discussed
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Phenol ablation being used more internationally vs. radiofrequency ablations.
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Considerations for more extensive targeting of genicular nerves:
• Importance of the median branch of the nerve to the vastus intermedius. • Expansion of targeting to include 6 nerves, not just 3.
• Anatomical variations require different approaches.Recommendations and Observations
• Importance of considering patient-specific anatomy and pain. • Repeat procedures and rehabilitation:
• Concerns about bio intensity and fascia integrity.
• Emphasizes muscle strengthening exercises to support knee.
• CRPS Considerations:
• Elderly patients may develop CRPS post-knee replacement.
• Importance of lumbar sympathetic block in diagnosis and treatment. -
Host Bio:
Dr. David Rosenblum, MD is an interventional pain physician based in New York City. With extensive experience in pain management techniques, Dr. Rosenblum is dedicated to advancing the field through education and innovative practices. He is particularly focused on the integration of ultrasound technology into pain management procedures.
Course Information:
Dr. Rosenblum's upcoming ultrasound courses are CME supported, monthly hands on workshops to give clinicians experience with ultrasound imaging to identify targets for nerve block joint injection, soft tissue injection and more..
• Monthly IV Ultrasound Course in Manhattan:
• Ideal for nurses, PAs, anesthesiologists, ER docs.
• Provides practice with phantoms, short lecture on IV ultrasound. • Offers CME credits.
• Ultrasound Courses:
• Held one Saturday a month, mostly in New York, but travels if needed. • Upcoming dates: December 21st, January 11th in Manhattan.
• Presentation Invitation at Pain Expo in Dubai: April 26-27. •
• Next LAPS conference in September in Chile.
Call to Action:
- Subscribe to our podcast for more episodes on advancements in pain management.
- Follow us on social media for updates on upcoming courses and events.
- Share this episode with colleagues who may benefit from learning about ultrasound techniques in pain management.
Upcoming Opportunities and Closing Remarks
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Dr. Rosenblum encourages attending his ultrasound courses and conferences.
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Mention of upcoming conferences in ASPN inMiami, Pain Expo in Dubai, and LAPS inChile.
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Recommendations to subscribe to newsletters for updates and free info.
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The podcast aims to support pain management professionals.