Regenokine is not the only treatment that uses the body's own cells. Platelet-rich plasma therapy, or PRP, also manipulates a patient's blood and reinjects it to restart the natural healing process. With PRP, blood is drawn and then centrifuged to concentrate the platelet count, increasing the number of protein growth factors. Doctors then use ultrasound to inject the PRP into the damaged tissue. Lab results in animal models have shown that PRP can speed the healing of ligaments and tendons, and plenty of people claim to have had success with the treatment. Tiger Woods, for one, made news when he admitted to going to a Canadian doctor to get PRP treatments. Pittsburgh Steelers safety Troy Polamalu underwent the therapy after an MCL injury. It has become a common treatment to speed up the recovery of baseball pitchers who have undergone Tommy John surgery. While the FDA has not specifically assessed Regenokine, it has approved a number of devices for PRP therapy.
The main obstacle with the treatments is the price tag. Wehling's therapy can cost as much as $10,000, depending on the number of injections needed. PRP costs $500 to $1,000 per injection. Both are typically not covered by insurance. Still, many are willing to pay the price if it means they can avoid surgery.
While much of the evidence supporting the treatments has been anecdotal, according to several recent studies, PRP seems to work. Last March, scientists at the Rothman Institute at Jefferson, an orthopedic clinic in Philadelphia, released a study of 230 patients suffering from tennis elbow. The researchers found that a group that underwent PRP did far better than those left to heal without it. In December, Alice La Marra, a doctor at the University of L'Aquila in Italy, presented a study demonstrating the effectiveness of PRP in treating the Achilles and patellar tendons. And a paper in the Journal of the American Academy of Orthopaedic Surgeons presented the first comprehensive, evidence-based recommendations for PRP, arguing that it has the potential to be effective for tennis elbow and knee arthritis and that it can help speed recovery from surgeries like ACL repair.
The rise of PRP therapy comes at a time when experts are rethinking orthopedic surgery, thanks to a growing body of evidence showing that many common surgeries just don't work. A study in The New England Journal of Medicine found that one of the most common knee surgeries performed in the U.S. – some 700,000 people have arthroscopic surgery on that joint – doesn't repair damage done to the knee-cushioning cartilage any better than doing nothing. Similar evidence has been found for common back and shoulder procedures. "Surgery sucks in general," says Marc Darrow, an assistant clinical professor at UCLA. "With PRP therapy, people walk out and go back to work. In time, we will not see these surgeries anymore. Unless they're doing regenerative techniques, orthopedic surgeons will be a thing of the past."
Wehling's approach has been slow to spread to the U.S., largely because it's complicated and he's been reluctant to share it. Only two doctors – Chris Renna in Los Angeles and Dallas and Douglas Schottenstein in New York – offer Regenokine. "I'm more about making sure this is done right than growing the application of the procedure quickly," Wehling says. For now, Düsseldorf will remain a center for cutting-edge pain management.