Athlete Use of Regenerative Medicine Raises Questions

Los Angeles Rams running back Todd Gurley has been plagued by a troublesome knee since his college days at Georgia. The knee kept him out of the Rams’ final two regular-season games in 2018 and probably inhibited his performance in the playoffs as well. It now appears as though Gurley may follow the lead of hundreds of other athletes by undergoing stem cell injections in hopes of repairing the damage to his knee.

Pro athletes turning to regenerative medicine is nothing new. It has been going on for years. Likewise, the practice has raised plenty of questions among skeptical doctors, members of the media, and amateur athletes alike. There is no doubt some of those questions are legitimate. But others are not.

The Advanced Regenerative Medicine Institute (ARMI) has trained some of the doctors who treat athletes with stem cell and platelet-rich plasma (PRP) procedures. They say both procedures are safe due to their use of autologous stem cells and platelets. They also say the procedures are FDA-approved despite media reports to the contrary.

With that said, let us look at some of the most frequently asked questions regarding athletes and their use of regenerative medicine:

How has the FDA given its approval?

The question of FDA approval is one that lingers despite it being an easy answer. Under existing regulations, doctors are allowed to make use of autologous material in certain procedures as long as that material remains minimally manipulated. To understand how PRP and stem cell injections meet approval requirements, you must understand how they work.

Autologous material is biological material provided by the patient being treated. In Gurley’s case, any stem cells injected into his troubled knee would be harvested from his own bone marrow or adipose fat. The material would be extracted, processed in a centrifuge in order to isolate the stem cells, and then injected into the knee. That’s all there is to it. Current FDA regulations already allow this type of procedure without any further approval required.

Do the procedures actually work?

The question of regenerative medicine’s relative efficacy is a legitimate one. Unfortunately, there isn’t a whole lot of clinical evidence settling the question one way or the other. Doctors and their patients must therefore rely on a combination of generally accepted medical principles and anecdotal evidence. As far as athletes are concerned, much of the anecdotal evidence they look to consists of the success stories of their peers.

If the procedures work, how do they work?

There is limited scientific data suggesting that stem cell and PRP injections do work as a treatment for musculoskeletal injuries. The question is, how do they work? The answer to that question is found in what we already know about stem cells and blood platelets.

Stem cells are the building blocks of human tissue. As for blood platelets, they play a vital role in the healing process. It is believed that both stem cells and blood platelets jump-start the healing process when injected into damaged muscle, cartilage, and other similar tissues.

Jump-starting the healing process encourages the body to repair any damage on its own. Platelet-rich plasma and its many growth factors signal the body that healing is required. Stem cells provide some of the raw materials for that healing as well as telling the body to get busy.

There is no doubt that regenerative medicine raises many questions in the minds of skeptics. But as time goes on, we are learning more and more about the efficacy of regenerative medicine treatments. We are discovering that athletes aren’t chasing quackery after all.