I’ve been a practicing physician for almost 30 years. In that time, I’ve seen a lot of expensive complications and pain generated by overly aggressive orthopedic surgery, and that trend seems to be accelerating. In fact, there really isn’t a day that goes by that I don’t witness the walking wounded created by misapplied orthopedic surgical procedures. I’m not alone either. Many colleagues also bear witness to the same thing. This is one of the reasons I pioneered interventional orthopedics, because there had to be a better way. This week’s press release announcing the partnership between Edison Health and Regenexx is the beginning of the maturation of that new medical specialty. Let me explain.
Orthopedic Surgery Evidence
This has been an awful decade for orthopedic surgery outcomes research. Study after study has shown that these invasive and common procedures are often no better than a placebo or sham surgery or physical therapy. Other studies have questioned the basic concept that it makes any common sense to try to surgically treat a meniscus tear or a torn tendon in the shoulder. This list of questionable procedures includes:
- Knee debridement and lavage
- Lumbar fusion
- Neck and back surgery to remove disc bulges or decompress nerves
- Shoulder rotator cuff repair
- Shoulder decompression surgery
- Knee replacement in most patients
Then there are many surgeries that are common practice but have no high-level evidence of efficacy. Meaning, we are exposing patients day in and day out to surgical risks without any hard evidence that these procedures help.
My Patient Example
As I have written, there isn’t a day that goes by that I don’t see some crazy and over-aggressive orthopedic surgery that could have been prevented by using orthobiologics and interventional orthopedics. Yesterday’s was a woman who had partial tears of her Achilles tendon and a bone spur. She was told that the bone spur was “shredding” her tendon, but in reality, it was merely an innocent bystander in a degenerating structure. As a result, she signed up to take out the tendon that flexed her big toe (she now can’t bend that toe) and transplant it to the Achilles tendon. What does the Achilles tendon look like 18 months after the surgery? On ultrasound, it’s a mess, still with big tears. In fact, her other one isn’t great, but, thankfully, she’ll never have that one operated on because we’ll treat it through an injection of high-dose platelet-rich plasma (PRP).
This whole medical misadventure could have been prevented by a skilled practitioner and injections into her Achilles that would run about $2,000. However, instead, we got a huge surgery that cost 10–15K and never fixed her tendon. In fact, scooting around for six weeks on a knee walker has caused several years of disabling low-back pain, which added other costs for her insurer. These costs will never be tied to her initial surgery, but they were a direct result of that surgery. She’s also now left with a big toe that can’t flex, which will slowly fry other joints in that foot and ankle, which will end up being paid for by her employer at some later date.
What Is Interventional Orthopedics?
I’ve blogged on this topic many times, so take a look at my video below for the differences between surgical and interventional orthopedics.
What Is Edison Health?
Edison health is a company that’s focused on reengineering healthcare by using smart care treatment centers. Regenexx, with its 45 existing US and 7 international (plus approximately 15 more added this year alone) treatment sites will serve as an orthopedic surgical gatekeeper. Meaning that the self-funded health insurance offered by companies that work with Edison will require that all patients booked for elective orthopedic procedures be evaluated first by a Regenexx provider. If that provider can help the patient with interventional orthopedics, then the patient will be treated nonsurgically.
Why Is This the Beginning of the Realization of Interventional Orthopedics?
We’ve been using orthobiologics with interventional orthopedics for 13 years and have successfully treated tens of thousands of patients. Several years ago, our Des Moines, Iowa, site began a pilot project to determine how much money we could save self-funded employer health plans. This was lead by our new CEO, Jason Hellickson. We ended up saving large companies on the order of 50–80% on their elective orthopedic surgery spend. For more info, see our RegenexxCorporate video below:
However, nationally, this new technology has only been available to those patients who can afford a cash-pay procedure. This agreement with Edison Health and many others like this that have already been created marks the first time that health insurance coverage will be available for interventional orthopedics on a large scale. This levels the playing field with surgical orthopedics.
What happens when both interventional and surgical orthopedics have health insurance coverage? My prediction is that by 2030, 50–70% of elective orthopedic surgical procedures will be firmly in the dustbin of history. Patients will opt in droves for less-invasive procedures with a quicker recovery.
The upshot? This press release marks the true beginning of interventional orthopedics as a medical specialty. Only Regenexx has the expert medical providers, training, registry, and technology that has been studied well enough to pull this off. Onward and upward! If you are with a self-funded employer health plan and want to learn more, please visit www.regenexxcorporate.com.