Panel Discussion on the Importantance of Regenerative Medicine in Orthopaedics with Dr. Vance Gardner, Dr. Vert Mooney, Dr. Michael Rossenblatt, Dr. Steven Phillips and Dr. Jack Chen.1. (Q1) What is the most exciting about the field of orthopedics?
a. Dr. Gardner: He speculated that 10 years from now, there will not much metal in the body. The future is in the regeneration of different types of tissues.
2. (Q2) In addressing the problem with aging population, the only industry left in the barbaric ages is the treatment of medicine (referenced the book The End Of Medicine) There is a new generation of people looking up medicine online (monitoring and diagnosing themselves), are they are going to take over the treatment process? Please address the issue of where you see the treatment of medicine in 20 or 30 years.
a. Dr. Phillips: The idea of going online sounds good in theory, but you need true behavioral modification and “stick-to-itiveness”. People know things are bad for them but they still do them anyway (i.e. cigarettes and drinking). He prefers the fact of better educated patients and supports internet knowledge. He feels there is still going to be a role for the medicine we’ve been discussing.
b. Dr. Mooney: The future of medicine is at social and economic level. Economics will drive medicine- care in the US is not as good as other countries and costs are much higher.
c. Dr. Rosenblatt: We can assess babies for medical issues today using genetic tools, but he is worried about the next 10-20 years due to the shortfall in number of physicians. We have a flat number of doctors we produce every year with an increase in the average lifespan. We need primary care doctors, geriatric physicians, OBGYN, etc….recently, we have had a 75% decline of physicians going into general medicine. We will fall below having 50% of physicians in the US being trained in US medical schools. Our system is not equipped to address these issues
d. Dr. Chen: Costs are increasing, but we cannot be pessimistic. In the next 15-20 years, something will change how we do things…there will be leaps and bounds in technology that will help the situation. Although this does drive up costs, it lowers costs in the long run. Microarrays are an example as they are costly, but they drive down the overall cost of sequencing genomes. Dr. Chen looks forward to the future of regenerative medicine.
3. (Q3) Is Prevention is one of the biggest factors we need to bring into play?
a. Dr. Phillips: Last year was the first time the life expectancy started to drop for males and females born in 2007. The average life expectancy was 76.6 years in 2000 and it has dropped to 76.4 years in 2007. Something is going on to cause this, but we aren’t using the information we have at our fingertips. Is it child obesity? That is only one aspect, but there are other factors, such as the increase in young women smoking.
4. (Q4) With respect to growth factors, what’s the biggest challenge for getting these products to patients that can benefit from their therapy?
a. Dr. Gardner: The cartilage regeneration will be most difficult, especially in the disc because this requires 2 different types of chondroblasts. Cartilage will regenerate quicker than the disc. Tissue will be available off-the-shelf to place where necessary- all implement the same techniques.
b. Dr. Chen: The biggest challenge itself will not be the biggest challenge- the problem with bone growth in BMP cases is not BMP itself, but rather the carrier allowing it to leak out of the site. Carriers need to be developed such that a medium exists to carry this growth factor where we want it to go or we develop a gene therapy in delivery of the growth factor. These are the next hurdles.
5. (Q5) What is your knowledge pertaining to spontaneous human combustion (i.e. body catches fire and is burned up, nothing is left but ashes)
a. Dr. Chen: “I never say never”- I am sure anything can happen, but I’ve never heard of it.
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