Interventional orthopedics in pain medicine practice

Interventional pain physicians are in a unique place to take advantage of regenerative medicine technology to improve patient outcomes and decrease the invasiveness of orthopedic procedural care. However, that sea of change would take significant changes to the educational system similar to those established when interventional spine was first introduced as a subspecialty. The tenets of interventional orthopedics are as follows: injectates that can facilitate healing of musculoskeletal tissues, precise placement of those injectates into damaged structures using imaging guidance, and the eventual development of new tools to facilitate percutaneous tissue manipulation. Stem cells are an early injectate being used in this developing field. The research supporting the use of stem cells to treat orthopedic conditions is more robust than many realize. Early clinical work to treat osteonecrosis and fracture nonunion began in the 1990s. Today, early clinical evidence to support the use of bone marrow concentrate to treat knee osteoarthritis and other orthopedic conditions exists and continues to develop. Although more research needs to be completed, the increased availability of biologic agents that can prompt healing in musculoskeletal tissues would usher in a new field of medicine—interventional orthopedics.