Sep 5, 2017Call for Caution
This article first appeared in the September 2017 issue of Training & Conditioning.
With elite athletes like Rafael Nadal and Cristiano Ronaldo using stem cell therapy and Kobe Bryant and Tiger Woods having received platelet-rich plasma injections for knee injuries, regenerative medicine treatments are making headlines. But are they a good option for youth and adolescent athletes?
Authors of a new study published in the American College of Sports Medicine’s (ACSM) Current Sports Medicine Reports are not so sure, advising caution before allowing those under 18 to undergo regenerative therapy. Titled “Not Missing the Future: A Call to Action for Investigating the Role of Regenerative Medicine Therapies in Pediatric/Adolescent Sports Injuries,” lead author Thomas Best, MD, PhD, Professor of Orthopedics, Family Medicine, Biomedical Engineering, and Kinesiology at the University of Miami’s Miller School of Medicine, says more research is needed before allowing young athletes to jump on the bandwagon.
“We still don’t have good evidence that the regenerative medicine therapies work, particularly in the long term,” says Dr. Best, who is a past president of the ACSM. “Some of the evidence we’ve seen in adults is encouraging, but we have absolutely no data on children yet, and that’s why we came out with the word of caution.”
Dr. Best acknowledges that the long-term healing process of injuries such as ACL tears can be frustrating for athletes, but he is wary of subjecting young people to therapies that have not been thoroughly studied. “It’s appealing to think that if we put stem cells into the knee joint, they would somehow turn on and regenerate or grow new cartilage,” he says. “But we still don’t know how to regulate stem cells so that they become what we want them to become after we put them in the body. In addition, depending on the age of the child, they might still have open growth plates, which creates a completely different environment.”
The study comes from the collaborative work of several sports medicine clinicians, researchers, and a bioethicist and offers the following seven-point call to action:
1. Exercise caution in treating youth with cell-based therapies as research continues.
2. Improve regulatory oversight of these emerging therapies.
3. Expand governmental and private research funding.
4. Create a system of patient registries to gather treatment and outcomes data.
5. Develop a multiyear policy and outreach agenda to increase public awareness.
6. Build a multidisciplinary consortium to gather data and promote systematic regulation.
7. Develop and pursue a clear collective impact agenda to address the “hype” surrounding regenerative medicine.
What advice does Dr. Best offer for working one-on-one with a young athlete interested in regenerative medicine? “Remind athletes and their parents that other treatments really do work,” he says. “Physical therapy, rest, nutrition, and exercise all play a major role in recovery.”