Monday, July 25, 2011

DNA Sequencing or Magnetic Resonance Imaging MRI

Today, one of the most common tests ordered in the United States is a Magnetic Resonance Image or MRI.  These images are typically ordered of a specific body part or region.  The cost of this type of test is variable ranging from $800 to over $3000 and produces exquisite information anatomic images.  

MRI of Torn Rotator Cuff

An MRI, however, gives the clinician no information about the patients systemic physiology or potential underlying risk factors.  If DNA sequencing can follow Moore's Law from computer science, then the cost should drop to $1000 within five years or perhaps less.  Databases are already being created with numbers reaching over 100,000 patients.  As the cost drops, physicians will begin ordering these tests almost as often as MRIs and we will then see dramatic shifts in the practice of medicine.  The natural history (what happens if no intervention occurs) is different for different patients.  We may be able to predict with DNA sequencing who will recover WITHOUT any specific or expensive treatment.  We also may be able to predict which patients will require aggressive treatment.  The era of personalized genomic medicine will have arrived.  This has broad implications for reducing the cost of care if implemented appropriately. 

Read more about the falling cost of DNA sequencing in the LA Times. 


Saturday, July 16, 2011

Kobe Bryant, Tiger Woods and Platelet Rich Plasma

According to published reports, Kobe Bryant has had three arthroscopic (scopes) surgeries on his right knee.  (2003, 2006 and 2010)  This is similar to the three surgeries that Tiger Woods has had on his left knee.  Both of these athletes are in their 30s and the question for both of them is:  What is going on inside these elite knee joints and why did they both turn to platelet rich plasma to potentially help them?

BLOODCURE thinks it is safe to assume that both of them have some arthritic changes in their knees.  This means that they have lost some of both the smooth cartilage covering the bone (articular cartilage) and some of the cushioning cartilage between the thigh and shin bones (meniscus cartilage).  In Tiger's case, he may have been treated for patellar tendonitis after an ACL reconstruction but there is no presented or published information about the specifics of his treatment.  In Kobe's case, he may have been treated for knee arthritis but despite BLOODCURE contacting its many sources in the USA and Europe, no one has come forward with specific information about his treatment.  What did he have done and why did he travel to Germany to get it done?  Plenty of physicians within the USA and specifically California have experience with PRP.  So, did he get some form of PRP that is not available in the USA?

Answers to these questions will help us all better understand the value of PRP for iconic professional athletes and for sports medicine in general.  Importantly, we also need to learn what type of PRP (many exist) they received.  Here is a video of a PRP Classification System.  

If anyone has information about these cases, please post a comment below.

Fitness/Sports Medicine Videos (4 million views)

Patient Application Form