Two years after his mountainside crash, 50-year-old Dr. Mike Solomonov of Cedar Knolls, who’s part of our practice, wondered if he’d ever be able to enjoy the outdoors again.
Not the vacation he expected
In February of 2014, pain management physician and anesthesiologist Solomonov crashed while skiing in Italy with his wife Viktoriya, his 9-year-old son, and 13-year-old daughter. The result: a partially torn ACL ligament, a tear of the meniscus cartilage, a strained MCL ligament, and a hairline fracture of the tibia, or shinbone.
As a pain specialist, he knew that his injury wasn’t an emergency. To avoid spoiling his family’s remaining vacation, he simply elevated, iced and braced the knee – and stayed off the slopes until it was time to head back to New Jersey.
Initially, he was optimistic…
Back home, a surgeon drained fluid from the injured knee, gave Solomonov steroid shots to reduce swelling and inflammation, and prescribed physical therapy to help heal the ligaments and cartilage.
It’s a treatment plan that’s all too familiar to the hundreds of thousands of recreational, high school, college and professional athletes who experience similar injuries due to the quick twists, bends and changes in direction these sports require.
As Solomonov says, “I knew surgery wasn’t usually the best answer for partial tears like mine. I was fairly sure that if I took physical therapy seriously, I’d regain stability in my knee and be able to ski and bike again in a couple of months.”
He diligently attended all of his physical therapy appointments and did extra sets of the recommended home exercises.
When his initial physical therapy didn’t result in improvement, he switched to a new physical therapist and gives him credit for major improvements in his knee’s stability.
But his knee didn’t heal well
But as time passed, it became clear that the knee itself had not healed well. Solomonov could only walk or jog 100 feet before his knee began swelling and hurting.
Before the ski crash, he had been very active – cycling, running, skiing and more. Now, he was almost completely inactive. Just getting through a day of patient appointments was a challenge, and repeated fluid drainage and steroid injections weren’t healing his knee.
Desperate to find something he could do without pain, he tried swimming – “I hated it,” he says – and his wife’s fitness boot camp. There, he could participate for only five minutes before his knee forced him to sit out the rest of the class.
Solomonov says, “I really felt a little panicky. It hadn’t occurred to me before that I simply might not be able to do much of anything except walk the dog.”
Looking back on that time, his wife Viktoriya, a nurse, says, “Every patient Mike sees is really suffering, and he’s 100% focused on helping them. Exercise was always his secret weapon against work stress, so he was anxious to find a way back to normal.”
Twelve months after his skiing crash, still unable to return to his normal activities, he was determined to find a better answer.
It was time to look at other options
His doctor discussed surgery to replace the torn ligaments with tendon grafts taken from Solomonov’s own body or from organ donors. But surgery for partial tears doesn’t always work, requires rehabilitation after surgery, and can cause arthritis later.
While exploring other options, Solomonov attended a September 2015 conference on the latest advances in regenerative medicine. This evolving medical specialty treats patients with their own stem cells or platelet-rich plasma (“PRP”) and other elements extracted from their own blood.
These minimally-invasive techniques help repair damaged joints without surgery and help partial tendon, cartilage, ligament, and muscle tears heal much faster. They can also help restore cartilage in arthritic joints.
He says that “For many years, I’ve used regenerative medicine techniques like PRP for carefully-selected patients. Today, we’ve got so much research and experience in these techniques that I feel comfortable offering it as the standard of care for far more injuries. And unlike surgery, the risk of complications when performed by a properly trained, experienced physician is very low.”
Solomonov was especially attentive to the latest findings shared at the conference, recognizing that regenerative medicine was likely the most promising option for his knee.
He adds that “The great thing about these procedures is that they can let people avoid surgery altogether or treat it as a last resort, and they offer new options when surgery just isn’t suitable.”
At last, a better answer
Finally, the doctor became the patient. In February 2016, almost two years after his initial injury, he made an appointment for stem cell therapy and platelet-rich plasma treatment at a leading regenerative medicine practice.
He says: “The treatment process is straightforward. A sample of your own blood or bone marrow is centrifuged so that only the stem cells or platelets are left. That’s injected into the damaged area guided by ultrasound or x-ray to ensure precise positioning of the small needle. Most people say it’s just uncomfortable, not seriously painful. The actual treatment is done within a couple of hours.”
Two weeks after stem cell and PRP injections into his injured knee, with no additional rehab, Solomonov was back on his mountain bike for the first time in two years. A month later, he was racking up 30-mile rides again, with no pain or swelling.
Six months later, he’s reflective: “My own firsthand experience has reinforced my confidence in these treatments. It’s one more reason I’m so comfortable offering them in my own practice and through my practice at Randolph Pain Relief and Wellness. It can truly give people their lives back, without drugs or surgical risks.”
His advice for others
Drawing on his personal experience and professional expertise, Solomonov offers this advice to others with persistent muscle and joint injuries:
- Give your body time to heal. Try physical therapy first, then consider stem cell and/or PRP therapy if you haven’t been able to return to your normal activities.
- Surgery should usually be the last resort unless you have a traumatic or severe injury. Steroid shots and draining fluid from joints mainly treat symptoms. They’re not cures.
Choose a physician who:
- Specializes in pain management, sports medicine, orthopedics, or physical medicine and rehabilitation (physiatry).
- Follows recommendations of the Interventional Orthopedics Foundation (IOF) or The Orthobiologic Institute (TOBI)
- Is familiar with the latest recommendations on patient selection for stem cell therapy and PRP. People with complete ligament tears or other severe damage, certain illnesses or who take certain medications aren’t good candidates.
- Uses x-ray, ultrasound or fluoroscopy to guide the injections in the injured area, rather than “feeling his way”
- Meticulously follows specialized treatment protocols before, during and after the procedure. Some doctors who aren’t specialists offer these injections as a quick way to make money, but may lack expertise in the constantly evolving nuances of successful treatment.
- Focuses on treatment of muscle, joint, tendon, ligament and cartilage damage. Stem cell treatments for cardiovascular, neurological and other conditions currently lack strong evidence.
- Offers payment options. Insurance normally covers the initial MRI, other diagnostic tests, and the initial consultation. However, most policies don’t currently cover the actual blood draws or injections. Fees vary based on the extent of treatment. Out-of-pocket costs are typically around $1,000 for a PRP treatment and around $5,000 for a stem cell treatment in one joint, or $7,500 for treatment of two joints, and Solomonov says that the treatments are becoming even more affordable as techniques evolve.
- Doctors whose primary specialty is family medicine, internal medicine, or general practice.
- Doctors who claim stem cell therapy can reverse or improve complex or chronic conditions like Type 2 diabetes, COPD, Parkinson’s disease and autoimmune diseases.