Dime Training, NBA / Jul 7, 2011 / 12:00 pm

Dime Q&A: Expert Surgeon Sheds Light on Kobe Bryant’s Mysterious Surgery

Dr. Bal Raj

Dr. Bal Raj (photo. M.S. & Associates Public Relations & Marketing)

What’s perhaps an athlete’s number one fear during a lockout? It might just be injuries. Already this summer, we’ve seen Gilbert Arenas be told not to play all year in order to rest his knees, Tyreke Evans battling to come back from plantar fasciitis and Kobe Bryant taking steps to try out a couple of new treatments, platelet-rich plasma therapy (also known as PRP) and cryotherapy.

Earlier this summer, we introduced you to Dr. Bal Raj, a leading Orthopedic Fitness Surgeon and expert based in Beverly Hills, Calif. Dr. Raj is a Double (American & Canadian) Board Certified Orthopedic Surgeon specializing in sports & fitness procedures, working with both athletes, Hollywood execs and A-Listers, and was named one of the “Top Orthopedic Surgeons in Los Angeles and a Leading Physician of the World” by the International Association of Orthopedic Surgeons. He has been featured on numerous television shows, and agreed to become a regular contributor here at Dime.

With the interesting news coming from Bryant’s foray into Germany for treatment, I caught up with Dr. Raj to talk about it (as well as knee issues/plantar fasciitis which will be posted shortly)…

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Dime: Recently, Kobe Bryant was in the news with platelet-rich plasma therapy done on his knee. What do you know about that?
Dr. Bal Raj: Yeah, this is a newer technology that’s coming out more and more in vogue. But, we’ve had a lot of strong backing. I’m even venturing into it myself. What it is is the platelet-rich, PRP, has a lot of platlet-rich derived factors, which actually are strong anti-inflammatories which induce collagen healing.

The concept is it’s supposed to aid in reversing arthritis, but there’s no strong-to-hardcore studies to it. But it’s definitely a strong anti-inflammatory. It’s also safe too because you are taking components from your own blood stream and injecting it into your knee for healing purposes, you are not going to hurt yourself.

Now, the one thing that different orthopedists are looking at combining that with stem cells, which is actually more advantageous because then you have these undifferentiated cells that are your own that suddenly attach onto an area. And these cells actually can produce cartilage because they are undifferentiated. But again, this is SO new and so controversial that we don’t really have any solid data on it on a long-term basis.

Dime: When you say controversial, you say that just because doctors aren’t sure if it helps? It’s pretty harmless right?
DBR: Yeah, it’s a simple, harmless procedure, but controversial in a sense because doctors aren’t convinced on the effects because the bone…actually where we get the stem cells from is from either your fat or your bone marrow so it’s actually products that are derived from your own body.

So it’s not an FDA (U.S. Food & Drug Administratrion) issue. It is more of a financial, “does this make sense” issue because it is pricey.

Dime: As Kobe gets older with all of his knee problems and the joints start to get arthritic, it’s pretty much impossible to get back to 100% right? You just have to continue to fight it as it gets worse and adjust?
DBR: Absolutely. For Kobe to get back to the level he’s at as his knee starts degenerating, it’s impossible. You just start adapting to it. So instead of being someone who drives a lot, maybe you are going to rely on not being that sprinter. You’re gonna change the way you play, number one. Number two, with a good solid trainer, you’re gonna be as preventative as you can be by making sure your quads and hamstrings are actively and aggressively trained because that strength will protect your joints for a long time.

It’s ironic because I’m venturing into, looking into the world of PRP and I’m trying to convince myself. I’m not there yet.

Dime: When did people really first start using it?
DBR: I would say four years ago. You had your general pain management pioneers using it. But it’s deemed as a financial reason for them using it. But now even orthopedists are starting to jump onto it. Now, I don’t think PRP alone for an injection is gonna do it. I do think you need to combine that with stem cells. But the problem with stem cells – the costs of PRP is about $1,200-1,500 – the cost of stem cells is about $4,000-6,000.

So it’s a cost issue, and when you tell someone I’m not sure that this is gonna help you, it’s a different type of population you’re gonna get in.

Dime: Is it just used for cartilage or does it have other effects as well?
DBR: Yeah. The PRP is used for inflammation. So that’s used for tendonitis, and the stem cells as well can be used for tendonitis and cartilage. Any area that needs to heal progressively, you can use it for to.

What do you think?

Follow Sean on Twitter at @SEANesweeney.

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  • karmatic

    next wave is injecting stem cells into the arthritic knees of athletes, along with growth factors and other signals to tell the stem cells to turn into chondrocytes (cartilage making cells), and hope the chondrocytes can smoothly coat the exposed bone with new cartilage- this has been done, i believe, with several athletes in sweden, but i am not aware of the long term (5 year) results- hope they figure it out before i need a knee replacement!

  • George W Kush Sr

    Sounds like Tylenol.

  • http://www.dimemag.com Dylan Murphy

    Great interview, Sean. Seems like we’ve come a long way from the era of “put some ice on it” as the universal cure for all maladies.

  • Rainman

    sounds like advil

  • Ekstor

    Smells like Teen Spirit.

  • http://www.plantar-fasciitis-elrofeet.com EZ

    Plantar fasciitis can take a long time to heal.
    Evans has Plantar Fasciitis. I have had it too.
    There is a good web site explaining what is Plantar fasciitis:
    http://www.plantar-fasciitis-elrofeet.com/What_is_plantar_fasciitis.html