Until recently, the evidence for new injection techniques was not compelling. However, more and more evidence is pointing to the newer techniques being as good, if not better, than steroid injections.
As such, we have now invested in equipment to allow us to perform injections based on the patient's own blood (platelet rich plasma or PRP injections). Stem cell therapy (derived from bone marrow) is still a much more painful and experimental procedure and something we are still watching with interest.
These are much safer for patients with diabetes, as there is no steroid to affect blood sugar levels, and rather than suppressing inflammation (leading to less pain but a poorer healing response), they appear to be better at promoting a healing response. They are also much safer than major surgery in those patients with significant risk factors.
Unfortunately, due to previous practice by less-than-scrupulous agents, these injections are no longer covered by Medicare (and therefore insurers) so there is an out-of-pocket expense. We have however had good success with both Work Cover Queenland and DVA to cover the costs. Ultimately, if you are not covered, we sadly cannot perform these injections without cost, but we do believe our costs reflect our commitment to regional practice.
Of course, no treatment is guaranteed, and if the injections fail then further options are always available for discussion.
With this in mind, any patient who has undergone these injections without success, who then has surgery recommended, will have the cost of the injections offset against any gap fee for surgery.