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This is Carly Beam with the Becker Spine

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and Orthopedics podcast, and I'm thrilled to be

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joined today by doctor Frank Cordesco

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with Hospital for Special Surgery out in New

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York. Doctor Cordesco, thank you so much for

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being here today.

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It's my pleasure, Carly.

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I'll I'll give you a little brief background

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on my,

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my history. So, again, Frank Cordasco.

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I received my orthopedic surgery residency training at

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Columbia Presbyterian Medical Center, New York Orthopedic Hospital,

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and my shoulder and elbow surgery fellowship training

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thereafter with doctor Charles Neer, also at Columbia

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n NYOH.

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I've spent the majority of my career in

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New York City, initially, as a faculty member

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at Columbia, and then I was recruited to

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the hospital for special surgery by doctor Russell

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Warren,

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where I've been for nearly three decades now.

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I'm an attending orthopedic surgeon at the Sports

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Medicine Institute at HSS as well as a

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senior research scientist at HSS

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and a professor of orthopedic surgery at Weill

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Cornell

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Medicine, which is part of Cornell University.

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And I've served as the thirty fifth president

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of the American Shoulder and Elbow Surgeons from

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2018 to 2019,

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And I'm currently an ex officio member of

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the ASCS executive committee

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as well as the ninth chair of the

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Journal of Shoulder and Elbow Surgery family of

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journals.

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Thank you. And doctor Cordesco,

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I've started wanna start with you. What are

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the top three trends that you're following in

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health care today, whether it's, you know, specific

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to orthopedics

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or just kind of looking overall at health

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care system as a whole?

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Yeah. I think that's an important question, Carly,

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and I think it's pretty clear to anybody

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who follows health care

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and innovation. It's it's really threefold. And I'll

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start by just being specific to health care

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overall, and then perhaps we could delve into

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sports medicine and orthopedics. But, you know, first

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off, AI and automation and care, I think,

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has had a a huge impact already on

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a number of,

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facets of human endeavor,

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specifically medicine.

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And so AI and automation and care is

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rapidly moving into diagnostics, risk prediction, clinical documentation,

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and administrative workflow automation. A lot of this

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has been present now for a few years.

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It's certainly an evolution, and we would expect,

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you know, fairly rapid

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change soon, meaning in the next one, two

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to five years.

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It's being used to read images, flag high

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risk patients, support triage,

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and reduce paperwork so clinicians can spend more

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time with patients.

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On the virtual care and remote monitoring and

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wearables, this is, again,

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amazing technology.

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Obviously, telemedicine

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is now a mainstream access point since the

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pandemic.

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It's especially useful for primary care and behavioral

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health, and it reduces the need for many

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in person visits for these individuals.

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Remote patient monitoring, consumer wearables can feed continuous

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data to clinicians,

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and it enables early detection of deterioration

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or more proactive chronic disease management at home.

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And on the health care delivery system, it's

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it's really personalized and value based care is

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becoming a kind of a transition. So I

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think many health systems around the country,

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perhaps New York as an outlier,

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are shifting from fee for service toward value

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based models.

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Their reward outcomes,

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with coordinated whole person care.

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So I I think that's, you know, specific

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to health care overall,

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using genomics, biomarkers, and individual care

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plans is becoming more and more common, particularly

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in areas like oncology and condition specific

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pathologies and programs.

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So as it relates to what I do,

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I mean, my wheelhouse is,

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I I practice as an orthopedic and sports

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medicine surgeon.

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The three big trends that I just mentioned

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translate into very practical shifts

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in how I diagnose,

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operate upon, and follow athletes back to return

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to sport at their prior level of performance.

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And it's an exciting time. And, again, a

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lot of this is not new. We tend

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to focus on

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what we've been hearing from the media and

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from our financial,

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colleagues, you know, over the last year to

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two. But

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AI and imaging, pathology,

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and,

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even instrumentation in the OR has been present

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already in orthopedics for the last several years,

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even predating COVID.

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I'll start with the imaging side. You know,

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AI and imaging planning and outcomes as it

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relates to imaging.

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AI tools are getting very good at detecting

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fractures, implant loosening,

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osteoarthritis

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severity, and sports injuries such as ACL tears,

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meniscus tears, and rotator cuff

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injuries,

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both with respect to radiographs as well as

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m r with MRI with with very good

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accuracy and some would say approaching MSK radiologists.

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And as you probably know in our field,

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orthopedic surgeons and sports medicine surgeons are often

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reading their own films

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and acting upon these patients within twenty four

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hours with respect to treatment modalities, counseling them

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even before we get a report from the

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radiology service. And and so AI is

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helping in those cases where perhaps more information

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is necessary to be to be accurate and

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manage the athlete effectively.

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So for sports, this means faster reads on

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knee and shoulder MRIs, automated measurements,

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and decision support on, you know, whether we

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proceed with operative or nonoperative care.

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As it relates to planning and intraoperative support,

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I think AI driven templating

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can predict implant sizes, alignment, and patient specific

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plans and is being integrated,

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as I mentioned earlier, into augmented and virtual,

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components within navigation robotics for joint reconstruction

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and complex reconstructive work. I think,

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you know, the low hanging fruit in orthopedics

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has been anything that is that involves bone.

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So total joint replacements,

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spine surgery with pedicle screw instrumentation.

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It's

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a bit easier to manage those patients with,

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preoperative imaging like three d CT scans where

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you can then

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utilize your intraoperative devices with robotics and

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computer instrumentation

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to really support that. I'd have to say

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that my field,

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sports medicine, meaning soft tissue work in terms

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of ligaments and and,

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tendons,

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has has probably been

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a little bit behind for a number of

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reasons. First off, as I mentioned, bone.

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But there are some exciting,

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you know, interests in the future and and

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facets that I think we can touch on

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in a little bit.

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Moving from imaging to planning and intraoperative support,

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I've I've mentioned that complex work, and I

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think arthroscopy and sports procedures

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will,

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over the short term, in the next year

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to five years,

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we can expect more automated recognition of anatomy

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and pathology,

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in arthroscopic video and the use of augmented

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reality guidance over the next few years.

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And then I think the predictive analysis

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models with outcomes and logistics

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are is another exciting aspect of this where

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we can forecast,

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again, on the arthroplasty

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side, length of stay, complications, and readmissions.

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But similar tools are emerging now in my

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areas of ACL, meniscus, and shoulder surgeries on

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the soft tissue side.

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And, obviously, on the practical side for clinics,

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clinic notes, etcetera,

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AI has already,

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used, for example, at my hospital at HSS

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and starting to auto draft clinic notes, op

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notes, and pre op plans,

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which can cut documentation

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time and help with burnout,

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for for many physicians and physicians,

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physician extenders.

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So if we move from there to remote

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monitoring, apps, and data rich rehab, again, this

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is

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really, exciting, and it has already been implemented

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and executed in the last several years, but

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there's more to more to follow.

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So virtual follow-up now is a a stable

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part of my post op care,

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particularly as a,

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a sports surgeon who sees

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athletes from all over the country and in

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some cases all over the world. So,

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historically, prior to the pandemic, it would be

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difficult to

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have those patients

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return to New York and to my office

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to to seek consultation.

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And, typically,

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with an ACL

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reconstruction, for example, we would see patients at

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ten days for wound check,

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one month, two months, three months, four and

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a half months, six months, nine months, and

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twelve months post op, and then a two

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year follow-up.

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And when you're dealing with patients who are

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both domestic and international

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distances from New York,

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this has just been a a game changer

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for us. So now myself,

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my own athletic trainer, and my PA can

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meet in a room, so to speak,

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virtually with an athlete in Seattle or Los

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Angeles

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and their entire

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group of local,

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physical therapists, trainers, and even the team physicians

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in their own training facility. And that's that

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has been a game changer for younger

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mobile patients and long distance athletes.

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Yeah. Yeah. Like, imagine it's especially helpful even,

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like, this week when we are

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recording in January, in the middle of one

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of the biggest, cold front storms in The

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US.

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Absolutely. Without question.

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And it also enables you to to see

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patients

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seven days a week. You know, if if

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they're if you're away at a conference,

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during the middle of the week, you can

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then extend hours for these types of post

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op visits

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into the weekends. Not that, you know, we

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can get into,

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you know, work life and and

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healthy

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wellness aspects in a later on in the

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discussion if you'd like, but I think this

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provides the surgeon and the patient with a

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lot of flexibility in terms of when to

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meet. And, again, these are most helpful, I

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think, postoperatively

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and during the rehabilitation and return to sport

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phases

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where it's so intensive in sports. You know,

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my arthroplasty colleagues,

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don't often require the need to see patients

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as frequently was as we do in soft

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tissue surgery for the obvious reasons.

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So I I think it's been a, as

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I said initially, a game changer.

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As it relates to wearables and sensors, this

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is an exciting area,

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in health care

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overall, as I mentioned earlier. So whether you're

276
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managing

277
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a cardiac patient postoperatively

278
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or more specifically in my field,

279
00:10:47,209 --> 00:10:47,709
athletes.

280
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We're now using

281
00:10:49,769 --> 00:10:52,089
and, again, these we're just touching on this

282
00:10:52,089 --> 00:10:54,490
at this point from a practicality standpoint, but

283
00:10:54,490 --> 00:10:56,490
I think the future is going to be

284
00:10:56,490 --> 00:10:58,490
very exciting as as it relates to the

285
00:10:58,490 --> 00:11:01,084
so called IMU based systems. These

286
00:11:01,625 --> 00:11:04,524
are inertial measurement units, which include accelerometers,

287
00:11:04,904 --> 00:11:06,764
gyroscopes, and often magnetometers.

288
00:11:08,105 --> 00:11:10,345
To create these systems, they can track range

289
00:11:10,345 --> 00:11:12,904
of motion, step counts, limb loading, return to

290
00:11:12,904 --> 00:11:13,644
play metrics

291
00:11:14,319 --> 00:11:16,639
after the types of surgeries I've discussed. So

292
00:11:16,639 --> 00:11:18,980
ACL reconstructions, meniscus surgeries,

293
00:11:19,839 --> 00:11:21,459
shoulder procedures, etcetera.

294
00:11:22,159 --> 00:11:23,539
And some of these platforms,

295
00:11:24,319 --> 00:11:27,679
combine sensor data with AI to flag patients

296
00:11:27,679 --> 00:11:29,860
who, for example, may be lagging in rehab

297
00:11:30,345 --> 00:11:32,764
or importantly, overloading too early,

298
00:11:33,464 --> 00:11:36,024
prompting in, you know, earlier intervention from the

299
00:11:36,024 --> 00:11:36,524
surgeon

300
00:11:37,065 --> 00:11:40,044
and their therapists and or athletic trainer colleagues.

301
00:11:40,985 --> 00:11:43,865
Yeah. And, doctor Kolesko, I wanna ask you

302
00:11:43,865 --> 00:11:45,964
also just kind of touching in on

303
00:11:46,549 --> 00:11:48,649
some of the some of the biggest innovations

304
00:11:48,789 --> 00:11:51,529
that you think will, kind of explode in

305
00:11:51,909 --> 00:11:52,789
2026,

306
00:11:52,789 --> 00:11:55,129
especially as it relates to sports medicine

307
00:11:55,669 --> 00:11:57,269
and, you know, these types of surgeries that

308
00:11:57,269 --> 00:11:58,889
you've been, talking about.

309
00:11:59,725 --> 00:12:01,804
Well, I think the wearable piece will continue

310
00:12:01,804 --> 00:12:04,205
to work, you know, very effectively in the

311
00:12:04,205 --> 00:12:06,065
coming in the coming twelve months.

312
00:12:06,684 --> 00:12:06,924
We

313
00:12:07,565 --> 00:12:10,065
you know, as I mentioned, these are available.

314
00:12:11,245 --> 00:12:13,230
The the issue related to practicality

315
00:12:17,230 --> 00:12:19,529
ascertained, I think, by and that's mostly

316
00:12:20,029 --> 00:12:20,529
by

317
00:12:21,029 --> 00:12:21,529
us.

318
00:12:22,350 --> 00:12:24,589
So the surgeons have to buy into these

319
00:12:24,589 --> 00:12:25,089
technologies.

320
00:12:25,715 --> 00:12:27,634
And I think most of us will. The

321
00:12:27,634 --> 00:12:28,934
the issue is logistically

322
00:12:29,634 --> 00:12:30,934
how to implement it,

323
00:12:31,315 --> 00:12:32,695
how to organize it.

324
00:12:33,475 --> 00:12:35,894
We haven't really gotten into the costs associated

325
00:12:36,035 --> 00:12:37,654
with monitoring this data,

326
00:12:38,370 --> 00:12:41,410
and utilizing the technology. So I think as

327
00:12:41,410 --> 00:12:41,910
we

328
00:12:42,450 --> 00:12:45,110
as it's clear we would benefit from these

329
00:12:45,570 --> 00:12:47,190
regarding the clinical need,

330
00:12:47,809 --> 00:12:50,070
the the real questions remain,

331
00:12:50,684 --> 00:12:52,764
again, as it relates to major health care

332
00:12:52,764 --> 00:12:54,465
delivery systems as to

333
00:12:54,845 --> 00:12:56,924
how we implement it, how we implement and

334
00:12:56,924 --> 00:12:59,184
execute. So I think that's a big piece

335
00:12:59,644 --> 00:13:00,465
over the next

336
00:13:00,924 --> 00:13:02,544
twelve to twenty four months.

337
00:13:03,509 --> 00:13:05,290
But technology is there.

338
00:13:05,910 --> 00:13:08,710
We we didn't talk about digital rehab as

339
00:13:08,710 --> 00:13:10,870
part of this, again, with respect to return

340
00:13:10,870 --> 00:13:11,529
to sport.

341
00:13:12,149 --> 00:13:13,910
So there are did I answer your question,

342
00:13:13,910 --> 00:13:15,910
Carly? I I wanna make Yes. Yes. This

343
00:13:15,910 --> 00:13:18,754
is great. Okay. As it relates to app

344
00:13:18,754 --> 00:13:20,934
based protocols, you know, clearly,

345
00:13:21,394 --> 00:13:22,615
if you follow any,

346
00:13:23,394 --> 00:13:26,375
software apps, whether you're whether you utilize Peloton

347
00:13:26,514 --> 00:13:26,995
or other,

348
00:13:28,754 --> 00:13:31,019
platforms like that, it's pretty clear that we

349
00:13:31,019 --> 00:13:32,799
can push exercise videos,

350
00:13:33,740 --> 00:13:35,820
as well as other aspects like pain and

351
00:13:35,820 --> 00:13:38,399
function scores and proms directly to dashboards

352
00:13:39,259 --> 00:13:41,980
that the the athlete and their surgeon and

353
00:13:41,980 --> 00:13:43,200
the team can review.

354
00:13:43,865 --> 00:13:47,144
And this can support more standardized pathways for

355
00:13:47,144 --> 00:13:48,044
common procedures

356
00:13:48,664 --> 00:13:50,284
and also generate outcomes,

357
00:13:51,944 --> 00:13:54,424
with respect to registries and our own research

358
00:13:54,424 --> 00:13:56,365
and quality work. Mhmm.

359
00:13:57,089 --> 00:13:58,389
Yeah. And then doctor Cortesco,

360
00:13:58,850 --> 00:14:00,850
one other topic that I really wanted to,

361
00:14:01,089 --> 00:14:04,230
touch base with you on is biologics

362
00:14:04,690 --> 00:14:05,589
in orthopedics.

363
00:14:06,769 --> 00:14:09,329
What what's your perspective on the state of

364
00:14:09,329 --> 00:14:12,264
biologics in orthopedic care now, and what are

365
00:14:12,264 --> 00:14:14,424
your predictions for the next two to three

366
00:14:14,424 --> 00:14:14,924
years?

367
00:14:15,544 --> 00:14:17,565
Well, again, this has been going on for

368
00:14:18,105 --> 00:14:20,605
over two decades. If we think back to

369
00:14:20,745 --> 00:14:22,524
athletes like Kobe Bryant,

370
00:14:22,904 --> 00:14:26,610
traveling to Dusseldorf to obtain injection treatments, it's,

371
00:14:26,690 --> 00:14:28,610
you know, this goes back a couple of

372
00:14:28,610 --> 00:14:29,110
decades.

373
00:14:29,730 --> 00:14:32,549
It's become much more prominent in The States,

374
00:14:33,089 --> 00:14:34,709
due to regulatory reforms.

375
00:14:35,570 --> 00:14:37,269
And, you know, I view biologics

376
00:14:37,889 --> 00:14:38,629
in in

377
00:14:38,945 --> 00:14:40,865
a couple of different ways. So as it

378
00:14:40,865 --> 00:14:42,384
relates to things that we do in the

379
00:14:42,384 --> 00:14:42,884
office

380
00:14:43,424 --> 00:14:44,164
to either

381
00:14:44,784 --> 00:14:47,184
enhance healing for patients we deem to be

382
00:14:47,184 --> 00:14:47,684
nonoperative

383
00:14:48,544 --> 00:14:49,284
or to

384
00:14:49,664 --> 00:14:52,164
promote healing in patients who are postoperative,

385
00:14:52,769 --> 00:14:54,950
I think most surgeons like myself,

386
00:14:55,970 --> 00:14:58,210
utilize these on a daily basis in our

387
00:14:58,210 --> 00:15:00,790
offices and sometimes in our operating rooms.

388
00:15:01,250 --> 00:15:01,750
So,

389
00:15:02,050 --> 00:15:04,550
you know, biologics, I think of in

390
00:15:05,024 --> 00:15:07,044
three basic ways, blood borne,

391
00:15:08,065 --> 00:15:09,824
bone marrow derived, and,

392
00:15:10,304 --> 00:15:11,365
adipose tissue.

393
00:15:11,985 --> 00:15:14,225
And so, for example, if I'm treating a

394
00:15:14,225 --> 00:15:16,485
younger athlete who has early osteoarthritis

395
00:15:17,024 --> 00:15:18,964
that is not a surgical problem,

396
00:15:19,940 --> 00:15:20,919
I might utilize

397
00:15:21,379 --> 00:15:22,039
a biologic

398
00:15:22,419 --> 00:15:23,080
to enhance

399
00:15:23,940 --> 00:15:26,660
pain relief and symptom relief. And I think

400
00:15:26,660 --> 00:15:29,860
I'll before getting into details, I'll I'll I'll

401
00:15:29,860 --> 00:15:32,660
sort of qualify this by saying, we wish

402
00:15:32,660 --> 00:15:34,600
we had more data than we do.

403
00:15:35,134 --> 00:15:37,294
And I think that's going to explode with

404
00:15:37,294 --> 00:15:39,214
the help of AI over the next two

405
00:15:39,214 --> 00:15:39,714
years.

406
00:15:40,414 --> 00:15:43,695
So historically, we believe that these products can

407
00:15:43,695 --> 00:15:45,075
help, and we have

408
00:15:45,455 --> 00:15:47,934
patient data that suggests that it will help,

409
00:15:47,934 --> 00:15:50,034
but we don't necessarily have the numbers

410
00:15:50,690 --> 00:15:51,990
for evidence based

411
00:15:52,769 --> 00:15:53,269
assessment

412
00:15:54,049 --> 00:15:56,950
that will that would allow health care delivery

413
00:15:57,009 --> 00:15:57,509
systems

414
00:15:57,889 --> 00:16:00,769
to feel comfort comfortable reimbursing for it. So

415
00:16:00,769 --> 00:16:01,750
as you know now,

416
00:16:02,129 --> 00:16:05,350
most of these techniques are not reimbursable upon,

417
00:16:06,004 --> 00:16:08,725
rather by health care delivery systems. So the

418
00:16:08,725 --> 00:16:10,105
onus is on the patient,

419
00:16:11,445 --> 00:16:11,945
to

420
00:16:12,565 --> 00:16:15,784
sort of establish these resource allocations, which is

421
00:16:15,845 --> 00:16:18,024
hard. So as a surgeon, as a clinical

422
00:16:18,085 --> 00:16:18,585
practitioner,

423
00:16:19,279 --> 00:16:21,940
it's hard for me to recommend a technology

424
00:16:22,879 --> 00:16:25,540
that requires the patient to expand a resource

425
00:16:25,919 --> 00:16:26,419
allocation.

426
00:16:27,200 --> 00:16:30,740
Having said that, there is data available for,

427
00:16:31,200 --> 00:16:32,500
for example, PRP

428
00:16:33,279 --> 00:16:33,940
to manage

429
00:16:34,804 --> 00:16:37,144
the use of these, techniques

430
00:16:37,684 --> 00:16:38,745
for early osteoarthritis.

431
00:16:39,125 --> 00:16:41,225
So there are lots of systematic reviews

432
00:16:41,684 --> 00:16:42,904
and meta analyses

433
00:16:43,684 --> 00:16:44,664
that will allow

434
00:16:45,125 --> 00:16:46,985
us to definitively say

435
00:16:47,610 --> 00:16:50,029
PRP is better than, for example, viscosupplementation

436
00:16:51,450 --> 00:16:53,389
for the management of early osteoarthritis.

437
00:16:54,409 --> 00:16:55,870
And I think that's that's

438
00:16:56,730 --> 00:16:59,049
an easy lift for most of us because

439
00:16:59,049 --> 00:17:00,190
the data is there.

440
00:17:00,570 --> 00:17:02,669
So I I mentioned the management of

441
00:17:03,464 --> 00:17:05,964
early o a in young athletes.

442
00:17:06,664 --> 00:17:08,045
There are other aspects,

443
00:17:08,505 --> 00:17:11,085
and a lot of this, Carly, honestly, is

444
00:17:11,144 --> 00:17:13,704
joint and disease specific. So we know, for

445
00:17:13,704 --> 00:17:16,045
example, and we've published on this at HSS,

446
00:17:17,000 --> 00:17:20,039
that some joints are more responsive and some

447
00:17:20,039 --> 00:17:22,619
tendon groups are more responsive to the application

448
00:17:22,680 --> 00:17:23,420
of PRP

449
00:17:24,680 --> 00:17:26,519
short of surgery. So many of these are

450
00:17:26,519 --> 00:17:27,740
nonoperative treatments.

451
00:17:28,360 --> 00:17:29,259
So for example,

452
00:17:29,865 --> 00:17:31,085
ECRB tendinosis,

453
00:17:31,944 --> 00:17:35,144
ECRB is the extensor carpi radialis brevis. It's,

454
00:17:35,625 --> 00:17:37,325
an elbow extensor tendon,

455
00:17:37,944 --> 00:17:40,744
otherwise known as tennis elbow. The same can

456
00:17:40,744 --> 00:17:43,609
be said of the common flexor tendon group,

457
00:17:43,910 --> 00:17:44,549
so called,

458
00:17:45,190 --> 00:17:46,250
golfer's elbow.

459
00:17:46,950 --> 00:17:47,850
These these

460
00:17:48,549 --> 00:17:51,190
treatments like platelet rich plasma have been shown

461
00:17:51,190 --> 00:17:52,009
to be helpful

462
00:17:52,549 --> 00:17:54,789
in Mhmm. Our own research and the research

463
00:17:54,789 --> 00:17:55,450
of others.

464
00:17:55,994 --> 00:17:58,154
And if you contrast that, for example, with

465
00:17:58,154 --> 00:17:59,295
rotator cuff

466
00:17:59,674 --> 00:18:01,214
tears or tendinosis,

467
00:18:03,035 --> 00:18:05,755
the the application of PRP has probably been

468
00:18:05,755 --> 00:18:07,295
less useful in that setting.

469
00:18:07,755 --> 00:18:09,535
So without getting into

470
00:18:10,250 --> 00:18:12,330
the weeds, so to speak, I I I

471
00:18:12,330 --> 00:18:13,390
wanna make it clear

472
00:18:13,850 --> 00:18:15,070
that there are differences

473
00:18:15,450 --> 00:18:15,950
among

474
00:18:16,650 --> 00:18:17,630
tendon groups

475
00:18:18,490 --> 00:18:18,990
within

476
00:18:19,690 --> 00:18:20,750
the human body,

477
00:18:21,210 --> 00:18:23,609
and there are also differences in the host

478
00:18:23,609 --> 00:18:24,109
response.

479
00:18:24,575 --> 00:18:27,055
So what may work for me with the

480
00:18:27,055 --> 00:18:27,795
same problem

481
00:18:28,174 --> 00:18:30,015
that you might have may not work for

482
00:18:30,015 --> 00:18:32,414
you, and and it's this is across many,

483
00:18:32,414 --> 00:18:33,795
many numbers of people.

484
00:18:34,174 --> 00:18:36,015
And we don't know the details of this,

485
00:18:36,015 --> 00:18:38,595
and I'm certainly no ex expert in regenerative

486
00:18:38,734 --> 00:18:39,234
medicine.

487
00:18:40,319 --> 00:18:42,480
But it's very clear that what you bring

488
00:18:42,480 --> 00:18:44,819
to the table based upon your own genetics

489
00:18:44,880 --> 00:18:45,700
and your own,

490
00:18:46,720 --> 00:18:49,279
composition, if you will, without once again getting

491
00:18:49,279 --> 00:18:49,779
into

492
00:18:50,319 --> 00:18:52,799
the nuances of what types of factors we're

493
00:18:52,799 --> 00:18:53,700
talking about,

494
00:18:54,414 --> 00:18:57,214
it's clear that the differences between humans have

495
00:18:57,214 --> 00:19:00,035
an impact on the responses to these biologics,

496
00:19:00,174 --> 00:19:02,115
which makes it that much more difficult.

497
00:19:02,414 --> 00:19:04,174
So I know it's an exciting area, and

498
00:19:04,174 --> 00:19:05,714
we're all interested in it.

499
00:19:06,539 --> 00:19:07,980
But I I think we don't have a

500
00:19:07,980 --> 00:19:10,080
lot of the data that we need to

501
00:19:10,380 --> 00:19:12,320
to promote it on a regular basis.

502
00:19:12,779 --> 00:19:14,620
Having said that, is it used in most

503
00:19:14,620 --> 00:19:17,180
sports medicine practices around The US and around

504
00:19:17,180 --> 00:19:17,840
the world?

505
00:19:18,220 --> 00:19:18,720
Absolutely.

506
00:19:19,534 --> 00:19:21,375
But we just don't have the data that

507
00:19:21,375 --> 00:19:23,794
that a purist would would like to have

508
00:19:24,414 --> 00:19:26,034
to implement this across

509
00:19:26,575 --> 00:19:27,794
all patient populations.

510
00:19:29,134 --> 00:19:31,694
Thank you for, breaking all that down. And

511
00:19:31,694 --> 00:19:32,994
we are coming to,

512
00:19:33,534 --> 00:19:36,669
about time. So doctor Cordesco, I wanna thank

513
00:19:36,669 --> 00:19:39,329
you again for joining us on today's podcast.

514
00:19:39,549 --> 00:19:41,710
It was great chatting, and I look forward

515
00:19:41,710 --> 00:19:43,250
to connecting again in the future.

516
00:19:43,710 --> 00:19:44,210
Perfect.