The Basis of AROmotion

The Problem: A Broken Orthopedic Paradigm

The Traditional Two-Tool Approach

For decades, orthopedic surgery has operated with essentially two tools: arthroscopic surgery (cutting and grinding) and total joint replacement. When patients present with severe joint pain and imaging shows narrowed joint space or "bone on bone" conditions, surgeons have traditionally declared the joint "shot" and recommended either living with pain, addictive medications, or total joint replacement surgery.

Understanding the Real Source of Joint Pain

Joints contain two types of cartilage. The fibrous meniscus acts as a cushioning pad, while articular (hyaline) cartilage forms a hard enamel coating on bone ends—identical to tooth enamel. The only location where pain can be sensed in a joint is within the bone itself, protected by this hard cartilage coating.

Chondromalacia—the wearing of this protective cartilage into small cavities or "potholes"—is the true culprit behind most joint pain. Like dental cavities, these compromised areas expose underlying nerve endings to mechanical trauma, generating pain signals that trigger inflammatory cytokines and interleukins, creating a destructive feedback loop of progressive joint degeneration.

The Genesis of AROmotion

A Physician's Mission

Dr. Dean, a highly regarded Internal Medicine physician voted one of Florida's Top Doctors, witnessed firsthand how orthopedic surgeons defaulted to total joint replacement surgery. His patients frequently returned with continued disability and pain following these procedures. Believing patients deserved better options, he assembled a multidisciplinary think tank of physicians, surgeons, and university scientists to research and develop a procedure that would bridge the gap between addictive pain medications and invasive major surgery.

How AROmotion Works: A Multi-Faceted Approach

The Pathology of Joint Degeneration

Joint degeneration begins with mechanical trauma—whether from repetitive non-cyclical motions like jumping and running, specific injuries, or even prior arthroscopic surgeries. This initial trauma triggers an inflammatory cycle. In youth, this might manifest as mild stiffness or aches. Over decades, the hard hyaline cartilage wears into thin spots and potholes (chondromalacia), progressively exposing nerve endings in the underlying bone.

As we age, similar activities generate significant pain because compromised nerve endings now sense pressure and trauma. This pain triggers the release of inflammatory cytokines and interleukins, perpetuating a vicious cycle of arthritis, joint injury, and progressive degeneration.

Step 1: Breaking the Pain-Inflammation Feedback Loop

Once a joint is confirmed as mechanically intact, AROmotion performs Radiofrequency Ablation (RFA) on the sensory nerves affected by chondromalacia (genicular nerves in the knee). This procedure accomplishes multiple critical objectives:

Step 2: Strategic Orthobiologic Placement

Unlike traditional orthopedic approaches that place orthobiologics (such as hyaluronic acid or stem cell therapies) as a "last ditch" effort into inflamed, hostile joint environments where they rapidly degrade, AROmotion strategically introduces these healing agents into the now-calmed, less toxic environment created by RFA.

This augmented environment allows orthobiologics to achieve maximum effectiveness. The procedure activates the chondrocyte matrix, which generates the hard enamel that protects underlying nerves—similar to how microfracture surgery works (drilling holes into bone to release healing bone marrow stem cells), but without the 4-6 weeks of non-weightbearing postoperative pain associated with that invasive approach.

Step 3: Total Joint Reconditioning

With pain signals turned off and inflammation reduced, patients can immediately begin reconditioning the muscles and ligaments surrounding the joint. This comprehensive rehabilitation protocol ensures long-term functional improvement and joint stability.

Clinical Evidence and Outcomes

Pioneering Clinical Research

Since initiating the first AROmotion cases in early 2017, the program has treated over 8,000 joints, making it one of the largest providers of non-surgical RFA with orthobiologic procedures and patient-centric reconditioning protocols in the United States.

AROmotion's trained physician observers conduct a multi-year, structured research protocol measuring both pre- and post-procedural outcomes using the WOMAC (Western Ontario and McMaster Universities Arthritis Index) Data Model—the gold standard for evaluating hip and knee osteoarthritis.

Superior Long-Term Results

Nine years of follow-up data collected since launching the clinical case series demonstrate that AROmotion has consistently outperformed total joint replacement surgery. The improvement in WOMAC scores unequivocally shows lasting improvement exceeding outcomes for patients who underwent total joint replacement.

Differentiation from Competitors

Orthopedic Surgery

Traditional orthopedic surgeons face significant limitations. With only cutting, sawing, and implantation in their toolbox, they cannot address chondromalacia without joint replacement. While some surgeons remain skeptical of non-surgical alternatives, even they acknowledge that 25% of total joint replacement patients continue experiencing chronic pain. More critically, once a joint is "sawed off," the procedure cannot be reversed.

In contrast, AROmotion treats pain and function without altering joint anatomy, preserving total joint replacement as a future option if ever needed.

Interventional Pain Management

While interventional pain management physicians are trained in RFA procedures and can perform genicular nerve ablations, few are interested in treating extremities due to complex billing/coding and poor reimbursement compared to more lucrative spine procedures. Additionally, standalone RFA—used sporadically since 1939—provides only temporary pain relief without addressing underlying pathology.

Traditional Orthobiologic Treatments

Current orthobiologic use by orthopedic surgeons typically fails because these fragile substances are placed into angry, inflamed osteoarthritic joint environments where they rapidly degrade. AROmotion is the only group in the United States that strategically combines RFA with orthobiologics to create an augmented environment for healing.

Historical Context: Building on Established Science

RFA for joint pain was first introduced in 1939 and has been used sporadically over the decades. However, RFA alone did not provide lasting relief, which limited its adoption. The breakthrough came from understanding that RFA's value extends beyond temporary pain relief—it fundamentally alters the joint environment, stopping the inflammatory cascade and creating optimal conditions for healing.

Similarly, microfracture surgery—where tiny holes are arthroscopically drilled into bone at chondromalacia sites, causing bone marrow bleeding rich in stem cells and healing factors—has demonstrated that chondromalacia can resolve through chondrocyte activation. Surgeons rarely perform this procedure due to associated long postoperative pain (4-6 weeks non-weightbearing). AROmotion achieves similar chondrocyte activation through orthobiologic placement in an optimized environment, without the drilling trauma.