Brevard sports doc bets on experimental remedy

Dr. David Dominguez injects the A2M into the knees of his physician-assistant Casey Runte to combat his arthritis.

One day in 1998, Florida Gators linebacker and Suntree native David Dominguez was rushing the opposing team’s quarterback during practice. And that day in The Swamp did not end well for him.

“I got injured,” Dominguez, a zoology major at the time, recalls. “My right shoulder was dislocated. That injury ended my football career.”

But a Gainesville surgeon, who repaired the injury, inadvertently prompted Dominguez toward his current career — and not one like his surgeon’s.

“I always felt I could do better than the guy treating me,” Dominguez said. “The procedures he used were very old.”

Fast forward to the present. Dominguez, 42, now a sports physician, runs 3D Sports Medicine & Orthopedic Center in Indialantic.

He graduated with honors from the University of Florida in 2000 with his bachelor’s degree in zoology, then went on to Duke University and earned an M.D. degree in 2006.

He later completed his orthopedic residency at Texas A&M University before moving to San Francisco for a fellowship led by San Francisco Giants team physicians.

And along the way he encountered Alpha-2-Macroglobulin — or A2M for short — something he now injects into patients, such as chronic arthritis sufferers, to combat their daily pain.

And he might be the only one in Brevard County to do so, according to an internet search.

A2M is a large protein molecule already in a person’s blood. What Dominguez does is to extract platelet-rich plasma, containing A2M, from a vial of a patient’s blood. He spins it in a centrifuge and then filters it to yield a concentrated dose of pure A2M.

On a recent visit, Dominguez agreed to give Physician Assistant Casey Runte an A2M injection in each knee.

“Oh, I’ve been begging for this,” Runte said, insisting he wasn’t peer-pressured into volunteering. “I’ve got arthritis from years of overuse, going back to high school soccer and running.”

Dominguez injected 15 cubic centimeters of A2M into each of Runte’s knees after first numbing them. Afterward, Runte slipped off the examination table and walked around. The only thing he felt, he said, was the weight of the added fluid in his knees.

“I can’t wait for the effects to kick in,” he said.

In a few days, Dominguez said, Runte should feel the lack of arthritic pain.

Other doctors would have injected cortisone. Dominguez said A2M can last about two years, a bit longer than cortisone, before the patient needs another injection.

But he said A2M removes pain-causing enzymes without harming the cartilage already in the joint. Cortisone poses long-term damage to the cartilage, he said.

In fact, Dr. Pat F. Bass III of Shreveport, La., a medical reviewer for the internet magazine Everyday Health, says cortisone shots can lead to permanent softening of the cartilage and weakening of the tendons in the affected joint.

“Of course, cortisone makes you feel better,” Dominguez said. “But it destroys the cartilage already there. We say those patients are ‘laughing their way to the grave.’ ”

Dominguez learned of the new procedure from Dr. Gaetano Scuderi, a Jupiter-based spine surgeon and founder of the Cytonics Corp, for which he also chairs the board of directors.

Cytonics is seeking to have the A2M injection procedure approved by the U.S. Food and Drug Administration. Until it is approved, Dominguez said, it is still considered “experimental.”

Dominguez said the FDA has already approved the process of gathering the A2M from the blood.

“However, concentrating (the plasma) is not covered under the FDA approval,” he said, adding he lets prospective patients know this upfront.