The Trainer's Take: Part Two

Since 1984, one constant remains in the Los Angeles Lakers locker room from the days of Magic Johnson and Kareem Abdul-Jabbar: head athletic trainer Gary Vitti.

In Part One of "The Trainer's Take," Vitti explained how he and his staff got the Lakers through the 2011-12 season in excellent health. Here, Vitti details the Orthokine and Regenokine treatments that Kobe Bryant and Andrew Bynum will undergo over the summer in Germany, the same process Bryant successfully went through last offseason:

MT: Andrew Bynum suggested at his exit interview that he will go see Dr. Peter Wehling in Germany this summer to explore the procedure called Orthokine or Regenokine, the same one that was successfully performed on Kobe's knee last offseason?
Vitti: I've already spoken to the doctor in Germany regarding Andrew going through the same procedure as Kobe did.

MT: And will Kobe go back to see the Dr. again? Perhaps after the Olympics in London?
Vitti: Yes. He could even do it while he's playing. I'm not sure if he's going to go before, during or after, but he says it helped doing it last offseason.

MT: You were actually the person who brought the idea and information to Kobe about the procedure, Gary. Can you take us through how it all started?
Vitti: The genesis of this came from Hollywood people, actors and actresses that were going over there that needed to perform stunts and such. Somebody found out about it and went over to Germany, and at some point, one of our season seat holders named Karyn Silver, the wife of Joel Silver, mentioned it to me and I initially didn't think much of it. But as I began to hear more about it – Troy Polamalu of the Pittsburgh Steelers had done it and had a good result — I became more intrigued, and soon after Dr. Wehling happened to be visiting Los Angeles from Dusseldorf. So I called (team physical therapist Dr.) Judy (Seto) in, and we met with Dr. Wehling. He was visiting a doctor here that was in the FDA study, since the treatment isn't approved yet in the U.S., and I decided to send one of our older players to see him. This individual had a lot of cartilage damage in his knee, and he thought it helped him a little bit, even though his knees were probably so far gone that there wasn't much that could be done. It still seemed like it helped him enough that if you went into it with a better joint, you might get a better result. So I kept communication up with Karen and Joel Silver and Dr. Wehling. After we lost to Dallas (in the 2011 Western Semi's), I told Kobe I thought he should do it, and do it immediately so that if we didn't get a good result, we could do something else. He bought into that logic, and was very soon on a plane to Germany. The proof is in the pudding. Kobe ran better, he felt better, we didn't have half the issues we had the year before. In my book, it was a go.

MT: How would you describe the actual treatment, called Orthokine or Regenokine, and how it differs from PRP? We'll be prepared for lots of big words and confusing terms.
Vitti: Yes. This is where things got very confusing in the press, where some said that Kobe went to Germany for PRP (platelet rich plasma). This is not PRP. That is a different treatment from what Kobe did, which is called Orthokine or Regenokine. They are similar to PRP in that they take your own blood and spin it down in a centrifuge. In PRP, they take the platelets out and then inject them back into the site you're having an issue with, which causes a therapeutic effect. Orthokine/Regonokine are different in that they take your blood, they spin it down, and instead of the platelets, there is a protein that is called interleukin which causes the inflammatory process. So when they spin the blood down, they take the antagonist of interleukin and make a serum out of the antagonist of the interleukin and then they inject that back into you. So if interleukin is the bad thing, they take the antagonist of it and then they inject it to stop the inflammatory process that the interleukin is causing. In addition, there are some stem cell things they are doing that are individual to the person, and that's the Regenokine part.

MT: So in short, there's a stoppage of inflammation (Orthokine) and then the regenerative part (Regenokine).
Vitti: Correct. The interleukin is the protein that causes the inflammatory process in your joint, and so the process takes the antagonist of interleukin out and then inject that back into the joint. It is an invasive process, where they stick a needle into your body to get the blood, then eventually inject a serum into your knee.

MT: How much confidence does this give you in the treatment?
Vitti: There's an old saying in sports medicine: when you have a new hammer, everything looks like a nail. What you have to understand is that even though this worked for Kobe and maybe a lot of others, it's not a panacea, it's not the answer to everything. But given certain things, if you fall into that category, this is probably a good way to treat it.

MT: Why hasn't it been approved in the United States?
Vitti: It will be some day. It's just that the U.S. is a lot more stringent with its ability to do things to people; other countries don't have the same laws that we do to protect the people in the studies. It is an invasive procedure, so there are certain steps we have that are harder to surpass to the end of the study … but eventually we'll get there.

MT: And Kobe is a good person to go through it as you know he'll follow through on the full rehabilitation process?
Vitti: He does everything he has to do. Comes early, stays late and so on. If you're going to accuse Kobe of anything, you'd accuse him of overdoing it, overworking.

MT: The Olympics are on the horizon in London; have you thought about working the Games?
Vitti: The people that are taking care of the Olympic team are very qualified. I think I have been the trainer for 364 playoff games on top of the regular seasons since 1984. That's a lot of games. We work seven days a week during the season, and usually go deep into the postseason, I think my wife would kill me if I took on the Olympic team. I want to see my wife and my kids. So it's just been something that has never been right for me, even though a part of me would like to do it. If they were interested in me, maybe it'd be something I'd do when I retire.

MT: Kobe will play for the USA, and Gasol for Spain, of course. Do you get nervous watching those games when you can't control anything?
Vitti: Yes. But like I said, they have very qualified people looking after them, and Kobe for one is very smart with his body. The rest of it, you just keep your fingers crossed. At the same time, you look at Lamar Odom, who had the best year of his career after playing for Team USA. He was in great shape, great rhythm. So you have to commend the athletic trainers that are working the Olympic program. We've never gotten anyone back broken, we've gotten them back in good shape.