Posts Tagged medicine
On Restoration, Regeneration and Resurrection
Posted by Mitchell B. Sheinkop, M.D. in Hip Pain, knee, Osteoarthritis, Stem Cells on April 3, 2012
Musculoskeletal Care of the Mature Patient
I feel the pain. This weekend was spent with my wife chasing trout in the Driftless Area of southwestern Wisconsin and I am hurting. Walking down a creek for miles is an adventure that is unlike no other. I have no idea what this has to do with stem cells so let’s get back to the week to be, actually the month ahead.
Passover begins in the evening of Friday, April 6 and ends in the evening of Saturday, April 14
Easter is Sunday, April 8
Regenexx visit is Monday, April 9 to Wednesday, April 11
Biovision needlescope introductory to regenerative medicine, April 12
American Academy of Orthopedic Surgery course “Advances in Care of the Aging Athelete” April 20 to April 22
I am undertaking an entire new direction as an orthopedic surgeon who performed and pioneered joint replacements for over 38 years. All I had to do was read the newspaper and listen to the media reports on orthopedic implant recalls to remind myself that someone from the orthopedic surgical community has to look ahead to alternative options for pain solutions. The AAOS course will address issues from stem cell and adjunctive therapies, nutrition, performance enhancing drugs, cutting edge regenerative and restorative treatments, and the application of other anti-aging substances and supplements for the shoulder, hip and knee-all with the goal of keeping patients well and at the top of their game. If you are severely impaired, then you still may need a joint replacement; but if you are still functional, there are viable alternatives to surgery. For the female athlete, I am developing an expanded approach to treatment and maintaining the opportunity to participate. My focus is personal and is somewhat brought about by my own interests, anti-aging and managing the aging process. Normal physiologic effects of aging affect participation in sports; reader, you are left to define the word sports. There is not necessarily a predictable positive impact of a joint replacement on function even if the implant is not recalled. If you want to analyze how cartilage regenerative techniques may apply to you in the new world of regenerative stem cell based medicine, call for an appointment. I will work with you to determine appropriate non-operative and minimally invasive stem cell treatment plans for mature adult “athletes” with traumatic, degenerative and arthritic conditions particularly related to the knee, hip and shoulder.
Mitchell B. Sheinkop, M.D.
847-390-7666 or 312-475-1893
1564 N. La Salle St
Chicago, Illinois 60610
Saving umbilical cord blood
Posted by Mitchell B. Sheinkop, M.D. in Cord Blood, Osteoarthritis, Regenerative Pain Center, Stem Cells on March 15, 2012
In the beginning, there was an umbilical cord. The blood in that cord was and is an invaluable source of stem cells that is unique to your body and family. These cells may be used to treat nearly 80 serious medical conditions at last count including leukemia, other cancers, and blood disorders. Cord blood stem cells are showing significant potential to treat conditions that have no cure today as juvenile diabetes and brain injury. Saving your baby’s or your grandchild’s cord blood secures the best treatment option for a healthy future.
According to the U.S. Department of Health and Human Services, “This revolutionary technology (regenerative medicine) has the potential to develop therapies for previously untreatable conditions. Examples of diseases regenerative medicine can cure include diabetes, heart disease, renal failure, osteoporosis, and spinal cord injuries. I am now ready to announce my personal entry into the new world of regenerative medicine in conjunction with the Regenerative pain Center by having joined the Regenexx network of physicians. I will start screening patients for bone marrow concentrate pilot study as of March 25th. The actual clinical process will be introduced at the beginning of May at the Regenerative Pain Center. There is as yet no assurance that bone marrow concentrate rich with autologous mesenchymal adult stem cells administered in to an arthritic joint will reverse arthritis or even stop progression but with the anecdotal observations around the country, I believe that as an orthopedic surgeon, I might or could be able to delay or avoid a joint replacement. Our pilot study will be the first step. In order to qualify, a patient will need to meet certain criteria determined by history, physical examination, X-ray and MRI. At times, a diagnostic out patient arthroscopic examination or prior treatment may be part of the program. For those who don’t qualify for the study, the patient may still seek treatment with a self-pay alternative.
Transplant medicine uses stem cells to help treat serious diseases, such as cancers and blood disorders. Regenerative medicine is a new and rapidly advancing area of medicine focusing on developing treatments using stem cells to repair damaged tissues and organs. The estimates to date that someone in your family will use stem cells in a lifetime include:
Transplant Medicine: 1 in 217
Regenerative Medicine: 1 in 3
I am thrilled to announce my entry in to the emerging stem cell application regenerative process. To learn more or see if you qualify, call the number listed below.
Mitchell B. Sheinkop, M.D.
847-390-7666
1565 N. LaSalle St., Chicago, Illinois, 60610
Bone Marrow Concentrate for Arthritis; the potential benefits and risks
Posted by Mitchell B. Sheinkop, M.D. in Hip Pain, knee, Osteoarthritis, Platelet Rich Plasma, Regenerative Pain Center, Stem Cells on March 8, 2012
Musculoskeletal Care of the Mature Patient
The potential benefit of regenerative medicine is avoidance of orthopedic surgery. That’s the goal and I am the orthopedic surgeon leading the charge. I have spent several years now investigating, meeting, traveling, learning and preparing for that reality with the start-up anticipated in mid-April. While there is anecdote about subjective improvement following autologous, mesenchymal, Bone Marrow Concentrate derived stem cells for management of arthritis, there are no peer reviewed published long-term clinical outcomes to the best of my knowledge. There have been testimonials by orthopedic surgeons that following the adjunctive use of stem cells in conjunction with arthroscopic micro fracture of an arthritis knee, when the patient subsequently underwent knee replacement, hyaline cartilage was observed growing rather than fibro cartilage. This is not good enough for me, as I want a procedure that will postpone the need for a joint replacement or possibly eliminate that need. Is it a matter of when to intervene with regenerative medicine? When there is major deformity of an arthritic joint, significant alteration in function and a “bone on bone” X-ray, it probably is too late. Will regenerative medical intervention delay the joint replacement by a three to five year control of pain by the anti-inflammatory nature of bone marrow concentrate or will the joint cartilage actually re-grow? These are unanswered questions and what I seek to learn as I embark on my clinical project
Recently, the orthopedic surgical spine community became aware of a fourfold risk of cancer in patients who underwent spinal fusion using Bone Morphogenic Protein to increase the likelihood of successful fusion. As a result, attention quickly was redirected to stem cells as an adjunct in spinal surgery to replace human BMP. As of this writing, I have found no evidence of carcinogenesis in conjunction with autologous, mesenchymal Bone Marrow Aspirate Concentrated stem cells used in the skeleton and certainly not when used in a joint. The same might not be said when embryonic stem cells have been injected into the blood of patients to treat probably what shouldn’t be addressed with stem cells in the first place. Desperate people are not infrequently victims of charlatans as has been repeatedly pointed out on 60 Minutes. Contrast the risks of stem cell misdeeds with the benefits of scientific application. Today, the AMA News headline covered the potential for stem cells to eliminate the need for long-term anti-rejection pharmaceuticals in organ transplant recipients.
How to avoid orthopedic surgery by an orthopedic surgeon? Not just a mission statement by an ethos. Call to see if you are a candidate.
Mitchell B. Sheinkop, M.D.
847-390-7666
1565 N. LaSalle Street, Chicago, Illinois 60610
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Surfing the Internet for stem cell updates
Posted by Mitchell B. Sheinkop, M.D. in knee, Osteoarthritis, Stem Cells on February 29, 2012
The New York Times (2/27, A8, Wade, Subscription Publication) reports, “Researchers at Massachusetts General Hospital say they have extracted stem cells from human ovaries and made them generate egg cells.” The report, “if confirmed, might provide a new source of eggs for treating infertility, though scientists say it is far too early to tell if the work holds such promise.”
The AP (2/27) reports that lead researcher Jonathan Tilly of Massachusetts General Hospital “collaborated with scientists at Japan’s Saitama Medical University, who were freezing ovaries donated for research.”
Bloomberg News (2/27, Flinn) reports “stem cells from the ovaries were injected into human ovarian tissue that was then grafted under the skin of mice, which provided the blood supply that enabled growth.” In less than “two weeks, early stage human follicles with oocytes had formed.”
The Boston Globe (2/27, Johnson) reports, however, that “scientists not involved with the Mass. General research said such an approach – if it is even possible – sits far in the future and will require considerably more work.” A number of “scientists said Tilly, who cofounded a company focused on developing novel infertility treatments, had not yet made a convincing case that the stem cells he discovered can yield viable eggs, a critical first step.”
The Wall Street Journal (2/27, Naik, Subscription Publication) reports that the research, published in published in Nature Medicine, was funded by the National Institutes of Health, among others.
HealthDay (2/27, Goodwin) reports that although “it was long believed that women were born with a lifetime supply of eggs, which was depleted by menopause,” an increasing “body of research,” such as this study, “suggests egg production may continue into adulthood.” Also covering the story are MedPage Today (2/27, Bankhead) and WebMD (2/27, Goodman).
Regenexx Web Site KJ is in his late 70′s and was evaluated by us in 2008, after a lifetime of knee problems since a torn meniscus in the 1960′s. After multiple failed arthroscopic knee surgeries through the 2000′s, he was told he needed a knee replacement. His MRI showed complete loss of the meniscus in the left knee (which had been surgically removed in the 1960′s) and severe cartilage loss (bone on bone), so he was told that he was a fair-poor candidate for the procedure (his knee is featured in this prior blog post). He didn’t want a knee replacement, so he decided to give the procedure a try. We treated him with the Regenexx-C knee stem cell treatment as well as a barbotage procedure to remove bone spurs and some injections to tighten his very loose ACL knee ligament. His last update on how the knee did with stem cell treatment is here. I examined him today, more than 2.5 years after his knee stem cell injection and his knee still feels great. He walks several miles a day, climbs ladders and stairs, and works on home improvement projects, all without significant pain other than mild stiffness now and then. His exam showed no significant tenderness or swelling. Looks like KJ was able to dodge the knee replacement bullet long-term because of an injection of his own stem cells and an Interventional Orthopedics approach
I am off to Regenexx on Friday.
Hand Surgery Alternative for Arthritis and Injury
Posted by Mitchell B. Sheinkop, M.D. in Hand, Osteoarthritis on February 21, 2012
I have recently seen an increasing number of patients with altered function of their hands because of pain or reduced range of motion due to common injuries, overuse, basal joint arthritis/osteoarthritis, or other degenerative problems.
Thumb arthritis (or basal joint arthritis) can appear early in life. Because of the constant swiveling and pivoting motions of the basal joint–the joint at the base of the thumb, or thumb CMC (carpometacarpal) joint–the thumb joint tends to wear out easily. Basal joint arthritis is also common in people who have osteoarthritis. As well, tendinitis in the wrist and hand is rampant because of over use of the computer mouse and improper ergonomics.
One way to treat the arthritic condition is with total joint reconstruction surgery. Perhaps over use syndromes may be reduced via voice recognition software but I personally still need to edit and then correct about 15% of my dictations. While surgery may improve the condition for some, this is not the case for all. New problems in the thumb joint may redevelop over time, causing such symptoms as numbness or tenderness. Then there is amazing increase in the occurrence of trigger finger and De Quervains Disease; both which lend themselves to ultrasound guided injection.
A reasonably successful approach to all of these wrist and hand problems is to start with an ultrasound guided intraarticular cortisone injection. Should the latter be of short-term relief, then platelet rich plasma may be successful for a longer period. Before considering the surgical alternative, be aware that Regenexx has published the outcome of 6 patients who were just under a year out (11.3 months) from treatment with their own stem cells 83.4% of thumb patients are reporting greater than 50% improvement after a simple injection of their own stem cells, 66.7% of thumb patients are reporting greater than 75% improvement and the average change is 70% improved. No significant complications in this group were reported.
If you have pain in your hand or wrist, start with a change in the ergonomics in your work place. Most office suppliers have the necessary mechanical devices available. The next step is an arthritic glove available in most large drug stores. If unsuccessful, the next step is an ultrasound guided injection of cortisone, platelet rich plasma and then stem cells in that order when all else fails.
Mitchell B. Sheinkop, M.D.
847-390-7666
1565 N. LaSalle Street, Chicago, Illinois 60622
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Stem Cells and the Lawsuit That May Shape Our Medical Future
Posted by Mitchell B. Sheinkop, M.D. in Stem Cells on February 14, 2012
Musculoskeletal Care of the Mature Patient
Forbes , 02/10/2012 Gergana Koleva
Regenerative Sciences, a medical company that pioneered a procedure to treat orthopedic injuries using patients’ own stem cells, is fighting the Food and Drug Administration tooth and nail over a claim that human cells should be federally regulated as drugs, in a landmark case that has far-reaching implications for the future of regenerative medicine.
At the heart of the debate is a therapy that uses stem cells derived from bone marrow to repair damaged joints. It was developed in 2005 by the Colorado-based company, which began offering it to patients around 2007, and has since gathered a raft of clinical evidence and testimony about its safety and efficacy. The FDA is questioning its legality, alleging that the stem cells it uses are more than minimally manipulated drugs and should be regulated and subject to approval as drugs. In 2008, the agency accused Regenerative of practicing medicine without a license required for the introduction of a new drug, and in 2010 sued to stop it from performing the procedure.
Despite the controversy, a number of clinics from coast to coast have licensed their physicians as recently as last month to provide the cell therapy, called Regenexx. This has led to renewed interest by consumers and would-be patients, and prompted the company to publish a sharply worded blog post on its website condemning the FDA’s reasoning.
The lawsuit is “concerning for every American who considers their body not to be an FDA regulated drug factory,” the blog says.
While the treatment that is the focus of the lawsuit is not used for life-threatening injuries, the company claims this case goes beyond a particular procedure to shed light on a misguided push by the FDA to establish authority over aspects of medicine never allowed it by Congress.
Regenexx works by taking a blood sample and a bone marrow sample from a patient and separating out the stem cells via centrifuge, then re-injecting those cells directly into the injured area, where they assimilate into the bone or cartilage and begin to regenerate it. Physicians for the company have shown in clinical studies cataloged at the U.S. National Library of Medicine that the therapy produces fewer and less severe complications than the more invasive and costlier surgical procedures it helps many patients avoid.
You may read the entire article on the Forbes web site. On March 2, I will be visiting Regenexx to explore my joining their network of physicians using stem cells.
Stem Cell Crier
Posted by Mitchell B. Sheinkop, M.D. in Regenerative Pain Center, Stem Cells on January 30, 2012
Musculoskeletal Care of the Mature Patient
I’m back from a short Blog sabbatical, refreshed and with much to discuss. During the time away, I spent a week skiing in Colorado with my wife, read a book, The Immortal Life of Henrietta Lacks, a must read for anyone interested in or considering regenerative medical care, and kept up on issues that I believe would be of interest to readers. While I was gone, my staff continued to work and both finalized and submitted the request to The Institutional Review Board that will enable us to begin The Bone marrow Aspirate Concentrate Stem Cell (BMAC) management of osteoarthritis. I will share with you what I read, watched and observed.
From the American Medical Association Morning Rounds of Tuesday, January 24, Leading the News “Stem cell treatment may help patients with macular degeneration”
On NBC’s The Doctors-Jan 25, a Regenexx stem cell procedure is featured for a patient with a failed microfracture in a woman with an arthritic knee seeking return to an active life style.
The Immortal Life of Henrietta Lacks , written by Rebecca Skloot is the fascinating biography of a woman whose cells were harvested without her knowledge in 1956 at Johns Hopkins; and ultimately became responsible for the world of regenerative medicine today. Along with the factual history of how the first cell cultures of human cells has evolved into the practice of medicine as we know it today, one learns about the evolution of medical ethics, government mandated patient protection and informed consent processes that govern contemporary medicine. You will better understand my approach to regenerative medicine when you finish this book named by more than 60 critics as one of the best books of 2010.
We arrived in Vail on Saturday afternoon, January 21, just as a snowstorm was starting. By time we ventured out on Sunday morning, there was 12 inches of fresh powder at the top of Rivas Ridge. It snowed again two more times during the week with another 14 inches of fresh powder by time we headed down Shangri-La in China Bowl. During the week, a friend came over from Breckenridge with his snow- board. By the end of our Wednesday skiing, I needed regenerative care for my entire body; almost no one was on the slopes besides us.
Over the next two weeks, I am scheduled to do site visits to observe and compare notes with centers involved in BMAC. If you want to move forward with learning whether you might be a candidate for regenerative medical care of your arthritis before scheduling that joint replacement, make an appointment or make a call. While no authority can promise success, there is an accumulating body of global information suggesting autogenous, autologous, adult bone marrow derived mesenchymal cells my be an effective, long term, anti-inflammatory and perhaps alter the natural history of degenerative arthritis.
Mitchell B. Sheinkop
1565 N. LaSalle Street
Chicago, Illinois 60610
847-390-7666
