Apr 14, 2023
The number of patients presenting with shoulder-generated complaints has dramatically increased in the past several months. Some complaints follow a single trauma, while others are the result of cumulative injury. Then there is osteoarthritis, inflammatory arthritis, and causation by metabolic disorders; and as in any joint, there is the possibility of a congenital predisposition.
When the patient presents to me with a chief complaint related to the shoulder, my initial focus is to make sure the symptoms are not referred from a cervical spine abnormality. Then a health assessment adds information about possible metabolic disorders and inflammatory causation. Once the examination of the neck is completed, my attention is directed to the shoulder. A visual inspection allows me to determine if there is muscle atrophy, both front and back. The physical examination includes a determination of whether adhesive capsulitis is playing a role or whether the range of shoulder motion has been limited by the underlying pathology within the shoulder. Manual muscle testing helps determine whether the problem is basically symptom-generating or function-limiting. There are several standard examination techniques available to help narrow the possible causes resulting in pain and altered shoulder function. A simple tape measure allows for the measurement of arm and forearm atrophy. The final information that helps to determine if the shoulder impairment is joint, muscle, tendon, or bone based is the X-ray. If the latter is “negative”, an MRI is indicated.
As far as treatment is concerned, the recommendation is based on the diagnosis. In most instances, physical therapy is the starting point. At times, a one-time steroid injection may be prescribed; I emphasize, it only once. In general, at reevaluation, a review of the initial assessment, and a review of imaging will allow me to determine if the problem is the rotator cuff or osteoarthritis. Treatment modalities after Physical Therapy include Micro-fractured adipose tissue (fat recovered by an office-based mini-liposuction containing stem cells and Growth Factor Proteins) for rotator cuff abnormality and Bone Marrow Concentrate (containing stem cells and Growth Factor Proteins) for osteoarthritis, and patient outcomes will be measured.
My disclaimer, the aforementioned is a general overview of shoulder-generated symptoms and altered function. As described, there are many possible causes contributing to shoulder disease. In the same way, there are many potential treatment options ranging from surgery when indicated to using a needle instead of a knife. Only an office visit and review of imaging will allow me to make an evidence-based recommendation for care; and only after informed consent from the patient will the two of us make the definitive decision for the best treatment option.
To learn more, visit my website at www.sheinkopmd.com. To schedule a consultation call (312) 475-1893.
Apr 6, 2023
It is about 15 years since I exchanged a scalpel for a needle; that is graduating from surgically replacing hips and knees to assisting patients impaired by pain and limited function from osteoarthritis to delaying, perhaps avoiding a joint replacement. During my many years of surgically replacing hips and knees at a major academic medical center in Chicago, where I became head of the joint replacement program and professor of Orthopedic Surgery, I collected outcomes data as I practiced thereby pioneering the integration of patient care with orthopedic research. The result was close to 100 scientific orthopedic publications influencing how joint replacements are carried out today; be it the cementless hip and knee replacement, the unicompartmental knee replacement, the long-term survivorship of a hip or knee prosthesis, the introduction of the mobile bearing knee prosthesis, robotic-assisted joint replacement, etc., etc., etc. At every step, it was the outcomes data collected that in part, led to how joint replacement surgery is practiced today.
When I graduated to a needle in lieu of a knife, cellular orthopedics, instead of a prosthesis, I used stem cells, platelets, and proteins taken from the patient’s own body to minimize or eliminate pain, improve function and at times even regenerate an arthritic joint. Now the skier, runner, cyclist, tennis player, golfer, hunter, sailor, runner, and fly fisherman could continue or return to their recreational passions. Along the way, as indicated, I used a variety of cell-based treatment options including concentrated bone marrow, microfractured adipose tissue, Platelet Rich Plasma, Plasma Rich Growth Factors, Protease Inhibitors, and subchondroplasty. Each and every patient was entered into our database allowing me to practice evidence-based Regenerative Medicine. By so doing, I was able to provide my patient with the best alternative to meet a particular need. At the same time, because of my evidence-based approach, I was able to publish several leading articles, again influencing clinical practice but this time in Regenerative Medicine rather than joint replacement surgery. Additionally, because of my commitment to an evidence-based practice, I was invited to participate in, to the best of my knowledge, the first FDA-approved use of adipose-derived stem cells for an arthritic knee sponsored by Personalized Stem Cells. That Clinical Trial was completed and a submission to the FDA for a second Trial, this time using culture-expanded cells is waiting for approval.
At present, I am participating in two clinical studies, one focused on Bone Marrow Concentrate and the second, on Microfractured Adipose Tissue for the arthritic joint. Regarding the latter, Rotator Cuff tears around the shoulder are included in The Study based on successes in tennis professionals. For those who meet the inclusion criteria for either Study and choose to participate, there is a significant cost reduction in care. To learn more schedule a consultation by calling (312) 475-1893 or visit my website at www.sheinkopmd.com. Enrollment for the Bone Marrow Concentrate and Microfractured Adipose Tissue Study will continue into early July.
Mar 17, 2023
Extra, Extra Read All About It
Cellular Orthopedics and Biologics, a Regenerative Medicine Medical Practice directed by Mitchell B Sheinkop, MD, that specializes in evidence-based care and the development of advanced patient therapies, announces it has entered into a Clinical Study with Celling Biosciences to jointly explore Bone Marrow Concentrate products.
Under the agreement, Mitchell B. Sheinkop, MD, will collaborate on the study of existing therapies as well as the development of new therapies that can potentially transform the treatment of musculoskeletal disease including acute injuries and chronic disease in joints.
This collaboration will leverage Cellular Orthopedics and Biologics’ extensive expertise in clinical research and patient care, as well as Celling Biosciences cutting-edge technology and innovative therapies. This partnership will allow accelerated development of new regenerative medicine products for my patients more efficiently and at a Lower cost.
A New Chapter of Innovation | Interventional Regenerative Orthobiologics
“Our team is dedicated to developing safe and effective therapies that can improve patient outcomes and quality of life. We believe that this collaboration will enable us to enhance our product development process through an even more rigorous data-driven approach,” says Dr. Sheinkop. The collaboration represents an exciting new chapter in the development of regenerative medicine products and has the potential to revolutionize the field of interventional regenerative orthobiologics.
Clinical Study – Osteoarthritis | Micro-fractured Fat
In addition to the aforementioned, I am also announcing that I have established a Clinical Study coordinated initiative with JoinTechLabs allowing for yet a second Regenerative Medicine option in which your fat is put to work. The micro-fractured fat obtained by a mini-liposuction in the office expands my scope of services so I can meet the needs of almost all patients with symptomatic and function-limiting Osteoarthritis.
About Mitchell B Sheinkop MD – a leader in orthobiologics. The practice is dedicated to the science and research of innovative biologic medicine and its potential while supplying patients with the best products and education available to improve their quality of life. Learn more about The Cellular Orthopedics and Biologics menu of options including platelet-rich plasma, bone marrow concentration, and protein concentration filters www.sheinkopmd.com or call and schedule a consultation (312) 475-1893.
Mar 13, 2023
It has been many years since I took personal time off to change offices and receive a “tune up” for my arthritic joint right hip. I am back. This past Wednesday, I completed three concentrated bone marrow procedures in my new settings under local anesthesia in our specially designed treatment room. Because the patients are participating in a Clinical Study, when combined with the elimination of the surgi-center dependency, the cost of Regenerative care for an arthritic joint is far less when compared to previous fee schedules. The same holds true for next Wednesday when the emphasis will be on Micro-fractured Fat following a mini-liposuction for those whose needs are best served by the latter methodology. Those patients who meet the micro-fractured adipose tissue inclusion criteria will also be entered into our Outcomes protocol and thus enjoy a cost reduction. Keeping in mind that my practice is evidence-based with treatment decisions made using scientific methodology and not an advertisement and a testimonial by a paid spokesperson; it requires an office assessment and review of images to enable me to make a definitive recommendation. We also use the full scope of Platelet Rich Plasma (PRP) alternatives and other Biologics when deemed appropriate.
For those who have stored adipose tissue from the first FDA-approved Stem Cell Clinical Trial, I am afraid we have to wait for a ruling on The FDA’s contesting of the California Appellate Court 2022 opinions. In the latter, Stem Cell culturing and usage was ruled part of the practice of medicine but then the FDA challenged the decision so we have to wait for the legal process to run its course. By the same token, for those interested in the second Personalized Stem Cell Clinical trial, the application is in progress; as of yesterday, PSC indicated a decision by the FDA should be forthcoming in 2023. Please understand that I share your frustration as my adipose tissue is waiting in the PSC deep freeze until the FDA to allows my arthritic knees to be addressed.
As I see it, the best option for a patient with symptomatic and functional limitations from an arthritic joint would be to call (312) 475-1893 and schedule an examination, review of images, and consultation. The ethos of my practice is informed consent. As of Thursday, March 16, 2023 patients will have a choice of locations including the 618 W Fulton Chicago office and the Glenview office, 2200 Waukegan Rd.
Feb 8, 2023
Marketing and Reach can be bought; experience cannot. What prompted me to address the fake news concerning Regenerative Medicine is the lasted media blitz repeated in print, on the radio, and on TV by the current opportunists with the standard unsubstantiated testimonials by influencers who are paid to play. While History Repeats Itself may be a song released in March of 1966 and recorded by Cab Calloway, the phrase actually has been credited in different forms to George Santayana, Winston Churchill, and Mark Twain. The general idea of history repeating itself, however, is of much more ancient origin. When it comes to Regenerative Medicine, beware and take care; only a few years ago we were bombarded by charlatans, now in prison, marketing amniotic fluid as a source of stem cells for all comers with arthritis. No need for a physical examination or a pretreatment X-ray, just show up for a seminar, free lunch, and write a check.
A Climb of Clinical Mastery & Human Connection Over Many Years
While marketing and reach can be bought, knowledge and experience come with time and within the context of evidence-based practice. The science and art of medicine is the ability to provide the right solution for each individual patient. This happens over the course of a journey… a climb of clinical mastery, a human connection between the surgeon and the patient, and the right tools for each situation:
1) Micro-fractured Adipose Tissue
2) Bone Marrow Aspiration Concentrate
3) Platelet Rich Plasma
4) Plasma Rich Growth Factors
5) Master Protease Inhibitor
6) Subchondroplasty
You may visit my website at www.sheinkopmd.com. Better yet, schedule a consultation by calling (312) 475-1893. While our Chicago office is now 618 West Fulton, in Mid-March, our Glenview office will be up and running. What may be of particular interest to some are our research studies concerning Bone Marrow Aspirate and Micro-Fractured Adipose Tissue. While not Clinical Trials, as safety and efficacy have already been established for Bone Marrow Concentrate and Micro-Fractured Adipose Tissue, hence FDA compliant, the long-term Outcomes of these applications have yet to be determined. Additionally, rather than a hit-or-miss technique, my studies will attempt to standardize the nature of the injectate through advanced scientific analysis. For those willing to participate in the studies, there is a significant discount for the standard out-of-pocket cost of Regenerative Medical procedures. For answers to all your questions or to schedule a consultation call (312) 475-1893.
