It has been said, you never forget the first time and Wednesday was that day. To the best of my knowledge, it was the first time in the Midwest that bone marrow aspirated and concentrated was used in an attempt to manage the pain and impairment secondary to an arthritic hip. The patient, in his early 50s, had previously undergone hip surgery on the left side and was seeking to avoid replacement of the other hip. I am the surgeon who performed his left hip replacement. He had followed my blog over the past several years where I began focusing on regenerative medicine for the management of arthritis. For 37 years, I had replaced hips and knees. When the pain and physical impairment had reached a point as to alter his athletic profile, his work related activities and his activities of daily living; he sought out my assistance again. This time though, in an attempt to maintain and perhaps restore his joint as contrasted to the last time, when I had replaced his hip joint.
After multiple office visits, examinations, documentations and repeated informed consent, the patient arrived at the surgicenter on Wednesday morning. I had dedicated over two years in preparation. He was anxious as was I; the first time, the initiation, the kickoff. Following registration and administrative perfunctory, he was taken into the surgicenter room and placed on a fluoroscopy table, resting on his belly. After scrubbing the low back and pelvis followed by sterile draping, under local anesthesia, using both sides of the back of the pelvis, I harvested 60 CCs of marrow following the algorithm of Regenexx. This was then taken to our lab for concentration and removal of everything but the autologous adult, mesenchymal stem cells; the latter were then transferred under sterile conditions into a 4 cc syringe. 45 minutes following the aspiration of the bone marrow, with the patient now on his back, fluoroscopic guidance was used for positioning those cells within the right hip joint between the femoral head and acetabulum. There are many other small steps to the process including the use of heparin; and following the administration of the bone marrow concentrate, administration of stem cell plasma (PRP). It all went as planned. The patient was taken to the recovery room and sent home with a set of crutches about three hours after he had arrived.
No significant pain during or after, but stay tuned. The patient will be seen next in six weeks with a return to work this Monday and a gradual resumption of physical activity. I will allow him to return to senior ice hockey at three months. The adage is one case does not make a series but we are off to a great start. Will it eliminate pain, restore motion, allow for return to full athletics, postpone or avoid a joint replacement? As in a realty show, stay tuned.