The Chicago Tribune story written by Mike Mullan appearing in the August 22nd Sports Section is a well written review of the approach of one physician using his particular theory to reverse the pain and impairment caused by osteoarthritis. In Uhrlacher’s case, it was his knee and his failure to respond prompted this Blog. As a Chicagoan, I have been involved with the Bears over a lifetime both as a fan and as an orthopedic surgeon. I wanted to see Urlacher back at middle line backer. As many now know, that failure of non-operative care resulted in his arthroscopic surgery; it is too soon to assign an outcome. Mr. Uhrlacher, a certain National Football Hall of Famer is now waiting it out to determine if he can return to professional football as the mainstay of the Bear defense.
There were other alternatives for Urlacher to pursue in the United States for which the FDA has no restrictions. The Orthokind procedure as practiced in Germany is a specific approach to counter the inflammatory effect of Interlukin -1. First, several test tubes of venous blood are taken from a vein in the front of the elbow. The blood vials are now incubated with glass beads for four days and then centrifuged. A layer is now drawn from the several test tubes, combined and injected into the problematic joint. The theory is that the injectate contains Interlukin-1 receptor inhibitor and that is what controls the inflammatory process. No claim is made about regenerating cartilage.
Why Germany? It is an interesting issue as we are seeing more and more athletes on a similar pilgrimage yet there are better alternatives available in Chicago, Illinois as well as elsewhere in the USA. The Orthokind explanation is not only IRAP but also at times, addition of other proteins to the injectate. The procedure that Urlacher underwent is directed to pain relief through an anti-inflammatory approach. What is proving to be a better option is an anti-inflammatory approach with the potential of regenerating cartilage, stem cells. We take Bone marrow in a relatively large quantity from the iliac crest and then concentrate the stem cells before being injected into an arthritic or injured joint. The bone marrow aspirate is teaming with adult mesenchymal stem cells; and when concentrated, are rich in orthokines including Interlukin-1 receptor inhibitor as well as chemokines with multiple anti-inflammatory agents and growth factors. Equally and perhaps more important is the potential to regenerate cartilage, especially in patients under 50. Our preliminary results are very exciting; you don’t have to travel out of the country and Bone Marrow Concentrate therapy is less than half of what was quoted in the Tribune article
Mitchell B. Sheinkop, M.D.
1565 North La Salle Street . Chicago . Illinois . 60610