Using minimally invasive options for patients, we are able to harvest, concentrate, and prepare a patient’s own fat for the repair, reconstruction, and replacement of injured or damaged tissue. Adipose tissue, commonly known as fat, has many natural reparative characteristics that help to promote a healing environment throughout the body.
Known Facts about FAT
- FAT is minimally invasive to harvest
- Most people have a lot of extra FAT
- FAT is the highest quality tissue
- FAT has 100-500 times more reparative cells than other similar tissue.
- Research has shown that as a person ages, their FAT maintains its reparative properties unlike other similar tissue, such as bone marrow, which may lose healing capacity with age. Look up Stromal Vascular Fraction (SVF)
Last week, I traveled to Carlsbad, California where I was updated about the progress of The Personalized Stem Cell Clinical Trial FDA submission. You may keep abreast of that announcement at www.personalizedstemcells.com. At the same time, I personally underwent a minimal liposuction, with recovery of 40 grams of fat containing 3.2 million stem cells. That Lipoaspirate is now cryopreserved and stored so that the moment the FDA approval of the PSC stem cell trial is announced, I will have access to my adipose-derived stem cells for injection into my arthritic joints. As well, a portion of those stem cells will remain cryopreserved and available should I ever require non-arthritic interventions for lung, heart, or other co-morbidities.
In November of 2018, I was the senior author of a scientific publication dealing with micro-fractured adipose tissue for osteoarthritic knees. In 2018, I was also the senior author of a scientific publication dealing with autologous bone marrow concentrate for knee arthritis. As a result of the aforementioned, I lay claim to one of the most evidence-based Regenerative, Orthobiologic clinical practices in the United States.
So Now What?
If you have symptoms and functional limitations imposed by osteoarthritis, call and schedule a consultation (847) 390-7666. After the orthopedic assessment and review of images, I will offer and recommend what I believe to be the best alternative for you from my menu of offerings:
1) Platelet Rich Plasma based interventions
2) Nano-particle interventions (ECVs)
3) Bone Marrow Concentrate applications
4) Adipose (fat) based approaches starting with mini-liposuction and then
a. Same day microfracture and injection into the symptomatic and function limiting joint. Learn more at www.understandlipogems.com
b. Cryopreservation until the FDA PSC Trial is approved
c. A combination of a. and b.
To learn more, visit my website at www.sheinkopmd.com or call (847)390-7666.
U.S. hospitals performed more than 100,000 surgeries on older patients during the first year of the pandemic, according to a new Lown Institute analysis. The healthcare think tank relied on Medicare claims data and analyzed eight common low-value procedures. It called the 100,000 procedures unnecessary and potentially harmful in a press release. It found that between March and December 2020, among the most-performed surgeries were coronary stents and back surgeries. Knee arthroscopies were amongst the top procedures to blame.
On the other hand, I am an orthopedic surgeon and when a surgical procedure is indicated, a successful outcome can be a major game-changer in life. For over 37 years, I specialized in total hip and total knee replacements during which time, I integrated patient care with research and education. 12 years ago, I “graduated” to Regenerative Medicine and again combined patient care with research and education; the latter through scientific publication. As evidence of my ongoing efforts, this morning, a manuscript Titled Evaluation of the Safety and Efficacy of Cryopreserved Human Umbilical Cord Tissue Allograft for the Supplementation of Cartilage Defects Associated to Knee Arthritis: An Observational Data Collection Study was submitted to a scientific journal for publication.
As an illustration of the indication for surgery versus the Role of Regenerative Medicine, I will cite the patient who presented to my office this morning with a painful knee and intermittent swelling for six months duration following a traumatic event. An avid tennis enthusiast, the pain and swelling were recurring after every match and required several days of rest before scheduling the next match. Prior to the knee injury, the patient was able to play multiple matches during weekend tournaments. An X-Ray and MRI taken five months ago were compatible with structural defects in the articular cartilage under the patella. All ligaments and menisci were intact. The degree of arthritis depicted by the imaging led to a classification of Grade 2 Osteoarthritis. At this point in time and with the findings today on physical examination and review of images, there is a major role for Orthobiologics; that is the initiation of Regenerative Medicine. My recommendation was to begin with a hyaluronic acid injection series. If the latter did not eliminate symptoms and improve functional capacity, then Platelet Rich Plasma alternatives should be explored. Ultimately, there may be a role for stem cell containing bone marrow concentrate.
The aforementioned is an example of the role of Regenerative Medicine for musculoskeletal generated symptoms and functional limitation. Time and space limit my continuing but there are no limitations should you choose to consult with me for a symptomatic or function limiting orthopedic condition or injury. You may learn more on my website at www.sheinkopmd.com. By calling (847) 390-7666, you may schedule an office visit.
I am an Orthopedic Surgeon; not an orthopedic physician or one of the many charlatans who hold themselves out as “specialists” in regenerative medicine. To be a Board Certified Orthopedic Surgeon and Fellow of the American Academy of Orthopedic Surgeons is an arduous undertaking requiring many years of education and surgical training as well as successful completion of many examinations. To upload a stem cell website and start offering regenerative care, all the charlatans have to do is attend a weekend course. Along the way, most of these rip-offs sell nutraceuticals either in their offices or online for financial reward without science to support the claims of benefit. There is an exception. This Blog will feature scientific evidence to support the value of Vitamin D supplementation in those with low levels.
Vitamin D status is associated with inflammatory biomarkers and clinical symptoms in patients with knee osteoarthritis
Published: April 29, 2022
Background and aim
The association between vitamin D status and osteoarthritis (OA) and bone remodeling has been shown previously. The present study was conducted to determine the association between vitamin D status and inflammatory biomarkers and clinical symptoms in patients with knee OA.
This case-control study was performed on 124 subjects with mild to moderate knee OA and 65 healthy controls. Demographic data was collected from all participants at baseline. We used Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC Index) for evaluating the severity of clinical symptoms in these patients. Serum levels of vitamin D, as well as markers of inflammation including interleukin 1-β (IL-1β), interleukin 6 (IL-6), interleukin 10 (IL-10), tumor necrosis factor-alpha (TNF-α), high-sensitivity C-reactive protein (hs-CRP), and nuclear factor k-B (NF-κB), p65 were evaluated for each participant.
The results of the present study showed that patients with knee OA had lower levels of vitamin D and higher levels of IL-1β, TNF-α, hs-CRP, and NF-кB p65 compared with healthy controls (P < 0.0001). The levels of IL-1β, TNF-α, and NF-кB p65 in knee OA patients with vitamin D insufficiency were significantly higher compared with the knee OA patients with sufficient vitamin D (P < 0.05). Based on the linear regression analysis, serum vitamin D levels were inversely correlated with IL-1β, TNF-α, hs-CRP, and NF-кB p65 levels (P < 0.0001). Patients with sufficient vitamin D levels had lower total and physical function WOMAC scores compared with patients with vitamin D insufficiency (P = 0.011 and P = 0.010, respectively).
The results suggest a strong link between vitamin D deficiency and increased inflammatory biomarkers as well as increased severity of clinical symptoms in knee OA patients.
I am off to Poway, California, the home of Personalized Stem Cells on June 14 and 15 to have my own adipose tissue harvested and stored in anticipation of FDA approval of the next clinical trial using my own stem cells for arthritic joints. If you want to learn more, read my website at www.sheinkopmd.com or upload the www.persoanlizedstemcell.com website.
To make an office appointment call (847)390-7666. In addition to the upcoming clinical trial, we offer a range of biologics for arthritis including bone marrow concentrate containing your stem cells as well as biologics based on your growth factors and anti-inflammatory proteins circulating in your blood.
Autologous stem cell therapy means your own stem cells are used to treat you. In other words, the donor is also the recipient. Over ten years ago, I started aspirating a patient’s own bone marrow as the source of stem cells for diminishing the symptoms and improving function in an osteoarthritic joint. Two years ago, I was a co-investigator in a clinical trial utilizing autologous adipose (belly fat) derived stem cell treatment for the arthritic knee. Trial participants had their fat collected via small liposuction. The fat was processed at the Personalized Stem Cells, FDA inspected cleanroom facility. Stem cells were extracted and concentrated to create what was required for the study as well as stored for possible future use. The processed cells were checked for Quality and Safety before they were allowed to be used. One dose of a participant’s personal cells was then shipped to me for injection into the participant’s knee and outcome data (results) were captured.
Treatment Now and in the Future
Your stem cells are only used to treat you. The additional goal of the first trial was to store cells from all clinical trial participants so that cells could potentially be used for future treatments and medical conditions. One fat collection could potentially provide you with a lifetime of stem cell treatments. The plan for the next clinical trial is in development; hopefully to be a reality by mid-summer. With FDA approval, we can not only begin recruiting patients for the trial; we will be able to make use of the banked cells from the participants in the first trial. To meet enrollment criteria, an office visit is required to make sure the patient meets FDA inclusion criteria; pre-enrollment imaging and laboratory testing are required.
Having your cells stored could provide the opportunity to receive treatment for other joints and other conditions as additional uses are developed and approved. On a personal note, I will be partaking in the upcoming Clinical Trial by having my own stem cells harvested and stored to be used once the FDA allows such for arthritic knees. The remaining cells will be stored for future use in my hips.
Meeting Inclusion Criteria
A word of caution. Over 60% of patients age 60 or greater will have a meniscal “tear” described by the radiologist interpreting the required pre-enrollment MRI. The job of the PSC clinical investigator is to determine if the meniscal pathology is a source of “mechanical” symptoms or merely a commonly described MRI observation with aging. Should the “torn” meniscus result in abnormal joint function, then arthroscopic prior correction may be indicated. It may be wise to schedule your prescreening earlier than you had planned so you won’t be excluded from the upcoming stem cell trial. Incidentally, if you don’t meet The Trial inclusion criteria, we still have Bone Marrow Concentrate and autologous blood-derived biologics as treatment options.
You may learn more by accessing my website www.sheinkopmd.com. The updates regarding the Personalized Stem Cell trial may be found at www.personalizedstemcells.com
To schedule a consultation or office visit call (847) 390-7666
My Cellular Orthopedic/Regenerative Medicine practice is evidence-based. In short, we integrate patient care with research. Our outcomes and patient satisfaction data over the last two years clearly show that the highly concentrated injectate of A2M and concentrated Growth Factor Proteins contained in our proprietary PRP solution is so more successful than the Hyaluronic acid injections (the gel/cushion) that we have discontinued use of the non-biologic option. Blood plasma is produced by the human body and contains a high level of proteins and growth factors that have healing properties helping the body repair itself while blocking pain from inflammation secondary to osteoarthritis. Proteins are concentrated from the patient’s own blood and injected into damaged joints of the body to diminish or eliminate symptoms, enhance function and promote regeneration.
As an example of the evidence, an athletic, active, physical therapist presented a year ago with a painful knee developed during the course of training for a marathon. The patient was forced to give up running. After a course of non-steroidal, anti-inflammatory medication, imaging was compatible with structural changes in the meniscus and articular cartilage of the knee. A cortisone injection rendered short-term relief. The hyaluronic acid injection that followed for several weeks was of no value. An arthroscopic evaluation and debridement (shaving) did not diminish symptoms or allow for a return to an athletic profile. Four months ago, the patient underwent a bone marrow concentrate intervention into the problematic knee. Four weeks later, a proprietary PRP injection was administered to the same knee as part of my treatment protocol. A hike into the Grand Canyon with family had been planned one year ago. This past Monday, my patient returned from the trek complaining of “sore calf muscles”, but, had enjoyed painless and unlimited participation in a grueling five-day event.
The ethos of my Cellular Orthopedic/ Regenerative Medicine practice is to stop the progression of painful conditions such as osteoarthritis with a needle and not a knife. The above vignette is one approach. Anticipated by midyear is a second Trial in which your adipose stored stem cells are made available for injection into the arthritic joint offering yet another treatment alternative. You may visit my website at www.sheinkopmd.com to learn more. For an in-office consultation, call (847) 390-7666. Follow the announcement of the Personalized Stem Cell Clinical Trial at www.PersonalizedStemCells.com
50 years ago, the treatment of choice for the rotator cuff tear was observation and physical therapy. The results were very unsatisfactory to the patient and physician. At the same time, historic attempts at surgical reconstruction were doomed to fail. The same was the case for the osteoarthritic shoulder joint. For both rotator cuff tears and advanced osteoarthritis of the shoulder, the only predictable outcome followed a shoulder fusion. The end result Inherent in surgically eliminating the joint (shoulder fusion) be it for trauma, osteoarthritis, or rotator cuff disease was most unsatisfactory.
With a better understanding of the shoulder, joint anatomy, and pathology over the ensuing years came the shoulder joint replacement and rotator cuff surgical repair. Unfortunately, as in any major surgical procedure, there are no assurances of a satisfactory outcome. The risk of postoperative wound infection is real and the need for immediate or delayed repeat revision surgery is ever-present. Additionally, the anatomic requirements for successful, elective shoulder joint replacement and/or rotator cuff repair are more demanding than those of a hip or knee replacement.
Over the past several weeks, four patients presented for hip or knee care for whom, in the past, I had performed a bone marrow concentrate for a combination of an arthritic shoulder joint accompanied by a rotator cuff tear. While it is possible to develop an arthritic shoulder with an intact rotator cuff or a rotator cuff tear without an arthritic shoulder joint; with advancing age, the two problems usually present together. The treatment algorithm for a new patient presenting with shoulder-related symptoms and limited function starts with the medical history followed by the X-ray. In the acute setting, six weeks of physical therapy and a cortisone injection may prove helpful. After six weeks of symptoms and limited function, the MRI is indicated. Based on the response to initial treatment coupled with the results of imaging, via informed consent, I allow the patient to participate in further treatment decision-making.
If the non-dominant shoulder is the source of impairment, some patients will elect to live with their problem. On the other hand, the four patients to whom I am referring at the beginning of the paragraph, elected to undergo a Bone Marrow Concentrate shoulder intervention thereby allowing me to apply autologous Stem Cells, Growth Factors, Precursor Cells, Platelets, Cytokines, and Extracellular Vesicles into the arthritic shoulder joint and torn rotator cuff. Their results are most satisfactory both to the patient and physician. Reader, please be aware that in all four patients, it took time and ongoing physical therapy but in the long run, my patients are functional, symptom-free, and satisfied.
Whether your problem is joint-related or soft tissue in nature and you would like to postpone, or perhaps avoid surgery; call (847) 390-7666 to schedule a consultation. You may visit my web site at visit my website at www.sheinkopmd.com.