From the front page of the September, 2018 issue of GOLF “This Tiger is for real. He’s faster, sharper-and an up-and-down machine.” Then, from the September/October issue of Tennis, “Juan Martin del Potro He’s back…. and ready to once again conquer”. His once promising career was reaching the end owing to wrist injuries. Quoting Del Potro in the article “one doctor would say something to me; another would say something different. It was difficult to believe one or the other”; however, he demanded excellence and eventually found it
I could go on citing and quoting from all sports and recreational resources but you get the idea. These are recovery and come back examples of what motivated individuals may accomplish. Now, if you tune in to upcoming US Open later this month, you will be able to follow Rafael Nadal, another super athlete who was able to return to compete at the top of his game owing to cellular orthopedics for several potentially career ending injuries over recent years. I could go on with the examples in each and every recreational pursuit or from those who wished to regain a pain free and very active life even if not at the aforementioned level of demand. Suffice it to say, the common denominator for those with skeletomuscular restrictions is a combination of physical training, mental motivation and timely medical care.
You can put some of this Tiger in your tank and reignite your enjoyment of activities at any level if arthritic or traumatic injury of your bone and joints is holding you back. The new world, (actually it is not so new anymore) of Cellular Orthopedics may allow for a return to a virtually unlimited lifestyle with a needle instead of a knife. I choose to define myself as a Cellular Orthopedist so a patient might not be trapped in the web of so called regenerative medicine specialists. An orthopedic surgeon has dedicated many years to understand the musculoskeletal system whereas a regenerative medicine clinic frequently is populated by those who attended a two-day training seminar. While my own recreational pursuits and fitness profile is far removed from those of the famous professionals noted earlier in this blog, following cellular orthopedic interventions into my own knees in December of 2017, and for my hips in January, 2018, I returned to skiing last winter, cycling and fly fishing this summer, and I am able to enjoy a full fitness commitment in doing my part to maintain the highest possible level of performance.
You may access my website at WWW.SheinkopMD.com or call (847) 390-7666 to schedule a consultation.
Tags: BMC, Bone Marrow Concentrate, cellular orthopedis, golfers elbow, injection, Platelet Rich Plasma, PRP, regenerative medicine, sports injury, stemcell, tendon repair, tendon tear, tennis elbow
The argument frequently advanced by orthopedic surgeons in response to a patient’s inquiry concerning stem cells for arthritis is that it is too early, there is not enough research, It is better to have a major surgical procedure. For those of you who have read my blog or have sought orthopedic consultation in my office, I have emphasized that my recommendations are evidence based. Each patient, for whom I have completed a cellular orthopedic intervention for arthritis, has been entered into a registry or clinical outcomes data base, IRB approved. Just as I pioneered the integration of clinical care with clinical research over 37 years as a joint replacement surgeon, so too do I now partake in the growth and development of the clinical pathways for regenerative medicine.
Last month, I exhibited a poster at a large regenerative medicine meeting wherein I shared my preliminary outcomes and thus educated other professionals using Intraarticular and Subchondral Bone Injection of Autologous Bone Marrow Concentrate and General Fluid Concentrate for Osteoarthritic Knees-A Prospective Clinical Study. Osteoarthritis is an organ disease that affects most structures of joints including cartilage, synovium and subchondral bone. Pathology in subchondral bone contributes to the initiation, progression and pain of Osteoarthritis. In previous European studies, the injection of autologous bone marrow concentrates into bone supporting the joint significantly relieved pain and improved function of the affected knee. The preliminary outcomes in the study that I presented via a poster exhibit, investigated the effectiveness of injections of Bone Marrow Concentrate with General Fluid Concentrate (Growth factors), into both the knee joint and the subchondral bone. The study recorded all the standard Endpoints I had previously used in joint replacement clinical outcomes trials.
Bone Marrow was collected from the pelvis and a filtration system allowed for concentration of Mesenchymal Stem Cells, Platelets, Precursor Cells and Growth factors such as A2M, IRAP, EGF, PDGF, TNF-B blocker, etc. After preparation, a mixture of Bone Marrow Concentrate and Growth factor Concentrate was injected into the bone (subchondral) and into the joint.
In the study, all patient injections went well and there were no complications. The Preliminary Results documented diminished pain and improved function. We concluded that injection of Bone Marrow Concentrate and Growth factor Concentrate into both the subchondral bone area and joint cavity significantly improved function of the affected knee joints and significantly reduced joint pain. While there are many stem cell providers to be found because of their marketing, choose the center of excellence in Cellular Orthopedics that is evidence based.
Call to schedule a scientific based consultation from an orthopedic surgeon 1 (847) 390-7666.
You may access my web site at www.SheinkopMD.com.
Tags: avascular necrosis, bone lession, bone marrow, Cartilage, cellular orthopedics, clinical study, Growth Factors, IRAP, joint pain, joint replacement, knee pain, knee replacement, meniscus tear, Osteoarthritis, platelets, PRP, regenerative medicine, sports medicine, stem cells, subchondral bone
My team dedicates an inordinate amount of time answering questions and attempting to clarify the misunderstanding of patients when it comes to Platelet Rich Plasma; actually, the entire subspecialty of “Stem Cell Therapy” but let’s start with PRP. As an orthopedic surgeon who introduced Cellular Orthopedics to the Midwest five years ago, I am in a unique position to help define the problem. Does PRP have a role in treating a painful or injured part of the musculoskeletal system? In an attempt to help clarify misconceptions and better define the term Platelet Rich Plasma, I sat down and wrote this Blog.
Platelets circulating in the blood play a fundamental role in blood clotting and are a natural source of growth factors. Platelet rich plasma (PRP), also termed autologous platelet gel, plasma rich in growth factors (PRGF), platelet concentrate (PC), is essentially an increased concentration of (autologous) your platelets suspended in a small amount of plasma after centrifugation. Although it is not exactly clear how PRP works, laboratory studies have shown that the increased concentration of growth factors in PRP can potentially speed up the healing process.
The amount of PRP necessary to achieve the intended biologic effects still remains unclear.; but we know PRP contains growth factors in high concentrations. Precise predictions of growth factor levels based on the platelet counts of whole blood or PRP are limited. In our office, we use a hemocytometer to count platelets and the different white blood cells contained in the preparation. Knowing there are different sources for growth factors (platelets, leukocytes, plasma), we assume the higher number of platelets and leukocytes counted in the hemocytometer, the higher the concentration of growth factors in the preparation. Treatments using these autologous platelet growth factors are an important reason to improve methods for isolating platelet-rich plasma (PRP) and that is why I am involved in an initiative to correlate counts with clinical outcomes.
PRP proponents assert that concentrated Platelet Rich Plasma fails to successfully treat symptoms in some cases because of differences in PRP formulation. There is no standardization thus leading to variables, such as PRP preparation methods, the amount of PRP injected, and the frequency of injections. These inconsistencies result in issues raised by patients: “PRP didn’t work for me” and “I had 15 PRP injections to my knee and I still have pain”. In addition to studying the numbers and monitoring results, I am involved with initiatives to filter and concentrate the growth factors in PRP so as to improve outcomes as well.
1)Platelet Rich Plasma
2)Concentrated Platelet Rich Plasma
3)Concentrated Stem Cell Plasma
4)Autologous Platelet and Growth Factor Concentrate
When you call (312- 475- 1893) to schedule a consultation or watch my webinar at www.Ilcelulartherapy.com, you will avail yourself of the aforementioned Platelet Rich Plasma treatment options in addition to our entire Cellular Orthopedic menu of regenerative care.
Tags: autologous injection, autologous platelet and growth factor concentrate, hemocytometer, injection, leukocytes, Platelet Rich Plasma, PRGF, PRP, Stem Cell Plasma
Every year at this time, we each recall and celebrate several significant events of historic, cultural and spiritual importance. No matter what your roots or upbringing or present belief, these past eight days usually involve a gathering of friends and family to jointly read and remember that which happened long ago and still impacts us today. Whether done in a house of worship or in the home, somehow, we ask similar questions and teach our children and grandchildren that which befell us in ancient days. To underscore those similarities, some years ago, when my son had his Bar Mitzvah at the Western Wall, a Franciscan Monk who I had come to know invited us the next day to a Pre-Easter service at the Church of the Holy Sepulchre. Other than The Gregorian chants and the frankincense, the superstructure of the 90-minute service was quite familiar.
I use this yearly celebration to reflect and meditate; it also initiates the spring cleaning ritual in our house. Having grown up in Humboldt Park and later Albany Park to parents who left Europe in time, Passover meant it was time to clean and wash the kitchen cabinets, recycle, and dispose of certain foods. On Division Street, we lived near my orthodox grandparents; in Albany Park, they lived with us, so the everyday plates and silverware were taken to the basement and exchanged for special settings reserved for this time of year.
Certainly, times have changed and we have assimilated; but my wife still prepares the appropriate meals for the week and makes sure the house is immaculate. Then the family and company visits end and we are challenged by the need to address the residual back scuffs on our wood kitchen floor; lots of them and pronounced. Here is where the ultimate test of the cellular orthopedic intervention to my own hips and knees, now almost four months ago comes into play.
With the coverage varying between the Masters, Cubs, and Sox games in the background, we genuflexed, spread the Murphy Oil Soap and started rubbing away with microfiber wipes. This exercise lasted about two hours, admittedly with several breaks. Nevertheless, we accomplished our mission and I got up unassisted to head to the health club for my strength training respite.
This morning, Section one of the Chicago Tribune carried three full pages, in color, competing ads concerning Regenerative Medicine; none giving much information about science or outcomes but certainly employing one-time prominent athletes as spoke persons. Is it worth a free lunch to become a marketing dupe? As readers of my Blog know, I myself had Cellular Orthopedic intervention to my knees at the end of 2017 and to my hips at the start of 2018. This morning I scheduled two ski trips in 2019 to Vail; on Saturday morning, I am headed to Southwest Wisconsin for a long weekend to bike and fly fish; and I am on standby at any time to genuflex and spread that murphy oil soap.
So as advertised on Friday night Cable, you may receive a $250 gift certificate for attending a Stem Cell Seminar, or you may get examined and receive counsel from this orthopedic surgeon focusing on Cellular orthopedics. For the latter call 312 475 1893 to schedule an appointment, one on one. You may access my web site and watch the webinar at www.Ilcellulartherapy.com
Tags: arthritis, genuflex, Hip pain, Hip Replacement, knee arthritis, knee injury, knee pain, Osteoarthritis
If you remember those children’s song lyrics, you will march right up the skeleton. The orthopedic message is that what’s happening in your foot and ankle will affect the well-being of your knee and hip. I was reminded of the continuum on Tuesday when a patient I had treated in November of 2017 returned for follow up this past Tuesday. Once a prominent running back at the college level, he had presented 20 years after a “high ankle sprain” with a Talar Dome Lesion at the right ankle and early onset post traumatic arthritis; in plain speak, an injury to the cartilage and underlying bone. Not only did the right ankle impairment affect his foot and ankle, he was experiencing progressive pain in his knee and hip thus altering his gait, his fitness pursuits and forcing change in his recreational profile. Running was no longer possible nor was snowboarding.
Increasingly, these Talar Dome lesions or osteochondral injuries are being diagnosed long after what was thought to have been a sprained ankle. In the case of my patient, last November, I performed a minimally invasive procedure wherein bone marrow was aspirated from his pelvis, concentrated, processed, and injected into both the ankle joint and bone marrow defect of the talus under fluoroscopic guidance. Osteochondral injuries and bone marrow lesions are a continuum of small posttraumatic defects that pathologists have shown represent a failed healing response. Most readily diagnosed on an MRI, with time, a rim of sclerosis may develop so the abnormality may lend itself to diagnosis with an X-ray. This type of defect is not limited to the ankle and may be found throughout the extremities and pelvis. They may be found in any joint region that sees weight bearing or repetitive stress though; most commonly, they are associated with trauma as was the case, though long removed in my patient.
In the case of this vignette, on Tuesday I had determined that ankle and subtalar joint motions had become symmetrical. He no longer complained of pain; equally important, the bony defect and joint changes could no longer be seen on X-ray. In short, he had healed. In the past six months, I have followed two other equally rewarding Bone Marrow (stem cell/growth factor/platelet) intervention outcomes at the talus and more than six around the knee.
If you are experiencing joint pain and altered function without an explanation or in spite of a course of “conservative” treatment, it may be time to learn more about how Bone Marrow Concentrate, that is stem cells, platelets and growth factors, may relieve bone and joint pain, restore function and help you postpone, perhaps even avoid a major surgical procedure.
Call 312 475 1896 to schedule a consultation or visit my web site and watch the webinar at www.ilcellulartherapy.com
Tags: ankle pain, bone lesion, bone marrow, Cartilage, joint pain, Mesenchymal Stem Cell, Osteoarthritis, osteochondral defect, osteochondral injurie, Osteochondritis Dissecans, Subchondroplasty, Talar Dome lesions
I write this Blog as an Orthopedic Surgeon following the 2018 annual meeting of the American Academy of Orthopedic Surgeons, just concluded in New Orleans. The topic matter is of sufficient concern that Use and Abuse of Biologics became an agenda focus receiving several hours of attention.
Clinical use of biologics to treat all health problems has greatly outpaced the evidence. Every office day, patients bring advertisements about Stem Cells appearing in the print media. The enticing cure all claims and testimonials are quite seductive. Concerns over misinformation from direct-to-consumer marketing of unproven treatments have led to recent calls to action from government and scientific agencies, including the National Academy of Sciences and the American Association for the Advancement of Science.
These calls to action are of special relevance to orthopedics because a recent study showed that more than 85 percent of 351 businesses, which represent 570 clinics across the country, were marketing “stem cell” treatments for musculoskeletal problems. Analyses of these treatments show a diversity of offerings with most clinics using preparations that do not contain clinically significant numbers of stem cells. Widespread use of these cash-for-service, unproven, and poorly described treatments raise concerns for public health and safety.
The Academy collaborated with the National Institutes of Arthritis, Musculoskeletal, and Skin Diseases (NIAMS) and held a think tank symposium on “Optimizing Clinical Use of Biologics in Orthopedic Surgery” on Feb. 15–17. 2018, at Stanford University to accomplish the following objectives:
- establish a clear, collective impact agenda for the clinical evaluation, use, and, optimization of biologics in orthopedics
- develop a guidance document on clinically meaningful endpoints and outcome metrics for the evaluation of biologics for common orthopedic problems
The symposium addressed key issues including poor definition of treatments and mechanisms of action; lack of standardized data and outcomes collection and reporting in existing clinical studies; and minimal evidence to support the myriad of ailments treated with these products. Leaders from clinical medicine, research, and government, as well as young investigators selected through a competitive process, participated in the event.
I am happy to be one of the first orthopedic surgeons in the Midwest limiting my practice to cellular orthopedics. Additionally, based on my model of having integrated patient care with outcomes surveillance as a joint replacement surgeon, anticipating and contributing to the new world of evidence-based regenerative medicine, I already have in place a cooperative venture allowing me to measure the platelets, growth factors and now stem cells that have been injected into a joint or the bone adjacent to that joint. I don’t know of any other practice or center that can make this claim. My team has entered into discussions to designate our model as the foundation for the future methodology of clinical evaluation, use and optimization of biologics in orthopedics.
As a patient, you have a choice to make: either respond to a marketing scheme or be educated and seek evidence before undergoing a “stem cell” procedure.
To schedule an appointment call 312 312 475 1893
Visit my web site and watch the webinar www.ilcellulartherapy.com
Tags: biologic intervention, cellular orthopedics, National Institutes of Arthritis