Osteoarthritis of the hip

Osteoarthritis of the hip

Hip osteoarthritis (OA) exerts a significant burden on society, affecting 3% of Americans aged >30 years. Recent advances in the understanding of the pathoanatomy and pathomechanics of the hip have led to treatment options for young adults with hip pain. Femoroacetabular impingement, specifically cam-type femoroacetabular impingement, hip dysplasia, and the sequelae of pediatric hip disease can predispose the hip to early OA. However, many patients with abnormal anatomic findings do not develop early OA, suggesting that there exist other patient characteristics that are protective despite abnormal bony anatomy. Outcome studies show that arthroscopic and open hip procedures improve pain and function in patients with symptomatic hips. However, there is currently limited evidence that these procedures extend the life of the patient’s natural hip. Additional studies are needed to determine protective or adaptive factors in patients with abnormal anatomy who do not develop early OA and to determine whether joint preserving hip surgery extends the life of the native hip joint.

Review Article:Natural History of Structural Hip Abnormalities and the Potential for Hip Preservation
James D. Wylie, Christopher L. Peters, Stephen Kenji Aoki

What makes the article so interesting to me is first, I played a role in training one of the authors in my earlier academic career. More important is the role I am now playing in helping to preserve the life of the hip joint with a needle instead of a knife and extending the life of the “native hip joint”. The latter is done via Cellular Orthopedics. By introducing Stem Cells, Platelets, Precursor Cells, and Growth Factors, I am now able to address arthritis at a Bio-Immune level, possibly regenerate cartilage, potentially influence healing of the torn acetabular labrum, certainly reverse the secondary inflammation and thereby diminish pain and improve function in the abnormal hip joint.

It takes an evaluation in my office including the history, a physical examination and my review of your hip images after which I am able to customize the Cellular Orthopedic intervention that will help with joint preservation and potentially, joint regeneration. Our Outcomes studies continue and it is the result of ongoing data collection that allows me to extend the life of your native hip. Call (312) 475 1893 to schedule a consultation. You may visit my web site at www.sheinkopmd.com

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A Regenerative and Restoration Milestone

A Regenerative and Restoration Milestone

It happens every year since the day I was born, there is a birthday celebration in my home and it happens again this week. Sure, I have a little more graying of my hair; but fortunately, I have my hair. I also have an activity level that would not have been possible, given the arthritis in my knees and hips, unless I had undergone restorative and regenerative intervention taking advantage of Bone Marrow Concentrate and Platelet Rich Plasma Offerings as I write about in these blogs. 

To give you some insight of what is possible no matter your age and before you become a couch potato owing to pain and functional limits imposed by arthritis, let me describe what I have planned for the Memorial Day weekend. You might recall that I was experiencing progressive functional limitation until a regenerative procedure was completed on my knees, December, 27, 2017 followed by a similar procedure in my hips on January 11, 2018. On this upcoming Thursday, I will begin planting a relatively large vegetable garden in the mid-day when we arrive in Southwest Wisconsin followed by a late afternoon 30-mile bike ride. First, we stop at the Amish Greenhouse in our neck of the woods to collect the vegetables and Herbs. On Friday the cycling and planting will continue; Saturday will be a half day of fly fishing followed by more planting and then another 30-mile bike ride. Sunday will be a repeat of Saturday after the evening outdoor barbecue. Monday morning is another half day of fly fishing, then planting of the herb plot after which we return to Chicago and office patients on Tuesday.

I felt your pain until I took advantage of the possibility for functional restoration and joint regeneration that I offer my patients. No more kvetching from me. The way I want to live is the way I practice.  I am not ready to slow down even though birthdays are being celebrated each year; and I don’t have to alter my way of life; having enjoyed symptom relief and functional restoration via Bone Marrow Concentrate and Platelet Rich Plasma offerings.

To learn about how you might continue to enjoy or perhaps return to an active, symptom free lifestyle, call (847) 390-7666 To schedule an appointment. You may visit my blog at HTTP://www.ILcellulartherapy.com where you may watch the webinar

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It’s been a busy week for our Cellular Orthopedic practice

On Wednesday, I completed several bone marrow concentrate procedures for patients with arthritic knees. You will recall that Concentrated Bone Marrow contains living Adult Mesenchymal Stem Cells, Growth Factors, Platelets, Exosomes, Precursor Cells and more allowing for pain relief, improved function and possible regeneration in those afflicted by arthritis. In the afternoon, four patients underwent Autologous Platelet and Growth Factor interventions; two in the hip and two in their knees. An example of the outcome, now four months following intervention in my own knees and hips, I spent last weekend hiking along several spring creeks, fly fishing in Southwest Wisconsin in the morning and planting over 150 Lilly bulbs in the afternoon. Admittedly, I slept well on Saturday and Sunday night but visited the health club on these past Tuesday and Wednesday evenings for my fitness routines.

On Monday, we finalized and edited a manuscript reporting the results of 56 patients with arthritic knees, followed for 2 to 4 years having received Bone Marrow Concentrate. Using the same outcome metrics and statistical tabulation methods I had employed as a joint replacement surgeon, this study is one of the most significant trials ever completed and to be published in Cellular Orthopedics. Our study not only will help determine the indications for a “stem cell” procedure, but also assist in determining how long the benefits will last, and provide a road map for when adjunct or repeat interventions are indicated. Now the physician will be better prepared to help a patient decide between a Total Joint Replacement and a Cellular Orthopedic intervention on an evidence based knowledge.

I am writing this Blog while flying to San Jose, California where I am partaking in advanced training that will allow me to expand my regenerative medicine practice to the low back. Again and again, patients ask as to what I might offer to address low back pain and disc disease now that I have successfully intervened in an arthritic hip or knee. Indications and techniques for addressing the lumbar spine will make up the curriculum enabling me to add discogenic and degenerative arthritic conditions of the low back to my scope of regenerative care by mid May.

To the patient who called, “I heard through the grapevine that it doesn’t work”, you may avoid falling victim to the Fake Stem Cell claims in newspaper ads or via celebrity testimonials; those in amniotic fluid are dead on arrival to you. Seek scientific evidence at (847) 390-7666 or learn more on my web site where you may watch my webinar www.Ilcellulartherapy.com.

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What is Platelet Rich Plasma?

What is Platelet Rich Plasma?

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.

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The Ultimate Performance Success Following a Cellular Orthopedic Procedure

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

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The foot bone’s connected to the ankle bone

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

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