News from the International Orthopedics Foundation Annual Meeting

News from the International Orthopedics Foundation Annual Meeting

I am sitting at my computer this morning writing the weekly Blog posting and not attending the IOF meeting taking place today in Broomfield, Colorado; yet I am reporting about the meeting. Instead of attending, I am preparing for a week-long ski adventure with my family next week in Vail, Colorado while trying to catch up in my practice. How is it than possible that I know what is taking place at the meeting? Listed below are five of the 10 ongoing or completed cellular orthopedic clinical trials in which I am a principal investigator or co-researcher. The preliminary and final data resulting from these clinical research initiatives is the outcomes foundation for what is being presented at the IOF podium today and tomorrow.

1) Stem Cell Counts and the Outcome of Bone Marrow Concentrate intra-articular and intra-osseous (subchondroplasty) interventions at the knee for grades 2 and 3 OA. (supported in part by Celling). Ongoing

2) Outcomes of Bone Marrow Concentrate (stem cell, platelet and growth factor) Intervention at the Knee for Grades 2 and 3 OA in 50 patients at 2 to 4 years. (supported in part by Regenexx)

3) Outcomes of Intra-articular Bone Marrow Concentrate versus those of combined Intraarticular and Intraosseous interventions for grades 2 and 3 OA at the knee at one year. (self-funded). Ongoing

4) How does the PRP and Mononucleated cell count affect the outcome of a BMC intervention for grades 2 and 3 Knee OA? (a joint project with Greyledge) Ongoing

5) Safety and Efficacy of Percutaneous Injection of Micro-Fractured Adipose Tissue for grade 4 Osteoarthritic Knees, minimum follow-up of 18 months in 30 patients (supported in part by Lipogems)

I had to prioritize; and since most of the arthritis data being presented is all or in part mine, I already know the subject matter. By staying home, I also found the opportunity to browse “stem cell” websites as suggested by ads in today’s newspapers or introduced by email blasts this week.  Wow, a patient acting more like a consumer is really at risk for succumbing to Regenerative Medicine “false news”.

If you want to learn more about the difference between the stem cell purveyors and a legitimate, FDA compliant, evidence based, cellular orthopedics initiative, call to schedule a consultation or to get a second opinion.

You may schedule a visit at (847) 390-7666

You may access my website and watch a webinar at   www.ilcellulartherapy.com

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Don’t be fooled by bogus stem cell claims

Don’t be fooled by bogus stem cell claims

When it comes to cellular orthopedics, for me, it is a matter of honor and self-interest.

If you aren’t aware of the bogus stem cell claims or “false news”, read the LA Times article that appeared last week http://www.latimes.com/business/hiltzik/la-fi-hiltzik–oz-stem-cell-20170213-story.html

The article followed a Dr. Oz television expose where he focused on charlatans victimizing the public with false information at extremely outrageous fee schedules. The egregious behavior stemmed (no pun intended) from mostly California based clinics but Texas was another state exposed. For those who read this Blog, you are familiar with the false advertising of “Stem Cell Clinics” highlighting regenerative medicine via Amniotic Fluid for arthritis in Illinois, that I have repeatedly taken to task. To repeat, while there may be living cells when amniotic fluid is harvested, following collection, processing, sterilizing, irradiating, freezing and fast thawing, there are no living or viable stem cells in the pat being offered as a regenerative alternative. Dr. Oz took his expose a lot further calling attention to false claims without medical evidence wherein the so called regenerative medicine clinics he exposed offer treatment for every and any affliction of the human body.

Since the innovations introduced by Regenexx 10 years or so ago, interventional orthopedics has become an evidence based approach to sports medicine related injuries and as an alternative to a major surgical reconstruction or replacement for an arthritic or chronically injured bone or joint. I am a member of the Regenexx network and, have continued to compile and contribute scientific evidence to support the Regenexx mission. Our menu of surgical alternatives is directed to afflictions of the musculoskeletal system.

A patient attempting to postpone or avoid a major orthopedic procedure for an arthritic joint and return to a relatively symptom free functional quality of life may find legitimate, well intentioned and evidence based regenerative medicine and interventional cellular orthopedic initiatives. I am proud to be one of those clinical settings

Next week, I will complete my interview with Dr Mitchell Sheinkop, part two-focusing on common athletic injuries amenable to cellular orthopedics and joint condition amenable to stem cell intervention.

To schedule an appointment call (847) 390-7666
To visit my web site go to www.sheinkopmd.com
To watch my webinar visit www.ilcellulartherapy.com

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The case for a repeat Bone Marrow Concentrate intervention

The case for a repeat Bone Marrow Concentrate intervention

This week, I am repeating stem cell/growth factor interventions in two patients; one with arthritis of the
hip, and the other with osteoarthritis of both knees. Four years ago, at the initiation of my interventional
orthopedic practice, I spoke of adult mesenchymal stem cells alone but now we know that Bone Marrow
Concentrate has in addition to the adult mesenchymal stem cells, hematopoietic stem cells, growth
factors and platelets all playing a role in managing the symptoms and the altered functional impairment
attributable to osteoarthritis. The outgrowth is in new speak; namely, Bone Marrow Concentrate and not
just mesenchymal stem cells. When the two patients I alluded to were initially cared for, we had not yet
gained the understanding of the importance of platelets in the regenerative process. Platelets contain
the growth factors and those growth factors are responsible, in addition to Mesenchymal and
Hematopoietic Stem Cells, for regulating cartilage well-being. By having become aware of the
contribution following concentrated platelet rich plasma in conjunction with the bone marrow
concentrate intervention, I believe we are already seeing improved outcomes.

As well, subchondroplasty has been added to our menu of services and the latter is proving very
beneficial in the knee. To refresh your knowledge base, subchondroplasty is a procedure popularized in France where in bone marrow concentrate is injected into the bone marrow adjacent to a joint at the
same time that the stem cell, growth factors and platelet containing concentrate is intervention of the
joint itself is being completed. The value of intervening into the bone supporting the joint is the fact that
there is communication between the joint itself and the supportive subchondral environment. I have
addressed Adult Mesenchymal Stem Cells many times in previous Blogs as the orchestrater of the
healing process. Now we know that Hemopoietic Stem Cells from the marrow contribute as well. Growth
Factors such as Interlukin-1 Receptor Antagonist Protein (IRAP) are present in bone marrow and
circulating blood; It was IRAP alone that extended the professional basketball career of Kobe Bryant by
seven years for an arthritic knee. With an improved means of extracting and activating the growth
factors contained in platelets, the two patients I introduced in the opening sentences of this blog should
enjoy a very satisfactory return to function and recreation.

Interventional Orthopedics is a dynamic process and I continue to learn from the integration of clinical
research and my clinical practice. On Thursday, I will host two very interested scientists dedicated to
customizing biologic preparations and together we will explore how to further leverage scientific
advancements in creating autologous biologic preparations thereby optimizing the practice of
Regenerative Medicine.
Call 312 475 1893 to schedule your consultation

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Comparing Stem Cell Outcomes to those of Total Joint Replacements

Comparing Stem Cell Outcomes to those of Total Joint Replacements

I recently received the yearly publication from the Orthopedic and Rheumatology Institute of the Cleveland Clinic; the latter recognized as one of the 10 most prestigious orthopedic centers in the nation. Every year the publication, a marketing exercise by the Cleveland Clinic, focuses on certain subspecialty areas within the discipline of the care and treatment of the musculoskeletal system. The obvious purpose of such a yearly event is to recruit referrals from practicing orthopedic surgeons and rheumatologists as well as the medical community in general.

This year the focus was on Adult Total Hip Arthroplasty for Osteoarthritis and Adult Unilateral Total Knee Arthroplasty for Osteoarthritis. I will summarize the results; let’s start with the hip:

“Hip-Related Pain 1 Year After Surgery: “on average, 92% of patients reported clinically important improvement in hip-related pain after 1 year, while 1% reported worsening (7% showed no detectable change in hip-related pain).”

“On average, 90% of patients reported a clinically important improvement in hip-related function after 1 year, while 1% reported worsening (9% showed no detectable change in hip-related function).”

The knee doesn’t fare as well:

“On average, 85% of patients reported a clinically important improvement in knee-related pain after 1 year, while 2% reported worsening (13% showed no detectable change in knee-related pain).”

“On average, 82% of patients reported a clinically important improvement in knee-related function after 1 year, while 2% reported worsening (16% showed no detectable change in knee-related function).”

The data was derived from patient self-reported scores collected during office visits up to 6 months before and 1 year after surgeries performed.

In my practice, every patient who undergoes a Bone Marrow Concentrate intervention is entered into an outcomes data base with both subjective and objective data points measured. It is quite comprehensive and numbers over 500 patients extending over a span now of 4 and ½ years. While the Cleveland Clinic report is based on subjective parameters and ours on both subjective and objective scores, I am able to extract subjective measures alone. I am pleased to report that in the case of the hip and the knee, our outcomes with a needle are equal to or better than those of the major surgery with a scalpel. Then factor in the prompt rehabilitation of a stem cell procedure compared with the prolonged rehabilitation inherent in a joint replacement. Lastly, consider the relative absence of complications of a stem cell intervention compared to the morbidity and mortality of a joint replacement.

Perhaps of greater significance to the stated advantage of a Bone Marrow Concentrate procedure for Osteoarthritis is the fact that no bridges are burned. If the patient is not satisfied at one year or five, a stem cell procedure may be repeated with a needle. If the arthritis progresses to an advanced stage, the fall back option is a joint replacement. The only choice following an unsatisfactory joint replacement is to accept the surgically induced impairment or undergo a risky revision surgery with a high likelihood of a complication or less than satisfactory outcome. Call 312 475 1893 to schedule an appointment today.

For more information watch my Regenerative Medicine Webinar Video

 

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The role Growth Factors play in Regenerative Medicine

The role Growth Factors play in Regenerative Medicine

Growth factor, any of a group of proteins that stimulate the growth of specific tissues. Growth factors play an important role I promoting cellular differentiation and cell division,” and they occur in bone marrow as well as your circulating blood.

“When investigators began studying the effects of biological substances on cells and tissues in culture, they discovered a group of peptide-hormone-like substances that were distinct from any previously known hormones. Because these substances were active in stimulating the growth of cells and tissues, they were called growth factors. Some growth factors are similar to hormones in that they can be secreted into the blood stream, which carries them to their target tissues. However, whereas the production of hormones is limited to glandular tissue, growth factors can be produced by many different types of tissue” and cells for that matter.

When a patient presents for a Bone Marrow Concentrate procedure for an arthritic joint in order to prevent, perhaps even avoid a joint replacement, the understanding to date is that it will be Mesenchymal Stem Cell that will serve as the key factor in reducing pain, increasing motion, improving function and influencing the progression of arthritis. The latter is only partially true but fails to address the role Growth Factors play in Cellular Orthopedics (Regenerative Medicine). When your orthopedic surgeon tells you that Stem Cells won’t work for your arthritis, schedule your joint replacement, that physician doesn’t understand that Stem cells are only part of what Bone Marrow concentrate provides us in assisting the patient with an arthritic joint, return to an active life style without surgery.

We now have several proprietary means of not only concentrating adult Mesenchymal Stem Cells but Growth Factors as well when addressing your arthritic joint with Bone Marrow Concentrate. While stem cells may be impacted by age, Growth Factors do not seem to be adversely impacted accounting for several recent successes with patients in their 90s. Since we have been concentrating stem cells with growth factors and combining the approach to the joint with subchondroplasty, we continue to document improving outcomes

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What does Bone Marrow Concentrate really do?

What does Bone Marrow Concentrate really do?

I challenge the reader with this question because it becomes apparent, even the majority of the medical community can’t provide an accurate answer.  There are all kinds of claims and statements running rampant; so today, I will try to make some order out of chaos.  Let me begin with the patient who repeats what they have been told by their orthopedic surgeon, stem cells don’t work.  My response, “for what?” Oh yes they do if you understand where, when, how and why?

Bone marrow has several categories of molecules, cells and vesicles; anti-inflammatory cytokines, adult mesenchymal stem cells and growth factors. The cytokines are a group of molecules that address the inflammation associated with osteoarthritis and thereby relieve pain.  The stem cells orchestrate regeneration of cartilage and the joint; while growth factors actually alter the bio-immune process of osteoarthritis.  Working together, bone marrow content, when concentrated, has the ability to relieve pain, improve motion, restore function, slow or halt the progression of arthritis and possibly regenerate the joint.

When the patient last Friday repeated that her orthopedic surgeon had told her stem cells don’t work, my response was he is right, there is no chance of regenerating cartilage in a 78 year old woman.  Yet the procedure would still be worthwhile as a long term pain reliever and the potential to improve function and postpone, or even avoid, a joint replacement.  While regeneration of cartilage is realistic under age 50, pain relief, improved function and better motion is probable at any age for those who chose to undergo a Bone Marrow Concentrate procedure for grades 2 and 3 osteoarthritis.

Three weeks ago, I completed a procedure on a 93 year old man who hadn’t been able to get out of his wheelchair since April.  Last week, his wife reported he was walking down the block with the aid of the walker.  Three years ago, I completed a bone marrow concentrate stem cell procedure on a 39 year old marathon runner who had stopped competing six months earlier because of knee pain from early onset degenerative arthritis.  As of last month, he had competed in 17 marathons since his intervention.

So, if you want to run, walk, bike, ski, and live pain free, call for a consultation.

847-390-7666

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