Autologous Bone Marrow Concentrate for Osteoarthritic Knee

Autologous Bone Marrow Concentrate for Osteoarthritic Knee

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.

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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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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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My Algorithm If Stem Cell Intervention Doesn’t Last or Doesn’t Work

I am being forthright; based on my review of data, while 80% or more of my patients continue to enjoy
satisfactory outcomes at four years or more following a stem cell intervention, there are those whose
symptoms and functional limitations recur. Please be aware that when I undertake the care and
treatment of a patient with a symptomatic and function limiting joint, it is with the notion of
regeneration and long-term benefit. It doesn’t always happen; there are may possible explanations.
Most important though is the need to identify possible causes of potential failure at the beginning, and
that is why we have recommendations before and after a procedure as to how to manage alcohol, diet,
supplements and a rehabilitation protocol. We also review your past medical history to identify any
possible indication that your stem cells have been adversely affected by co-morbidity or prior
treatments.

Assume if you will that you adhered to the initial pre-and post-intervention protocol but now returned
to my office months or years later with recurring symptoms. First and foremost is an updated medical
history and physical examination. That is followed by repeat images including X-rays and an MRI.
Mechanical progression of joint injury may result from aggravation of the preexisting damage by
subsequent trauma. Then there is the reality of identifying new processes within or adjacent to the joint.
This morning, I returned the phone call of a southwest Wisconsin dairy farmer; not the same patient I
wrote about last week. He has been a patient for over four years with a full restoration of work related
activities and recreational pursuits following several regenerative interventional options. After three
hours of basketball, three weeks ago, his knee pain returned. I called him back while he was milking his
cows and it was the first time I have been “mooed” at over a cell phone. I requested that the patient
update his X-rays, MRIs and then allow me to reevaluate him. A repeat stem cell intervention with a
more advanced technology, a subchondroplasty in addition to the stem cell intervention of his joint?
The recommendations will be based on an updated evaluation. In my practice of cellular orthopedics, it
isn’t one and done. Additionally, some of the more advanced techniques are being covered in part by
health care insurance

If you want to learn more, call for an appointment (312)475 1893
You may access my web site at www.Ilcellulartherapy.com and watch my webinar

After I completed writing this Blog, I opened the Bone and Joint Newsletter.
Lead article: Study Suggests Knee Replacement Be Reserved for Those More Severely Affected by Osteoarthritis. A recent analysis found that the current practice of TKR as performed in the USA had minimal effects on quality of life and quality adjusted life years

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Exciting Cellular Orthopedic Debates

Exciting Cellular Orthopedic Debates

Well, it is really an internal debate as to whether I should have a concentrated platelet rich plasma procedure or a bone marrow concentrate procedure as I get ready for the upcoming ski season. While it is true that I exercise five to six days a week rotating between outdoor cycling, strength training and rowing, the demands of skiing on the knees are such that I need to rethink my approach. I share this personal flow of conscience to provide guidance and council for readers of this blog. As for so many of us senior recreational participants, each activity has unique demands so we must anticipate each activity from a separate approach. While generalized fitness improves the quality of life and even well-being, maybe even prolonging life, if you want to ski with arthritic knees, now is the time to plan ahead.

Let me share with you my plan based on an observation of the outcomes in over 1500 patients in whom I have intervened with Cellular Orthopedic alternatives over the past five years. In the next several weeks, I will undergo a concentrated PRP intervention ultrasound guided into both of my knees. I will be using the upgraded methodologies for preparation of injectate and customize the PRP with our soon to be activated cell counter. This will provide me with a 20x dosage over that which has been available up until the present; and yes, I too have to pay for the methodology. I will then wait until mid-December, and if I am not satisfied, I will undergo a Bone Marrow Cell Concentrate procedure for both of my knees.

Below are two reasons received in the last 48 hours as to why I believe Cellular Orthopedic is exciting:

“My uber-condensed version, though, is that on almost all days in the last 8 months, I’ve had virtually no knee pain with daily activity. That’s a massive improvement from even the 12-month follow-up visit. I first started to suspect things were improving at about 10 months post-op. At 12 months, I was hopeful but still skeptical. At 14 months things, rapidly improved and have mainly remained there ever since. So, on the whole, I’m vastly improved. I suppose any number of factors could have contributed to that improvement, but Regenexx certainly seems to have helped tremendously.”

“Attended the company golf outing this past weekend. Last year I was concerned so I took an Advil before we started and ended up taking another halfway through the 18 holes. The last four holes I didn’t even leave the cart (to sore/tight to get in and out).

This year I fully intended to bring the Advil again but forgot it. Turned out I did not need it. Finished the 18 holes like nothing. Felt fine after and the next day.

Believe we can consider this a win!!!!”

Do you want to enjoy relief from arthritic symptoms and limitations?

Call 312 475 1893 to schedule a visit or visit my website to watch my webinar   www.Ilcellulartherapy.com

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Back from St Petersburg, Russia where I educated the Orthopedic   Surgeons from Russia, Ukraine and more

Back from St Petersburg, Russia where I educated the Orthopedic   Surgeons from Russia, Ukraine and more

“I already started getting numerous enquirers regarding your research and practical application of SCP using bone marrow material. People are asking how can they learn more, maybe pay a visit and observe the procedure with their own eyes. Quick and massive feedback, unprecedented.” This from the sponsor of the meeting of the Russian Orthopedic Society meeting in St Petersburg, September 21 to 23 where I had been an invited speaker to introduce Regenerative Orthopedics and Orthobiologics to an audience previously unaware of developments evolving in the United States wherein a patient symptomatic or otherwise affected by osteoarthritis might postpone or avoid a joint replacement with a needle rather than a knife.

What first struck me on our return from the airport on Monday afternoon while driving down the Kennedy was the unending display of outdoor advertising that really obstructs the view of the beautiful skyline of downtown Chicago. My wife and I had just enjoyed unobstructed beauty for five days in St Petersburg. While a case can be made for freedom of speech, I could rapidly adjust to less visual pollution in our City. Next came the pollution of Regenerative Medicine ads appearing in the newspaper when we arrived home and started catching up on the news. I had devoted four weeks developing my evidence based and outcomes supported, scientific presentations prior to departing on September 19 for the St Petersburg meeting, only to return to claims by local health care professionals without scientific authenticity and without evidence based support. While I was speaking at an international clinical conference to orthopedic surgeons; and the media hype appearing in Chicago and suburban newspapers was direct to the public marketing be it in an ad format or Health and Fitness section of a suburban newspaper, professionals have a moral, ethical and professional obligation to present materials based on evidence and science.   

Perhaps my criticism is the result of a view of health care from the unique perspective of an Orthopedic Surgeon integrating science and outcomes surveillance with clinical care in his practice. These are the reasons why I was invited to introduce evidence based cellular orthopedics to the international orthopedic community. If you want to take advantage of that knowledge and experience for the care and treatment of your arthritic joint, watch my webinar and visit the website www.ilcellulartherapy.com or call for a consultation 312 475 1893.

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