Get Back To An Active Lifestyle With Cellular Orthopedic Therapy
There has always been a category of patients for whom Bone Marrow Concentrate derived stem cells and growth factors were not a viable option. Patients who have received or are receiving chemotherapy, radiation therapy or immunosuppression have diminished stem cell viability and actual numbers. Such patients have historically been denied cellular orthopedic intervention; at the same time, they are problematic candidates for a joint replacement. Within the last 18 months, scientific advances are changing the algorithms of regenerative care for patients with symptomatic and debilitating osteoarthritis. I now have several options available for patients who would have been denied interventional orthopedic opportunity; patients who are impacted and limited by Osteoarthritis but for whom there previously was not a viable non-surgical alternative.
Alpha 2 Macroglobulin (A2M)
A2M is a very large plasma protein found in blood acting as a very strong protease inhibitor; and for patients who meet certain prerequisites, could well be highly effective in the treatment of osteoarthritis. The prerequisite is a synovial fluid analysis looking for the Fibronectin Aggrecans Complex (FAC). While it sounds complex, it is uncomplicated testing of a sample of synovial fluid easily performed under ultrasound guidance in the office setting. Recently, A2M became available in a synthetic recombinant format as an “off-the-shelf” alternative.
Umbilical cord-derived blood and cells
When our first grandchild arrived, our gift was a regenerative one; namely, the gifting of the cost of freezing her umbilical cord should there ultimately be a need for stem cells in her life. Now, there are scientific and pharmacologic interventions available from allograft umbilical cords retrieved at delivery, sterilized, and frozen. It is a new but emerging resource with regenerative and pain-relieving potential for patients with osteoarthritis who otherwise have no other treatment options.
Amniotic fluid concentrate
While there are no living stem cells in amniotic fluid once sterilized, frozen, and fast thawed, hence no regenerative possibility; the anti-inflammatory effect is real and the pain-relieving potential, although limited in duration, is being scientifically documented. Harvested by amniocentesis at the time of a cesarean section in a donor screened for communicable and infectious diseases, it is possible to repeat the intervention after a year should symptoms return. There are now “off the shelf” preparations of lyophilized Amniotic Fluid Concentrate.
Bone Marrow Concentrate derived stem cells and growth factors
I am in the process of developing a protocol to be submitted for IRB oversite wherein a bone marrow analysis would be completed allowing for stem cell and growth factor analysis pretreatment not unlike a bone biopsy for a lesion prior to the definitive surgery. This would allow me a patient-specific approach to those who otherwise would not be considered candidates for regenerative autograft options.