In seeking to continually improve results of Bone Marrow Concentrate Stem Cell interventions, we review our data base to try and better understand how to improve the success of a stem cell procedure both from the standpoint of pain control and the length of success. When it comes to the knee, I have looked at age and that isn’t as significant in anticipating a successful outcome as I had previously anticipated. Next it was the weight issue and Body Max Index but that hasn’t proved to have as significant an adverse influence on outcomes as I once had predicted although it does have a relation to the difficulty of the harvest. . There is no question that certain prescription medications have a very negative effect on stem cell performance; so much so that dependency on certain pharmaceuticals has caused me to seek an alternative approach to Bone Marrow Aspirate Concentrate. The pre-treatment range of knee motion is as reliable predictor of the outcome as is knee stability. If a patient has an unstable knee or less than 110 degrees of motion, the chances of stem cell success are problematic.
What influenced me to write this Blog is the correlation I am seeing between knee deformity and the degree of success and the length of success If a patient has a mechanical bowing of five to seven degrees or more or a knock knee over seven degrees, the results of stem cell intervention are less predictable and carry with a shorter length of success than might otherwise be the outcome. Knowing that your knee which still allows you to be active is worth saving in spite of the X-ray, will provide a higher certainty of maintaining an active functional capacity than a knee replacement affords; the stem cell route before considering a joint replacement is one worth serious consideration. In order to improve candidacy and long term success, I am now recommending correction of mechanical deformity via a procedure termed an osteotomy in conjunction with the stem cell intervention. The concept of correcting a mechanical knee axis for arthritis has over 50 years of history. With the advent of knee replacement, osteotomy alone fell out of favor; but with the short term success of stem cell intervention in avoiding or postponing the joint replacement while maintaining or returning an individual to a very active profile, mechanical axis correction makes a lot of sense. My initial goal when I undertook this Cellular Orthopedic initiative was to assist in postponing a joint replacement; now I seek to influence avoidance of a joint replacement