Orthopedic Care of the Mature Athlete
The phone is ringing and my office team is doing the best possible at returning calls and answering questions. One of my recent Blogs introduced a new way of approaching arthritis when I discussed the arthroscopic package in conjunction with bone marrow aspirated concentrate. To remind you, I am an orthopedic surgeon with a 38 plus year at replacing arthritic joints. During that time span, there have been several attempts advanced within the orthopedic surgical community at sparing a joint either via a biological arthroplasty, a cartilage restoration or an arthroscopic micro plasty . Each approach is based on the same two principles, save the joint and regrow the cartilage. There have been some remarkable scenarios reported for patients under 40 using the aforementioned surgical approaches. The challenge I have undertaken is expanding the reality for cartilage restoration for the mature athlete over age 40.
Micro-plasty is based on using an arthroscope to first remove torn cartilage,
loose bodies and other debris from the joint. Next the surgeon creates multiple bleeding points in the exposed bone, which in a healthy state was covered with hyaline cartilage. As the micro fractures heal, the theory is that cartilage will reform because of migration of stem cells form adjacent bone marrow. While this may be true in the young patient, there is little active marrow remaining as we age so any cartilage regrowth is fibrocartilage which won’t stand up to normal stress and strain. There is animal evidence to suggest that adding bone marrow concentrate following a micro fracture results in the actual regrowth of hyaline cartilage. There are now several anecdotal success stories. To that end, when a patient calls to discuss whether to proceed with an arthroscopic package or whether to come to Chicago for the bone marrow aspirated concentrate program, my response is to do both. Have the Arthroscopic package at home with micro fracture as indicated thereby removing torn meniscal fragments, loose bodies and other debris; then come to Chicago in three weeks for the mesenchymal stem cell adjunct.
I don’t have evidence yet but the outcome data will be studied. The goal is to reverse the unsatisfactory experience of arthroscopy alone for arthritis with bone marrow aspirated concentrate derived stem cells as an adjunct. If you want to learn more, call and schedule a consultation.
Mitchell B. Sheinkop, M.D.
312-475-1893 or 312-475-1893
1565 N. LaSalle Street . Chicago . Illinois . 60622