Jul 13, 2015
Cartilage is known to be damaged by Interleukin-1B (IL-1B), a cell signaling protein responsible for blood-induced cartilage damage. When there is trauma to a joint and a hematoma ensues, the faster the hematoma is evacuated, the less damage to cartilage long term. The blood in the joint now provides an explanation as to why some years after an injury, a patient will present with an osteoarthritic joint. An example is the tear of the Anterior Cruciate Ligament. Findings in the research laboratory also indicate that the faster the blood is removed from the injured joint, the less damage to the cartilage. To emphasize the harm from IL-B1, we are experiencing increased number of patients with a history of an ACL tear who are in need of intervention for post traumatic arthritis at younger ages than in the past even when the ACL has been successfully repaired.
Turning our attention to fractures within the joint, it is important for orthopedic surgeons to realize the impact of blood on cartilage. There is an upregulation of cartilage-degrading enzymes suggesting that the indications for surgical repair of an intra-articular fracture should be expanded and the surgery considered urgent and not delayed. There is an additional adjunct that should be introduced into the algorithm of care of the joint injury and resulting hematoma; namely, Bone Marrow Aspirate Concentrate. Interleukin-1B Receptor Antagonist Protein serves as a dose- and time-dependent protection from blood-induced damage. The higher the concentration and the earlier the introduction, the less cartilage damage sustained. When Bone Marrow is aspirated, recovered with the Mesenchymal Stem Cells (MSCs) are those cells in the bone marrow that produce Interleukin-1 Receptor Antagonist Proteins (IRAP). When the aspirate is concentrated, included in the centrifugate along with the MSCs is a therapeutic quantity of IRAP and that means stopping the degradation of cartilage by the harmful blood born Il-1B.
So what is my take home message? The swollen joint after trauma needs to be aspirated as quickly as possible to remove blood. The intra-articular injury to a joint must be addressed either by surgery or non-operative means on an urgent basis; intervention should not be considered elective. Bone Marrow Aspirate Concentrate should be increasingly used as an adjunct in the care of a joint injury. Should you experience that joint injury, discuss using Bone Marrow Aspirate Concentrate as an adjunct. If your orthopedic surgeon is unfamiliar, once the damage is acutely addressed, call us to see if there is a place for Cellular Orthopedics as a means of improving your long term outcome.
Tags: ACL Injury, arthritis, athletes, Benefits and Risk, bone marrow, Bone Marrow Concentrate, Clinical Studies, Interventional Orthopedics, Knee, medicine, Orthopedic Care, Orthopedic Surgeon, Orthopedics, Osteoarthritis, Pain Management, Regenerative, stem cells, treatment
Apr 16, 2015
Thursday, April 16, 2015 9:51 am
“Stem Cells working great. 4 days of skiing and 90,000 vertical feet already. Knees only slightly swollen. Using the new braces seems to really help. Last 4 to 5 runs of the day, it is very hard to get in and out of the heli-knees very sore by then. Hard to get up from a fall (so skiing carefully so as not to fall anymore). Pure powder last 2 days, so skiing itself has been easy. Biking every morning and after skiing, using Voltaren 2x’s/day, hot tub and ice-water on legs 3x’s after skiing and knee massage every day. Gary made his 3 million suit on Tuesday, and I missed mine yesterday by just 90 feet!! Huge Day of skiing yesterday-everyone exhausted. Skiing a half day today. Will see about tomorrow (only if all powder)”
This report was sent by a friend and patient who is helicopter skiing with CMH in British Columbia this week. I had originally planned to join the trip but work load prevented me. The skier-writer of the message had been unable to ski any longer until I completed a Bone Marrow Aspirate Concentrate/Stem cell intervention to his right knee two years ago; and for the left, last year. He is 70 years of age
Dwight Howard returns to Houston in time for NBA playoffs
In February, The Houston Rockets star center was sidelined by knee pain for which he underwent a Bone Marrow Aspirate Concentrate/Stem cell intervention. As I wasn’t his treating physician, I am not familiar with the details of his diagnosis, but suffice it to say from what I have gleaned from ESPN on the internet, it was cartilaginous damage with continued pain and inflammation. Last week, he returned to action and will be very much part of the Rockets quest for an NBA championship.
The Anti-Aging Movement Continues to Rise
By Terry Stanton
From the April, 2015 edition of AAOS Now/Clinical News and Views.
“During an Annual Meeting Symposium on considerations in treating the aging athletic patient, a panel of surgeons covered both injuries and treatment for “weekend warriors” and the science of aging.” I enjoyed the article in that it once again underscores how Regenexx is ahead of the pack with non operative, minimally invasive interventions with a needle for those sports injuries and the arthritic progression that alters function. The article cited above concludes “Field though legitimate, lacks science to support health benefits of treatment”. That this is partially true was emphasized by a patient from Hong Kong this week who had written me to tell me all the promises she had found while surfing the internet to seek non surgical options for her recently torn ACL. Her experience underscores the need for the Aging Athlete to ask the question: “show me your evidence”. There is only one Regenerative Medical Network that has the Data based on which your questions may be truthfully answered. It is called Regenexx and I am not only a part of, but a contributor to their scientific Outcomes process.
Tags: ACL Injury, arthritis, athletes, Benefits and Risk, Bone Marrow Concentrate, Hip Replacement, Interventional Orthopedics, joint replacement, Knee, Knee Pain Relief, Mature Athlete, medicine, Orthopedic Care, Orthopedics, Osteoarthritis, Pain Management, Pilot Study, Regenexx, stem cells, treatment
Aug 14, 2012
With the increasing data supporting biological repair of certain forms of ACL injury and with the increasing evidence supporting cartilage repair in an injured joint, is there a case for expanding the scope of Bone Marrow Aspirated Concentrate to these increasingly common injuries in the adolescent? For one, the healthiest resource for active and large numbers of mesenchymal derived stem cells is the marrow of an adolescent. There are all kinds of operative approaches for the adolescent presenting with Osteochondritis Dissecans from debridement to whole segment cartilage grafting through open procedures. The net result though of OD in a weight bearing zone is early onset osteoarthritis. There is ever increasing scientific evidence that the adverse long term outcome of joint trauma may be reversed by early application of mesenchymal stem cells. If you add to the treatment algorithm, the cartilage restoration potential of stem cells in the joints of patient’s under age 40, the fact about stem cell repair in adolescents speaks for itself
Turning our discussion to the adolescent Anterior Cruciate Ligament injury, there is no question that said surgical repair has limited survivorship and is only the beginning of a series of revisions over a lifetime. With the recent evidence reported by Regenexx at its annual network meeting, there is a roll for stem cell management of ACL injury in selected cases. Presented were several successfully repaired ACL ruptures in adolescent girls who had sustained recent injury on the athletic field. While we are early in the development of Regenerative Medicine and stem cell treatment for orthopedic injury is still investigational, there are no bridges burned; and just maybe, a lifetime of repeat surgical procedures avoided.
I had occasion on Monday to discuss the stem cell debate with a writer for an orthopedic weekly newsletter. I pointed out that we have been using stem cells in orthopedics for over 70 years whenever we harvest tissue from elsewhere for repairing a defect be it traumatic or degenerative. Bone graft is a means of delivering stem cells to foster bone healing from any cause. Tendon graft is a means of facilitating healing of a traumatic instability, another application of stem cells to effect healing. It just maybe that the legal and payer bottlenecks are the result of lack of clinical understanding of what orthopedics is all about. Would a repackaging of terminology change the stem cell debate in the USA? Stay tuned!
Mitchell B. Sheinkop, M.D.
1565 N. LaSalle St . Chicago . Illinois . 60610
312-475-1893
Tags: ACL Injury, Osteochondritis Dissecans
