“Hello, I thought you would like to know that my stem cell in my left knee has worked. I didn’t expect it to take so long but I have had little to no pain for the past two months. Thank you all again for your care and please advise your patients to be patient! If not for Covid, I would have had knee replacement several months ago. Only good thing about Covid!”
I received this e-mail message of gratitude this morning and I began to think what this patient’s recovery might have been following a Total Knee Replacement (TKR). In the latter scenario, maximum medical improvement is not realized on the average for over six months or longer. Following a Stem Cell procedure, Maximum Medical Improvement may take six months or longer. In the population of patients who undergo a TKR, 40% are left with an incomplete recovery; that is, some pain and a significant permanent loss of motion. In those who opt for the Stem Cell intervention to relieve symptoms of arthritis and improve functional capacity, our data suggest 10% of patients don’t experience satisfaction. Following a failed Total Knee Replacement, outcome, the choices are to accept the permanent alteration of life style or undergo yet a second major surgical procedure; namely, a revision (ouch). Following a Stem cell procedure that doesn’t provide the sought-after outcome, we still offer a needle and not a knife to improve the end results.
Looking back at 2020 and looking forward to 2021, based on observations following our regenerative medicine interventions, I will adjust my post intervention management with a more concentrated Growth Factor/ PRP booster. Our evidence-based results over the past several months using Growth Factors in higher concentrations have been most rewarding. As many readers of this Blog are aware, I am working closely with Personalized Stem Cells, Inc. and the FDA to help launch the next Adipose based Stem Cell Clinical Trial. It is our hope that the Trial will be approved by the end of Q1 or the start of Q2. In the interim, if you are experiencing pain and functional limitation from knee arthritis, consider a Growth Factor /PRP concentrate intervention. While there is an out-of-pocket fee for the treatment to keep you going, ultimately, for those who meet the inclusion criteria for the PSC Clinical Trial, there will be a facility fee but no out of pocket expense for the entire Adipose Based Stem Cell undertaking.
To learn more, follow my website at www.sheinkopmd.com.
To schedule a consultation call (312) 475-1893
Tags: arthritis, arthritis treatment, regenerative medicine, stem cell, stem cell therapy
Better stated, how do you bridge the gaps in the continuum of joint care from early intervention to joint replacement?
Arthritic Joint Pain Management
First and foremost, our goal is functional restoration and maintenance, relieving symptoms, and postponing, perhaps avoiding joint replacement. In the beginning, conservative measures might include non-steroidal anti-inflammatory medications, weight reduction, physical therapy for strengthening muscles and preserving or restoring a full range of joint motion. At times, an unloader brace may be of benefit in settings where a joint shows early signs of mechanical changes such as a knock knee (valgus) or bowed leg (varus). In addition to the aforementioned measures, joint preservation is a major goal using such measures as Platelet Rich Plasma, Highly Cross-linked Hyaluronic Acid and Acellular Amniotic Fluid.
Within the Preservation Classification, there are multiple options available. Our evidence-based practice concentrates on those options in which we have done outcome research; as well as published our results in scientific journals. Only using evidence-based options allows us to provide the patient the highest chance of a successful outcome.
Cellular Therapy to Treat Joints
There are times in the continuum of care that the patient will present further along in the arthritic process so that Conserve and Preserve are no longer indicated. Joint Restoration is the next consideration that might or could go a long way in postponing or even avoiding a joint replacement. Autologous Growth Factor Solutions contain proteins circulating in your blood that potentially stops pain, and reverses the arthritic process at the molecular level in the joint. The ultimate Regenerative Orthopedic approach is stem cell mediated and bone marrow concentrate is the only FDA approved source of mesenchymal stem cells at this time. Your bone marrow is recovered by an outpatient aspiration procedure, the recovered bone marrow via a specially designed needle, (troachar), contains adult mesenchymal stem cells, exosomes, platelets, growth factors and precursor cells. When concentrated, your bone marrow is the richest source of joint restoration potential available to date. It is FDA approved as long as guidelines are adhered to; has no potential for disease transfer; and offers pain relief, return of motion and function, and postponement, perhaps avoidance of a joint replacement. Please note that I indicated “at this time.”
The Personalized Stem Cell trial in which I played a major role just concluded. The results are being analyzed. In the PSC Trial, the source of stem cells was adipose tissue, abdominal fat. When approved, Personalized Stem Cells will allow abdominal fat to serve as an alternative source of stem cells in addition to bone marrow on a clinical basis. The next advance will come following the FDA approval for the PSC trial of stem cell culturing. To stay informed, read my weekly blog. To schedule a consultation call (847)390-7666. You may visit my web site and attend a webinar at www.sheinkopmd.com
Tags: arthritic joint pain, arthritis, cellular therapy for arthritic joints, joint, joint pain, preventing joint replacements
The science and art of my biologic initiative to help a patient deal with the symptoms and limitations imposed by osteoarthritis requires the right tools for each situation. Concentrated Bone Marrow Aspirate or Platelet Rich Plasma has emerged as an important biologic tool for me because I have scientific evidence to support what I recommend.
Mesenchymal Stem Cells are undifferentiated cells that influence healing and growth of tissues making up the musculoskeletal system. MSCs are found in bone marrow.
Osteogenic Precursor Cells are derived from MSCs but basically have the potential to produce bone. Hematopoietic Stem cells are precursors to all red blood cells, white blood cells, platelets and other cells influencing bone density. They are found in bone marrow
Platelets are small, colorless bodies found in blood. They contain alpha granules which play a vital role in blood clotting, inflammation and wound healing. They are found in bone marrow.
White Blood Cells (Leukocytes) provide the body with protection against foreign matter. There are several types of white blood cells and they play a role in inflammation and the immune response
I started this Blog with the sentence “The science and art of my biologic initiative.” At times, the art favors the delivery of autologous, Concentrated Growth Factors contained in your blood so as to reverse inflammation. It is inflammation that generates the pain associated with Osteoarthritis.
By centrifuging your Blood and Bone Marrow, I am able to deliver a large number of stem cells, progenitor cells, and growth factors directly to your arthritic bone and joint thus harnessing the body’s biologic potential. I use a proprietary approach having evolved from our research, when possible, introducing concentrated Platelet Rich Plasma before and after the Concentrated Bone Marrow injection or occasionally all together.
In spite of the misinformation found in the marketplace, the Amniotic Fluid Products do not provide a living source of Mesenchymal Stem Cells. They do contain various growth factors relevant to orthopaedics (platelet-derived growth factor ββ, vascular endothelial growth factor, interleukin 8, bone morphogenetic protein 2, transforming growth factor β1) and may have some value.
As I have indicated, Regenerative Medicine and Cellular Orthopedics is both an art and a science. This morning, I am working on the science as a co-author on the outcomes of the subchondroplasty manuscript. To learn more, visit my website at www.sheinkopmd.com.
You may schedule and an appointment or consultation by calling (312) 475-1893.
Tags: arthritis, Bone Marrow Concentrate, Platelet Rich Plasma
The New York Times: 2019/05/13 “Stem cell Treatments Flourish with Little Evidence That They Work”
Several years ago, I asked a question of a cellular biologist as to how is Bone Marrow Concentrate effective if the number of adult mesenchymal stem cells diminish as we age? His response: “Bone Marrow contains lots of things including stem cells and proteins called cytokines or growth factors. It may be that the growth factors are most important in joint restoration and blocking pain.”
Let’s take for example, inflammatory arthritis such as Rheumatoid and Psoriatic arthritis. The common denominator is a pro-inflammatory cytokine called Tissue Necrosis Factor found in the body’s immune system. The growth factor, TNF-alpha blocker is now used to control the inflammation and alter the body’s immune response to the proinflammatory protein. As a result of TNF-alpha blockers, Phil Mickelson is a very competitive golf professional, (You have seen him as a spokes person for Psoriatic Arthritis treatment with Humira). Since the introduction of TNF alpha blockers in Scandinavia five years ago, there has been a 40% reduction in Total Knee Replacements for inflammatory arthritis. When Kobe Bryant traveled to Dusseldorf, Germany almost nine years ago, he received treatment for a very arthritic knee with Interleukin -1 Receptor Antagonist Protein, along with other blockers. Shortly thereafter, he returned to play another five years in the NBA. The IRAP that Bryant received was and is an anti-inflammatory, a growth factor blocker, a cytokine.
As I agree in part with the criticism in the New York Times concerning Stem Cells, those who read this Blog will recall that I don’t “sell” stem cells. Bone Marrow is used in part because of the fact that it contains stem cells; but more importantly as we age, Bone Marrow contains Growth Factors, the anti-inflammatory protein Cytokines that restore a joint by minimizing pain and improving function. Over the last eight years, we have accumulated the evidence that Bone Marrow Concentrate works for arthritis via stem cells, growth factors, or all of the above. Recently we have taken a major step forward by filtering high concentrations of Growth Factors from the Platelet Poor Plasma, previously discarded, that remained after we centrifuge the bone marrow and add the filtrate to that which is injected into the painful joint. Stem Cells maybe, highly concentrated Growth Factors that act to block pain and improve function, for certain.
You may learn more by visiting my web site at www.sheinkopmd.com or call for a consultation (847)390-7666
Tags: ACL, ACL Injury, anterior cruciate, arthritic knee, arthritis, Autologous Protein Concentrate, BMC, board-certified, Bone Marrow Concentrate, bone marrow edema, cells, cellular orthopedic, cellular orthopedics, FDA, Growth Factors, hematopoietic cell, inflammatory arthritis, injection, Interleukin 1 Receptor Antagonist Protein, IRAP, joint health, joint pain, knee replacement, Kobe Bryant, meniscal injury, meniscectomy, Mesenchymal Stem Cell, micro-fragmented adipose, muscle injury, muscle strain, nterleukin -1 Receptor Antagonist Protein, OA, Orthopedic Surgeon, Osteoarthritis, pain, Physical Therapy, Platelet Rich Plasma, platelets, pro-inflammatory cytokine, PRP, Psoriatic Arthritis, regenerative medicine, repair, Rotator cuff tear, sports injuries, sports medicine, stem cells, strain, tear, Tissue Necrosis Factor, TNF alpha blocker, torn medial meniscus, training
I consider myself an aging athlete who still skis, cycles, dedicates five days a week to fitness, plans to soon plant a garden, and walks up a spring creek with a fly rod. When my arthritic hips and knees began to limit my recreational profile several years ago, I chose the regenerative medicine option rather than joint replacements. Having performed joint replacements for 37 years and studied the benefits and limitations of such, I elected to postpone, perhaps avoid major surgery with the inherent risks and limitations. First it was Platelet rich plasma, next came PRP with Growth factor Proteins; and next came stem cells. At the get go, I did not expect to regenerate cartilage; but I did hope to restore joint function, minimize pain, and maintain the highest possible activity potential. Even with Grade 4 osteoarthritis of my major joints, I can report that I skied for a week in Vail this past February as I did a year ago, recently spent three days wading though spring creeks in Southwestern Wisconsin with a fly rod in pursuit of trout, and cycled 30 miles last Saturday. I am not alone as my biking, skiing and cycling buddy with similar knee issues returned last week from his yearly helicopter skiing adventure. I have been managing his knee arthritic issues with regenerative medicine interventions for over five years.
Then there are the athletes in their 50s. Certainly, the option is there for a joint replacement for a grade three arthritic joint but what If? What if there is a complication, an adverse event, a failure to regain motion, or residual pain? The fall back potion after a failed joint replacement is another joint replacement and the outcomes of revision surgery are frequently not satisfactory. Several weeks ago, I described the recreational pursuits of a 58-year-old volleyball enthusiast who had initially considered a joint replacement when 15 years after an arthroscopic partial meniscectomy, the predictable post traumatic arthritis had forced him to suspend his activities. He chose a regenerative medicine stem cell option; and eight weeks thereafter, he is back to playing volleyball three times a week. While on occasion, a booster follow-up injection is needed; we are in the process of developing a manuscript for scientific publication focusing on the successful outcomes of 20 patients followed for one to two years after a combined injection of bone marrow concentrate containing stem cells into the knee and the bone adjacent to the knee. These are recreational athletes between ages 45 and 60 who won’t quit.
On May 4, I am one of three invited faculty to present at The Regenerative Medicine Training Institute (RMTI). On June 7 and 8, I have been asked to participate in the Workshop and Lab Faculty at the largest Regenerative Medicine program in North America (TOBI). Owing to our integration of patient care with scientific outcomes monitoring, we have been able and continue to provide masterful and evidence-based care to aging athletes. To continue to remain in the forefront of Regenerative Medicine, I dedicate a good deal of time reviewing the future while monitoring the outcomes of patient care. Several new treatment options are soon to be launched including expanding my scope of care to those with inflammatory arthritis.
To learn more, call for a consultation (312) 475-1893. You may visit my website: www.sheinkopmd.com
Tags: ACL, ACL Injury, anterior cruciate, arthritic knee, arthritis, Autologous Protein Concentrate, baseball, BMC, board-certified, Bone Marrow Concentrate, bone marrow edema, cells, cellular orthopedic, cellular orthopedics, FDA, football, golf, Growth Factors, hematopoietic cell, injection, Interleukin 1 Receptor Antagonist Protein, IRAP, joint health, joint pain, knee replacement, lipogems, meniscal injury, meniscectomy, Mesenchymal Stem Cell, micro-fragmented adipose, muscle injury, muscle strain, OA, Orthopedic Surgeon, Osteoarthritis, pain, Physical Therapy, Platelet Rich Plasma, platelets, PRP, regenerative medicine, repair, Rotator cuff tear, soccer, sports injuries, sports medicine, stem cells, strain, tear, torn medial meniscus, training, volleyball