Apr 9, 2015
The New York Times recently published a story about a lawsuit brought against an orthopedic prosthetic company for distributing their product without appropriate FDA approval. The story calls into question not only the process by which new technology is brought into practice, but the choices the clinician must make when deciding the best options to use on a patient. We need to study every new technology with evidence based means and make critical decisions on the outcomes resulting from those studies. We clinicians strive to always do better.
As I am sure you realize, the FDA and other parties are anxious to have more data, especially when it comes to the newer technologies in Regenerative Medicine. To the best of my knowledge and based on my ongoing scrutiny of the scientific and orthopedic medical literature, Regenexx is the only scientific laboratory to date that has repeatedly met with the FDA and their agents and been allowed to offer regenerative technology under the highest level of scrutiny. My particular targets are arthritis and synovitis. My therapeutic approach to pain, altered function, reduced motion, delaying and even avoiding a joint replacement, and reversing the natural progression of arthritis is mostly based on the research and publications of Regenexx; and in addition more recently, on the outcomes from the continuing monitoring of our own Regenexx Chicago data base.
When it comes to patient care, I explain risks and benefits in generic terms citing percentages from my understanding of the information presented at scientific meetings, that which I read in the medical literature, the publications from Regenexx, and information gleaned from my own investigations. The Decision-Making process should be and at Regenexx is based on registries. The governments of countries outside the United States have required participation in registries for many years; there is no such requirement in the United States. Regenexx for the past seven years has maintained such a registry, and when I joined the Network three years ago, added to the comprehensive nature of those outcome measurements.
Innovation is important to advance patient care. Regenerative Medicine is truly a transformational innovation. We want patients to respect our ability to make decisions about what is in their best interests. This foundation of respect will only result from unbiased decisions and will be strengthened when more recent entries into the field of stem cell care present scientific data and not “this is how I do it” or criticism based on market place competition. Regenexx has introduced a stable and stem cell methodology with a proven track record. This being the case, others should be careful when choosing to forgo that approach. In a spin on the words of the immortal Jerry Maguire, Show Me Your Data.
Tags: arthritis, Benefits and Risk, bone marrow, Bone Marrow Concentrate, Clinical Studies, Hip Replacement, Interventional Orthopedics, joint replacement, Knee, Knee Pain Relief, Mature Athlete, medicine, Orthopedic Care, Orthopedic Surgeon, Orthopedics, Osteoarthritis, Pain Management, Regenerative, Regenexx, Regenexx-SD, stem cells, technology, treatment
Apr 2, 2015
Intervertebral disc degeneration is characterized by a gradual loss of cellular function and related breakdown of extracellular matrix. This process leads to a decrease in the mechanical stability of the spine and activation of molecules that trigger painful back and neck symptoms. Implantation of mesenchymal stem cells has been shown to counteract the degenerative process in animal models of disc degeneration and in some initial clinical studies. The regenerative activity of Mesenchymal Stem Cells when injected into the disc results in a reversal of that degenerative disc process. In addition, the injection of MSCs also releases trophic factors that may stimulate the metabolism of disc cells and suppress inflammatory reactions. However, in spite of these promising perspectives, clinical application of MSCs has certain limitations. Potential adverse events such as cell leaking and osteophyte (spur) formation are at present, the limiting factors. I am updating my Blog readers concerning what is on the horizon as every week I receive a question about the subject of the low back and stem cells. Low Back degenerative disease also is something I must consider in each and every patient for whom I perform a Cellular Orthopedic intervention in a hip or knee as there is no question about a Hip-Knee-Spine connection and I must understand its importance when I treat hip and knee pathology. These areas are closely related in function and symptom distribution
The limitation at present of Cellular Orthopedic intervention for intervertebral disc degeneration is the need to further identify potential side effects. While an attractive target for future regenerative strategies, Bone Marrow Aspirate Concentrate/Stem Cell intervention is not ready for prime time. The logical question then is how to cope with the limitations of spinal stenosis and Degenerative Disc and Joint disease of the low back until stem cell care is proven safe and effective? First and foremost comes weight reduction. Next in line is core strengthening in conjunction with stretching. This may be accomplished through Pilates, Tai Chi, Yoga and any other program that follows the principles of strengthening and stretching the core. Incidentally, running and jogging are not injurious to an arthritic spine; just the opposite, both help rehydrate the dried out disc.
To learn more about your personal kinematic Knee-Hip-Low Back continuum, you need an assessment. That’s the only way I can determine the key problem and if one or all need to be addressed.
847 390 7666 to make an appointment
Tags: arthritis, athletes, Benefits and Risk, bone marrow, Bone Marrow Concentrate, Clinical Studies, Interventional Orthopedics, Mature Athlete, medicine, Regenerative, Regenexx, stem cells, treatment
Mar 24, 2015
At least it is spring on Astronomical chart although six inches of snow yesterday in Chicago causes one to take pause. Nevertheless, I am off to Southwest Wisconsin this weekend to initiate my fly fishing journeys for 2015. One doesn’t necessarily equate fishing with physical demand. Yet last Friday, at an 18 month follow-up of a Bone Marrow Aspirate Concentrate/Stem cell intervention in a 74 year old patient with arthritic knees, who incidentally had been told he needed knee replacements, I received a very serious thank you because my patient was planning several fishing trips to Canada this year with children and grandchildren; something he had not been able to do for several years as he couldn’t get in and out of a boat. Now he is able to do so and plans to enjoy every moment. I plan to wade up the spring creeks and vault up and down the cliffs and boulders as a result of my own regenerative care last year. Two weeks ago, my wife and I returned from a fabulous week of skiing in Vail and the only runs I avoided were the cliffs.
I learned much over the winter about several golfers who had undergone stem cell care for both knee and hip. The post intervention rehabilitation regimen had resulted in their ability to travel to the South East and Southwest to play golf on multiple occasions when such had not been possible in the past several years for them. Of particular interest to me was the report from one patient who I had met two years ago when he was scheduled to undergo a hip replacement. First he spent some time changing his swing and in particular the positioning of his leg so it would turn out. That seems to have taken the pressure off the area of missing cartilage and impingement. Next, he underwent a stem cell procedure and he is no longer considering a joint replacement. Not being a golfer, I checked it out on the internet and indeed, a change in golf mechanics may eliminate the painful swing. When followed by the stem cell procedure, there is something akin to bacon and eggs or love and marriage.
In looking back over the winter that hopefully was, a 45 year old man who had had to stop running because of “bone on bone” in his knee and who had received a recommendation elsewhere for a knee replacement, indeed turned out not to have “bone on bone” when I reviewed his images although he did have a problematic knee. 90 days after undergoing an SD Regenexx procedure, he ran the Madison 50 furlong-Race. Well, now it’s time to put air in my tires and start planning ahead. I did receive a call last Saturday by my cycling partner concerning a Sunday morning ride; but with a temperature forecast of 29 degrees, I respectfully declined the offer. For those with joint injury or arthritis, everything and anything is possible in fitness, recreation, sports and a pain free walk in this new world of Cellular Orthopedics.
Tags: 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, Regenexx, Regenexx-SD, stem cells, treatment
Mar 16, 2015
When a patient schedules a Bone Marrow Aspirate Concentrate/Stem cell procedure in our office, part of the recommendations leading up to and following your SD procedure is elimination of Statins for a period before and after the procedure. While Statins are clearly effective in reducing the risk of major atherosclerotic cardiovascular events, and the cardiovascular benefits outweigh the risks of treatment, there is a skeletomuscular price to be paid with the use of Statins. With accumulation of more data and longer term monitoring on the outcomes of Statin prescription, we have learned that adverse events include, most commonly, muscle pain, aching and weakness usually without elevation of muscle enzymes, specifically the CreatineKinase. All Statins can cause myopathy defined here as unexplained muscle pain or weakness. While in rare settings, the myopathy may be accompanied by CPK levels more than 10 times the upper limit of normal, and progression to a serious irreversible form of myopathy, rhabdomyolysis, in most situations, it is muscle pain and weakness without changes in muscle related enzymes. In spite of all of these observations, as of this time there is no scientific explanation in most settings as to why a patient may manifest Statin intolerance.
As far as why Statins are associated with weakness, pain and muscle aches, there is no pharmacologic evidence other than the disappearance of symptoms when the dose is lowered , the proprietary prescription is changed or the pharmacologic is discontinued altogether. The high success rate of the disappearance of symptoms following a period of abstinence and then reintroduction is consistent with nonpharmocological mechanisms for intolerance.
Do Statins adversely affect the muscle cell mitochondria? In a group of obese patients for whom an exercise regimen was incorporated into their weight loss, fitness routine, those on Statins had a more difficult time with a higher expression of diabetes as contrasted with those who had not been prescribed the Statins. I am not an internist; I admit I use Statins as I have a cardiovascular disease family history. They are prescribed by my internist and I don’t challenge his expertise; my recent ultrasound/echocardiogram stress test results confirm his wisdom. Nevertheless, I now have a reasonable explanation for my own transient muscle discomfort and you have a reasonable explanation as to why we recommend the elimination of Statins prior to and following a Regenexx SD Stem Cell procedure for an arthritic joint.
Tags: arthritis, athletes, Benefits and Risk, bone marrow, Bone Marrow Concentrate, Interventional Orthopedics, Knee Pain Relief, Mature Athlete, medicine, Orthopedic Care, Orthopedic Surgeon, Orthopedics, Osteoarthritis, Pain Management, Regenexx, stem cells, treatment
Mar 2, 2015
It starts with an evaluation, a Bone Marrow Aspirate Concentrate intervention, a custom brace, and sports specific physical rehabilitation protocol that changes with the seasons, a nutritional consultation, a dietary supplement prescription, and a Concentrated Platelet Rich Plasma/Lysate Booster when appropriate. That’s my recommendation for hiking, biking, climbing, skiing, staying fit and fly-fishing. These far reaching futuristic statements are based on my clinical research, anecdotal observations on patients who join me in the aforementioned activities and my own lifestyle. Should your impairment return once you are a Sheinkop alumnus, or should you see an increase in arthritic related symptoms, do it again in a year or five.
You are what you eat is in part a truism. So too, you can be what you want to be. Sure we age and sure we all have to live with age related adjustments; the answer is not to quit. Take my prescription for maintaining or returning to the active life. To learn more, call for an appointment. As an example, we have changed our visco-supplementation formula because of a new development to one injection rather than three. We have improved our Platelet Rich Plasma formula to be much more effective than last year and we are constantly updating our Bone Marrow Concentrate formula.
So what’s in the Cellular Orthopedic news? “Novel Technology to increase Concentrations of Stem and Progenitor Cells in Marrow Aspiration.” Headline this weekend and I looked into it further. After all, I have a responsibility to my patients to stay in the forefront of new developments. As I delved further, I found that this “advanced” technology was tested on three patients before being brought to market. My analysis of this “breakthrough”, come back when you are for real. Then came the Alpha 2 Macroglobulin filter positioned to compete with Platelet Rich Plasma methodologies. The cart was put before the horse on this one, as we don’t even know if Alpha 2 Macroglobulin will work on a human. Then there is the Hip-Spine connection; but I will save that for next time.
Tags: arthritis, athletes, Benefits and Risk, bone marrow, Bone Marrow Concentrate, Hip Replacement, Interventional Orthopedics, Knee Pain Relief, Mature Athlete, medicine, Orthopedics, Osteoarthritis, Pain Management, Regenerative, Regenexx, Regenexx-SD, stem cells, Synvisc, treatment
