Apr 7, 2017
I have purposely used the terms interventional orthopedics and cellular orthopedics when referring to regenerative medicine to remind my reader that I am an orthopedic surgeon. Later in life, I graduated into my present role as a clinician seeking to assist a patient in postponing, at times avoiding a major surgical procedure for an arthritic or otherwise compromised joint. You will note that I limit my discussion and topic matter to the musculoskeletal system and, do not allow vanity or greed to suggest that I am willing to expand my scope of care directed to conditions and diseases for which I am willing to provide treatment. In my 37-year commitment to reconstructive orthopedics and joint replacement surgery, I did not increase my scope of services outside the musculoskeletal system and I won’t consider anything more in my regenerative medicine undertakings, today.
To take things a bit further, when it comes to cartilage damage in any joint and from any causation, there are three categories of care: Palliative, Reparative and Restorative. In the first category, palliative, I do offer anti-inflammatory prescription, cortisone injection and hyaluronic intervention. At times, for those who meet inclusion criteria, I even enroll patients in an amniotic fluid clinical trial for pain management when deemed appropriate knowing there is no regenerative or even reparative potential therein. Reparative may take place during a Bone Marrow Concentrate procedure; but my goal is Restorative (Regeneration). The only FDA complaint method for delivering stem cells to an arthritic joint is the use of your aspirated and then concentrated bone marrow from your pelvis. In spite of the misleading and false news to be found on the various web sites, in order for stem cells to be separated from fat, an enzymatic digestion must take place and that manipulation renders adipose derived stem cell usage contrary to FDA mandates. Furthermore, there is no published scientific literature demonstrating adipose derived stem cells are of value in the care and treatment of an arthritic or otherwise altered joint function.
When you decide to seek out a provider of regenerative services, a very important part of the decision- making process should be to question that provider as to whether services are limited to the musculoskeletal system and what outcomes and data of that particular practice experiences? I have noted recently that my data and outcomes are being posted on web sites around the country as if the results were being achieved in settings other than mine.
If you want to learn more about postponing or perhaps even avoiding surgery for a joint that alters your quality of life, call 312-475-1893.
To learn more, check out my web site at www.Sheinkopmd.com
View my webinar at www.ilcellulartherapy.com
Tags: arthritis, Bone Marrow Concentrate, Clinical Trial. Mitchell B. Sheinkop, Concentrated Stem Cell Plasma, Interventional Orthopedics, joint pain, joint replacement, Knee, knee pain, regenerative medicine, stem cells
Mar 13, 2017
It came to pass over the last several weeks that I had contact with two separate patients; one in my office and one by e-mail inquiry. Both individuals had, prior to treatment, roughly the same levels of arthritic impairment. Both with grade three arthritic knees, were similar in age, weight, height and previous levels of activity. The e-mail contact presented with a history of having undergone a total knee replacement two years earlier. The outcome was a swollen, painful and stiff knee leading to a repeat surgery (revision) one year later. Because of persistent pain, swelling and stiffness, a recent knee aspiration had been completed leading to the diagnosis of an infection. The email inquirer indicated that his orthopedic surgeon and infectious disease consultant had recommended surgical removal of the prosthesis, placement of an antibiotic impregnated cement spacer for three months during which time a pic line would allow for a three-month continuum of intravenous antibiotics. There after assuming repeat cultures of the joint would be consistent with elimination of the infection as well confirmed by a normal Erythrocyte Sedimentation Rate, C-Reactive Protein and White Blood Cell Count, yet a fourth surgery would allow for another attempt with a Total Knee Prosthesis. All this assuming the infection had been eradicated. Space does not allow for the options if all of the above measures were to fail.
Turning our attention to the second patient who had undergone a Bone Marrow Concentrate/Stem cell intervention as contrasted to the surgical approach, he had recently returned from a second week of helicopter skiing. While it is true that he couldn’t ski eight hours a day for seven straight days, he had enjoyed a great week with friends and his daughter even if he had skied only two full days and four half days. This is his third consecutive year of helicopter skiing made possible by the Bone Marrow Concentrate/Stem Cell intervention he had undergone three and a half years ago.
Certainly, there is a time and place for a joint replacement; but the saga in my first paragraph reviews only some of the risks inherent in said surgery. On the other hand, a Cellular Orthopedic intervention in my experience carries a very minimal risk. In over seven hundred procedures in the last four and a half years, I have not found an infection. Certainly, every patient doesn’t go helicopter skiing after the procedure; our outcomes data clearly documents a return to or continuation of a very active lifestyle after a cellular procedure for an arthritic joint.
To schedule an appointment call (312) 475-1893
To visit my web site go to www.sheinkopmd.com
To watch my webinar visit www.ilcellulartherapy.com
Tags: arthritis, Bone Marrow Concentrate, Clinical Trial. Mitchell B. Sheinkop, Interventional Orthopedics, knee arthritis, knee injury, knee pain, knee replacement, knee revision, Orthopedic Surgeon, Osteoarthritis, regenerative medicine
Mar 6, 2017
Blog: Dr. Sheinkop , let’s pick up where we ended at the last interview. You were going to tell us about the hip labrum?
Sheinkop: Recently, there has been an increased frequency of diagnosis pertaining to an acetabular labral tear when a patient presents to a physician with groin pain. The cause may be attributed to trauma or it may be spontaneous in nature. While only an orthopedic surgeon really understands how to properly examine the hip joint, I am observing the next step in every and all patients with “hip” or “groin” pain is an MRI prescription. While a torn acetabular labrum is best diagnosed on the MRI after arthrogram, even that exercise may not result in a proper diagnosis. There are anatomic variants that are frequently mistakenly diagnosed as a tear and there are positive findings for a labral tear that when surgically addressed do not result in clinical improvement. In general, unless there are mechanical signs such as snapping, clunking or giving way, pain alone is not justification for arthroscopic hip surgery. In the presence of arthritis, arthroscopy is almost never indicated in the new world of evidence based medicine.
Blog: If I am not mistaken, the way you responded to the labral question is how you have responded in the past to a “positive” MRI of the knee and a diagnosis of a torn meniscus (cartilage).
Sheinkop: You are correct. The scientific evidence clearly identifies the fact that a pain generator must be identified before a surgical procedure. Even if the MRI is compatible with a torn labrum or meniscus, in the presence of arthritis, arthroscopic surgery will make things worse over six months. Surgery in said circumstances should be reserved for mechanical symptoms and not pain.
Blog: Then what is a patient with pain in the groin or knee to do?
Sheinkop: First and foremost, my job is to identify the cause of the pain and treat the patient, not the image. In the absence of clunking, snapping and giving way (joint instability), Interventional Orthopedics based on Platelet Rich Plasma and Bone Marrow Aspirate derived stem cells and growth factors provide the surgical alternative-remember the needle and not the knife.
Blog: I learned this week that you have been invited to St. Petersburg, Russia, this September to present non surgical alternatives for arthritis, at an international orthopedic meeting focused on joint replacement.
Sheinkop: Your information is correct. The role for Interventional and Cellular orthopedics, basically regenerative medicine, is in grades two and three osteoarthritis; while a patient is quite functional and not yet sufficiently impaired to justify the risks inherent in a joint replacement. On the other hand, there is a large patient population with advanced osteoarthritis of a major joint wherein the joint replacement option is to great a medical challenge and may risk survival. The evidence I have gathered over almost five years is not only of interest in the United States but has global potential impact.
To learn more call (312) 475-1893 to schedule a consultation
View my web site at www.sheinkopmd.com
Watch my webinar at www.ilcellulartherapy.com
Tags: arthritis, Bone Marrow Concentrate, Clinical Trial. Mitchell B. Sheinkop, hip surgery, joint replacement, knee surgery, Orthopedic Surgeon, Pain Management, Platelet Rich Plasma, stem cell treatment, torn labrum, torn meniscus
Feb 28, 2017
When it comes to cellular orthopedics, for me, it is a matter of honor and self-interest.
If you aren’t aware of the bogus stem cell claims or “false news”, read the LA Times article that appeared last week http://www.latimes.com/business/hiltzik/la-fi-hiltzik–oz-stem-cell-20170213-story.html
The article followed a Dr. Oz television expose where he focused on charlatans victimizing the public with false information at extremely outrageous fee schedules. The egregious behavior stemmed (no pun intended) from mostly California based clinics but Texas was another state exposed. For those who read this Blog, you are familiar with the false advertising of “Stem Cell Clinics” highlighting regenerative medicine via Amniotic Fluid for arthritis in Illinois, that I have repeatedly taken to task. To repeat, while there may be living cells when amniotic fluid is harvested, following collection, processing, sterilizing, irradiating, freezing and fast thawing, there are no living or viable stem cells in the pat being offered as a regenerative alternative. Dr. Oz took his expose a lot further calling attention to false claims without medical evidence wherein the so called regenerative medicine clinics he exposed offer treatment for every and any affliction of the human body.
Since the innovations introduced by Regenexx 10 years or so ago, interventional orthopedics has become an evidence based approach to sports medicine related injuries and as an alternative to a major surgical reconstruction or replacement for an arthritic or chronically injured bone or joint. I am a member of the Regenexx network and, have continued to compile and contribute scientific evidence to support the Regenexx mission. Our menu of surgical alternatives is directed to afflictions of the musculoskeletal system.
A patient attempting to postpone or avoid a major orthopedic procedure for an arthritic joint and return to a relatively symptom free functional quality of life may find legitimate, well intentioned and evidence based regenerative medicine and interventional cellular orthopedic initiatives. I am proud to be one of those clinical settings
Next week, I will complete my interview with Dr Mitchell Sheinkop, part two-focusing on common athletic injuries amenable to cellular orthopedics and joint condition amenable to stem cell intervention.
To schedule an appointment call (312) 475-1893
To visit my web site go to www.sheinkopmd.com
To watch my webinar visit www.ilcellulartherapy.com
Tags: Bone Marrow Concentrate, Clinical Studies, Clinical Trial. Mitchell B. Sheinkop, Concentrated Stem Cell Plasma, Interventional Orthopedics, Mesenchymal Stem Cell, regenerative medicine, stem cell treatment
Feb 20, 2017
Blog: “Please explain Interventional Orthopedics?”
Dr Sheinkop: “Five years ago, after 37 years of performing hip and knee replacements at a major medical center in Chicago, where I served as director of the Joint Replacement program, I exchanged the scalpel for a needle. Having achieved my surgical goals, I elected to help pioneer the emerging subspecialty of interventional orthopedics, introducing clinical research so that regenerative medicine in the musculoskeletal system would be evidence based. Instead of a long incision, lengthy rehabilitation, potential major complications, and potential infection, I use bone marrow and growth factor concentrate through a needle to help a patient reduce or eliminate pain from an arthritic joint, improve motion and increase functional capacity.”
Blog: “Why did you take this route?”
Dr Sheinkop: “My clinical joint replacement research initiatives, wherein every patient on whom I had operated was closely monitored and followed, made me realize that patients under 60 were too prone to early revision surgery; that is a repeat replacement in a relatively short time. I became aware of the potential of the stem cells and growth factors in bone marrow concentrate to assist a patient with grades two and three arthritis of a major joint in postponing, perhaps avoiding a major joint replacement. As well, for older patients with grade four osteoarthritis who have too many co-morbidities and aren’t safe surgical risks, Bone Marrow Concentrate is a reasonable option.
Blog: “What evidence have you accumulated?”
Dr Sheinkop: “80% of our patients are very satisfied after four years. At the knee, only 7 % have gone on to have a joint replacement. At the hip, that number is about the same. I now have about four percent of patients who have undergone or are scheduled to undergo a repeat Bone Marrow Concentrate procedure after three to four years. Equally important is the comparison of activities after a Bone Marrow/ Growth Factor intervention versus a Total Joint Replacement. I have arthritic knees, grade three. I underwent an intervention on my left side 18 months ago. Last weekend, I went fly fishing for two days in Southwest Wisconsin walking along the creeks, at times in the spring creeks. This week, I am going skiing in Vail with my family. None of this would be possible with a joint replacement.”
Blog: “This is fascinating information; so much so that I want to continue this interview into next week. I want to ask you in particular about the acetabular labrum which seems to be receiving all kinds or attention, arthroscopic knee meniscectomy in the presence of arthritis, non-surgical alternatives for a torn ACL, and subchondroplasty”
Tags: arthritis, Bone Marrow Concentrate, Clinical Trial. Mitchell B. Sheinkop, Interventional Orthopedics, Orthopedic Care, Regenerative
