May 11, 2017
Last week, my associate attended a continued medical education course held in a venue near the Wisconsin-Illinois border; a site frequently used by the Stem Cell Institute of America to host amniotic fluid marketing seminars. My colleague overheard a conversation between several physical therapists touting the success of amniotic fluid in regenerating cartilage on their patients, “you can see the increased joint space on the x-ray when we see the patient in follow-up”. I have addressed the issue of the absence of viable stem cells in amniotic fluid ad-nauseam (borrowing a recently expressed symptom from the Director of the FBI) but I am continually amazed at how false news when repeated takes on a fantasy of its own. Additionally, my patients frequently ask to repeat the imaging so they might see if the cartilage is growing.
Much of the current research effort pertaining to cartilage is experimental and has to do with the MRI techniques known as T2 mapping and delayed gadolinium enhanced MRI of cartilage (dGEMRIC). In addition to MRI techniques, optical coherence tomography (OCT) may allow arthroscopic evaluation of cartilage by performing microscopic cross-sectional imaging of articular cartilage. In the final analysis, the only present clinical cost effective, non-invasive means of quantitating and qualitating the patient response to an intervention are exactly the parameters I measure in my office; the only comprehensive methodology of its kind in the clinical field of Regenerative Medicine.
When a patient asks me how do I know whether an intervention is a success, I don’t point to an increased joint space on the X-ray as it is not there to be seen. I review patient specific outcomes including pain scores, activity scores, subjective input, and objective measurements and compare the pre-intervention findings with the latest scoring.
In the interval between starting to write this Blog and now, I received an unsolicited update from a patient who had attended the Stem Cell Institute of America seminar. He had asked so many questions during the seminar, the chiropractors running the seminar gave him the PalinGen Flow brochure (their source of amniotic fluid) as my patient had challenged their evidence beyond the speakers’ ability to respond. My patient, who eventually underwent a bone marrow concentrate intervention with my assistance, read the document and learned that PalinGen Flow makes no mention of stem cell content in their literature.
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, Bone Marrow Concentrate, Clinical Trial. Mitchell B. Sheinkop, Concentrated Stem Cell Plasma, Interventional Orthopedics, joint replacement, Mesenchymal Stem Cell, Regenerative, regenerative medicine, stem cell treatment
Mar 27, 2017
I am an orthopedic surgeon. The new focus for the arthritic joint is restoration and not replacement. Almost five years ago, I joined that emerging initiative after a 37-year professional career of having replaced joints. One of the recent problems emerging in this discipline of regenerative medicine is that marketing is inaccurate. There is no quick fix be it a replacement or an interventional orthopedic procedure. What stem cells do not risk is a joint replacement failure requiring a repeat procedure (revision), a significant occurrence of infection, a blood clot or a nerve injury. As a surgeon, I replaced arthritic joints because the original cartilage had degenerated and the bone surfaces degraded. My effort now is to restore and not replace. This is an evolving field using stem cells derived from bone marrow, using inflammatory blockers, and growth factors.
Finding a good interventional cellular orthopedist is partly a numbers game. Research shows a regenerative specialist must do a minimum of 50 interventions a year to provide a consistently satisfactory end result. Five years ago, the orthopedic surgical community including my past associates were all nay-sayers. Today, they are embracing that which I pioneered. While there are of this time, no true standards and regulatory bodies outside the FDA, in my office, I have pioneered a standardization initiative via qualitative analysis of that which we aspirate and then inject. The meeting of the American Academy of Orthopedic Surgeons in San Diego ending last week dedicated a relatively large part of the educational and scientific agenda to regenerative medicine and interventional orthopedics. All this being said, the patient seeking out one of America’s fastest growing procedures must assure the provider is experienced, knowledgeable and be prepared to meet a patient’s expectations. The explosive growth of those holding themselves out to be capable of delivery an excellent or at least a good regenerative outcome is not supported by evidence or experience. To repeat what I indicated above, all doctors are not the same. If you want the evidence, make an appointment. If you want a procedure by those who market themselves as treating Alzheimer’s, Alopecia, facial wrinkles, Arthritis, so on and so forth all under the same roof, I am not the that clinician.
To learn more, check out my web site at www.Sheinkopmd.com
View my webinar at www.ilcellulartherapy.com
Or call for an appointment 847 390 7666
Tags: arthritis, bone marrow, Clinical Trial. Mitchell B. Sheinkop, Concentrated Stem Cell Plasma, Interventional Orthopedics, Mesenchymal Stem Cell, Regenerative, regenerative medicine, stem cell treatment
Dec 26, 2016
On October 28, 2013, I received IRB approval for a clinical trial with Regenexx Sciences, LLC as the sponsor and me as the Principal Investigator. The study, A Randomized Controlled Trial of Regenexx SD versus Exercise Therapy for Treatment of Knee Osteoarthritis with Historical Comparison to Total Knee Arthroplasty, was undertaken by me because of my recent “graduation” from joint replacement surgery to the new world of interventional orthopedics and because of my 37-year history as a joint replacement pioneer. Earlier this month, I was able to begin forwarding outcomes data to Regenexx in Broomfield, Colorado, for statistical tabulation. The results of this trial will not only impact what and how the Regenexx Network will make interventional recommendations, as the first and most comprehensive study of its kind, it will serve as the basis for comparison of all ongoing and future Regenerative Medicine methodologies for the care and treatment of the arthritic knee.
From Stem cells to Growth factors, the integration of our clinical research and clinical practice is having a major impact within the field of interventional orthopedics. Our results are allowing patients to return to activities they enjoy using a needle instead of a knife. I do not claim to be a cellular biologist but my network now allows me insight into the latest cellular advances. With the incorporation of the Abbott’s Ruby cell counting system into my clinical practice, I now customize the Bone Marrow Concentrate to the individual needs of a patient and thus not only quantitate but qualitate that which I inject into an arthritic joint.
Many Musculoskeletal injuries and certainly arthritis, do not heal with conservative management and historically required surgical intervention. The most contemporary method of effecting healing and regeneration is both Platelet Rich Plasma and Bone Marrow Concentrate. If you take a second look at the title of the clinical trial cited above, you will see the complete title ends with “Historical Comparison to Total Knee Arthroplasty”. The control group for the trial were patients with an arthritic knee in whom I had performed Total Knee Replacements during my surgical years. I am one of the few Orthopedic Surgeons who have experiences both in joint replacement surgery and interventional orthopedics. The majority of stem cell recipients have returned to activities they enjoy; the majority of Total Knee recipients are couch potatoes. When the numbers become available after statistical tabulation, I will post the data on my Blog.
Recently, I became aware of a relatively new web site www.Desirelist.com. The web site allows you to discover, capture and list all you may desire with a high probability of realizing your desires. So, I went on line and listed that which I want for my patients in 2017; namely, Internal Peace in a World at Peace. Where I can make a difference for those limited by arthritis of a major joint , and deliver on your desire for an improved quality of life is through Regenerative Medicine and Interventional Orthopedics.
Happy Chanukah, Merry Christmas and Happy and Healthy New Year
Tags: ACL Injury, arthritis, athletes, bone marrow, Clinical Trial. Mitchell B. Sheinkop, Growth Factors, Hip Replacement, Orthopedic Care, stem cells, treatment
Dec 19, 2016
I use bone marrow derived stem cells because they have been proven to be most effective at treating orthopedic conditions when compared to adipose derived stem cells. There have been 13 papers published showing bone marrow superiority to adipose tissue in regards to treating orthopedic conditions and to the best of my knowledge, none reporting adipose derived results for arthritis. In addition to Adult Mesenchymal Stem Cells, bone marrow has 1,000-10,000x more hematopoietic stem cells than adipose tissue; the former is necessary for muscle repair. Recently, we learned that bone marrow also has osteochondral reticular cells which are not found in adipose tissue and serve as orthopedic repair cells. While adipose tissue and bone marrow both have stem cells, the skeletomuscular specific cells only found in bone marrow make it the best at treating orthopedic conditions. I don’t have a stake in doing bone marrow derived stem cells, I practice evidence based medicine and do what’s been shown to provide the best results. If with continued research something superior to bone marrow derived stem cells becomes available, then I will gladly adopt that protocol.
http://www.regenexx.com/fat-vs-bone-marrow-stem-cell-video/
- As I have reported on this Blog many times, research has shown the amniotic fluid samples being marketed as having stem cells actually do not have any viable stem cells when received and viewed in the laboratory. I do use amniotic fluid concentrate from time to time for its concentrated hyaluronic acid effect.
http://www.regenexx.com/amniotic-stem-cells-great-deception/
- Since we manually process bone marrow when aspirated, I am able to customize PRP which we call SCP or super concentrated platelets. The ubiquitous beside centrifuge only has one setting for volume and concentration so those using this approach are treating every patient without concern for individual differences. With the addition of the Abbott Ruby Hemocytometer, I am able to customize the treatment of the individual patient. We can concentrate our SCP from 3-40X over baseline-with or without red or white blood cells. From my outcomes data base, I know what volume and concentration works best for treating the various body parts.
- We’ve developed HD BMC or high dose bone marrow concentrate which is far superior to that produced with bedside centrifuges used by most claiming expertise in Regenerative Medicine
- I perform BMAs in compliance with the peer-reviewed literature recommendations as well as in keeping with my internal best practices research to maximize MSC yield. As stated, I count cells and know the quality in addition to the quantity of the injectate. Most doctors don’t count cells and have no idea what dose they are giving their patients
Tags: adipose tissue, amniotic fluid, arthritis, BMA, bone marrow, Bone Marrow Concentrate, Clinical Studies, Clinical Trial. Mitchell B. Sheinkop, Interventional Orthopedics, Mesenchymal Stem Cell, MSC, PRP, Regenerative, SCP, stem cells
Dec 16, 2016
You no longer will even need a physician, and I have been wasting my Blog space crusading about quality assurance; making certain your Regenerative Medicine specialist is Board Certified and willing to provide outcomes data. According to a recent email I received, all one needs is “Online Training” to practice Regenerative Medicine:
If you believe this is FDA compliant, no longer does stem cell treatment need to be done by a highly trained, highly experienced specialist; you won’t even have to use a physician.“Everything gets commoditized, including training to do stuff” (personal communication).
I believe the most effective approach is to direct a patient with joint pain to my credentials—37.5 years of joint replacement experience, Board-certified, Emeritus Professor, four and a half years of Cellular Orthopedic experience, the largest most comprehensive outcomes data base on which to base my recommendations for care, while introducing an analytical program based on a FDA-audited analytical laboratory for assessing the quality of regenerative preparations. As for the latter point, I am now working with a team using a FDA consultant to create approved text that I will post on my website, highlighting the standards I have adopted for all phases of therapy.
I hate to conclude that the current practice of interventional orthopedics and regenerative medicine ultimately comes down to how flashy the website may be or a free lunch from the camp followers.
To watch my Webinar, access www.ilCellulartherapy.com
To make an appointment, call 312 475 1893
Tags: bone marrow, Bone Marrow Concentrate, Concentrated Stem Cell Plasma, joint replacement, Orthopedics, Osteoarthritis, Regenerative, Regenerative Pain Center, stem cell certification, stem cells, training
