Dec 20, 2018
How long will the benefits last?
Yesterday, an individual presented in the office on a professional matter for a scheduled business meeting and during our discussions, related that he had undergone right hip arthroscopy, eight weeks earlier. He had an antalgic (painful) gait while walking into the meeting room so I discussed the rationale for undergoing a Platelet Rich Plasma concentrate/Growth Factor Concentrate intervention when he returned to his home base. The individual elected to become my patient on the spot so I performed a physical assessment and noted asymmetrical hip motion with limitation on the right side. His pre-arthroscopic diagnosis was a torn acetabular labrum. In 45 minutes, my team had drawn his blood and prepared the concentrated injectate followed by my completing an ultrasound guided intraarticular right hip injection. Within five minutes, his inability to fully spread his legs, flex and extend his hip, and tolerate internal and external rotation had been corrected. This is not an infrequent observation following a Cellular Orthopedic intervention to the hip; yet I have no explanation for the immediate pain relief and return of joint function. He left the office with almost no discernable limp.
This past Monday, the office received this communication from a patient who began treatment with Bone Marrow Concentrate to her knees about four years ago; returning on several occasions until she reached maximum medial improvement at 18 months post intervention.
“I wanted to write to you and Dr Sheinkop to congratulate you on the published study in the Journal of Translational Medicine in which I was a participant. It is really satisfying to see that results finally in print. I want to thank you both for allowing me to participate, even though I was outside of the Chicago area.
Just to follow up, my knees have been doing really well for the past year. I enjoyed a long summer of bicycling, including regular 20-30 mile rides as well as a 40 and 50-mile ride, without significant pain. I also have been able to use the elliptical pain free and just in the past two weeks I started running on the treadmill (alternating one minute of running & walking for about 20-25 minutes on a 4% incline). I’m starting really slow -but I never thought I would be able to run relatively pain-free again”.
There is no way of predicting how soon and for how long a cellular orthopedic intervention will have an effect. Our ongoing outcomes observations for over six years may eventually help answer the question; but in the meantime, we ask our patients to return periodically so we may learn from them and intervene if needed.
To learn how you may benefit from a Cellular Orthopedic intervention schedule a consultation by calling (847)-390-7666. My web site is at www.sheinkopmd.com.
Tags: Adult Mesenchymal Stem Cells, arthritis, Bone Marrow Concentrate, cellular orthopedics, Clinical Trial. Mitchell B. Sheinkop, Growth Factors, Interventional Orthopedics, Knee Pain Relief, Mesenchymal Stem Cell, micro-fractured fat, Orthopedics, Platelet Rich Plasma, Platelet Rich Plasma concentrate/Growth Factor Concentrate, stem cells, Subchondroplasty, torn labrum
Dec 5, 2018
As interest in biologic therapies for arthritis-a needle, not a knife-continues to expand; patients increasingly are turning to the ads in newspapers or searching the Internet to gather information on this topic. While there is still a lack of scientific consensus on the use of biologics, it is most important for those seeking information not to be misled. My own analysis of resources for patients seeking on line information about biologic therapies for arthritis is that the overall quality is very poor and anything but scientific. Even worse, is a seminar, neither a reliable or credible source of scientific evidence.
Biologic therapies consist of stem cells, platelet rich plasma product and bone marrow aspirate concentrate. New research, I co-authored and that was published last month in The American Journal of Orthopedics: Safety and Efficacy of Micro-Fractured Adipose Tissue for Knee Arthritis, is indicative of the ever-evolving nature of Regenerative Medicine. Biologic therapies and their use in arthritis or musculoskeletal injury in general are an area of vast research and interest within the medical field. Understanding the information online and the misinformation provided at seminars pertaining to biologics allows me to tailor my conversation and address commonly found inaccuracies.
The use of Biologic Therapies is expected to significantly increase in the coming years as our knowledge advances on the use of such. That initiative will be led by well informed, well-educated Board Certified, and Fellowship trained specialists. Unfortunately owing to the relative lack of oversite at present, every type of charlatan, parasite and camp follower can buy an ad for a seminar or produce a web site on the internet. How then should a patient with pain and limited function from arthritis seek to postpone or avoid surgery without becoming a victim of the cord blood or amniotic fluid hoax?
- Your physician must complete a comprehensive medical history, physical examination and review of diagnostic studies.
- Explain the disease process and grade of progression,
- Discuss possible treatment options,
- Present a balanced assessment of the current scientific evidence.
Woe, while writing this Blog, I was just notified about acceptance of yet another scientific article by a peer reviewed medical journal in which I am the senior author: A Specific Protocol of Autologous Bone Marrow Concentrate and Platelet Products Versus Exercise Therapy for Symptomatic Knee Osteoarthritis; a Randomized Control Trial with 2 Year Follow-up.
Hopefully some time soon, a Biologic Arthroplasty will be possible; but until then, a Total Joint Replacement is still a necessary option for those not meeting specified inclusion criteria for biologics. To see what treatments may be possible for your arthritic generated pain call (312) 475-1893 to schedule a consultation. Visit my website www.SheinkopMD.com for additional information.
Tags: Adult Mesenchymal Stem Cells, amniotic fluid, ankle pain, arthritic pain, autologous bone marrow concentrate, biologic, biologics, cellular orthopedics, Cord blood, Hip pain, injury, joint pain, knee pain, lipogems, Osteoarthritis, PRP, regenerative medicine, rupture, shoulder pain, sports injury, stem cell, tear, tendinitis
Nov 29, 2018
My Blog has frequently addressed the false ads claiming Amniotic Fluid, Chord Blood, Wharton’s Jelly and the like contain living stem cells emphasizing that the processes of preservation and sterilization followed by freezing kills off any living cells. Sylvia Perez first addressed the issue on Fox News’ Conversation in Health, January 29, 2018 and Pam Zekman posted her investigative report on WBBM-TV, the week before Thanksgiving. Yet patients continue falling for the hoax.
In contrast, let’s address the positive, cellular orthopedics; the ongoing practice of evidence- based medicine. Below are two statistically significant scientific studies that play a role in helping determine the best possible outcomes to a regenerative intervention
November 21, 2018
Safety and Efficacy of Micro-Fractured Adipose Tissue for Knee Osteoarthritis
New research published by TOBI Faculty suggests autologous, micro-fractured, minimally manipulated adipose tissue may represent a nonsurgical treatment option for knee osteoarthritis patients seeking alternatives to total knee replacement.
Congratulations Jay Panchal, MD, Gerard Malanga, MD, Mitchell Sheinkop, MD on this new publication in The American Journal of Orthopedics.
Safety and Efficacy of Percutaneous Injection of Lipogems Micro-Fractured Adipose Tissue for Osteoarthritic Knees
To download or read the publication: https://www.amjorthopedics.com/article/safety-and-efficacy-percutaneous-injection-lipogems-micro-fractured-adipose-tissue
Treatment of Knee Osteoarthritis with Autologous Bone Marrow Concentrate and Cytokine Concentrate – A Prospective Clinical Case Series Study
Abstract submitted to the Orthopedic Research Society Annual Meeting, 2019
Mitchell B. Sheinkop1 , Marry Langhenry2 , Jizong Gao3 1. Orthopedic Surgery, Rush University, Chicago, IL.2. Cellular Orthopedics, Chicago, IL 3. Celling Biosciences, Austin, Texas.
INTRODUCTION: Osteoarthritis (OA) is an organ disease that affects most structures of the joints including cartilage, synovium and subchondral bone. The pathophysiology of knee osteoarthritis can be broken down into pathoanatomy, cell biology, and genetics. Although fibrillation of articular cartilage is regarded as the primary changes and potential cause of clinical symptoms, the synovium and capsule undergo progressively inflammatory changes and secrete proteolytic enzymes that may contribute to the progression of OA. Meanwhile, the subchondral bone tissue develops lytic lesions with edema, sclerosis, and cyst formation. Therefore, it has been recommended that the treatment of OA should be a comprehensive approach to create a homeostatic environment to facilitate the OA treatment with a long-lasting outcome. Bone marrow contains mesenchymal stem cells (MSCs). Different cytokines such as alpha 2-macroglobulin (A2M) (Wang et al) and growth factors have been identified in the blood and bone marrow aspirate. Either bone marrow concentrate (BMC) or MSCs have been injected into the knee joint to treat OA with promising clinical outcomes. Hernigou et al reported that injection of BMC into the subchondral bone area was able to delay or eliminate the need for total knee arthroplasty (TKA) and clinical outcome was comparable to TKA in the contralateral knee. Cytokines and growth factors in the blood or bone marrow aspirate were concentrated by filtering method to prepare autologous therapeutic biologics. In the current study, a consecutive series of patients with moderate to severe OA were treated by intra-articular and intra-subchondral bone injection of BMC and autologous concentrated cytokines/growth factors. The quantity of representative cytokines and growth factors in the concentrate were also measured. Patients were evaluated for the improvement of systems and knee functions by following up to 6 months after injection. METHODS: This prospective case series study was approved by the Institutional Review Board.
To learn more or to schedule an evidence-based consultation call (312) 475-1893
You may visit my web site and read my blogs at www.sheinkopmd.com
Regenerative Medicine is an option for those with arthritis but don’t be fleeced by the hucksters and camp followers.
Tags: autologous bone marrow concentrate, biologics, BMC, cellular orthopedics, cytokine concentrate, Growth Factors, knee pain, lipogems, Micro-Fractured Adipose, MSC, OA, Orthopedic Surgeon, Osteoarthritis, PRP, regenerative medicine, stem cells, suchondral, TOBI
Oct 5, 2018
After reviewing a CT scan of the right knee where a Total Knee Replacement had been done provided by a patient who sought my opinion for stem cell treatment of her arthritic left knee, I called her to discuss the possible reasons that the right Total Knee Replacement that she had undergone over ten years ago was never satisfactory. At the time of the right TKR for arthritis, she had elected for what seemed at the time as a logical intervention for a painful, arthritic, right knee. The outcome was at first complicated by a lot of postoperative swelling and pain; at one-year post-operative, the patient had never been pain-free nor had she ever regained her preoperative range of motion and that adverse outcome has persisted for over ten years. Fast forward a decade and the right knee has continued to be a source of pain and limited motion; so much so that the patient decided to seek consultation for a Stem Cell treatment for her now arthritic left knee.
Her first question was basically “does stem cell therapy for knees work?”. Our data collected on patients treated in this office over the past six years, since I started my practice, is compatible with an 85% patient satisfaction rate. We have not recorded one complication. To be forthright, not every patient has a perfect result; but the vast majority experience marked reduction in pain, increased motion and a significant improvement in functional capacity. Unlike a failed outcome of a Total Knee Replacement, our stem cell injections may be repeated at anytime if the benefits of the initial intervention do not last.
When it comes to the cost of a stem cell intervention, while the Total Joint Replacement is more often than not covered by some type of insurance, our fee schedule is in keeping in line with the deductible a patient has to pay out of pocket for the major surgery. If you do the math and additionally compare the risks and benefits of a stem cell intervention with a total knee replacement, you will note:
- Remote to little risk of complication with a stem cell procedure
- Comparable cost comparing my charges for a stem cell intervention with the inherent deductible obligation for a Total Joint Replacement
- Rapid recovery with a stem cell intervention versus the risks of an adverse outcome as experienced by the patient seeking consultation for stem cells
To seek consultation call (312) 475-1893. You may visit my website at WWW.sheinkopmd.com
Tags: cellular orthopedics, ct scan, joint health, joint replacement, knee pain, knee replacement, Osteoarthritis, regenerative medicine, stem cell treatment, TKA
Sep 17, 2018
Seems strange that I would start thinking about the upcoming winter season but conditioning is sports specific and it will take about eight weeks to get ready. This past weekend, I increased my conditioning program with more cycling and strength training. It is now about nine months since I underwent cellular orthopedic interventions to both on my knees followed by both of my hips. The results have been most gratifying allowing me to extend my recreational lifestyle indefinitely; so here I am planning ahead for the upcoming ski season even though the Chicago temperature prediction is for a high of 87 degrees. Last year at this time, I questioned whether my skiing days were over. The reasoning behind much of my autobiographical, recreational subject matter is so the reader will better understand what is possible through stem cell, growth factor and platelet intervention for those with pain and limitations inherent in osteoarthritis. While an orthopedic surgeon does not need to break his or her own bones to better enable that surgeon to treat a fracture, given the number of clinics now advertising stem cell treatment, the patient choosing a regenerative medicine provider might take note of the fact that not only have I been playing a prominent role in the evolution of this expanding specialty of Cellular Orthopedics by introducing evidence based care over five years ago, I can tell you what works best from the standpoint of a patient.
There is an ever-increasing number of good and some excellent outcomes logged into our database. To be quite frank, there are some who have not fared as well. By continued surveillance and monitoring of outcomes, I am able to identify those who would improve their results by some means of augmentation be it a Platelet Rich Plasma follow-up or a repeat stem cells intervention. Let me paraphrase a message received from a patient in whose knees I have completed several cellular orthopedic interventions over the past three years. This mid 50s farmer is back to regularly playing age related group basketball several evenings each without limitation and without recurrence of symptoms the following day. Concerning yet another patient, this one in his early 90s from a patient who happens to be a family acquaintance, “I watched your patient painting the side of his garage the other day.”
Yes, these are anecdotes and so is my story; however, I think you get the message.
To learn more, you may call (312) 475-1893 to schedule a consultation. Access my web site at www.sheinkopmd.com.
Tags: cellular orthopedics, chicago, Osteoarthritis, Plate Rich Plasma, regenerative medicine, stem cells