Let me think, where did I leave off last week?
Is there any chance of postponing, or perhaps avoiding a joint replacement, either total or partial? The answer to the question is why I “graduated” from joint replacement to the new discipline of Cellular Orthopedics or Orthobiologics: In the attempt to relieve pain, improve function, restore motion, and stop the progression of osteoarthritis with a needle instead of a knife is based on cells, platelets, and proteins – the latter known as Growth Factors. In order to be FDA compliant, the cells and platelets must be autologous; that is, they must come from you. It is most desirable and effective to use Growth Factors from your bone marrow or circulating blood. Recently, Medicare and some private insurance carriers have pre-authorized amniotic fluid as long as it is produced for pain relief and as a source of Growth Factors but, without stem cells (acellular). Is there the possibility of cartilage regeneration? Or is the goal joint restoration under any set of circumstances?
Orthobiologics Treatment Options
Up until now, other than a Total Joint Replacement, the treatment options for arthritis have been limited in duration of effect, that is palliative. Even a Total Knee Replacement has a limited survivorship or duration of success; indeed, there are some short-term failures and always the risk of a need for revision. In the world of biologics, a repeat intervention is still with a needle, followed by a short-term rehabilitation. Our data indicates that those who repeat a biologic intervention have a better and longer lasting outcome than that following a single injection. Our successes have been focused on blood derived Growth Factors and Platelets and Bone Marrow Concentrate. The latter are autologous (come from you) and FDA compliant.
Returning to the beginning of the Orthobiologics Informed Consent message, I haven’t forgotten about my nephew; the previously very athletic one with the Grade 2 to 3 Osteoarthritis of the knee. The therapeutic recommendation is to start with an injection of growth factors and Platelets obtained from his circulating blood. The benefits should be realized in less than six weeks and last two to three years. After that time, he could repeat the initial injection process or advance to a Bone Marrow Concentrate intervention. Bone marrow contains stem cells introducing regenerative potential a swell as providing a wealth of Growth Factors. Both blood derived platelets with Growth Factors and Bone Marrow Concentrate are Evidence Based therapies.
Recently, a third option became available to me; Stromal Vascular Fraction or Stem cells derived from your adipose tissue. At this time, there are seven centers in the United States, approved by the FDA, participating in the Personalized Stem Cell Trial; I am one of the investigators. The PSC Trial is that of a drug created from your adipose tissue, the latter harvested from your own fat and processed under very stringent governmental controls, processed and injected into your knee. To learn more about the PSC Trial visit www.PersonalizedStemCells.com. You may visit my web site at www.sheinkopmd.com to become familiar with my treatment options and participate in my webinars. Your consultation may be scheduled by calling (312) 475-1893.