Jan 12, 2015
That quote comes from University of Chicago Economist and Nobel Laureate, Gary Becker, who died in 2014. Central to his work was the concept that economics can help explain behavior. As seems to be happening more and more, this Blog will expand on the evidence concerning Bone Marrow Aspirate Concentrate/Stem cell outcomes for intervention in the arthritic joint. The Data and my experience clearly document success at all stages of arthritis in a major joint for some period of time. What I am unable to conclude is in whom we are actually regenerating cartilage or in whom we are seeing pain relief and improved functional capacity owing to concentrated Growth Factors and Cytokines. Whereas my initial interventions two and a half years ago were limited to a “younger” arthritic demographic, the successes resulted in my expanding the inclusion criteria last year without age exclusion as I observed Outcomes success in those approaching 80 years of age. What I don’t know yet is in whom the improvements are related to the stem cells in the Bone Marrow Aspirate Concentrate or whether to the Growth Factors influencing your own stem cells or the Cytokines acting as anti-inflammatories, accompanying the stem cells in the Bone Marrow Aspirate Concentrate. What the evidence does indicate is that the older the patient or the more advanced the arthritis at the time of BMAC intervention, the better the outcome with a second or even third procedure. What I don’t know yet is a predictor of the survivorship of an outcome. I do know that the best chances of long-term benefits are in those with less than Grade 4 arthritis. For those who experience something less than hoped either in the initial result or extent of benefit, let’s explore the economics.
Just as our health care indemnification is undergoing change, so is my understanding of the scope of services that may be beneficial in this evolving discipline of Cellular Orthopedics. The good news is that unlike the insurance world where less health care coverage seems to be associated with greater cost for indemnification to the patient, I have identified a means of decreasing the economic burden to a patient for a repeat Bone Marrow Aspirate Concentrate/Stem cell intervention or related Regenerative Medicine injection, if a single procedure doesn’t provide the degree of relief or survivorship of outcome desired. It may well be that Cellular Orthopedics involves a range of approaches and not a single intervention. My office will work with you to provide you a scope of Evidence Based Care with an economic approach that allows the patient to avoid or at least delay a joint replacement.
Tags: arthritis, bone marrow, Bone Marrow Concentrate, Clinical Studies, Concentrated Stem Cell Plasma, Hip, Hip Replacement, Interventional Orthopedics, Knee Pain Relief, Mature Athlete, medicine, Orthopedics, Osteoarthritis, Pain Management, Regenexx, Regenexx-SD, stem cells, treatment
Dec 16, 2014
Let’s enter the new world of Cellular Orthopedics into which I graduated three years ago. Several months, ago, a long time friend was visiting his family in Chicago and stopped by to say hello. He told me about his skiing last winter and his hiking over the summer and fall. He also related he was seeing an orthopedic surgeon in the state where he now lived and that he had “bone on bone” in his knee. I launched into my customary spiel about his current level of athleticism, my cellular orthopedic initiative and the limits and risks of a knee replacement. Last week, a mutual friend told me that the out of state visitor had related “Mitch was right, I shouldn’t have done it”. He had undergone the Total Knee Replacement in spite of there being no limit in his recreational capacity and was now readmitted with an infected total knee prosthesis that might have to be removed to clear up the infection. Not being one to suggest “I told you so” but that’s what I am trying to get across to the patients I advise.
The Stem Cell Solution, Using the body’s almost magical repair kit to fix bad knees and hips-no surgery required is the title of an article appearing in the December, 2014, edition of The Saturday Evening Post, written by Sharon Begley, the senior U.S. health and science correspondent at Reuters. Last spring, the author had contacted me for an interview after having followed my Blogs unbeknownst to me. Ms Begley introduced herself and told me about an article she was writing for The Post to be published in June. I had forgotten about the interview until a patient came in last week and told me that she had read the article in the December issue. What I didn’t recognize at the time of the interview was that not only is the bone marrow a source of Adult Mesenchymal Stem Cells but of Growth factors and Cytokines as well that may be of equal importance. The opening of the article features my patient. In 2011,”I was in a bad way.” ”He was diagnosed with osteoarthritis, a degenerative disease eating away at the cartilage in his knees writes Begley.”The patient: ”and now I’m climbing stairs, have gone on two skiing trips, planning another, and playing golf in the summer.” “I am way beyond pleased.”
Tags: arthritis, athletes, Bone Marrow Concentrate, Concentrated Stem Cell Plasma, Hip Replacement, Interventional Orthopedics, joint replacement, Knee Pain Relief, Mature Athlete, Orthopedic Surgeon, Osteoarthritis, Pain Management, Regenerative, Regenexx-SD, stem cells, treatment
Nov 17, 2014
Nadal to get stem cell treatment
Updated: November 10, 2014, 2:18 PM ET
Associated Press
BARCELONA, Spain — Rafael Nadal‘s doctor says the 14-time Grand Slam winner will receive stem cell treatment on his ailing back.
Angel Ruiz-Cotorro told The Associated Press by phone on Monday that, “we are going to put cells in a joint in his spine” next week in Barcelona.
The Spanish tennis star was already sidelined for the rest of the season after having his appendix removed last week.
Ruiz-Cotorro, who has worked as a doctor for Nadal for the past 14 years, said Nadal’s back pain is “typical of tennis” players and that the treatment is meant to help repair his cartilage and is similar to stem cell treatment Nadal received on his knee last year.
He said Nadal is expected to return to training in early December.
Several NFL players and baseball players have received stem cell treatment. Nadal’s fellow Spaniard Pau Gasol, center of the Chicago Bulls, received stem cell treatment on his knee in 2013.
Stem Cell Treatment: Out from the Shadows, Onto the Cutting Edge
From Muscle and Medicine by Jenny Vrentas
Wed Jul. 30, 2014
The Jets’ Chris Johnson is one of hundreds of NFL players who’ve turned to stem cells to aid in recovery from injury. It may be the next big breakthrough in the treatment of sports ailments, but for now the use of such therapy is strictly limited in the U.S.—and questions about effectiveness outweigh the answers
New Jet Chris Johnson had stem cells from his bone marrow reinjected into his knee to augment January surgery for a torn meniscus. The hope is that it would boost healing and perhaps rebuild cartilage. (AP)
He’s 28. He has five 1,000-yard NFL rushing seasons to his name, one 2,000-yarder and a burning desire to prove he’s the same speedster he’s always been. So when Chris Johnson visited orthopedic surgeon James Andrews in January to fix his ailing left knee, he liked the sound of two intriguing words: Stem cells.
The veteran running back tore the meniscus in that knee in Week 3 of the 2013 season—his last with the Titans before being cut—but never missed a game. The injury to the knee’s natural shock absorber also caused other damage in the joint, and Andrews presented an option that might augment what surgery alone could do. The plan: Take stem cells, the body’s universal building blocks, and deliver them directly to the construction site.
“When I tore my meniscus and played the season out, through the wear and tear, I lost a lot of cartilage,” says Johnson, who was signed by the Jets to bring explosiveness to their offense. “When you put the stem cells in, it might be able to help rebuild that cartilage in your knee. Hopefully, it makes your knee better for even more years.”
For more Information on the Aging Adult and Regenerative Medicine:
312-475-1893 or 312-475-1893
Tags: arthritis, athletes, bone marrow, Bone Marrow Concentrate, Concentrated Stem Cell Plasma, Interventional Orthopedics, Mature Athlete, medicine, Orthopedics, Osteoarthritis, Pain Management, Regenerative, Regenexx, stem cells, treatment
Nov 3, 2014
From time to time, I consult with patients who just don’t meet the inclusion criteria regarding Bone Marrow Aspirate Concentrate intervention for arthritis. At the same time, some of those patients are so pharmacologically dependent owing to medical conditions demanding maintenance that I am unable to offer them autogenous hope from their own Platelet Rich Plasma or that which may be created from a patient’s own platelets. While in the minority, as an orthopedic surgeon offering Cellular Orthopedic interventions for arthritis in those unable to undergo a joint replacement wherein the internist deems the procedure unsafe or who seek to avoid or at least postpone a joint replacement; weight loss, physical therapy, cortisone injection and visco-supplementation are short term fixes and not necessarily without potential risks. The real damage to stem cells from cortisone injections became the subject matter of several recent scientific publications. First no harm is what I was first taught in my orthopedic training.
Over the past several months, I have sought treatment alternatives for patients as described above; not candidates for current interventions with standard autogenous procedures. Enter the new alternative, allograft. Derived from Amniotic Fluid, the intervention is FDA approved, safe, and in some cases, even covered by third party indemnification. There are many companies offering this treatment alternative and I am investigating the multiple options. Please be aware, amniotic fluid alternatives are not a substitute for Bone Marrow Aspirate Concentrate derived stem cells ; but there may be a place for this anti-inflammatory alternative when established Cellular Orthopedic options can’t be used in an arthritic because of medical co-morbidities such as heart disease, chemotherapy, kidney disease, liver disease, obesity, Diabetes, etc, etc, etc. Amniotic Fluid usage in Orthopedic is not new; there are publications dating back to 1938 in the orthopedic scientific literature. It wasn’t though until the last five years evidently that allograft investigation led to the development of currently available products.
If you fall into the category of patients who do not meet the inclusion criteria for Bone Marrow Aspirate Concentrate or in whom your Platelet Rich Plasma would not be a suitable alternative, you may be a candidate for Amniotic Fluid Concentrate intervention. Under certain circumstances, the allograft may be covered by your insurance. To learn more, call for a consultation:
847 390 7666
Tags: arthritis, athletes, Benefits and Risk, Bone Marrow Concentrate, Concentrated Stem Cell Plasma, Interventional Orthopedics, joint replacement, Knee Pain Relief, Mature Athlete, medicine, Orthopedic Care, Osteoarthritis, Pain Management, Regenerative, stem cells, Synvisc, treatment
Oct 20, 2014
We have been inundated with the fear of Ebola infections; the media has treated this as if each posting is to be a sensational headline in the National Inquirer. If the truth be told, your chance of acquiring an Ebola infection here in the US is about as likely as my winning the mega jackpot in the lottery. Fear Strikes Out was a marvelous film from the 50’s about a ball player overcoming mental disease; caution, you are being given mental disease by the sensationalism regarding Ebola and will succumb if not careful. What you should really be frightened about are hospital acquired infections. It has been estimated that in excess of one million MRSA infections take place in the US each year with in excess of 100,000 deaths. That doesn’t include the community acquired MRSA infections estimated last year at an additional 14%. The cost of Methicillin Resistant Staph Aureus infection last year exceeded 45 Billion Dollars Now what about C-Diff infections superimposed on those receiving antibiotics for hospital acquired infections, over 14,000 deaths last year according to governmental sources?
Regenexx published a study earlier this year in which not one single deep infection could be attributed to the minimally invasive methodology associated with a stem cell or similar cellular orthopedic procedure. In my practice, not only have I not recorded a deep infection, there hasn’t even been a superficial one reported. That’s not to say it may not happen in the future as I deal with Diabetics from time to time and patients with other immunosuppressive disorders; but I haven’t seen an infection yet in what is now approaching 400 procedures. I perform Bone Marrow Concentrate/ Stem Cell and related Cellular Orthopedic-Regenerative interventions in a surgi-center with all fluid manipulations in a sterile environment and under a sterile hood with a fully gowned RN. A joint replacement carries with a known infection rate. That incidence no longer is accurately recorded as the patient is promptly discharged from the hospital and the subsequent readmission for infection is not reported as associated with the recent joint replacement surgery
I have posted my results of Bone Marrow Aspirate Concentrate /Stem Cell interventions in this Blog on many occasions and compared the 18 month results to those of a knee replacement noting a lot more activity and recreational pursuits in the Cellular Orthopedic recipient group being realized. When a patient has advanced arthritis, a joint replacement is the treatment of choice. For those who want to continue or return to the highest possible age related profile, why not consider a stem cell procedure?
Tags: arthritis, Benefits and Risk, Bone Marrow Concentrate, Concentrated Stem Cell Plasma, FDA, Hip Replacement, Interventional Orthopedics, joint replacement, Knee Pain Relief, medicine, Orthopedic Care, Orthopedic Surgeon, Orthopedics, Osteoarthritis, Pain Management, Regenerative Pain Center, Regenexx, stem cells, treatment
