Apr 29, 2014
We do not quit
Playing because
We grow old;
We grow
Old because
We quit playing.
– Oliver Wendell Holmes first half of 19th century
Last Monday, I took my first early morning, outdoor, cycling ride of the spring along the Chicago lakefront. It was a perfect morning and with so few on the bike path, I was able to let my mind wonder. I thought about this past Saturday and Sunday spent on the spring creeks of Wisconsin wading up a stream in search of the brown trout with a fly rod in hand. I thought about my on going training days in the health club where I run on the treadmill, row on the Concept 2 ergometer, and mix in some strength training. I thought about the several weeks of skiing this past winter in the fabulous powder I found in Colorado. Why the reminiscence? It’s my birthday this month.
That Oliver Wendell Holmes Sr. certainly got it right. Yet everyday I read about and listen to the diabetic epidemic in the world and the associated obesity, hypertension, renal failure, vascular dysfunction, etc., etc., etc. You don’t have to be a diabetic to be a victim of all the above. There is something though you can do about it: loose weight, get fit.
While there might or could be a congenital or inherited contribution to your arthritis, and while you may have sustained a trauma, the vast majority of arthritis in the hip and knee is either caused by or worsened because of the extra weight you carry.
My professional ethos is the Musculoskeletal care of the aging athlete. Your world is weight reduction and getting fit; my world is enabling you to improve your well being through Regenerative Medicine/ Cellular Orthopedics and I have professional company. The professional company is illustrated by an article published April 17: Growth Factor May Help Arthritic Knees. In the Swedish study, Fibroblast Growth Factor was used to stimulate cartilage repair in arthritic knees. A significant difference was found when compared with placebo when Sprifermin, an agent that specifically activates fibroblast-growth-factor-3 receptors in cartilage to promote chondrogenesis, cartilage matrix formation and cartilage repair was injected at high dose. While at 12 months, the cohort receiving Sprifermin didn’t show an increased joint space, when compared to the placebo group, they didn’t loose thickness.
We do more with our Bone Marrow Aspirate Concentrate stem cell intervention than inject one agent though our bone marrow derived Mesenchymal Stem cell preparation certainly contains the agent used in the Swedish study. The point, while stem cells may not regenerate the joint after a yet to be determined age, there is continuing evidence that the stem cells will alter the arthritic progression.
Tags: arthritis, athletes, bone marrow, Bone Marrow Concentrate, Concentrated Stem Cell Plasma, Hip Replacement, Interventional Orthopedics, Knee, Mature Athlete, Regenerative Pain Center, stem cells
Feb 18, 2014
Musculoskeletal Care of the Mature Athlete
A 67-year-old man came to my office to learn more about Bone Marrow derived Stem Cells for his arthritic knees. While he had been discouraged by his sports medicine physician from seeking the Regenerative Cellular alternative, he was not ready to undergo a bilateral total knee replacement after having investigated the potential complications associated with the surgery. I started with a review of his medication profile and determined that BMAC/Stem Cells might not produce the quantity and quality potential I would want to see to justify the procedure. My concern had to do with the adverse effects of certain medicinals on stem cell numbers. I offered an alternative, Concentrated Stem cell Plasma.
The development of Regenerative Cellular interventions for the management of arthritis started several years ago with Platelet Rich Plasma. Platelets not only play a role in initiating the clotting cascade, they contain an abundance of anti-inflammatories and healing agents termed growth factors. At the outset, clinicians performed a venous puncture and filled a test tube with blood. The latter was now spun in a centrifuge and the plasma with platelets suspended was injected in the arthritic knee. Within a year, it became apparent that two or three staged PRP interventions would result in better outcomes. About a year ago, the group of physicians at Regenexx began concentrating the Platelet Rich Plasma 10X and the results of treatment have been very encouraging in that patients did better and for longer than with standard PRP. More recently, we have developed a better way to activate with a faster and longer acting release of growth factors.
Bone Marrow Aspirate Concentrated/Stem Cells remain the best possible alternative in our Cellular Orthopedic Regimen at this time. Concentrated Stem Cell Plasma (PRP 10X) is a reasonable alternative although with a shorter outcome potential and probably to a lesser extent. No bridges are burned. I have suggested the 10X PRP option to patients heavily dependent on pharmaceuticals for co-morbidities or when I anticipate a possible compromise in the quantity or quality of stem cells because of age or other factors. Primum Non Nocere, First No Harm. There is nothing lost and a lot gained by a staged approach to the Regenerative Medical management of arthritis.
Addendum: I now have several patients who were managed as above when their pharmaceutical profile excluded them from a stem cell procedure; that went on to loose weight and get fit, and minimize their medication dependency. By so doing they became reasonable candidates for stem cells; and, now are enjoying the longer term and more comprehensive benefits of Bone Marrow Concentrate Stem Cell intervention.
Tags: C-SCP, Concentrated Stem Cell Plasma, Growth Factors, joint replacement, Orthopedic Care, Orthopedics, Platelet Rich Plasma, PRP, Ultrasound Guided Injection
Jan 13, 2014
It has been cold, dark, and dreary for the past several weeks here in Chicago so I needed a change of scene. Too cold to enjoy the 12 to16 inches of snow accumulation over the holidays and then a sudden warm up with rain removing any chance of outdoor recreation. As an aging athlete, I was left with only one choice; so good cheer and greetings from Vail, Colorado, where I am spending the week skiing with my wife. Our stem cells are enjoying the rocky mountain high.
All year long, I attend to the aging athlete and the inherent musculoskeletal wear and tear. While the majority of my professional life had been dedicated to joint replacement for advanced arthritis, over the last several years, the goal has been to delay or possibly eliminate the need for a joint replacement with Regenerative Stem Cell intervention. Let me share with you what I have learned and observed as a result of my professional redirection; the advances based on stem cell focused regenerative medicine are a very significant contribution to the musculoskeletal care of the aging athlete. I am empowered to make the argument based on my patient responses and the data documented in our outcomes surveillance. What is so exciting to see first hand is the number of master skiers still excited about the sport. As it is after school vacation, the majority of skiers this week approach master athlete status; so much so that there no longer is a senior discount for the lift ticket. So what’s the magic in the care of the aging athlete?
First and foremost, be as thin as possible and still maintain good health. The reward will be a marked diminution in a propensity toward metabolic syndrome (hypertension and diabetes). If you don’t have the problems, you won’t need to medicate; less is better. While your genetics plays a role, the pursuit of fitness will make a difference. Where I am constantly reminded of the adverse consequences of anti-inflammatories, statins and the like, is when I harvest bone marrow and count nucleated cells for a mesenchymal stem cell intervention. The less prescription pharmaceuticals needed by a patient, the higher the nucleated cell count at the time of bone marrow aspiration and concentration. The number of my patients with knee and hip arthritis who are and will be enjoying the ski slopes this winter is significant; many who have been forced to forego the sport in recent years because of symptomatic hips and knees. If you want to ski again, return to a sport or for that matter, be pain free and avoid or postpone a joint replacement for arthritis; give it a though and give us a call for a consultation. 847 390 7666
Tags: arthritis, athletes, Clinical Trial. Mitchell B. Sheinkop, Concentrated Stem Cell Plasma, Interventional Orthopedics, Orthopedic Surgeon, Osteoarthritis, skiing, stem cells
Nov 8, 2012
October 25, 2012
Dear Fellow Softball Devotees:
The 2012 Season is history. As you may or may not know, I had problems with my knee that required a pinch runner in order to continue to play. For the past four to five months I had several different injections starting with steroids and ending with Concentrated Stem Cell Plasma (C-SCP). The last one worked well enough that I ran out a triple two weeks ago.
Therefore, I am recommending that those of you who are hurting consider C-SCP.
I am enclosing a letter from my good friend, and treating physician, Dr. Mitchell Sheinkop, that describes the procedure.
Very truly yours,
James
P.S. I met Mitch playing softball years ago. He knows the game.
October 18, 2012
Dear Jim:
I am thrilled to learn of your triumphant return to you softball passion when you were on the verge of forced retirement due to an arthritic knee. When I first undertook your care, I used the usual and customary approached including physical therapy, antiinflammatories, cortisone injections and the series of three viscosupplementation injections. While you have been under my care, I decided to retire from active surgery and see what I could do to keep patients such as yourself athletically active without a joint replacement. While a new joint might have relieved your pain, it would have caused you to give up running, jumping, pivoting; basically most sports. I must admit my search for a non surgical option is personally motivated as I am surgery adverse and not yet ready to give up skiing, cycling and fly fishing or a good workout in exchange for a new joint. In my professional travels and continuing education, I by chance happened on Regenerative Medicine options. These include Platelet Rich Plasma and Stem Cells. I had the opportunity to not only watch the procedures being done but to follow the results of those non operative treatments. As a result, you were offered a Concentrated Stem Cell Plasma alternative and it looks like it is working. The downside was that because of the relatively short history with Regenerative Medicine alternative, the approach is not covered by insurance or Medicare. What the heck, you pay a lot more to a dentist than the C-SCP procedure costs and it is certainly cheaper than a psychiatrist would have been when you had to quit playing softball. What you received now is the future of orthopedics, an advance in the care of the mature athlete. Doping is out, stem cells are in; it’s the future of sports medicine.
Sincerely,
Mitch
Tags: C-SCP, Concentrated Stem Cell Plasma
