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
Oct 9, 2014
While it is understood that a Bone Marrow Aspirate Concentrate Stem Cell intervention introduces a cartilage regeneration potential via Mesenchymal Stem Cells, continued research is expanding our knowledge as to what else is in the concentrate in addition to stem cells. For instance, many have heard the story of basketball legend Kobie Bryant’s trip to Germany several years ago and the success of the procedure called IRAP wherein Interleukin 1 Receptor Antagonist Protein was concentrated after a blood draw over a four day period and injected into his arthritic knee with great success allowing him to return to professional basketball. There followed many professional athletes and famous persons. Most recently, I read of Willie Nelson’s converting a failed rotator cuff repair into a functioning painless shoulder with IRAP. There have been marked improvements though in the non surgical approach to arthritis and soft tissue injury since the introduction of IRAP, we know it as Bone Marrow Aspirate Concentrate and Stem cells.
OA progression is due, at least in part, to the up-regulation of inflammatory mediators and proteases after injury. Since elevated levels of catabolic enzymes in synovial fluid (SF) are associated with chondrocyte death and cartilage matrix degeneration within 1 week of injury, early intervention strategies should focus on modulating these cartilage-degrading enzymes within this time frame. Evidence suggests that the molecules and growth factors in the Bone Marrow Concentrate target these enzymes arresting adverse events and preserving joint health. That’s why in addition to pain relief and improved function, our informed consent speaks toward actually reversing the arthritic process.
Alpha’2Macroglobulin is a negative regulator of cartilage catabolic enzymes but that it is not present in vivo at sufficient levels to counteract the increased concentrations of catabolic factors that appear after injury. Therefore, the intraarticular injection of alpha’2M via bone marrow concentrate in addition to the stem cells along with all the other growth factors contained in bone marrow , when concentrated, is the only means of actually treating arthritis other than a joint replacement. All other medicinal and pharmacologic approaches are directed to the symptoms but not the disease.
Alpha2Macroglobulin is a powerful inhibitor of many cartilage catabolic factors and it can attenuate posttraumatic OsteoArthritic cartilage degeneration in the animal model… Alpha2-macroglobulin is a major protease inhibitor; the largest fraction is produced by the liver while the synovium produces smaller amounts.
In summary, up-regulation of cartilage catabolic cytokines and enzymes is thought to be a key mechanism of cartilage damage. Thus, inhibition of these molecules will likely slow or prevent the progression of disease while the stem cells regenerate the joint. If you want to learn more, call 847 390 7666.
Tags: arthritis, athletes, Bone Marrow Concentrate, Hip Replacement, Interventional Orthopedics, joint replacement, Knee Pain Relief, Orthopedics, Osteoarthritis, Regenerative, Regenexx, stem cells
Aug 11, 2014
Last Thursday, I presented my Data on our minimum 12 month Outcomes regarding Marrow Aspirate Concentrate derived Stem Cells for Osteoarthritis of the knee to the Regenexx 3rd Annual Conference. It was held at the Scientific and Research Institute in Thornton, Colorado. The baseline number included 118 patients. While I presented the customary orthopedic objective data on the patient cohort such as point scores, Range of motion, patient satisfaction, psychological profiles and pain scores, I introduced two new Scoring parameters: 1) Activity Scores and 2) Comparison to Knee Replacement Outcomes.
Activity Scores are increasingly recognized as an objective outcome measurement documenting results without superimposed psychological disability, sociological factors, and serves as a quantitative measure of how much rather than how well. We measured impact sports breaking them down into very active categories, active, moderate and mild categories. In each category, the patients who had undergone stem cell intervention scored very well in either returning to a prior level of activity recently abandoned or actually advancing to a higher category of activity. As an example, I saw a patient last week six weeks past stem cell intervention for osteoarthritis of the knee. He had presented for treatment when his ability to walk was less than a city block. He marched in six weeks post treatment without a smile indicating that he was dissatisfied, as he still needed to use a handrail for stairs. When I asked him how he got to the office for the six-week follow-up, he responded that he had walked from home. I then inquired how far? His response ” 3 and 1/2 miles”.
In comparing knee replacement outcomes to stem cell interventions, the mean functional score for patients who had received Total Knee Prosthesis at a minimum of one year was 67. In comparison, the functional score for BMAC Stem Cell interventions was 90.5. While it may be that the stem cell population was not exactly comparable to those who had received a Total Knee Replacement, you decide, knee replacement or try stem cells first.
Tags: arthritis, arthritis treatment, athletes, Bone Marrow Concentrate, Clinical Trial. Mitchell B. Sheinkop, Hip Replacement, Interventional Orthopedics, Mature Athlete, Orthopedic Surgeon, Osteoarthritis, Regenexx-SD, stem cells
Jun 9, 2014
Thickening and increase of area of cartilage have been proposed as two alternative mechanisms of cartilage functional adaptation. The latter has been reported in endurance sportsmen. In weightlifters, extreme strain applied to the articular surfaces can result in other forms of adaptation. The aim of this research is to determine whether cartilage thickness is greater in elite weightlifters than in physically inactive men. Weightlifters (13) and 20 controls [age and body mass index (BMI) matched] underwent knee Magnetic Resonance Imaging (MRI). A single sagittal slice of the knee was taken and cartilage thickness was measured in five and six regions of the medial and lateral femoral condyles, respectively. The analyzed segments represented weight-bearing and non-weight-bearing regions. The tibia cartilage in the weight-bearing area was also measured. The time of training onset and its duration in the weightlifter group were recorded. The cartilage was found to be significantly thicker in weightlifters in most of the analyzed regions. The distribution of cartilage thickness on the medial and lateral femoral condyles was similar in both groups. The duration of training was not associated with cartilage thickness, but the time of training onset correlated inversely with cartilage thickness. It is possible that in high-strain sports, joint cartilage can undergo functional adaptation by thickening. Thus, mechanical loading history could exert a postnatal influence on cartilage morphology. Clin. Anat., 2014. © 2014 Wiley Periodicals, Inc.”
Although, many physicians warn against jogging, to the best of my knowledge, there is no scientific evidence that running or jogging injures cartilage. Now there is evidence that loading cartilage is beneficial. Certainly, there is still much to be learned about maintaining joint health when it comes to the musculoskeletal care of the aging athlete. Remember, as I have stated many times in my Blogs, cartilage is only part of what makes up the joint. The cartilage joint space as determined by the space between bones is hyaline in nature. Then there is meniscal cartilage that is of a different cellular and chemical makeup. The lining of the joint is synovium and this can become a source of chronic inflammation. Next are the ligaments and capsule so injury and arthritis affect the entire joint and not just what is seen or not seen in an X-ray; arthritis is the result of a bio-immune response and not simply mechanical injury. That’s where stem cells may come to the rescue along with weight loss and strength training. Stem Cells seem to have a place in influencing the well being of the joint at any age; first as an anti-inflammatory, then as an immune modulator. What about cartilage regeneration? I don’t know for sure yet, there is probably an inverse relationship with the potential for cartilage regeneration and age. On the other hand, if a bone marrow aspirate concentrate intervention in an injured or arthritic joint helps maintain the well being of the mature athlete, I am not concerned about the MRI 18 months later.
Tags: arthritis, Cartilage, Clinical Trial. Mitchell B. Sheinkop, Hip Replacement, Interventional Orthopedics, Knee, Osteoarthritis, Regenerative Pain Center, stem cells
Jun 4, 2014
A Town Crier according to Black’s Law Dictionary is an officer of the court who makes public announcements as required by the court. The crier can also be used to make public announcements in the streets. The Town Crier came into being when people couldn’t read and write. Hear Ye, hear Ye, I am calling for silence and attention so you may understand the informed consent process accompanying a Bone Marrow Aspirate Concentrate Stem Cell intervention for Musculoskeletal Care of the Aging Athlete as it seems many patients who could and would be helped by Bone Marrow Derived Stem Cells aren’t listening. Then there is the subset that hears what they want to hear. The only stem cell resource at this time, which meets FDA guidelines, is your own body. I am aware that there are websites offering stem cells from adipose issue, amniotic fluid, corium, etc. Show me the outcomes data and the documentation of FDA compliance.
The Mesenchymal Stem Cell is found in your bone marrow and is responsible for repair and replacement of injured or cells dying from aging during your lifetime.. If the number of stem cells are increased by concentrating them and used within four hours in the patient from which they were harvested, all governmental guidelines have been met. Those stem cells may eliminate pain, increase motion, improve function and alter the natural history of an arthritic or injured joint. As to whether they will result in the re-growth of cartilage, it remains to be seen what will happen at 18 months as found on a quantitative MRI. The larger experience with Bone Marrow derived Stem Cells has been in delayed union and non-unions of fractures and improving the chances of a spinal fusion during elective surgery. At the same time, the Regenexx and Regenerative Pain Center combined data- base continually document patient satisfaction and an increasing length of improved functional outcome in an arthritic or traumatized joint.
Hear ye, Hear Ye! The younger the patient, the better the chance of articular cartilage regeneration with stem cells. By the same token, stem cells may be very beneficial even if the MRI doesn’t confirm cartilage re-growth by pathways not fully understood. If the arthritis doesn’t progress and there is improved functional outcome following a Bone Marrow Aspirate Concentrate, I am not concerned about demonstrating cartilage regeneration. I am an orthopedic surgeon by education and experience. I have been involved in replacing arthritic joints and repairing injured joints and bones for 40 plus years. There is something to be gained from that experience that allows me to be a Stem cell Town Crier
Tags: arthritis, Bone Marrow Concentrate, Hip Replacement, Mesenchymal Stem Cell, Orthopedic Surgeon, stem cells
