My goal is to inform each and every patient who presents with a painful joint, the cause of their pain; and based on our scientific and clinical evidence, that intervention which will have the greatest chance of short term and long-term success. While inflammation in the joint is a proximate cause of pain, that pain is not generated by cartilage deterioration as cartilage doesn’t have a nerve supply. While joint pain in part is generated by the synovial tissue lining the arthritic or traumatized joint, the subchondral bone supporting the joint may be even more important when it comes to the pain and limitations resulting from the arthritic affliction.
Bone pathologies resulting from acute or chronic injury presenting as bone marrow lesions associated with insufficiency fractures, persistent bone bruises, osteoarthritis and early stages of avascular necrosis are too often neglected by those holding themselves out to be regenerative medicine specialists. Options for the treatment of these subchondral conditions require a core decompression of the problematic bone and direct application of either bone marrow aspirate or a synthetic orthobiologic. The biologic treatment of bone marrow lesions with these techniques that encourage physiologic bone remodeling and repair when combined with Stem Cell and Protein/Growth Factor concentrates into an arthritic joint offers the best chance for joint preservation and a successful outcome for the patient undergoing a Stem Cell procedure.
Are there Stem Cells in Cord Blood, Wharton’s Jelly or Amniotic Fluid? These three alleged sources of Stem cells are processed when collected. The tissues are then cryopreserved with DMSO or some other cryopreservant. When thawing takes place, the few cells contained do not survive the thawing process. Additionally, DMSO is cytotoxic, a cell killer at room temperature.
As many of my patients are aware, I began my Cellular Orthopedic journey some years ago as an early member of the Regenexx Network. While my personal and practice ethos as the only orthopedic surgeon caused me to leave the network, I still follow the Blog and I find the one posted today most appropriate.
I was on a local radio show this week and a woman called in and claimed that she had been defrauded by a local chiropractic clinic. She paid big bucks for what she was told were “millions of young stem cells” injected intravenous. As I will show you this morning, as a medical expert in this area, I can show you that she is more likely than not the victim of consumer fraud. Let me explain.
The Problem of the Chiro Clinic Bait and Switch
I’ve blogged extensively about how chiropractic, acupuncture, naturopathic, and some physician clinics are defrauding patients by claiming to inject millions of live and young stem cells from amniotic fluid or cord blood (or other products). The problem is that none of these 361 registered tissue products has any significant number of live stem cells.
Tags: ACL Injury, bone edema, bone lesion, bone marrow, Cartilage, chondromalacia, chronic pain, Cord blood, cryopreserved, Hip, joint pain, joint replacement, Knee, meniscus tear, naturopathic, Osteoarthritis, osteochondral defect, regenerative medicine, shoulder, stem cell, subcondral bone
The lack of scientific foundation in stem cell marketing is all around us and negatively impacting those doing the right thing in the evolving discipline of Regenerative Medicine. Yesterday afternoon, a patient for whom I successfully completed a Bone Marrow Concentrate/Stem cell procedure presented to the office for a follow-up visit. She was accompanied by her husband who was experiencing progressive limitation attributable to an arthritic left knee. Because of my patient’s successful experience, her husband had determined now it was his turn. After the intake, I provided the customary explanation of what was to take place. During the question and answer follow-up, both husband, the new patient, and wife, the successful outcome, wanted to know why hers had worked whereas several of their friends had not enjoyed successful outcomes after amniotic fluid interventions.
The explanation is straightforward and based on a precedent, the fact speaks for itself. While Bone Marrow is full of Adult Mesenchymal Stem Cells and Growth Factors when harvested, processed, concentrated and reinjected into the symptomatic joint within 60 to 90 minutes after the harvesting; Amniotic Fluid has no living stem cells after sterilizing, freezing and fast thawing. Restated, Amniotic Fluid has little if any regenerative potential. Why am I able to make said statements in the face of such aggressive marketing claims regarding amniotic fluid? In addition to my work clinically and scientifically with Bone Marrow Derived stem cells and growth factors, I am the Principal Investigator in a clinical trial wherein amniotic fluid both frozen and fast thawed, and most recently, Lyophilized, has been used in lieu of hyaluronic acid to reduce or possible relieve the symptoms of osteoarthritis for six to 12 months. At no time did the largest amniotic product based pharmaceutical company in the United States suggest there are viable stem cells in amniotic fluid nor did they make any claim for regenerative potential. Returning to my office encounter, during our continued discussion, I learned that those who had opted for the amniotic fluid injection had paid more for the injections than I charge for the Bone Marrow intervention. So, think about the harm done to the “victims” as well as the public in general. The trusting patients paid for a regenerative procedure that they never received. The patients believing that the stem cell procedure didn’t work are now considering total joint replacements.
How might you protect yourself if you are considering a means by which you might postpone or avoid a joint replacement for arthritis? Make sure you choose a residency and fellowship trained interventional specialist. Second, ask the clinician to share his or her scientific outcomes data.
If you want to become better informed, browse my website www.sheinkopmd.com.
You may watch my webinar at www.ilcellulartherapy.com or call to schedule a consultation (847) 390-7666.
Tags: ACL Injury, arthritis, Bone Marrow Concentrate, Clinical Trial. Mitchell B. Sheinkop, Hip, Interventional Orthopedics, joint replacement, Knee Pain Relief, Mesenchymal Stem Cell, Orthopedic Surgeon, regenerative medicine, stem cell treatment
Aging is known to contribute to a multitude of systemic changes including those of the musculoskeletal system leading to decreased health, mobility and function. Most changes in well-being are exacerbated by inactivity. It has been scientifically documented that physical activity and exercise may slow or even reverse these deleterious effects thereby improving health, mobility and function.
In particular, ligaments, tendons and joint capsules become stiffer with age as elastic fibers decrease and cross-links between collagen fibers increase. As connective tissue surrounding the joint changes, so too does the synovial fluid within the joint making movement more difficult. Not only do changes occur within the joint, they also occur in the muscles. The loss of muscle mass and strength also known as sarcopenia, increases with age. Then there is the fatty infiltration of muscle that comes with aging and lack of use.
Recognizing the value of Bone Marrow Concentrate derived Stem Cells, Cytokines and Growth Factors in dealing with his arthritic hip when the alternative was a joint replacement, seven months ago, a 58-year-old man underwent a cellular orthopedic intervention. Over the past many months, the patient committed himself to a minimum of 30 minutes a day, five days a week at moderate intensity aerobic exercise alternating with three days a week at vigorous intensity. In addition, he partook in resistance exercise a minimum of two days a week at a moderate high intensity focusing on 10 exercises at each session targeting most major muscle groups, with 10 to 15 repetitions for each exercise performed thus adding an additional 20 to 30 minutes to the commitment. Then there are the benefits of his additional flexibility and stretching. When this individual came to me at his first visit, his stated goals were to return to a high level of recreational enjoyment with a particular interest in ball room dancing. As of last week, he had reached those goals but he has no intention of failing to comply with his exercise prescription.
The obvious message of my Blog is to let you know I am unable to reach a desired goal without your commitment. I may introduce Stem Cells, Cytokines and Growth Factors into an arthritic joint but to reach your desired goal or delay or perhaps avoid a joint replacement, those many changes that occur with aging can be slowed and even reversed by a combination of cellular orthopedics and exercise.
If you want to learn about the evidence, schedule an appointment 312 475 1893
Tags: arthritis, athletes, Benefits and Risk, bone marrow, Bone Marrow Concentrate, Concentrated Stem Cell Plasma, Growth Factors, Hip, Hip Replacement, Interventional Orthopedics, joint replacement, Knee Pain Relief, Mature Athlete, Orthopedic Care, Orthopedic Surgeon, Orthopedics, Osteoarthritis, Pain Management, Regenerative, regenerative medicine, Regenexx, stem cells, treatment
There are now available six month follow up Outcomes Data regarding 20 patients who underwent a fat graft harvest, micro-fracture of the fat graft and intervention in an arthritic knee, the latter so severe that the original recommendation to the patient had been a Total Knee Replacement. 85% of this group are very satisfied at this time with the post intervention pain relief and functional improvement. One patient did elect to undergo a Total Knee Replacement eight weeks after the initial intervention. While six-month Data is very preliminary and doesn’t lend itself to a scientific journal publication, I am told the results will become the subject matter of a White Paper, an authoritative report, while the outcomes of the 20 patients will continue to be monitored.
As I have previously reported, I personally am taking a Principal Investigator role in a Clinical Trial centered on the most contemporary ortho-biologic methodology for processing Amniotic Fluid Concentrate. What piqued my interest is the continued marketing placements in our media: ”Stem Cell therapy is an exciting new therapy option that treats arthritis”. “Free Educational Seminar”. “Stem cell regeneration utilizes amniotic stem cells”. I am reminded of the prank I used as a child on my playmates “Pete and Repeat were sitting in a boat, Pete fell out, who was left?” As I have written on my Blog multiple times, there are no viable stem cells in amniotic fluid once processed, irradiated, frozen and fast thawed. That is not to say that AFC may not act as an anti-inflammatory eventually replacing visco-supplementation in attempting to improve the well-being of patients affected by arthritis; but it has no regenerative potential. My interest in leading a Multi-Center Clinical Trial -no out of pocket expense for those who meet the inclusion criteria-is to learn appropriate dosage and duration of effect if any. Subchondroplasty continues to be a subject of increasing interest in the orthobiologic world. I will be serving as a Principal Investigator in a stem cell based subchondroplasty clinical trial as soon as there is IRB approval toward the end of August. I hope to determine if a combined intraarticular and extra-articular Bone Marrow Concentrate approach will result in superior outcomes when contrasted to the standard intraarticular approach.
Be advised and reminded the Regenerative Medicine discipline is evolving and the over seer is the FDA. Make sure that should you decide to pay unreasonable amounts for unproven therapies, those marketing such are doing so under an IRB regulatory methodology. To learn more, schedule an appointment:
312 475 1893
Tags: Amniotic, arthritis, athletes, Benefits and Risk, Bone Marrow Concentrate, Clinical Studies, Clinical Trial. Mitchell B. Sheinkop, FDA, Hip, Hip Replacement, Interventional Orthopedics, joint replacement, Knee Pain Relief, medicine, Orthopedic Care, Orthopedic Surgeon, Orthopedics, Osteoarthritis, Pain Management, Pilot Study, Regenerative, Regenexx, stem cells, Subchondroplasty, treatment
For those new to this Blog, my focus on Regenerative Medicine has just started its fifth year. Prior to that time, I was an orthopedic surgeon surgically replacing hips and knees at a major academic Chicago Medical center for almost 40 years. I then graduated into Regenerative Medicine where I have dedicated the past four years helping patients avoid or at least postpone when possible, a joint replacement for an arthritic hip, knee, shoulder or ankle. You may have learned from that previously written, during my joint replacement years, every patient undergoing a hip or knee replacement became part of a comprehensive database wherein by integrating research with patient care, I would continue to stay in the forefront of reconstructive orthopedics. I would present my findings at various orthopedic seminars around the world and share my knowledge with interested orthopedic surgeons so they could determine the best prostheses, the best surgical approaches, the best rehabilitation techniques, how to prepare a patient for a procedure, and how to achieve the best possible outcome both functionally and from the standpoint of survivorship of components.
When I entered the emerging discipline of Interventional Orthopedics, I introduced my knowledge of orthopedic research as well as my support team, adapting joint replacement clinical research methodology for stem cell intervention outcome surveillance. Owing to my long tenure as a clinician and my Emeritus Professorship designation, many now are seeking my advice and counsel on how to maximize outcomes from a Bone Marrow Concentrate intervention in an arthritic joint. All this being said, within the last several days, I have provided stem cell consultation to a retired professional baseball player of note, and to a medical tourist from the United Arab Emirates, where I had taught joint replacement surgery over 11 times between 2001 and 2007. Today, my office received a call requesting a consultation from a family of Turkish tourists visiting Chicago. Between 2002 and 2006, I had visited Turkish Orthopedic Centers in Izmir, Ankara and Istanbul to demonstrate hip and knee replacement procedures while also lecturing on five separate occasions by invitation around the country.
The point is that there are those of us who are qualified intellectually, experientially, and clinically to assist the patient limited by arthritis of a major joint using Evidence Based Medicine for stem cell care; while there are those who recruit patients by placing a marketing ad with unsupported claims in the media. If you want a consultation based on Best Regenerative Medicine Practices, call for that consultation: 312 475 1893
Tags: arthritis, athletes, Benefits and Risk, bone marrow, Clinical Studies, Hip, Hip Replacement, Interventional Orthopedics, joint replacement, Knee Pain Relief, Mature Athlete, medicine, Orthopedic Care, Orthopedic Surgeon, Orthopedics, Osteoarthritis, Regenerative, Regenexx, treatment