Jun 8, 2016
In the late summer of 2015, I was featured on a Fox cable news segment featuring a patient on whom I had performed a Bone Marrow Aspirate Concentrate –Stem Cell intervention coupled with a subchondroplasty procedure. The patient had experienced a poor result from a right Total Knee Replacement years earlier and was seeking a means of improving function and minimizing her left knee pain resulting from arthritis. Cartilage does not have a nerve supply so scientists and clinicians have long sought a clear understanding of the pain generator in osteoarthritis. While there still is not a clear-cut consensus, many clinicians are looking at the bone marrow lesions seen on an MRI when taken of an arthritic joint as the possible cause of pain associated with arthritis.
In the case of my patient, the combined BMAC-Stem Cell procedure coupled with the subchondroplasty had resulted in a very satisfactory outcome and such maintains at this time to the best of my knowledge. What was unique about my patient was the use of Bone Marrow Concentrate-Stem Cells to serve as the catalyst to effect healing of the bone marrow lesions. Up until that time, surgeons were using a synthetic calcium phosphate material to fill the defects above and below a joint surface with a mandatory three months of protected weight bearing and six months of altered physical activity. The introduction of Bone Marrow Concentrate with Stem cells required 48 hours of crutch support and six weeks of restricted physical activity.
My patient who received media attention served to foster a debate in the medical device industry as to the superior methodology serving as an adjunct to a subchondroplasty. First came the initial trial using a subchondroplasty procedure and synthetic filler with the inherent need for prolonged altered function and assisted ambulation. Now there are several clinical trials in development pertaining to an arthritic joint and the minimally invasive, percutaneous subchondroplasty comparing the synthetic filler to the Bone Marrow Aspirate Concentrate-stem cell adjunct; with the latter used both inside the joint and in the adjacent subchondral bone.
Are your arthritic joint changes affecting both the cartilage and the supporting bone? Is the actual source of your joint pain, the supporting bone or bone marrow lesions adjacent to the hip, knee, ankle or shoulder? It would require a complete examination and review of X-rays and an MRI for me to answer the question and advance the most appropriate therapeutic recommendation. Could it be that the failure of a regenerative intervention wasn’t a failure of the stem cells but rather a failure to address the real pain generator, subchondral bone?
Call for an assessment 312 475 1893 and I will try to answer that question.
Tags: arthritis, athletes, Benefits and Risk, bone marrow, Bone Marrow Concentrate, Clinical Studies, Clinical Trial. Mitchell B. Sheinkop, Hip, Hip Replacement, Interventional Orthopedics, joint replacement, Knee, Knee Pain Relief, Mature Athlete, Microfracture surgery, Orthopedic Care, Orthopedic Surgeon, Orthopedics, Osteoarthritis, Pain Management, Pilot Study, Regenerative, Regenexx, Regenexx-SD, stem cells, Subchondroplasty, treatment, Ultrasound Guided Injection
May 19, 2016
From the AMA Morning Rounds May 16, 2016
Today’s Medical News Prepared Exclusively for You
Leading News
“Exercise linked to reduced risk of several cancers”
ABC World News Tonight (5/16, story 11, 0:25, Muir) reported, “The
National Cancer Institute confirms that moderate exercise, all the way
up to intense exercise, lowers the risk of” cancer “in many forms.”
The Los Angeles Times (5/16, Healy) reports that the research,
published in JAMA Internal Medicine, suggests, “exercise is a powerful
cancer-preventive.” Investigators found that “physical activity worked
to drive down rates of a broad array of cancers even among smokers,
former smokers, and the overweight and obese.”
US News & World Report (5/16, Esposito) reports that
investigators “analyzed data from participants in 12 US and European
study groups who self-reported their physical activity between 1987
and 2004.” The researchers “looked at the incidence of 26 kinds of
cancer occurring in the study follow-up period, which lasted 11 years
on average.” The data indicated that “overall, a higher level of activity
was tied to a 7 percent lower risk of developing any type of cancer.”
TIME (5/16, Park) reports that “the reduced risk was especially
striking for 13 types of cancers.” Individuals “who were more active
had on average a 20% lower risk of cancers of the esophagus, lung,
kidney, stomach, endometrium and others compared with people who
were less active.” Meanwhile, “the reduction was slightly lower for
colon, bladder, and breast cancers.”
Historically, I have directed my Blog to fitness, improved activities of
daily living, and recreational endeavors. The Leading News report
quoted above introduces an additional goal. Considering the significant
progress in research and management of different cancer types, after
mesothelioma explained, I am not going to suggest
that you will prevent cancer by undergoing a cellular orthopedic
intervention to an arthritic hip or knee; but, I am introducing the
concept that by my improving your activity level and functional
potential with a cellular orthopedic intervention for the symptoms of an
arthritic hip or knee, I will improve your exercise capacity and your
exercise tolerance with the inferred inherent health care benefits be it
cancer prevention, heart health, etc.
Tags: arthritis, athletes, Benefits and Risk, bone marrow, Bone Marrow Concentrate, cancer and exercise, cancer statistics, Clinical Trial. Mitchell B. Sheinkop, Concentrated Stem Cell Plasma, Dr. Sheinkop, Hip, Hip pain, Hip Replacement, improve joint pain, joint pain, joint replacement, Knee Pain Relief, Mitchell B. Sheinkop MD, national cancer institute, Orthopedic Care, Osteoarthritis, Regenerative, Subchondroplasty
Mar 21, 2016
Physicians should be in a constant state of education to keep their skills and knowledge at the forefront so that their patients get the best care possible. At the same time, I personally have devoted over 40 years to integrating patient care with research and education be it directed to joint replacement, and for the past four years, to postponing and at times, avoiding joint replacement. As the vast majority of health professionals, I strive on a daily basis to meet the need of my patients. Each and every patient for whom I provide care is entered into a HIPAA compliant outcomes database. From time to time, results are extracted from that data-base and presented at Cellular Orthopedic meetings. Soon we will be submitting the outcomes of several clinical trials for statistical analysis and publication. Almost every therapeutic intervention I recommend is based on science and statistically significant outcomes; rarely on anecdote.
The emerging field of regenerative medicine aims to deal with arthritis and cartilage injury by providing the required elements (cells, inductive molecules, and local environment) to promote true joint and cartilage regeneration. Cellular Regenerative Medicine is rapidly evolving and changing on an almost weekly basis. This is both good news and bad news as there are those who would try to prosper through marketing rather than science. Witness the invitation I received last week to travel to the Bahamas for stem cell care based on anecdote; or the advertisement for the “opportunity” to attend a weekend course to teach me how to use adipose tissue for every malady in the human body. How is it possible to track outcomes from medical tourism or to teach adipose related cellular orthopedic intervention when the latter is not FDA approved?
To assure you that I remain in the forefront of Cellular Orthopedics, from March 31-April 2, 2016, I will be participating in a Continuing Educational course, Articular Cartilage Restoration: The Modern Frontier, sponsored by the American Academy of Orthopedic Surgeons. This is a premier skills course that provides hands-on exposure and practice for the most updated techniques in cartilage restoration while allowing for a contemporary overview of established and new procedures to treat the entire knee joint for cartilage damage ranging from focal defects to arthritis.
Although I no longer am involved with orthopedic resident education, as Professor Emeritus at Rush, I have taken the Interventional Orthopedics Foundation pledge to continue to integrate my clinical interventions with outcomes surveillance. Several scientific presentations at the early March meeting of the American Academy of Orthopedic Surgeons resulted because of my ongoing initiatives. I am the orthopedic surgeon who four years ago, exchanged a scalpel for a stem cell.
Tags: arthritis, athletes, Benefits and Risk, bone marrow, Bone Marrow Concentrate, Clinical Studies, FDA, Hip, Interventional Orthopedics, joint replacement, Knee Pain Relief, Mature Athlete, medicine, Orthopedic Care, Orthopedic Surgeon, Osteoarthritis, Pain Management, Pilot Study, Regenerative, Regenexx, Regenexx-SD, stem cells, treatment
Feb 8, 2016
Every week, I receive updates via brochures and journals concerning the clinical and basic science orthopedic research being done around the country at the various university medical centers. I like to read them to understand how Cellular Orthopedics is emerging and is being accepted in academic institutions. When I retired from Rush and joint replacement surgery five years ago, my colleagues had a very jaundiced view of my new endeavors telling me and then my patients that Regenerative Medicine was unproven, was ten years away, and was not a reasonable alternative to a joint replacement. It is with great pleasure that I am able to announce the American Academy of Orthopedic Surgery Surgical Skills update will include a three day course next month on Articular Cartilage Restoration: The Modern Frontier, as a continuing educational initiative. The title of one particular lecture really caught my attention Move-Over PRP/Viscosupplementation: Stem cells are in and why.
Taking it a step further, the latest bulletin from Jefferson Medical College’s department of orthopedic surgery reviews the basic science being done in the Laboratory of Theresa Freeman, PhD, Associate Professor of Orthopedic Surgery. “The development of Osteoarthritis can often be attributed to a trauma that occurs in youth, which begins the slow degeneration of cartilage. By reducing cartilage damage immediately after an injury, the development of osteoarthritis can be dramatically slowed.”
I have been making the case for an affirmative stem cell intervention every time an anterior cruciate surgical repair takes place or for that matter, when an individual undergoes an arthroscopic procedure. Two weeks ago, I completed a Bone Marrow Aspirate Concentrate Stem cell procedure three weeks after a young middle aged man had undergone micro fracture for a cartilage defect on the weight bearing part of his femur at the knee. On Friday, I scheduled a 72 year old gentleman for a stem cell procedure ten days after he had undergone arthroscopic surgery for a degenerative tear of his medial meniscus during the course of which degenerative changes were documented in the weight bearing zone at the inner compartment of his knee.
A webinar is scheduled by the American Academy of Orthopedic Surgeons next month in order to introduce its orthopedic membership to what may be possible through Cellular Orthopedics. I have already advised you about the Continuing Education Course next month on Articular Restoration. The orthopedic academy membership is only now being introduced to what I have been practicing for almost four years. There are now close to 750 patients in my data base who have undergone Cellular Orthopedic procedures for arthritic joints to relieve pain, increase function and avoid, certainly postpone a joint replacement. On Saturday, I am headed out to Colorado to ski with family for a week. For readers of my blog, you may recall I have undergone a regenerative procedure for my left knee. While I am realistic and I don’t dwell on being who I used to be, I believe anything is possible at any age. If you want to continue or possibly return to skiing, biking, hiking, climbing, fly fishing, skating, fitness, etc, and the limitation is arthritis, schedule a consultation
847 390 7666
Tags: ACL Injury, arthritis, athletes, Benefits and Risk, bone marrow, Bone Marrow Concentrate, Hip, Hip Replacement, Interventional Orthopedics, joint replacement, Knee, Knee Pain Relief, Mature Athlete, medicine, Microfracture surgery, Orthopedic Care, Orthopedic Surgeon, Orthopedics, Osteoarthritis, Pain Management, Regenerative, Regenerative Pain Center, Regenexx, stem cells, treatment
Jan 25, 2016
Although Orthobiologics and Cellular Orthopedic interventions generally result in excellent pain relief and return to or maintenance of a high degree of function, approximately 20 percent of patients have persistent functional deficits that affect their quality of life as I have learned after review of three and a half years of Regenexx procedures for the hip and knee.
It looks as if lumbar spine problems are a common cause of functional disability in patients presenting with hip and knee arthritis. While, I didn’t perform a particular study, in reviewing those with less than optimal outcomes from my first three plus years of Regenerative Medical procedures, I observed that patients with a prior history of lumbar spine problems had significantly worse hip and knee functional scores when compared to the majority who did well and had no documentation of a preexisting spinal abnormality.
The results of my observations mirror multiple previous studies that have found poor pre operative and post operative knee and hip function in patients undergoing a joint replacement who had a spinal degenerative co-morbidity. Through the review of our data base, we have identified the problem. Now I must determine the alternatives in dealing with the problem. First of all, from here on out, all new and returning patients will be questioned about their back related symptoms; and when deemed appropriate, images will be requested. If a significant degenerative disc or joint process is identified then the patient will be appropriately advised and referred for timely intervention. As of this writing, the options are either classical pain management or surgical in nature. The good news is that included in classical pain management for the spine is a very successful approach focusing on weight reduction, Pilates core strengthening, and Tai Chi, yoga or stretching. The failure of these non operative approaches is based on the failure of a patient to commit three or four days a week. The next level of pain management is injection based. Historically, an epidural series has been the standard but more recently, Regenexx introduced PRP as a safer and longer lasting approach. As of this writing, Regenexx and others have introduced intradiscal procedures, but I want more outcomes before I recommend such.
As far as what I do for arthritis, there will be more attention to devoted to the patient’s back when we do the intake for an arthritic joint. On the other hand, we do have several improvements and additions in our ever evolving menu of services for the arthritis hip and knee. To learn more, schedule a consultation:
847 390 7666
Tags: arthritis, Benefits and Risk, Bone Marrow Concentrate, Hip, Hip Replacement, Interventional Orthopedics, Knee, Knee Pain Relief, Mature Athlete, medicine, Orthopedic Care, Orthopedic Surgeon, Orthopedics, Osteoarthritis, Pain Management, Platelet Rich Plasma, PRP, Regenerative, Regenexx, Regenexx-SD, stem cells, treatment
