Patients receiving either Hyaluronic Acid (HA- Synvisc, Supartz, Euflexxa) or Platelet Rich Plasma (PRP) injections will experience modest-term pain relief according to an article appearing in Orthopedics Today, August, 2017. In the study reviewed, Ultrasound Guided injections were given weekly for three weeks and patient-reported outcome measures (PROMS) were recorded for up to one year. “Both the PRP and HA groups demonstrated an improvement in PROMS at 24 weeks that declined to near baseline levels at one year” according to the article. “Patients with lower grade Osteoarthritis and lower weight responded more favorably to intra-articular injections”. The effect of both Hyaluronic Acid and Platelet Rich Plasma appeared to be modest and temporary.
Why I chose this topic this week for my Blog has to do with my preparation for the upcoming talks I am invited to give September 21st and 22nd in St. Petersburg, Russia at the meeting of 1200 orthopedic surgeons from Russia, Ukraine and neighboring countries both in Europe and Asia. As I indicated last week, this will be the first time a non-operative intervention of a cellular orthopedic, regenerative nature, as I practice, will have been introduced into this region of the world. While Hyaluronic Acid and Platelet Rich Plasma may offer short term pain diminution for individuals limited in function by the symptoms of Osteoarthritis, it becomes clear by scrutinizing my data base that not only does concentrated bone marrow afford long term relief, the Mesenchymal Stem Cells and Growth Factors found in bone marrow when concentrated participate in regenerative possibility thereby delaying and perhaps even avoiding a joint replacement. My presentations will be evidence based without the false news and unsupported marketing claims ever present in the media.
What we have learned about Amniotic Fluid (AF) from my role as principal investigator in several multisite studies is that AF does have concentrated Hyaluronic Acid and therein may offer six to 12 months decrease in symptoms and increase in function, the effect is limited in duration; and with no viable stem cells in Amniotic Fluid Concentrate, there is no regenerative potential. Owing to the absence of inherent absence of stem cells and hence regenerative potential, I will not include amniotic fluid in my presentations.
As a scientific invitee, my responsibility is to introduce that for which we have scientific support and clinical evidence. If you want to gain a better understanding of Regenerative Medicine and Cellular Orthopedic and learn how you may postpone or perhaps avoid a joint replacement for the symptoms and limitations imposed by osteoarthritis, make an appointment, visit my web site and watch my webinar.
Tags: arthritis, hyaluronic acid, Interventional Orthopedics, Knee Pain Relief, Orthopedics, Osteoarthritis, PRP, Regenerative, stem cells
The current marketing of amniotic fluid as a regenerative approach to arthritis based on delivery of
viable stem cells falls is no different than the bending of the truth behavior we recently experienced
in the run up to the presidential election. Did the campaigns of the candidates reinforce some
notion that facts don’t necessarily matter? It seems that every office session, a patient shares with
me their having accepted a free lunch in exchange for the promise that for $7,000 to $9,000,
Amniotic Fluid containing living stem cells may be injected into an arthritic joint to regenerate that
During my entire 40-year plus orthopedic surgical and now regenerative medicine career, I never
accepted a free lunch from the army of pharmaceutical and orthopedic sales personnel who show
up daily as these gifts are contrary to corporate compliance requirements; and obligate me to listen
to sales pitches, Medical decisions must be based on evidence based medicine. At this time, there is
no scientific evidence of living stem cells in amniotic fluid once that fluid has been harvested,
sterilized, fast frozen for storage and fast thawed when used.
Before going any further, I will make it clear that, when indicated, I use amniotic fluid in my practice; but I also will make it clear, not as a source of stem cells or regeneration. Amniotic Fluid contains 15
times more hyaluronic acid than any available drug; hyaluronic acid is marketed under many trade
names starting with SynVisc. When I believe a patient with an arthritic joint might benefit from
hyaluronic acid, the best methodology is amniotic fluid. As well, the latter may contain viable
growth factors that play a role in controlling the limitations imposed by arthritis. At issue is the
question as to whether it is worth $7,000 to $9,000 for “generic” hyaluronic acid; when in fact, in a
proprietary form is covered by health insurance and Medicare?
There is another alternative if you are interested in Amniotic Fluid as a source of Hyaluronic Acid
and Growth Factors for which there is no charge to you if you meet the clinical trial inclusion
criteria. I am the principal investigator in a national amniotic fluid clinical trial underwritten by a
large pharmaceutical company that started working with amniotic fluid in 2006. Their focus now is
the use of amniotic fluid in the arthritic knee and determining dose and the duration of efficacy.
Facts do matter and the company is willing to underwrite the costs for gathering medical evidence.
To learn if you meet inclusion criteria, make an appointment at 312 475 1893
Tags: amniotic fluid, arthritis, bone marrow, Clinical Trial. Mitchell B. Sheinkop, Concentrated Stem Cell Plasma, Growth Factors, hyaluronic acid, Knee, Orthopedic Surgeon, stem cells