Special Announcement - Now Enrolling for FDA Approved Stem Cell Study
Dr. Mitchell Sheinkop has completed training and is credentialed for the first of its kind FDA approved stem cell clinical trial for knee arthritis. Our clinic is now enrolling patients in this trial. Contact us at 312-767-5761 for details. Click here to learn more.

Masterful Care of The Aging Athlete

I consider myself an aging athlete who still skis, cycles, dedicates five days a week to fitness, plans to soon plant a garden, and walks up a spring creek with a fly rod. When my arthritic hips and knees began to limit my recreational profile several years ago, I chose the regenerative medicine option rather than joint replacements. Having performed joint replacements for 37 years and studied the benefits and limitations of such, I elected to postpone, perhaps avoid major surgery with the inherent risks and limitations. First it was Platelet rich plasma, next came PRP with Growth factor Proteins; and next came stem cells. At the get go, I did not expect to regenerate cartilage; but I did hope to restore joint function, minimize pain, and maintain the highest possible activity potential. Even with Grade 4 osteoarthritis of my major joints, I can report that I skied for a week in Vail this past February as I did a year ago, recently spent three days wading though spring creeks in Southwestern Wisconsin with a fly rod in pursuit of trout, and cycled 30 miles last Saturday. I am not alone as my biking, skiing and cycling buddy with similar knee issues returned last week from his yearly helicopter skiing adventure. I have been managing his knee arthritic issues with regenerative medicine interventions for over five years.

Then there are the athletes in their 50s. Certainly, the option is there for a joint replacement for a grade three arthritic joint but what If? What if there is a complication, an adverse event, a failure to regain motion, or residual pain? The fall back potion after a failed joint replacement is another joint replacement and the outcomes of revision surgery are frequently not satisfactory. Several weeks ago, I described the recreational pursuits of a 58-year-old volleyball enthusiast who had initially considered a joint replacement when 15 years after an arthroscopic partial meniscectomy, the predictable post traumatic arthritis had forced him to suspend his activities. He chose a regenerative medicine stem cell option; and eight weeks thereafter, he is back to playing volleyball three times a week. While on occasion, a booster follow-up injection is needed; we are in the process of developing a manuscript for scientific publication focusing on the successful outcomes of 20 patients followed for one to two years after a combined injection of bone marrow concentrate containing stem cells into the knee and the bone adjacent to the knee. These are recreational athletes between ages 45 and 60 who won’t quit.

On May 4, I am one of three invited faculty to present at The Regenerative Medicine Training Institute (RMTI). On June 7 and 8, I have been asked to participate in the Workshop and Lab Faculty at the largest Regenerative Medicine program in North America (TOBI). Owing to our integration of patient care with scientific outcomes monitoring, we have been able and continue to provide masterful and evidence-based care to aging athletes. To continue to remain in the forefront of Regenerative Medicine, I dedicate a good deal of time reviewing the future while monitoring the outcomes of patient care. Several new treatment options are soon to be launched including expanding my scope of care to those with inflammatory arthritis.

To learn more, call for a consultation (312) 475-1893. You may visit my website: www.sheinkopmd.com

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Should All Meniscal Injuries Undergo Operative Treatment ?

Should All Meniscal Injuries Undergo Operative Treatment ?

A patient presents to the office because of pain in the knee with or without a history of injury. An examination is performed followed by an X-Ray. Osteoarthritis may or may not be seen on the X-ray. If there is an altered range of knee motion when compared to the “normal” side, then a preexisting condition is considered. Whether or not the physician considers arthritis, an MRI is requested. The MRI report 48 hours after imaging is consistent with a torn medial meniscus. Should all patients with a torn medial meniscus undergo surgical intervention? If surgery is undertaken, should the procedure be a repair or a partial removal? The management of meniscal injuries must be influenced by the knowledge that meniscal integrity is important in load distribution across the joint. Meniscal injury causes altered joint mechanics and is related to the onset of arthritis.

According to a recently published online article in the British Journal of Sports Medicine, arthroscopic partial meniscectomy (APM) may not be the best option for all patients with knee pain and meniscal tear. Researchers investigated patients with meniscal tears that compared Arthroscopic Partial Meniscectomy to nonsurgical intervention, pharmacological intervention, and no intervention. At six to 12 months, APM patients had a slight improvement in knee pain, knee-specific quality of life, and knee function compared to physiotherapy patients. When excluding osteoarthritis (OA) patients, the aforementioned outcomes exhibited small to moderate improvement. Knee pain, function, and quality of life did not improve for APM patients compared to placebo surgery patients at six to 12 months regardless of OA status.

There may, however, be a small-to-moderate benefit from APM compared with physiotherapy for patients without osteoarthritis and who have mechanical or obstructive signs. Arthroscopic partial meniscectomy (APM), a keyhole surgery where loose and fragmented pieces of a torn meniscus is removed, is one of the most common orthopedic procedures performed. Over half of these are performed to treat a meniscus tear in a degenerative knee; however, several recent randomized trials have shown that Arthroscopic Partial Meniscectomy is not superior to conservative treatment or placebo treating meniscus tears associated with a degenerative knee. On the other hand, there is universal agreement that the traumatic meniscus tear, the result of a knee injury in a younger patient with otherwise healthy knee (with no degeneration), should be treated by surgery.

Then what is the downside of meniscal injury and surgery? The medial and lateral meniscus together provide shock absorption, establish a broad base of contact surface and help provide stability to the knee. Those who have undergone total or partial meniscectomy should understand that in five to 15 years, they will develop degenerative arthritis. The long-term outcomes of those whose tears were treated by repair rather than removal has not been established. My Regenerative Medicine practice in part, is the result of those seeking to postpone or avoid a Total Knee Replacement years after a meniscal injury followed by arthroscopic surgery. As long as the arthritis has not progressed to a Grade 4, I am able to assist the patient with joint restoration, at times joint regeneration, it is matter of age and health. While I am able to offer joint restoration, on occasion, joint restoration for those who sustained meniscal and Anterior Cruciate injury in the past, is there anything that could be used as an adjunct at the time of the meniscal injury to promote healing without surgery or postpone, perhaps avoid future postraumatic arthritis?

To learn more. Schedule a consultation (312) 475-1893.You may view my web site at www.sheinkopmd.com.

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Hamstring, calf, elbow and shoulder injury-Tis the season

Hamstring, calf, elbow and shoulder injury-Tis the season

Opening day of the baseball season is today, Thursday, March 28. I noted this morning on the sports pages how many players will not be available for the start of the race owing to injuries sustained in Spring training. In the basketball coverage, from the get go of March Madness to now, most teams have been playing at times without a star owing to injury. Then there are the final weeks of hockey, will Chicago make the playoffs? Certainly, injury could play a major role. Next in line are the joggers, cyclists, tennis players, so on and so forth who will soon be unable to meet their recreational goals owing to tendon, muscle and ligament injury. With spring comes strains and sprains.

The term strain applies to the over stretching or tearing of muscles and tendons; while a sprain is the overstretching or tearing of a ligament. The most common location for a muscle strain is the hamstring; while the most common location for a sprain is at the ankle joint. Stretching muscle and tendon groups is the best prevention for strain. At this time of the year, especially for the weekend warriors, stretching strengthening and hydration are paramount for minimizing injury.

In spite of the best of fitness preparation and compliance, you feel that stabbing pain in your calf, in the back of the thigh, in your low back in the area of the shoulder. You may choose to take advantage of direct access to the physical therapist. Should you have a greater concern regarding the nature and severity of an injury, call for an orthopedic assessment. After a physical examination, the X-ray, Ultrasound or MRI may be ordered for a most accurate diagnosis or to grade the severity of injury. If and when, physical therapy, anti-inflammatories, or a cortisone injection do not provide relatively short-term relief, it may be time to consider a regenerative medicine intervention. For sports injuries, Platelet Rich Plasma is increasingly proving effective in promoting healing, minimizing impairment, and allowing for the quickest return to highest levels of performance. The major determinant of success is the quality of the PRP as measured by either ratios of protein, platelet and cellular content; or by the actual platelet content of the plasma itself.

While in some clinics, Platelet Rich Plasma is produced by a blood draw and centrifuging, there is no standardization or quality control. In my practice, we create a known and standardized PRP. At the beginning, a finger stick is leads to a platelet count of the patient’s circulating blood. Next, the number is entered into a computer algorithm taking into account the proprietary kit being used as well as the ultimate platelet concentration and plasma volume following the centrifuging process.  A repeat platelet count is done prior to injection making sure that desired numbers have been reached. if not, we are able to adjust numbers and concentration to the sought-after target. In this way we can customize the platelet Rich Plasma for each patient’s needs. Once prepared, an ultrasound unit is employed to assist targeting and making sure the PRP is injected into the desired location; that is the site of injury. The procedure is standardized in our office but customized for the shoulder, elbow, hamstring or calf. On occasion, the process may have to be repeated in three to six weeks for maximum benefit. Don’t let an injury ruin your season; if usual and customary is not effective, call for an appointment.

For more information, visit https://sheinkopmd.com or call  (847) 390-7666 to schedule a consultation. 

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Opening Day Coming Soon! For Major League Baseball on March 28; for Golf, Even Sooner

The basic principles behind the golf swing and the swing at home plate are not that much different. While the preferences may vary, when you break down the mechanics, there is similarity. Certainly there are differences between laying down a bunt and a 230-yard drive off the first Tee. The same differences are in play when putting is contrasted to the swing driving a 385-foot home run out of the park. In the several scenarios, the swing should look like one smooth, continuous motion that culminates with you holding a nicely balanced finish as the ball sails through the air. Within that motion however, is a series of techniques that each must be executed properly in order to produce the desired outcome.

Concentrating on golf swing mechanics, there is the Takeaway, Back swing, Transition, Impact, and Follow through. Continuing to explore the swing mechanics, backward movement of the shoulders and arms is followed by backward rotation of the spine, cocking of the hips, cocking of the wrists, timing, rotation of the pelvis, forward rotation of the spine, pushing and pulling of the arms and shoulders, guiding action and follow through.

Even if the physics behind my explanation is not perfect, the point here is that any pain and altered motion caused by injury or arthritis will affect your game. If you haven’t been able to play since last fall, now is the time to head out to the gym to catch up on strength training, stretching, with emphasis on spinal and pelvic rotation. Then there are the golf simulators and indoor driving ranges in and around Chicago. 

If you experience pain in your muscles and joints along with limited motion, recent legislative changes in Illinois allow you direct access to the physical therapist. If after several sessions with the physical therapist, you haven’t realized the improvement you seek, it is time for an evaluation by an orthopedic surgeon. She or he, perhaps me, will complete a medical history and physical examination and review X-ray and MRIs of the effected anatomy. The end result of that intake may be a prescription for further PT, a prescription of pharmacologic management or in my case, a Regenerative Medicine/ Stem Cell procedure; that is a needle and not a knife.  

I have documented in several recent scientific publications that Regenerative Medicine using either Bone Marrow Concentrate or Micro-fragmented Adipose tissue recovered by Liposuction will allow you to play 18 holes of golf this upcoming season. At times concentrated and then processed Platelets offer an opportunity for a patient afflicted with arthritis or limited by bodily injury to return to an active lifestyle and enjoy a full schedule of outdoor recreational pursuits. Please make note that my regenerative menu of services is based on your own cells and proteins that have been proven to work and meet FDA and FTC guidelines.

The weather forecast is improving and the sun was out today; the opening of both the baseball and golf season is only a about a week or so away.  I say “Play ball.” 

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The Right Cellular Orthopedic Procedure for You

The truth about reparative medicine in orthopaedics and why it matters to you is that in the USA, millions of people suffer from orthopedic conditions and are looking for options to major surgery. At the same time, there is a segment of the population that can’t safely undergo a major joint replacement procedure. Then there are those who are highly active and are looking to keep up with their sporting activities and an unlimited life style. The older generation is living longer and very active. The younger generation is also participating in sports and playing for a longer period. The wear and tear in joints cause pain and ultimately may cause or aggravate an arthritic process. There is an option to surgery and a means of postponing, perhaps avoiding a Total Joint Replacement. While Cellular Orthopaedics (Regenerative Medicine), offers a reparative technology, it is important to recognize that all therapies in the marketplace are not equal. There are many different types of tissues: fat, bone marrow, amniotic fluid, placental tissue, cord blood, Wharton’s Jelly, and circulating blood marketed for intervention but only concentrate from your own bone marrow, concentrate and filtered platelet product from your own blood, and now micro-fractured fat from your own adipose tissue meet FDA compliance requirements.

Over the past ten years, advances in reparative medicine have resulted from science and research behind the different options. You may read about my role at www.sheinkopmd.com/published-research-articles/ to learn more. I was one of the first orthopaedic surgeons to study the effects of Micro-fractured Fat (Lipogems) in patients with Grade 4 Osteoarthritis of the knee who were en route to a Total Knee Replacement. Now that the FDA has granted clearance, many physicians are showing up with claims of offering adipose stem cells. While fat has reparative qualities and can help promote a healing environment, it is not a resource for cartilage regeneration.

As always though in the current health marketing environment, a patient must guard against misrepresentation of product, effect and outcomes. The article I published in November of 2018, is the only scholarly article of which I am aware that has true clinical adipose outcomes data. https://www.amjorthopedics.com/article/safety-and-efficacy-percutaneous-injection-lipogems-micro-fractured-adipose-tissue. Those clinics offering a type of fat technology that is processed using enzymes and manipulates the cells are doing so by failing to abide by FDA Guidance. Additionally, some providers are offering “Stem Cell Treatments” at very high costs and thus mislead the public along with the parasites, camp followers and charlatans promoting amniotic fluid, cord blood and Wharton’s jelly. Our goal is to provide the right treatment options for a patient with solutions that have strong scientific evidence behind the technology and are cleared by the FDA. I am happy to be a leader in the Evidence Based initiative.

To schedule a consultation call (847) 390-7666          You may visit my web site at www.sheinkopmd.com

 

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