Feb 16, 2015
Well OK, maybe a week, unless you work from your home or have a sedentary job; then you may go back to productivity in days. What caused me to call your attention to the minimal inconvenience and the potential major benefit when Bone Marrow Aspirate Concentrate/Stem Cell is selected as the treatment of choice for an arthritic joint as contrasted with a Total Joint replacement is the minimal need to take time off from work. In addition to the superior athletic performance inherent in a stem cell procedure along with the almost complete absence of complication is the fact that you won’t miss days from your job.
I was reminded of the minimal and short term impact on your life when choosing Bone Marrow Aspirate Concentrate /Stem cells for an arthritic joint this past Friday when a busy Podiatrist sought consultation because of an arthritic knee. She had experienced progressive impairment from advancing arthritis of her knee and three months ago had undergone a Cellular Orthopedic intervention for that arthritic knee. A week later she was on her way to Europe for a long anticipated vacation. She came to the office looking for a long term plan of action as the patient realized as a mature adult, Cellular Orthopedics is a continuum of care and not a onetime experience. That continuum is something I will focus on next time; but for now, let’s focus on the “No Time Off” theme. Inherent in a Total Joint Replacement is obligatory six to 12 week convalescence; that may become a six-month ordeal if a complication such as an infection is experienced. The patient about whom I am writing made it clear that she did not wish to take time away from her profession nor did she wish to risk complication, hence she was planning six or 12 month boosters to keep her working and active. Incidentally, please don’t forget that a total joint replacement may not be a onetime surgical event either. They wear, they fail, they get infected and need to be revised. That revision never is a happy event nor does the outcome come close to the results following an uncomplicated first procedure.
When comparing the potential benefits of a Bone Marrow Aspirate Concentrate/Stem Cell procedure for an arthritic joint to the lost productivity, financial obligation in the new world of high deductibles, and risks of a total joint replacement, the balance sheet speaks for itself. Speaking of balance sheets, I am off to Vail this week for a ski week with family and friends. On Monday, the 23rd, I will be visiting Regenexx to review our Outcomes Data and set forward several interventional protocols. While I seem to Blog mostly about stem cells and arthritis, there is unlimited possibility in the world of Sports Medicine for you to avoid surgery should trauma put you on “Injury Reserve” Check out Sports Illustrated and Stem Cells- that is for injury, not bathing suits.
Tags: arthritis, athletes, bone marrow, Bone Marrow Concentrate, Hip, Interventional Orthopedics, joint replacement, Knee, Knee Pain Relief, Mature Athlete, medicine, Orthopedic Care, Orthopedics, Osteoarthritis, Regenerative, Regenexx, stem cells, treatment
Feb 9, 2015
As we worked away in our Chicago offices last week, a group of five skiers were Helicopter skiing along the Columbian River basin in British Columbia. What is so special is that each of the five is over age 65 and three of them are able to ski because of the care received in my office. 15 years ago, while I was still a joint replacement surgeon, one of the five underwent a uni-compartmental knee replacement. About six years later, because of progression of the arthritis in the remaining compartments of his knee, I converted the “UNI” to a Mobile Bearing Knee Prosthesis. Fast forward to 2012 when I began Bone Marrow Aspirate Concentrate/ Stem Cell interventions for an arthritic joint to postpone or prevent a joint replacement. The patient for whom I performed those surgical reconstructions presented with end stage arthritis and thus would not have been a candidate for a Cellular Orthopedic Regenerative procedure. The other two skiers ascending the slopes via helicopter in search of fresh limitless powder have undergone Bone Marrow Aspirate Concentrate / Stem cell procedures over the last 24 months and there they are enjoying an ultimate skiing experience as “master “ skiers. As a point of reference for my notion of the continuum of care for the scope of cellular orthopedics, one of those two has undergone the procedure several times. The first year, it was for the left knee. The second round was for the right knee and this year, a “refresher” for both knees. While actually thinking about this Blog, I received the following ALERT real time from the lodge –I just received word from the five skiers that there is a blizzard so the helicopter couldn’t fly this morning but the group hopes to get out this afternoon.
If I have piqued your interest, read more about skiing here: Knee Stem cells in Chicago and Heliskiing-Regenexx. Not only is the article of interest, you get to see what I looked like in 2012 in my retro ski outfit.
The January 13, 2015, article Stem Cell ACL: Cutting Edge Knee Repair Sans Surgery appearing in www.onthesnow.com is also informative and it features one of my five alumni.
Reader be aware, Cellular Orthopedic benefits are not only realized by heli-skiers. What happened next to those skiers was that the rains came and that resulted in a premature ending of their Canadian Mountain Heli-skiing adventure. Now for the happy outcome, the group went back home and this week, each member is preparing for a repeat ultimate skiing endeavor by returning to training on their road bicycles in this balmy weather.
Tags: arthritis, athletes, Benefits and Risk, Bone Marrow Concentrate, Clinical Studies, Interventional Orthopedics, joint replacement, Knee Pain Relief, Mature Athlete, medicine, Orthopedic Surgeon, Orthopedics, Osteoarthritis, Pain Management, Regenerative, Regenexx, stem cells, treatment
Feb 2, 2015
The world of Regenerative Orthopedics began in the United States with the publication of a scientific article reporting the results of platelet rich plasma in the treatment of knee arthritis. That took place about six years ago. No one really understood at the time of the publication why something so important in the clotting cascade of the human body would be beneficial in the treatment of an arthritic joint.
The next step in improving results of Platelet Rich Plasma injections for an arthritic joint was the understanding that whereas one injection would help, three injections over a three month period would improve outcomes. Scientists began further efforts at understanding why the platelet, so critical in the clotting cascade, would be beneficial in treating arthritis, and soon a better understanding of how platelets function came to be appreciated.
Platelets are the primary source of bioactive tissue growth factors. When concentrated they are potent. When activated, they release their growth factors and cytokines in clinically active quantities. Regenexx has developed a formula for superior concentrations and immediate activation. Whereas most Platelet Rich Plasma is created at bedside, we create ours in a laboratory with maximum concentration and prompt activation. Our research supports better stem cell growth following the Regenexx SCP procedure. Although the Regenexx Stem Cell Plasma formula is part of the Bone Marrow Aspirate Concentrate algorithm, we now are able to offer it when indicated as an independent intervention when Bone Marrow Concentrate is not possible. In addition, it is a wonderful “booster” when anticipated milestones with Bone Marrow Aspirate Concentrate are not met. Let me cite two patient examples.
Two years ago, an 83 year old man was selling his condo in Palm Springs because his arthritic knee would no longer tolerate a round of golf and his co-morbidity posed a very high risk for a joint replacement. He sought consultation and I recommended a Regenexx SCP intervention. Three weeks after the procedure, he took his condo off the market and returned to Palm Springs for the winter migration from Chicago. I spoke with him via phone in August and he had purchased his tickets for the return migration to the desert this winter.
36 weeks ago, I performed a Bone Marrow Aspirate Concentrate/Stem Cell intervention into the right hip of a 29 year old man with early onset degenerative arthritis. At six weeks, he was 25% symptomatically improved. At 12 weeks, he was 50% improved. At 18 weeks, he was still 50% improved so I administered a C-SCP booster. At 36 weeks he is 80% improved and thrilled. Cellular Orthopedics requires a continuum of monitoring and possibly more than one intervention.
Contact us to learn more.
847 390 7666
Tags: arthritis, athletes, Benefits and Risk, bone marrow, Bone Marrow Concentrate, Concentrated Stem Cell Plasma, Interventional Orthopedics, Knee Pain Relief, Mature Athlete, medicine, Orthopedic Care, Orthopedics, Osteoarthritis, Pain Management, Platelet Rich Plasma, PRP, Regenerative, Regenexx, Regenexx-SD, stem cells, treatment
Jan 12, 2015
That quote comes from University of Chicago Economist and Nobel Laureate, Gary Becker, who died in 2014. Central to his work was the concept that economics can help explain behavior. As seems to be happening more and more, this Blog will expand on the evidence concerning Bone Marrow Aspirate Concentrate/Stem cell outcomes for intervention in the arthritic joint. The Data and my experience clearly document success at all stages of arthritis in a major joint for some period of time. What I am unable to conclude is in whom we are actually regenerating cartilage or in whom we are seeing pain relief and improved functional capacity owing to concentrated Growth Factors and Cytokines. Whereas my initial interventions two and a half years ago were limited to a “younger” arthritic demographic, the successes resulted in my expanding the inclusion criteria last year without age exclusion as I observed Outcomes success in those approaching 80 years of age. What I don’t know yet is in whom the improvements are related to the stem cells in the Bone Marrow Aspirate Concentrate or whether to the Growth Factors influencing your own stem cells or the Cytokines acting as anti-inflammatories, accompanying the stem cells in the Bone Marrow Aspirate Concentrate. What the evidence does indicate is that the older the patient or the more advanced the arthritis at the time of BMAC intervention, the better the outcome with a second or even third procedure. What I don’t know yet is a predictor of the survivorship of an outcome. I do know that the best chances of long-term benefits are in those with less than Grade 4 arthritis. For those who experience something less than hoped either in the initial result or extent of benefit, let’s explore the economics.
Just as our health care indemnification is undergoing change, so is my understanding of the scope of services that may be beneficial in this evolving discipline of Cellular Orthopedics. The good news is that unlike the insurance world where less health care coverage seems to be associated with greater cost for indemnification to the patient, I have identified a means of decreasing the economic burden to a patient for a repeat Bone Marrow Aspirate Concentrate/Stem cell intervention or related Regenerative Medicine injection, if a single procedure doesn’t provide the degree of relief or survivorship of outcome desired. It may well be that Cellular Orthopedics involves a range of approaches and not a single intervention. My office will work with you to provide you a scope of Evidence Based Care with an economic approach that allows the patient to avoid or at least delay a joint replacement.
Tags: arthritis, bone marrow, Bone Marrow Concentrate, Clinical Studies, Concentrated Stem Cell Plasma, Hip, Hip Replacement, Interventional Orthopedics, Knee Pain Relief, Mature Athlete, medicine, Orthopedics, Osteoarthritis, Pain Management, Regenexx, Regenexx-SD, stem cells, treatment
Jan 5, 2015
This time of year always brings with retrospection, reviews and prophecy, no matter what area of interest. As my area of professional concern is arthritis and assisting a patient avoid or at least delay a joint replacement, I thought it would be helpful to look at what Outcomes we recorded in our Data Base. Unlike the majority of Regenerative “experts” marketing themselves on the internet, I don’t cite the results of others or make unsupported claims, I document what I learn from having treated patients with Bone Marrow Aspirate Concentrate over two and a half years. Imagine if you would the complexity of having integrated patient care with clinical research using all the parameters I applied to development of new generations of total hip and total knee prosthetics during my almost 40 year joint replacement career. That’s why there are few if any involved in musculoskeletal care via Regenerative Medicine who are able to provide a patient the comprehensive experience I offer.
As of this morning, we have registered over 525 patients in our comprehensive Data Base with measurement pre and post Bone Marrow Aspirate Concentrate/Stem Cell intervention in 125 hips and almost 400 knees. Of the hips, three have gone on to a joint replacement; of the knees, two have gone on to a total knee replacement to the best of my knowledge. What I have defined from my experience is who will benefit from a BMAC intervention and who should undergo a joint replacement. Note the absence of reference to adipose derived stem cells. The explanation is simple; the FDA views such as a drug and hence does not approve the use of fat in the management of arthritis. I am also beginning to get a better understanding about how long the benefits of the intervention will maintain and how to best manage and extend those benefits. In the joint replacement world, the benchmark parameter is survivorship, how long until the prosthesis fails? In the stem cell world, I am interested in observing and prolonging the pain relief and functional improvement after the Bone Marrow Aspirate Concentrate Stem Cell procedure.
Evidence Based Medicine and Best Practices require maintenance of an outcomes data base; not an injection without ongoing follow-up. As I perused the internet this morning, other than Regenexx, I find a paucity of clinical data and a predominance of unsupported claims. In my lifetime of joint replacement surgery, there were many others performing large numbers of procedures around the country. We would meet periodically and present our own scientific outcomes and the evidence and learn from each other, all leading to the best possible clinical practices of total joint replacements. When it comes to the seductive claims from Stem Cell clinics found all over the Web, my challenge this year: Show Me Your Evidence
Tags: arthritis, athletes, Benefits and Risk, Bone Marrow Concentrate, Clinical Studies, FDA, Hip Replacement, Interventional Orthopedics, joint replacement, Knee, Mature Athlete, Orthopedic Care, Orthopedic Surgeon, Orthopedics, Pain Management, Regenexx, Regenexx-SD, stem cells, treatment
