Dec 29, 2014
Actually it is closer to stem cell misrepresentations and is being propagated by the uninformed clinician, clever marketing schemes, and out and out charlatans. Last week, the FDA made a very strong statement warning against the use of Adipose Derived Stem Cells in the treatment of arthritis. The Government Health Care oversight process stated that there would be large fines and perhaps imprisonment for those health care providers who do not comply with the law. The regulations clearly state that your stem cells may be used if not manipulated or expanded. In order to liberate stem cells from adipose tissue, the adipose tissue has to be treated with an enzyme collagenase, a clear violation of the law. Yet, there are the web sites too numerous to list marketing adipose derived stem cells for arthritis. I am aware of several clinics that circumvent the law by performing liposuction and injecting the fat into the joint without liberating the stem cells with collagenase. My response, beware and take care.
Then come those providers who use local anesthetics to expand the Bone Marrow Aspirate Concentrate when Regenexx has documented the death of stem cells if mixed with local anesthetics. Don’t stop reading, I have yet another alert. The latest addition to the field of Regenerative Medicine comes from Amniotic Fluid that is marketed as an allograft. The pregnant woman at term donates her amniotic fluid that is then processed and made available for wound healing or as an injectate for the arthritic joint in either a concentrated or powder form. While the early outcomes are promising for pain relief, no one has more than four months of outcomes monitoring for amniotic fluid preparations in arthritis. The processing laboratories claim an abundance of stem cells in the concentrate as well as large quantities of Cytokines and Growth Factors; but this is yet to be corroborated by independent researchers. The good news here is the latter research is taking place and more being planned; there should be preliminary data by mid 2015.
Assume if you will that you have an arthritic joint, and are not yet ready for a joint replacement or the extent of your arthritis still lends itself to non-operative management. How can you be sure that you are protected from the abuses I describe above? Regenexx initiated outcomes surveillance over five years ago and as an orthopedic surgeon, I joined and expanded those data points Regenexx studies two and a half years ago. No other Cellular Orthopedic or Regenerative Medicine initiative has the comprehensive Outcomes Data or basic research to support a clinical intervention recommendation, as do the members of the Regenexx Network. Beware here as well of non Regenexx Network web sites that post Regenexx Outcomes as if the patient is too uninformed to recognize the deception. If you want the truth, make an appointment: 847 390 7666
Tags: Amniotic, arthritis, athletes, Bone Marrow Concentrate, Clinical Studies, Interventional Orthopedics, joint replacement, Mature Athlete, medicine, Orthopedic Care, Orthopedic Surgeon, Orthopedics, Osteoarthritis, Regenerative, Regenexx, stem cells, treatment
Dec 22, 2014
Last week, a call was placed to my office by the sponsor of a multicenter knee replacement clinical trial in which I had taken part since 2004.The FDA mandated Post Release Requirement for the Zimmer Mobile Knee had been fulfilled. Because of my world wide teaching and visiting professorships starting in 2001, I had been asked to be a co-investigator in that initiative. My participation in part led to the release of the High-Flex Zimmer Mobile Bearing Knee in 2007 and several major clinical papers in which I was the Co-Author. As many readers of this Blog are aware, I had dedicated 37 years of my professional endeavors to integrating joint replacement research with my clinical practice at Rush for the care and treatment of the arthritic hip and knee. For the past two and a half years, I have dedicated my professional energies to assisting patients with osteoarthritis avoid or at least postpone the joint replacement.
I want to go on record; when a patient has altered function, unrelenting pain, and an image with a Kellgren/Lawrence Grade 4 osteoarthritic hip or knee, that patient needs a joint replacement. While I have called the readers’ attention to inherent risks of a joint replacement, the effected patient with medical approval will benefit from the joint replacement. On the other hand, the ever increasing evidence and my experience confirm that the patient with Grade 2 and 3 Osteoarthritis of a major joint may significantly benefit from a Bone Marrow Aspirate Concentrate /Stem cell intervention. The end result of an uncomplicated major joint replacement is pain relief, improved function, better motion, and correction of a deformity. The potential risks of a joint replacement gone badly require a revision or major reconstruction with major medical interventions for associated complications. The end result of a Bone Marrow Aspirate Concentrate /Stem Cell intervention is pain relief, improved function, better motion and continuation of or return to a very active recreational profile without risk of complication. While the stem cell procedure will not correct a deformity, it may alter the natural history of the arthritic process at the molecular level. Actually, the presence of deformity puts a patient in a Grade 4 setting and is an indication for a joint replacement; Grade 4 is a predictor of a poor result from stem cells.
Well it’s the week of Chanukah and Christmas so let’s celebrate this week of miracles with a wonderful stem cell story; it concerns hockey great Gordie Howe to be found in the Detroit Free Press. Freep.com:
http://on.freep.com/16AQIIO
Tags: arthritis, athletes, Benefits and Risk, Bone Marrow Concentrate, Hip Replacement, Interventional Orthopedics, joint replacement, Knee Pain Relief, Mature Athlete, Orthopedic Surgeon, Orthopedics, Osteoarthritis, Pain Management, Regenerative, Regenexx, Regenexx-SD, stem cells, treatment
Dec 16, 2014
Let’s enter the new world of Cellular Orthopedics into which I graduated three years ago. Several months, ago, a long time friend was visiting his family in Chicago and stopped by to say hello. He told me about his skiing last winter and his hiking over the summer and fall. He also related he was seeing an orthopedic surgeon in the state where he now lived and that he had “bone on bone” in his knee. I launched into my customary spiel about his current level of athleticism, my cellular orthopedic initiative and the limits and risks of a knee replacement. Last week, a mutual friend told me that the out of state visitor had related “Mitch was right, I shouldn’t have done it”. He had undergone the Total Knee Replacement in spite of there being no limit in his recreational capacity and was now readmitted with an infected total knee prosthesis that might have to be removed to clear up the infection. Not being one to suggest “I told you so” but that’s what I am trying to get across to the patients I advise.
The Stem Cell Solution, Using the body’s almost magical repair kit to fix bad knees and hips-no surgery required is the title of an article appearing in the December, 2014, edition of The Saturday Evening Post, written by Sharon Begley, the senior U.S. health and science correspondent at Reuters. Last spring, the author had contacted me for an interview after having followed my Blogs unbeknownst to me. Ms Begley introduced herself and told me about an article she was writing for The Post to be published in June. I had forgotten about the interview until a patient came in last week and told me that she had read the article in the December issue. What I didn’t recognize at the time of the interview was that not only is the bone marrow a source of Adult Mesenchymal Stem Cells but of Growth factors and Cytokines as well that may be of equal importance. The opening of the article features my patient. In 2011,”I was in a bad way.” ”He was diagnosed with osteoarthritis, a degenerative disease eating away at the cartilage in his knees writes Begley.”The patient: ”and now I’m climbing stairs, have gone on two skiing trips, planning another, and playing golf in the summer.” “I am way beyond pleased.”
Tags: arthritis, athletes, Bone Marrow Concentrate, Concentrated Stem Cell Plasma, Hip Replacement, Interventional Orthopedics, joint replacement, Knee Pain Relief, Mature Athlete, Orthopedic Surgeon, Osteoarthritis, Pain Management, Regenerative, Regenexx-SD, stem cells, treatment
Nov 24, 2014
Patient dissatisfaction following total knee replacement is a growing concern. An article appearing in the November issue of the Bone and Joint Journal focused on a questionnaire in the United Kingdom attempted to quantify the degree of patient satisfaction and residual symptoms following knee replacements. I decided to focus on this subject after having completed a consultation for a 70 year old woman who four years ago, had undergone a bilateral total knee replacement that went on to fail in 24 months. She then underwent a bilateral revision or repeat total knee replacement and is left with inability to fully straighten either side or bend the right and left knee more than 80 degrees. She is severely handicapped. I don’t know what her arthritic impairment had been prior to the original surgery but there really isn’t much to offer her now. What an awful situation.
The article to which I alluded above reports that somewhere between 35 to 54% of those surveyed reported residual symptoms and functional problems and general dissatisfaction. Those who regularly read my Blog might remember a similar result that I reported about in a Canadian survey of patients who had undergone Total Knee Replacement five years earlier. In the current study, neither the use of contemporary prosthetic designs or custom cutting guides improved patient perceived outcomes. The data clearly shows a degree of dissatisfaction and residual symptoms following Total Knee Replacement and those recent modifications in implant design and surgical technique have not improved the current situation
Activity Levels and Functional Outcomes of Young Patients Undergoing Total Hip Arthroplasty
In yet another journal reviewing Hip Replacement Outcomes, appearing this month in Orthopedics, patient dissatisfaction described greater hip symptoms and poorer hip-related quality of life in those under age 50 undergoing Total Hip Replacement than anticipated. It only makes sense to postpone a joint replacement until there is advanced arthritic impairment. Until then, our evidence in the laboratory and in the office clearly document that Bone Marrow Aspirate Concentrate has the potential to relieve pain, improve function, increase motion, and alter the actual molecular progress of the arthritic process.
Tags: arthritis, Bone Marrow Concentrate, Hip Replacement, Interventional Orthopedics, joint replacement, Knee Pain Relief, Mature Athlete, medicine, Orthopedic Surgeon, Osteoarthritis, Pain Management, Regenerative, stem cells
Nov 17, 2014
Nadal to get stem cell treatment
Updated: November 10, 2014, 2:18 PM ET
Associated Press
BARCELONA, Spain — Rafael Nadal‘s doctor says the 14-time Grand Slam winner will receive stem cell treatment on his ailing back.
Angel Ruiz-Cotorro told The Associated Press by phone on Monday that, “we are going to put cells in a joint in his spine” next week in Barcelona.
The Spanish tennis star was already sidelined for the rest of the season after having his appendix removed last week.
Ruiz-Cotorro, who has worked as a doctor for Nadal for the past 14 years, said Nadal’s back pain is “typical of tennis” players and that the treatment is meant to help repair his cartilage and is similar to stem cell treatment Nadal received on his knee last year.
He said Nadal is expected to return to training in early December.
Several NFL players and baseball players have received stem cell treatment. Nadal’s fellow Spaniard Pau Gasol, center of the Chicago Bulls, received stem cell treatment on his knee in 2013.
Stem Cell Treatment: Out from the Shadows, Onto the Cutting Edge
From Muscle and Medicine by Jenny Vrentas
Wed Jul. 30, 2014
The Jets’ Chris Johnson is one of hundreds of NFL players who’ve turned to stem cells to aid in recovery from injury. It may be the next big breakthrough in the treatment of sports ailments, but for now the use of such therapy is strictly limited in the U.S.—and questions about effectiveness outweigh the answers
New Jet Chris Johnson had stem cells from his bone marrow reinjected into his knee to augment January surgery for a torn meniscus. The hope is that it would boost healing and perhaps rebuild cartilage. (AP)
He’s 28. He has five 1,000-yard NFL rushing seasons to his name, one 2,000-yarder and a burning desire to prove he’s the same speedster he’s always been. So when Chris Johnson visited orthopedic surgeon James Andrews in January to fix his ailing left knee, he liked the sound of two intriguing words: Stem cells.
The veteran running back tore the meniscus in that knee in Week 3 of the 2013 season—his last with the Titans before being cut—but never missed a game. The injury to the knee’s natural shock absorber also caused other damage in the joint, and Andrews presented an option that might augment what surgery alone could do. The plan: Take stem cells, the body’s universal building blocks, and deliver them directly to the construction site.
“When I tore my meniscus and played the season out, through the wear and tear, I lost a lot of cartilage,” says Johnson, who was signed by the Jets to bring explosiveness to their offense. “When you put the stem cells in, it might be able to help rebuild that cartilage in your knee. Hopefully, it makes your knee better for even more years.”
For more Information on the Aging Adult and Regenerative Medicine:
312-475-1893 or 312-475-1893
Tags: arthritis, athletes, bone marrow, Bone Marrow Concentrate, Concentrated Stem Cell Plasma, Interventional Orthopedics, Mature Athlete, medicine, Orthopedics, Osteoarthritis, Pain Management, Regenerative, Regenexx, stem cells, treatment
