Mar 27, 2017
I am an orthopedic surgeon. The new focus for the arthritic joint is restoration and not replacement. Almost five years ago, I joined that emerging initiative after a 37-year professional career of having replaced joints. One of the recent problems emerging in this discipline of regenerative medicine is that marketing is inaccurate. There is no quick fix be it a replacement or an interventional orthopedic procedure. What stem cells do not risk is a joint replacement failure requiring a repeat procedure (revision), a significant occurrence of infection, a blood clot or a nerve injury. As a surgeon, I replaced arthritic joints because the original cartilage had degenerated and the bone surfaces degraded. My effort now is to restore and not replace. This is an evolving field using stem cells derived from bone marrow, using inflammatory blockers, and growth factors.
Finding a good interventional cellular orthopedist is partly a numbers game. Research shows a regenerative specialist must do a minimum of 50 interventions a year to provide a consistently satisfactory end result. Five years ago, the orthopedic surgical community including my past associates were all nay-sayers. Today, they are embracing that which I pioneered. While there are of this time, no true standards and regulatory bodies outside the FDA, in my office, I have pioneered a standardization initiative via qualitative analysis of that which we aspirate and then inject. The meeting of the American Academy of Orthopedic Surgeons in San Diego ending last week dedicated a relatively large part of the educational and scientific agenda to regenerative medicine and interventional orthopedics. All this being said, the patient seeking out one of America’s fastest growing procedures must assure the provider is experienced, knowledgeable and be prepared to meet a patient’s expectations. The explosive growth of those holding themselves out to be capable of delivery an excellent or at least a good regenerative outcome is not supported by evidence or experience. To repeat what I indicated above, all doctors are not the same. If you want the evidence, make an appointment. If you want a procedure by those who market themselves as treating Alzheimer’s, Alopecia, facial wrinkles, Arthritis, so on and so forth all under the same roof, I am not the that clinician.
To learn more, check out my web site at www.Sheinkopmd.com
View my webinar at www.ilcellulartherapy.com
Or call for an appointment 847 390 7666
Tags: arthritis, bone marrow, Clinical Trial. Mitchell B. Sheinkop, Concentrated Stem Cell Plasma, Interventional Orthopedics, Mesenchymal Stem Cell, Regenerative, regenerative medicine, stem cell treatment
Feb 28, 2017
When it comes to cellular orthopedics, for me, it is a matter of honor and self-interest.
If you aren’t aware of the bogus stem cell claims or “false news”, read the LA Times article that appeared last week http://www.latimes.com/business/hiltzik/la-fi-hiltzik–oz-stem-cell-20170213-story.html
The article followed a Dr. Oz television expose where he focused on charlatans victimizing the public with false information at extremely outrageous fee schedules. The egregious behavior stemmed (no pun intended) from mostly California based clinics but Texas was another state exposed. For those who read this Blog, you are familiar with the false advertising of “Stem Cell Clinics” highlighting regenerative medicine via Amniotic Fluid for arthritis in Illinois, that I have repeatedly taken to task. To repeat, while there may be living cells when amniotic fluid is harvested, following collection, processing, sterilizing, irradiating, freezing and fast thawing, there are no living or viable stem cells in the pat being offered as a regenerative alternative. Dr. Oz took his expose a lot further calling attention to false claims without medical evidence wherein the so called regenerative medicine clinics he exposed offer treatment for every and any affliction of the human body.
Since the innovations introduced by Regenexx 10 years or so ago, interventional orthopedics has become an evidence based approach to sports medicine related injuries and as an alternative to a major surgical reconstruction or replacement for an arthritic or chronically injured bone or joint. I am a member of the Regenexx network and, have continued to compile and contribute scientific evidence to support the Regenexx mission. Our menu of surgical alternatives is directed to afflictions of the musculoskeletal system.
A patient attempting to postpone or avoid a major orthopedic procedure for an arthritic joint and return to a relatively symptom free functional quality of life may find legitimate, well intentioned and evidence based regenerative medicine and interventional cellular orthopedic initiatives. I am proud to be one of those clinical settings
Next week, I will complete my interview with Dr Mitchell Sheinkop, part two-focusing on common athletic injuries amenable to cellular orthopedics and joint condition amenable to stem cell intervention.
To schedule an appointment call (312) 475-1893
To visit my web site go to www.sheinkopmd.com
To watch my webinar visit www.ilcellulartherapy.com
Tags: Bone Marrow Concentrate, Clinical Studies, Clinical Trial. Mitchell B. Sheinkop, Concentrated Stem Cell Plasma, Interventional Orthopedics, Mesenchymal Stem Cell, regenerative medicine, stem cell treatment
Dec 19, 2016
I use bone marrow derived stem cells because they have been proven to be most effective at treating orthopedic conditions when compared to adipose derived stem cells. There have been 13 papers published showing bone marrow superiority to adipose tissue in regards to treating orthopedic conditions and to the best of my knowledge, none reporting adipose derived results for arthritis. In addition to Adult Mesenchymal Stem Cells, bone marrow has 1,000-10,000x more hematopoietic stem cells than adipose tissue; the former is necessary for muscle repair. Recently, we learned that bone marrow also has osteochondral reticular cells which are not found in adipose tissue and serve as orthopedic repair cells. While adipose tissue and bone marrow both have stem cells, the skeletomuscular specific cells only found in bone marrow make it the best at treating orthopedic conditions. I don’t have a stake in doing bone marrow derived stem cells, I practice evidence based medicine and do what’s been shown to provide the best results. If with continued research something superior to bone marrow derived stem cells becomes available, then I will gladly adopt that protocol.
http://www.regenexx.com/fat-vs-bone-marrow-stem-cell-video/
- As I have reported on this Blog many times, research has shown the amniotic fluid samples being marketed as having stem cells actually do not have any viable stem cells when received and viewed in the laboratory. I do use amniotic fluid concentrate from time to time for its concentrated hyaluronic acid effect.
http://www.regenexx.com/amniotic-stem-cells-great-deception/
- Since we manually process bone marrow when aspirated, I am able to customize PRP which we call SCP or super concentrated platelets. The ubiquitous beside centrifuge only has one setting for volume and concentration so those using this approach are treating every patient without concern for individual differences. With the addition of the Abbott Ruby Hemocytometer, I am able to customize the treatment of the individual patient. We can concentrate our SCP from 3-40X over baseline-with or without red or white blood cells. From my outcomes data base, I know what volume and concentration works best for treating the various body parts.
- We’ve developed HD BMC or high dose bone marrow concentrate which is far superior to that produced with bedside centrifuges used by most claiming expertise in Regenerative Medicine
- I perform BMAs in compliance with the peer-reviewed literature recommendations as well as in keeping with my internal best practices research to maximize MSC yield. As stated, I count cells and know the quality in addition to the quantity of the injectate. Most doctors don’t count cells and have no idea what dose they are giving their patients
Tags: adipose tissue, amniotic fluid, arthritis, BMA, bone marrow, Bone Marrow Concentrate, Clinical Studies, Clinical Trial. Mitchell B. Sheinkop, Interventional Orthopedics, Mesenchymal Stem Cell, MSC, PRP, Regenerative, SCP, stem cells
Dec 1, 2016
Actually, that future started last week when we used a more aggressive PRP adjunct at the time of two Bone Marrow Concentrate/ Stem Cell interventions; one for an arthritic hip and the other, in an arthritic knee. More accurate and descriptive would be a Bone Marrow Concentrate/Adult Mesenchymal Stem Cell/ Hematopoietic Stem Cell/ Growth Factor Concentrate/Platelet Rich Plasma/Interleukin-1 Receptor Antagonist cellular orthopedic intervention to an arthritic joint but even I get confused, so I will stick to cellular orthopedics and Bone Marrow Concentrate.
It would seem from current Regenerative Medicine Science, that while concentrated and activated Platelet Rich Plasma alone has not been provided a predictable and reliable independent approach to arthritis, when aggressively used in conjunction with stem cell interventions, PRP significantly enhances the results in the short term. It will require another several years to determine if what we are seeing in the short term will continue to improve our outcomes in the long run. I am not waiting as concentrating and activating the platelets will cause no harm; and if there is the promise of long term benefits when used as an adjunct both at the time of the Bone Marrow collection, concentration and intervention as well as again in two to five days, there is no reason not to proceed.
What about the future? While we have been great advocates of counting cells at the time of the stem cell intervention, new tools are being introduced to allow us to better customize that which we inject after concentrating and processing of the bone marrow. We now will be able to get a more accurate count of that which is present in the concentrated and processed injectate prior to the intervention and add bone marrow or platelets if indicated.
Are Mesenchymal Stem cells really Stem Cells? Professor Arnold Caplan of Case Western Reserve is widely considered the father of mesenchymal stem cells. He now takes the view that MSCs aren’t stem cells and that he should have never given them that name. He also believes that the primary function of these cells is paracrine, so he calls them “medicinal signaling cells”. To save you the trouble, paracrine is defined as “a form of cell-cell communication in which a cell produces a signal to induce changes in nearby cells.” I am not negating the importance of mesenchymal stem cells, rather I want the reader to better understand the role of each component involved with regenerative medicine. It was Professor Caplan’s prodding that in part is responsible for my having entered the discipline of interventional orthopedics. Long ago, we became friends as team mates of the Roosevelt High School championship football team in Chicago; and our professional paths, while parallel, he in basic orthopedic research while I chose orthopedic surgery finally crossed again five years ago.
To learn more about the basic science behind Cellular Orthopedics or to find out about how you might postpone or avoid a Total Joint replacement for an arthritic joint, schedule a consultation (312) 475 1893
Tags: arthritis, athletes, bone marrow, Bone Marrow Concentrate, cellular orthopedics, Clinical Studies, Concentrated Stem Cell Plasma, Growth Factor Concentrate, Growth Factors, Hematopoietic Stem Cell, Hip Replacement, Interleukin-1 Receptor Antagonist, knee arthritis, Mesenchymal Stem Cell, Mitchell B. Sheinkop MD, Orthopedics, Osteoarthritis, paracrine, Platelet Rich Plasma, Professor Arnold Caplan, PRP, Regenerative Pain Center, stem cells
Oct 6, 2016
“Growth factor, any of a group of proteins that stimulate the growth of specific tissues. Growth factors play an important role I promoting cellular differentiation and cell division,” and they occur in bone marrow as well as your circulating blood.
“When investigators began studying the effects of biological substances on cells and tissues in culture, they discovered a group of peptide-hormone-like substances that were distinct from any previously known hormones. Because these substances were active in stimulating the growth of cells and tissues, they were called growth factors. Some growth factors are similar to hormones in that they can be secreted into the blood stream, which carries them to their target tissues. However, whereas the production of hormones is limited to glandular tissue, growth factors can be produced by many different types of tissue” and cells for that matter.
When a patient presents for a Bone Marrow Concentrate procedure for an arthritic joint in order to prevent, perhaps even avoid a joint replacement, the understanding to date is that it will be Mesenchymal Stem Cell that will serve as the key factor in reducing pain, increasing motion, improving function and influencing the progression of arthritis. The latter is only partially true but fails to address the role Growth Factors play in Cellular Orthopedics (Regenerative Medicine). When your orthopedic surgeon tells you that Stem Cells won’t work for your arthritis, schedule your joint replacement, that physician doesn’t understand that Stem cells are only part of what Bone Marrow concentrate provides us in assisting the patient with an arthritic joint, return to an active life style without surgery.
We now have several proprietary means of not only concentrating adult Mesenchymal Stem Cells but Growth Factors as well when addressing your arthritic joint with Bone Marrow Concentrate. While stem cells may be impacted by age, Growth Factors do not seem to be adversely impacted accounting for several recent successes with patients in their 90s. Since we have been concentrating stem cells with growth factors and combining the approach to the joint with subchondroplasty, we continue to document improving outcomes
Tags: arthritic pain, arthritis, arthritis treatment, Bone Marrow Concentrate, Concentrated Stem Cell Plasma, Growth Factors, Hip Replacement, joint replacement, Mesenchymal Stem Cell, Orthopedic Surgeon, Osteoarthritis, regenerative medicine, Regenerative Pain Center, stem cell treatment
