Special Announcement - Now Screening for FDA Approved Stem Cell Study
Dr. Mitchell Sheinkop has completed training and is credentialed for an FDA-approved stem cell clinical trial for knee arthritis. Our clinic is now screening patients for this trial. Contact us at 312-475-1893 for details. Click here to learn more.
Regenerative Medicine or Joint Replacement?

Regenerative Medicine or Joint Replacement?

Jun 28, 2012

 

This past weekend, I had chance social encounters with two patients, not mine, unhappy with the outcome of their joint replacements. Their painful prostheses behaved no different than the patient with chronic osteoarthritis: swelling, limited motion, limp. Might stem cell management with an appropriate postoperative rehabilitation regimen have given the joint a better chance at remodeling and avoided a painful total joint?

We continually seek better mechanical and biologic approaches to osteoarthritis prevention and treatment. It is now known that following high-energy joint injury, articular remodeling can be promoted through distraction and motion of cartilage surfaces. Papers presented at the International Cartilage Repair Society -Montreal-May 12-15 confirmed that altered motion and loading might really make a difference in treating end stage osteoarthritis. Equally important though, what about the pain generators in OA?

  • Loss of articular cartilage (bone on bone)
  • Synovitis (chronic inflammation)
  • Flexion contractures (loss of motion/capsular compliance)

It is paramount that the physician managing your arthritis try to understand all pain generators in a joint and optimize the joint environment prior to surgery, during the surgery or using stem cells in lieu of surgery. First, the joint volume and capsular compliance need be addressed. Second, the inflammatory burden need be minimized. Last, mal-alignment need be neutralized. I will stress over and over that the data to support my treatment algorithm must be increased via outcome surveillance. That data can only be gathered through clinical practice. Based on what we have learned in managing arthritis with stem cells over five years, there is data to support the reversal in loss of articlular cartilage, eliminate inflammation and increase range of motion.

Prior to undergoing a bone marrow aspirate concentrate procedure, the patient is directed to physical therapy. In the case of a knee, an offloading brace is prescribed. After the procedure, protected weight-bearing, range of motion exercising and gradual strengthening is introduced. The stem cells altering the bio-immune environment inside the joint might be the alternative at eliminating pain generators and postponing or even avoiding the joint replacement

 Mitchell B. Sheinkop, M.D.

312-475-1893 or 312-475-1893

1565 N. La Salle Street . Chicago . Illinois . 60610

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Regenerative Medicine or Joint Replacement?

Planning ahead with stem cells

Jun 21, 2012

 

Orthopedic Care of the Mature Athlete

The phone is ringing and my office team is doing the best possible at returning calls and answering questions. One of my recent Blogs introduced a new way of approaching arthritis when I discussed the arthroscopic package in conjunction with bone marrow aspirated concentrate. To remind you, I am an orthopedic surgeon with a 38 plus year at replacing arthritic joints. During that time span, there have been several attempts advanced within the orthopedic surgical community at sparing a joint either via a biological arthroplasty, a cartilage restoration or an arthroscopic micro plasty . Each approach is based on the same two principles, save the joint and regrow the cartilage. There have been some remarkable scenarios reported for patients under 40 using the aforementioned surgical approaches. The challenge I have undertaken is expanding the reality for cartilage restoration for the mature athlete over age 40.

Micro-plasty is based on using an arthroscope to first remove torn cartilage,

loose bodies and other debris from the joint. Next the surgeon creates multiple bleeding points in the exposed bone, which in a healthy state was covered with hyaline cartilage. As the micro fractures heal, the theory is that cartilage will reform because of migration of stem cells form adjacent bone marrow. While this may be true in the young patient, there is little active marrow remaining as we age so any cartilage regrowth is fibrocartilage which won’t stand up to normal stress and strain. There is animal evidence to suggest that adding bone marrow concentrate following a micro fracture results in the actual regrowth of hyaline cartilage.  There are now several anecdotal success stories. To that end, when a patient calls to discuss whether to proceed with an arthroscopic package or whether to come to Chicago for the bone marrow aspirated concentrate program, my response is to do both. Have the Arthroscopic package at home with micro fracture as indicated thereby removing torn meniscal fragments, loose bodies and other debris; then come to Chicago in three weeks for the mesenchymal stem cell adjunct.

I don’t have evidence yet but the outcome data will be studied. The goal is to reverse the unsatisfactory experience of arthroscopy alone for arthritis with bone marrow aspirated concentrate derived stem cells as an adjunct.  If you want to learn more, call and schedule a consultation.

 Mitchell B. Sheinkop, M.D.

312-475-1893 or 312-475-1893

1565 N. LaSalle Street . Chicago . Illinois . 60622

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