May 7, 2015
Prolotherapy
In spite of what you may read and hear about repeated injections of 12 ½ % dextrose into your joint or in the soft tissues surrounding your joint, there is no scientific evidence to support the claims regarding a regenerative influence from Prolotherapy. That is not to say it might or could lessen pain around a joint; but the benefits, if any, are anecdotal in nature and fall under the realm of homeopathy. It belongs under the same classification as Acupuncture; there are followers, anecdote and practitioners but an absence of scientific proof as to how it works. Yet, even with paucity, if not absence of scientific evidence, there is no end to web sites extolling the regenerative nature of Prolotherapy.
From science to tabloid
This week, my office and email were inundated following the headline in the Monday Wall Street Journal concerning a 3D printing of a medial meniscus lattice into which stem cells had been injected. A total of one patient was featured who had an experimental meniscus surgically introduced to replace a previously torn medial meniscus. While in years to come, this may become common place, there are limited indications and many more years of clinical trial ahead before an artificial meniscus becomes a standard of practice. After age 40 or so, meniscal injury as documented on an MRI is more often than not accompanied by arthritis. Post traumatic arthritis and degenerative arthritis are contraindications to meniscal replacement and even are associated with a less than satisfactory outcome to existing arthroscopic interventions. I must remind the reader that degenerative and post traumatic knee arthritis may be reflected on the MRI as an abnormal meniscus but in addition, physical examination is compatible with an altered range of joint motion and mechanical axis deformities.
A Regenerative Medicine Offering with emerging Scientific Evidence
I am finishing up my statistical analysis concerning 170 patients with degenerative and post traumatic knee arthritis who have undergone Bone marrow Aspirate Concentrate/Stem Cell knee care in preparation for my presentation at the June meeting of The Orthopedic and Biologic Institute. After two years of follow-up, there is a statistically significant improvement in diminishing pain, increasing range of motion, enhancing well-being, and facilitating return to or maintenance of a highly active recreational profile. This is scientific evidence and the basis for my Regenerative Medicine approach to helping a patient manage arthritis.
Tags: arthritis, athletes, bone marrow, Bone Marrow Concentrate, Clinical Studies, Concentrated Stem Cell Plasma, Interventional Orthopedics, Knee, Knee Pain Relief, Mature Athlete, medicine, Orthopedic Care, Orthopedic Surgeon, Osteoarthritis, Pain Management, Regenerative, Regenexx, Regenexx-SD, stem cells, treatment
Apr 20, 2015
We are dealing in a field of science that aims to restore or establish normal functional capacity and eliminate, certainly reduce pain from arthritic inflammation by replacing or influencing human cells. Advances in cell biology have led to new options for cellular therapies and new strategies to stimulate endogenous repair and regeneration. Stem Cell populations have been identified in perinatal and adult tissues including amniotic fluid, placenta, bone marrow, and blood vessels. The US Department of Health and Human Services, in its report “2020: A New Vision-A Future for Regenerative Medicine” published in 2006, calls regenerative medicine “the next evolution of medical treatments” and predicts that regenerative medicine will be the “vanguard of 21st century healthcare.”
So what about costs and reimbursements? Government has made it clear that there is a relative lack of clinical science in this area and it will not pay at this time. We at Regenexx are making progress in gathering data and educating our patients and the medical profession as how to postpone or perhaps eliminate the need for a joint replacement when the symptoms and functional limitations of arthritis affect an individual. We believe that our data documents that Bone Marrow Aspirate Concentrate does reverse the course of osteoarthritis, relieve symptoms, restore function and allow the patient an improved recreational and athletic capacity. As an orthopedic surgeon dealing with a mixed patient population, I strive to deliver what matters most and that which will make the most profound difference in a patient’s life. First and foremost is the history and physical examination in the office. I won’t treat an image. For instance, a study presented at the recent Annual Meeting of the American Academy of Orthopedic Surgeons found a high incidence of Superior Labral Tears diagnosed by MRI in patients without shoulder symptoms or functional shoulder limitation. While the image was abnormal, the patient wasn’t limited in any functional way nor did they have a shoulder related complaint.
This morning, I am working on the scientific paper, I will be delivering at the June Meeting of the Ortho and Biologic Institute which is attended by the majority of scientists and clinicians involved in skeletal muscular Regenerative Medicine. It will scientifically and statistically document our successes; at Regenexx, we integrate clinical care with research and education. It is evidence based medicine helping to mold the future of Regenerative Medicine.
Tags: arthritis, athletes, bone marrow, Bone Marrow Concentrate, Clinical Trial. Mitchell B. Sheinkop, FDA, Hip Replacement, Interventional Orthopedics, joint replacement, Knee, Mature Athlete, medicine, Orthopedic Care, Orthopedics, Osteoarthritis, Pain Management, Regenerative, shoulder, stem cells, treatment
Apr 16, 2015
Thursday, April 16, 2015 9:51 am
“Stem Cells working great. 4 days of skiing and 90,000 vertical feet already. Knees only slightly swollen. Using the new braces seems to really help. Last 4 to 5 runs of the day, it is very hard to get in and out of the heli-knees very sore by then. Hard to get up from a fall (so skiing carefully so as not to fall anymore). Pure powder last 2 days, so skiing itself has been easy. Biking every morning and after skiing, using Voltaren 2x’s/day, hot tub and ice-water on legs 3x’s after skiing and knee massage every day. Gary made his 3 million suit on Tuesday, and I missed mine yesterday by just 90 feet!! Huge Day of skiing yesterday-everyone exhausted. Skiing a half day today. Will see about tomorrow (only if all powder)”
This report was sent by a friend and patient who is helicopter skiing with CMH in British Columbia this week. I had originally planned to join the trip but work load prevented me. The skier-writer of the message had been unable to ski any longer until I completed a Bone Marrow Aspirate Concentrate/Stem cell intervention to his right knee two years ago; and for the left, last year. He is 70 years of age
Dwight Howard returns to Houston in time for NBA playoffs
In February, The Houston Rockets star center was sidelined by knee pain for which he underwent a Bone Marrow Aspirate Concentrate/Stem cell intervention. As I wasn’t his treating physician, I am not familiar with the details of his diagnosis, but suffice it to say from what I have gleaned from ESPN on the internet, it was cartilaginous damage with continued pain and inflammation. Last week, he returned to action and will be very much part of the Rockets quest for an NBA championship.
The Anti-Aging Movement Continues to Rise
By Terry Stanton
From the April, 2015 edition of AAOS Now/Clinical News and Views.
“During an Annual Meeting Symposium on considerations in treating the aging athletic patient, a panel of surgeons covered both injuries and treatment for “weekend warriors” and the science of aging.” I enjoyed the article in that it once again underscores how Regenexx is ahead of the pack with non operative, minimally invasive interventions with a needle for those sports injuries and the arthritic progression that alters function. The article cited above concludes “Field though legitimate, lacks science to support health benefits of treatment”. That this is partially true was emphasized by a patient from Hong Kong this week who had written me to tell me all the promises she had found while surfing the internet to seek non surgical options for her recently torn ACL. Her experience underscores the need for the Aging Athlete to ask the question: “show me your evidence”. There is only one Regenerative Medical Network that has the Data based on which your questions may be truthfully answered. It is called Regenexx and I am not only a part of, but a contributor to their scientific Outcomes process.
Tags: ACL Injury, arthritis, athletes, Benefits and Risk, Bone Marrow Concentrate, Hip Replacement, Interventional Orthopedics, joint replacement, Knee, Knee Pain Relief, Mature Athlete, medicine, Orthopedic Care, Orthopedics, Osteoarthritis, Pain Management, Pilot Study, Regenexx, stem cells, treatment
Apr 9, 2015
The New York Times recently published a story about a lawsuit brought against an orthopedic prosthetic company for distributing their product without appropriate FDA approval. The story calls into question not only the process by which new technology is brought into practice, but the choices the clinician must make when deciding the best options to use on a patient. We need to study every new technology with evidence based means and make critical decisions on the outcomes resulting from those studies. We clinicians strive to always do better.
As I am sure you realize, the FDA and other parties are anxious to have more data, especially when it comes to the newer technologies in Regenerative Medicine. To the best of my knowledge and based on my ongoing scrutiny of the scientific and orthopedic medical literature, Regenexx is the only scientific laboratory to date that has repeatedly met with the FDA and their agents and been allowed to offer regenerative technology under the highest level of scrutiny. My particular targets are arthritis and synovitis. My therapeutic approach to pain, altered function, reduced motion, delaying and even avoiding a joint replacement, and reversing the natural progression of arthritis is mostly based on the research and publications of Regenexx; and in addition more recently, on the outcomes from the continuing monitoring of our own Regenexx Chicago data base.
When it comes to patient care, I explain risks and benefits in generic terms citing percentages from my understanding of the information presented at scientific meetings, that which I read in the medical literature, the publications from Regenexx, and information gleaned from my own investigations. The Decision-Making process should be and at Regenexx is based on registries. The governments of countries outside the United States have required participation in registries for many years; there is no such requirement in the United States. Regenexx for the past seven years has maintained such a registry, and when I joined the Network three years ago, added to the comprehensive nature of those outcome measurements.
Innovation is important to advance patient care. Regenerative Medicine is truly a transformational innovation. We want patients to respect our ability to make decisions about what is in their best interests. This foundation of respect will only result from unbiased decisions and will be strengthened when more recent entries into the field of stem cell care present scientific data and not “this is how I do it” or criticism based on market place competition. Regenexx has introduced a stable and stem cell methodology with a proven track record. This being the case, others should be careful when choosing to forgo that approach. In a spin on the words of the immortal Jerry Maguire, Show Me Your Data.
Tags: arthritis, Benefits and Risk, bone marrow, Bone Marrow Concentrate, Clinical Studies, Hip Replacement, Interventional Orthopedics, joint replacement, Knee, Knee Pain Relief, Mature Athlete, medicine, Orthopedic Care, Orthopedic Surgeon, Orthopedics, Osteoarthritis, Pain Management, Regenerative, Regenexx, Regenexx-SD, stem cells, technology, treatment
Mar 24, 2015
At least it is spring on Astronomical chart although six inches of snow yesterday in Chicago causes one to take pause. Nevertheless, I am off to Southwest Wisconsin this weekend to initiate my fly fishing journeys for 2015. One doesn’t necessarily equate fishing with physical demand. Yet last Friday, at an 18 month follow-up of a Bone Marrow Aspirate Concentrate/Stem cell intervention in a 74 year old patient with arthritic knees, who incidentally had been told he needed knee replacements, I received a very serious thank you because my patient was planning several fishing trips to Canada this year with children and grandchildren; something he had not been able to do for several years as he couldn’t get in and out of a boat. Now he is able to do so and plans to enjoy every moment. I plan to wade up the spring creeks and vault up and down the cliffs and boulders as a result of my own regenerative care last year. Two weeks ago, my wife and I returned from a fabulous week of skiing in Vail and the only runs I avoided were the cliffs.
I learned much over the winter about several golfers who had undergone stem cell care for both knee and hip. The post intervention rehabilitation regimen had resulted in their ability to travel to the South East and Southwest to play golf on multiple occasions when such had not been possible in the past several years for them. Of particular interest to me was the report from one patient who I had met two years ago when he was scheduled to undergo a hip replacement. First he spent some time changing his swing and in particular the positioning of his leg so it would turn out. That seems to have taken the pressure off the area of missing cartilage and impingement. Next, he underwent a stem cell procedure and he is no longer considering a joint replacement. Not being a golfer, I checked it out on the internet and indeed, a change in golf mechanics may eliminate the painful swing. When followed by the stem cell procedure, there is something akin to bacon and eggs or love and marriage.
In looking back over the winter that hopefully was, a 45 year old man who had had to stop running because of “bone on bone” in his knee and who had received a recommendation elsewhere for a knee replacement, indeed turned out not to have “bone on bone” when I reviewed his images although he did have a problematic knee. 90 days after undergoing an SD Regenexx procedure, he ran the Madison 50 furlong-Race. Well, now it’s time to put air in my tires and start planning ahead. I did receive a call last Saturday by my cycling partner concerning a Sunday morning ride; but with a temperature forecast of 29 degrees, I respectfully declined the offer. For those with joint injury or arthritis, everything and anything is possible in fitness, recreation, sports and a pain free walk in this new world of Cellular Orthopedics.
Tags: arthritis, athletes, Benefits and Risk, Bone Marrow Concentrate, Hip Replacement, Interventional Orthopedics, joint replacement, Knee, Knee Pain Relief, Mature Athlete, medicine, Orthopedic Care, Orthopedics, Osteoarthritis, Pain Management, Regenexx, Regenexx-SD, stem cells, treatment
