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 27, 2016
I recently received the yearly publication from the Orthopedic and Rheumatology Institute of the Cleveland Clinic; the latter recognized as one of the 10 most prestigious orthopedic centers in the nation. Every year the publication, a marketing exercise by the Cleveland Clinic, focuses on certain subspecialty areas within the discipline of the care and treatment of the musculoskeletal system. The obvious purpose of such a yearly event is to recruit referrals from practicing orthopedic surgeons and rheumatologists as well as the medical community in general.
This year the focus was on Adult Total Hip Arthroplasty for Osteoarthritis and Adult Unilateral Total Knee Arthroplasty for Osteoarthritis. I will summarize the results; let’s start with the hip:
“Hip-Related Pain 1 Year After Surgery: “on average, 92% of patients reported clinically important improvement in hip-related pain after 1 year, while 1% reported worsening (7% showed no detectable change in hip-related pain).”
“On average, 90% of patients reported a clinically important improvement in hip-related function after 1 year, while 1% reported worsening (9% showed no detectable change in hip-related function).”
The knee doesn’t fare as well:
“On average, 85% of patients reported a clinically important improvement in knee-related pain after 1 year, while 2% reported worsening (13% showed no detectable change in knee-related pain).”
“On average, 82% of patients reported a clinically important improvement in knee-related function after 1 year, while 2% reported worsening (16% showed no detectable change in knee-related function).”
The data was derived from patient self-reported scores collected during office visits up to 6 months before and 1 year after surgeries performed.
In my practice, every patient who undergoes a Bone Marrow Concentrate intervention is entered into an outcomes data base with both subjective and objective data points measured. It is quite comprehensive and numbers over 500 patients extending over a span now of 4 and ½ years. While the Cleveland Clinic report is based on subjective parameters and ours on both subjective and objective scores, I am able to extract subjective measures alone. I am pleased to report that in the case of the hip and the knee, our outcomes with a needle are equal to or better than those of the major surgery with a scalpel. Then factor in the prompt rehabilitation of a stem cell procedure compared with the prolonged rehabilitation inherent in a joint replacement. Lastly, consider the relative absence of complications of a stem cell intervention compared to the morbidity and mortality of a joint replacement.
Perhaps of greater significance to the stated advantage of a Bone Marrow Concentrate procedure for Osteoarthritis is the fact that no bridges are burned. If the patient is not satisfied at one year or five, a stem cell procedure may be repeated with a needle. If the arthritis progresses to an advanced stage, the fall back option is a joint replacement. The only choice following an unsatisfactory joint replacement is to accept the surgically induced impairment or undergo a risky revision surgery with a high likelihood of a complication or less than satisfactory outcome. Call 312 475 1893 to schedule an appointment today.
For more information watch my Regenerative Medicine Webinar Video
Tags: arthritis, Bone Marrow Concentrate, Clinical Studies, Clinical Trial. Mitchell B. Sheinkop, Hip Replacement, Interventional Orthopedics, joint replacement, knee replacement, Orthopedic Care, Orthopedics
Oct 20, 2016
Aging is known to contribute to a multitude of systemic changes including those of the musculoskeletal system leading to decreased health, mobility and function. Most changes in well-being are exacerbated by inactivity. It has been scientifically documented that physical activity and exercise may slow or even reverse these deleterious effects thereby improving health, mobility and function.
In particular, ligaments, tendons and joint capsules become stiffer with age as elastic fibers decrease and cross-links between collagen fibers increase. As connective tissue surrounding the joint changes, so too does the synovial fluid within the joint making movement more difficult. Not only do changes occur within the joint, they also occur in the muscles. The loss of muscle mass and strength also known as sarcopenia, increases with age. Then there is the fatty infiltration of muscle that comes with aging and lack of use.
Recognizing the value of Bone Marrow Concentrate derived Stem Cells, Cytokines and Growth Factors in dealing with his arthritic hip when the alternative was a joint replacement, seven months ago, a 58-year-old man underwent a cellular orthopedic intervention. Over the past many months, the patient committed himself to a minimum of 30 minutes a day, five days a week at moderate intensity aerobic exercise alternating with three days a week at vigorous intensity. In addition, he partook in resistance exercise a minimum of two days a week at a moderate high intensity focusing on 10 exercises at each session targeting most major muscle groups, with 10 to 15 repetitions for each exercise performed thus adding an additional 20 to 30 minutes to the commitment. Then there are the benefits of his additional flexibility and stretching. When this individual came to me at his first visit, his stated goals were to return to a high level of recreational enjoyment with a particular interest in ball room dancing. As of last week, he had reached those goals but he has no intention of failing to comply with his exercise prescription.
The obvious message of my Blog is to let you know I am unable to reach a desired goal without your commitment. I may introduce Stem Cells, Cytokines and Growth Factors into an arthritic joint but to reach your desired goal or delay or perhaps avoid a joint replacement, those many changes that occur with aging can be slowed and even reversed by a combination of cellular orthopedics and exercise.
If you want to learn about the evidence, schedule an appointment 312 475 1893
Tags: arthritis, athletes, Benefits and Risk, bone marrow, Bone Marrow Concentrate, Concentrated Stem Cell Plasma, Growth Factors, Hip, Hip Replacement, Interventional Orthopedics, joint replacement, Knee Pain Relief, Mature Athlete, Orthopedic Care, Orthopedic Surgeon, Orthopedics, Osteoarthritis, Pain Management, Regenerative, regenerative medicine, Regenexx, stem cells, treatment
Sep 27, 2016
I challenge the reader with this question because it becomes apparent, even the majority of the medical community can’t provide an accurate answer. There are all kinds of claims and statements running rampant; so today, I will try to make some order out of chaos. Let me begin with the patient who repeats what they have been told by their orthopedic surgeon, stem cells don’t work. My response, “for what?” Oh yes they do if you understand where, when, how and why?
Bone marrow has several categories of molecules, cells and vesicles; anti-inflammatory cytokines, adult mesenchymal stem cells and growth factors. The cytokines are a group of molecules that address the inflammation associated with osteoarthritis and thereby relieve pain. The stem cells orchestrate regeneration of cartilage and the joint; while growth factors actually alter the bio-immune process of osteoarthritis. Working together, bone marrow content, when concentrated, has the ability to relieve pain, improve motion, restore function, slow or halt the progression of arthritis and possibly regenerate the joint.
When the patient last Friday repeated that her orthopedic surgeon had told her stem cells don’t work, my response was he is right, there is no chance of regenerating cartilage in a 78 year old woman. Yet the procedure would still be worthwhile as a long term pain reliever and the potential to improve function and postpone, or even avoid, a joint replacement. While regeneration of cartilage is realistic under age 50, pain relief, improved function and better motion is probable at any age for those who chose to undergo a Bone Marrow Concentrate procedure for grades 2 and 3 osteoarthritis.
Three weeks ago, I completed a procedure on a 93 year old man who hadn’t been able to get out of his wheelchair since April. Last week, his wife reported he was walking down the block with the aid of the walker. Three years ago, I completed a bone marrow concentrate stem cell procedure on a 39 year old marathon runner who had stopped competing six months earlier because of knee pain from early onset degenerative arthritis. As of last month, he had competed in 17 marathons since his intervention.
So, if you want to run, walk, bike, ski, and live pain free, call for a consultation.
312-475-1893
Tags: arthritis, athletes, Benefits and Risk, bone marrow, Bone Marrow Concentrate, 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, treatment
Sep 20, 2016
Last week, a patient called and cancelled her scheduled Bone Marrow Concentrate Regenexx SD Stem cell procedure declaring that she had found a less expensive provider for stem cells. I wished her well and devoted some time to trying to better understand the price range posted on the internet for the Regenexx SD procedure. While I couldn’t really get a grasp on the geographic differences in costs, I did realize the chaos and confusion potential of trying to compare apples and oranges. The Regenexx SD Stem cell procedure is the gold standard in the emerging world of Cellular Orthopedics (Regenerative Medicine). There is a seven year outcomes data base supporting the safety and efficacy of the Regenexx methodology. We have been monitoring the successful outcomes of our procedures for a longer time and with the most detailed, reproducible criteria in the field. If you look at non Regenexx websites, you frequently find our outcomes data reproduced (many times without permission).
The Regenexx mission statement is to get the patient back to things he or she loves faster and without surgery. The actual preparation for the procedure, the harvesting and processing of the bone marrow and the follow up management is proprietary in nature; that’s why price shopping doesn’t work. If it isn’t a Regenexx SD procedure, it is a generic knockoff and you will really minimize the chance of success. There are several Regenerative Medicine practices outside of Regenexx in the Midwest; yesterday, a patient called to schedule a Regenexx SD procedure after having gone elsewhere for less cost and experienced the anticipated unsatisfactory outcome.
This is not cookie cutter technology. The harvesting of the bone marrow cannot be from a single site or you risk a marked diminution in the number of adult mesenchymal stem cells harvested. The amount of bone marrow harvested must meet the quantitative requirements for maximum benefit. The simple recovery of 10 ccs of bone marrow is doomed to fail yet the latter is frequent in some settings so as to minimize charges. Then there is the proprietary system of concentrating and processing only available through Regenexx. Last of all, the counting of cells is not a futile exercise as suggested by the “knock off” clinics. We are able to sense success in numbers.
To determine if you are a candidate for stem cell management of your arthritis, you need to make an appointment. A telephone interview doesn’t do it nor does my looking at your images. The determinant is based on my intake and my experience. There are patients whose needs are better served by a joint replacement. If you do meet the inclusion criteria for management for your arthritis with stem cells, there is no better alternative than the Regenexx SD intervention
312 475 1893 to schedule an appointment.
Tags: arthritis, athletes, Benefits and Risk, bone marrow, Bone Marrow Concentrate, Hip Replacement, Interventional Orthopedics, joint replacement, Knee Pain Relief, Mature Athlete, medicine, Orthopedic Care, Orthopedic Surgeon, Orthopedics, Osteoarthritis, Pain Management, Regenerative, Regenexx, Regenexx-SD, stem cells, treatment
