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
Mar 16, 2015
When a patient schedules a Bone Marrow Aspirate Concentrate/Stem cell procedure in our office, part of the recommendations leading up to and following your SD procedure is elimination of Statins for a period before and after the procedure. While Statins are clearly effective in reducing the risk of major atherosclerotic cardiovascular events, and the cardiovascular benefits outweigh the risks of treatment, there is a skeletomuscular price to be paid with the use of Statins. With accumulation of more data and longer term monitoring on the outcomes of Statin prescription, we have learned that adverse events include, most commonly, muscle pain, aching and weakness usually without elevation of muscle enzymes, specifically the CreatineKinase. All Statins can cause myopathy defined here as unexplained muscle pain or weakness. While in rare settings, the myopathy may be accompanied by CPK levels more than 10 times the upper limit of normal, and progression to a serious irreversible form of myopathy, rhabdomyolysis, in most situations, it is muscle pain and weakness without changes in muscle related enzymes. In spite of all of these observations, as of this time there is no scientific explanation in most settings as to why a patient may manifest Statin intolerance.
As far as why Statins are associated with weakness, pain and muscle aches, there is no pharmacologic evidence other than the disappearance of symptoms when the dose is lowered , the proprietary prescription is changed or the pharmacologic is discontinued altogether. The high success rate of the disappearance of symptoms following a period of abstinence and then reintroduction is consistent with nonpharmocological mechanisms for intolerance.
Do Statins adversely affect the muscle cell mitochondria? In a group of obese patients for whom an exercise regimen was incorporated into their weight loss, fitness routine, those on Statins had a more difficult time with a higher expression of diabetes as contrasted with those who had not been prescribed the Statins. I am not an internist; I admit I use Statins as I have a cardiovascular disease family history. They are prescribed by my internist and I don’t challenge his expertise; my recent ultrasound/echocardiogram stress test results confirm his wisdom. Nevertheless, I now have a reasonable explanation for my own transient muscle discomfort and you have a reasonable explanation as to why we recommend the elimination of Statins prior to and following a Regenexx SD Stem Cell procedure for an arthritic joint.
Tags: arthritis, athletes, Benefits and Risk, bone marrow, Bone Marrow Concentrate, Interventional Orthopedics, Knee Pain Relief, Mature Athlete, medicine, Orthopedic Care, Orthopedic Surgeon, Orthopedics, Osteoarthritis, Pain Management, Regenexx, stem cells, treatment
Mar 9, 2015
We are always learning from Data and in this Blog, I will let you learn with me. Please note that the results reproduced below are very preliminary and not to confused with the indications or results of our Bone Marrow Aspirate Concentrate/Stem cell interventions and outcomes. Because of the American Academy of Orthopedic withdrawal of support for visco-supplementaion (Hyaluronic Acid)in the arthritic knee, the orthopedic world is seeking something to fill that void, hence the interest in Amniotic Fluid Concentrate. Cortisone injections expanded with local anesthetics has been the mainstay but recent data indicates that local anesthetics kill cartilage and several cortisone injections are equally toxic to cartilage in animal models.
Interim Analysis of Prospective, Multi-Center Outcome Observational Cohort Registry of Amniotic Fluid Treatment for Osteoarthritis of the Knee Douglas Beall, MD,* Sri Nalamachu MD, **
Introduction Osteoarthritis (OA) of the knee is one of the leading causes of functional limitations and poor quality of life. Nonsurgical treatment of OA of knee includes oral medications and injection. Corticosteroid or hyaluronic acid (HA) injections to alleviate pain and/or improve function are common techniques but recently HA effectiveness has been questioned for the treatment of OA of knee in the Medicare population as well as for its overall efficacy. Alternatives are sought to provide pain relief and improve functional outcomes. Allograft amniotic tissues have a long history of clinical use. The use of amniotic fluid in the treatment of knee OA was initially reported by Shimberg who demonstrated that injections of the fluid improved knee function and pain relief without any significant adverse events in 68 patients. Amniotic fluid is a homologue to synovial fluid which acts as a cushion to protect and lubricate the contents in a closed environment. This study measures the safety and efficacy of processed allograft amniotic fluid in treating osteoarthritic knees using common, validated instruments.
Summary of methods This is a protocol-driven, single arm post-market Registry reviewed and approved by the Western Institutional Review Board (Olympia, WA). Patients with Kellgren Lawrence Grade 1-3 OA via radiologic examination were eligible for enrollment. Excluded patients were < 35 years, had BMI > 45 or had received Hyaluronic Acid injections in the previous six months, or steroid or PRP injection in the last three months. There were no threshold pain inclusion or exclusion criteria. Eligible patients were injected with 4cc of minimally processed amniotic fluid (AmnioClear LCT; Liventa Bioscience, West Conshohocken, PA) into the affected knee. Primary efficacy endpoints are VAS scores and WOMAC overall and Pain, Stiffness and Difficulty (function) subscore scales, measured during office visits at baseline and at 30, 90 and 180 days. Enrollees also filled out weekly Pain Diaries to report WOMAC Pain subscore (5 questions) at weeks 1-4 post-treatment. Results To date over 420 of an anticipated 470 Registry enrollees have been treated. This is an interim analysis of the first 181 patients to attain 30 day follow up and the first 51 to attain 90 day follow up visits, with 15 of 23 investigational sites reporting. WOMAC Pain subscore average improvement over baseline was 62.1 percent (150.9 mm) and 62.3 percent (151.2 mm), respectively at 30 days and at 90 days. VAS average improvement over baseline was 58.9 percent (37.7mm) and 62.5 percent (40 mm) at 30 and 90 days, respectively. All other WOMAC scores showed similar improvement.
OMEGA Statistics, Murieta, CA On average, patient outcomes improved significantly compared to basel
Tags: Amniotic, arthritis, athletes, Bone Marrow Concentrate, Clinical Studies, Hip Replacement, Interventional Orthopedics, Knee, Knee Pain Relief, Mature Athlete, medicine, Orthopedic Care, Orthopedic Surgeon, Osteoarthritis, Pain Management, Regenexx, stem cells, treatment, Ultrasound Guided Injection
