Jan 29, 2015
From a Patient in Canada
On January 20, 2015
“Thank you, Doctor,
How are you today? Hope well.
My Mom is very grateful for your kind help, mentions your name frequently and wants to schedule the 3rd Rx-SD visit to your office in 2-3 months.
Please provide us with the special 50% discounted price for the procedure similar to the last time in July and the time convenient for you if possible.
Thank you for your help.
My Mom is currently almost free of pain, walks around the house with a walker. The 2nd Rx-SD procedure on July 9,11, 2014 went really well and with the anesthesia was painless. My Mom trusts you, wants to see you every 8-12 months and to start walking without a walker this summer.”
This was the Holiday greeting last month
“Thank you, Doctor,
We wish you a merry Xmas and all the best in 2015.
Thanks to your kindness and knowledge, we found you when we were in real pain and needed you the most and you saved us. My Mom is very gratefull to You, calls you God and mentions your name daily, she’s feeling better only because of your help. My Mom and I both wishing you good health and all the happiness, many years ahead and a Happy New Year 2015.
Thank you for your help
Kind Regards,”
On Oct 7, 2014, at 8:32 AM
“Thank you, Doctor,
3 months passed after the 2nd SD procedure (9 July).
My Mom feels a better improvement now vs right after the 1st procedure.
We have no words to express how grateful we are.
She still uses a walker but occasionally tries a bit on her own with a cane. The pain is almost gone, just occasionally when its rainy or she stands for too long. She didn’t find a great improvement after the PRP refill (2 May), followed by the 1st SD procedure (4 Dec).
What do you think, Doctor, should she just do the 3rd SD procedure in 6-11 months or is it better to do the PRP refill now prior to this. I was surprised to learn the latest Rx SD 2013-14 data show the result doesn’t depend on age (74), OA severity (3), BMI (35).
With BMI=35 what’s the average total hrs per day should she stand/walk?
Thank you for your help.
Kind Regards, “
On Aug 9, 2014, at 12:16 PM
“Thank you, Doctor,
The 2nd SD procedure on 9 July went well and with the knees anesthesia was very painless. After 1 month my Mom feels good, no pain, just a little bit of pain when its humid and raining, still can’t walk without a walker.
My Mom is really grateful for your help and hopes to start walking one day.
Thank you for your help.
Kind Regards,”
Tags: arthritis, Benefits and Risk, Bone Marrow Concentrate, Hip, Hip Replacement, Interventional Orthopedics, joint replacement, Orthopedic Care, Orthopedics, Osteoarthritis, Pain Management, Regenexx, Regenexx-SD, stem cells, treatment
Jan 22, 2015
With all of our attention directed to arthritis, patients need to be reminded of the continued successes we are experiencing when using Bone Marrow Concentrate in fractures that fail to heal. When a fracture fails to heal in the expected average time, that is a Delayed Union. When it looses the ability to heal all together, that’s a Non-Union. The reasons that a fracture might fail to heal are beyond the scope of this Blog but non-union is not a rare complication. Areas of predilection toward difficulty in healing have to do with blood supply. The upper end of the femur (hip), navicular bone at the wrist, upper end of the humerus (shoulder), and clavicle as well as the tibia are areas of predilection. Historically, the only remedy has been a major operative procedure and even at that, there is a high failure rate with multiple complications including infection. It has been said that the only thing worse than an infected non-union is cancer. Let me share with you the story of two recent patients for whom I successfully intervened with Bone Marrow Concentrate when prior attempts at achieving fracture healing, one through surgery had failed.
VDVR is a 46-year-old woman who ten years ago sustained multiple fractures to her spine and lower extremities while serving in Iraq. She had undergone numerous surgical procedures, all successful except the inability to cause healing of fractures to her left calcaneus and talus. She had been left with Oxycontin addiction and crutch dependency. After several further orthopedic consultations she had a choice of amputation or more major surgical repair attempts with only 50% chance of success. Twelve weeks ago, I performed a Bone Marrow Concentrate/ Stem Cell intervention to her left calcaneus and talus. Last week she called and indicated she no longer required narcotics and could walk without crutches. The X-ray I received a day or two after the call was indicative of fracture healing.
JM is a 76-year old man with an established non-union of the left clavicle, of several years duration. He was experiencing arthritic changes in his left shoulder and asked me to try and achieve healing of the clavicle, even after several years while I was injecting Bone Marrow Concentrate into his arthritic left shoulder. About 16 weeks ago, I completed a stem cell intervention to his left shoulder and into the area of non-union of the outer one-third of the left clavicle. When I saw him in follow-up last week, the collarbone was completely healed. He had been afraid to undergo a surgical repair because of the high incidence of infection, failure and neurovascular injury associated with surgery of non-union at the clavicle.
These are but two illustrations of what is happening in the new world of Cellular Orthopedics. The initiative is gaining traction in the orthopedic world as I more and more success stories are realized
Tags: arthritis, athletes, Benefits and Risk, Bone Marrow Concentrate, Fracture, Interventional Orthopedics, Non-Union Fracture, Orthopedic Care, Orthopedics, Osteoarthritis, Pain Management, Regenexx, shoulder, stem cells, treatment
Jan 12, 2015
That quote comes from University of Chicago Economist and Nobel Laureate, Gary Becker, who died in 2014. Central to his work was the concept that economics can help explain behavior. As seems to be happening more and more, this Blog will expand on the evidence concerning Bone Marrow Aspirate Concentrate/Stem cell outcomes for intervention in the arthritic joint. The Data and my experience clearly document success at all stages of arthritis in a major joint for some period of time. What I am unable to conclude is in whom we are actually regenerating cartilage or in whom we are seeing pain relief and improved functional capacity owing to concentrated Growth Factors and Cytokines. Whereas my initial interventions two and a half years ago were limited to a “younger” arthritic demographic, the successes resulted in my expanding the inclusion criteria last year without age exclusion as I observed Outcomes success in those approaching 80 years of age. What I don’t know yet is in whom the improvements are related to the stem cells in the Bone Marrow Aspirate Concentrate or whether to the Growth Factors influencing your own stem cells or the Cytokines acting as anti-inflammatories, accompanying the stem cells in the Bone Marrow Aspirate Concentrate. What the evidence does indicate is that the older the patient or the more advanced the arthritis at the time of BMAC intervention, the better the outcome with a second or even third procedure. What I don’t know yet is a predictor of the survivorship of an outcome. I do know that the best chances of long-term benefits are in those with less than Grade 4 arthritis. For those who experience something less than hoped either in the initial result or extent of benefit, let’s explore the economics.
Just as our health care indemnification is undergoing change, so is my understanding of the scope of services that may be beneficial in this evolving discipline of Cellular Orthopedics. The good news is that unlike the insurance world where less health care coverage seems to be associated with greater cost for indemnification to the patient, I have identified a means of decreasing the economic burden to a patient for a repeat Bone Marrow Aspirate Concentrate/Stem cell intervention or related Regenerative Medicine injection, if a single procedure doesn’t provide the degree of relief or survivorship of outcome desired. It may well be that Cellular Orthopedics involves a range of approaches and not a single intervention. My office will work with you to provide you a scope of Evidence Based Care with an economic approach that allows the patient to avoid or at least delay a joint replacement.
Tags: arthritis, bone marrow, Bone Marrow Concentrate, Clinical Studies, Concentrated Stem Cell Plasma, Hip, Hip Replacement, Interventional Orthopedics, Knee Pain Relief, Mature Athlete, medicine, Orthopedics, Osteoarthritis, Pain Management, Regenexx, Regenexx-SD, stem cells, treatment
Dec 29, 2014
Actually it is closer to stem cell misrepresentations and is being propagated by the uninformed clinician, clever marketing schemes, and out and out charlatans. Last week, the FDA made a very strong statement warning against the use of Adipose Derived Stem Cells in the treatment of arthritis. The Government Health Care oversight process stated that there would be large fines and perhaps imprisonment for those health care providers who do not comply with the law. The regulations clearly state that your stem cells may be used if not manipulated or expanded. In order to liberate stem cells from adipose tissue, the adipose tissue has to be treated with an enzyme collagenase, a clear violation of the law. Yet, there are the web sites too numerous to list marketing adipose derived stem cells for arthritis. I am aware of several clinics that circumvent the law by performing liposuction and injecting the fat into the joint without liberating the stem cells with collagenase. My response, beware and take care.
Then come those providers who use local anesthetics to expand the Bone Marrow Aspirate Concentrate when Regenexx has documented the death of stem cells if mixed with local anesthetics. Don’t stop reading, I have yet another alert. The latest addition to the field of Regenerative Medicine comes from Amniotic Fluid that is marketed as an allograft. The pregnant woman at term donates her amniotic fluid that is then processed and made available for wound healing or as an injectate for the arthritic joint in either a concentrated or powder form. While the early outcomes are promising for pain relief, no one has more than four months of outcomes monitoring for amniotic fluid preparations in arthritis. The processing laboratories claim an abundance of stem cells in the concentrate as well as large quantities of Cytokines and Growth Factors; but this is yet to be corroborated by independent researchers. The good news here is the latter research is taking place and more being planned; there should be preliminary data by mid 2015.
Assume if you will that you have an arthritic joint, and are not yet ready for a joint replacement or the extent of your arthritis still lends itself to non-operative management. How can you be sure that you are protected from the abuses I describe above? Regenexx initiated outcomes surveillance over five years ago and as an orthopedic surgeon, I joined and expanded those data points Regenexx studies two and a half years ago. No other Cellular Orthopedic or Regenerative Medicine initiative has the comprehensive Outcomes Data or basic research to support a clinical intervention recommendation, as do the members of the Regenexx Network. Beware here as well of non Regenexx Network web sites that post Regenexx Outcomes as if the patient is too uninformed to recognize the deception. If you want the truth, make an appointment: 847 390 7666
Tags: Amniotic, arthritis, athletes, Bone Marrow Concentrate, Clinical Studies, Interventional Orthopedics, joint replacement, Mature Athlete, medicine, Orthopedic Care, Orthopedic Surgeon, Orthopedics, Osteoarthritis, Regenerative, Regenexx, stem cells, treatment
Dec 22, 2014
Last week, a call was placed to my office by the sponsor of a multicenter knee replacement clinical trial in which I had taken part since 2004.The FDA mandated Post Release Requirement for the Zimmer Mobile Knee had been fulfilled. Because of my world wide teaching and visiting professorships starting in 2001, I had been asked to be a co-investigator in that initiative. My participation in part led to the release of the High-Flex Zimmer Mobile Bearing Knee in 2007 and several major clinical papers in which I was the Co-Author. As many readers of this Blog are aware, I had dedicated 37 years of my professional endeavors to integrating joint replacement research with my clinical practice at Rush for the care and treatment of the arthritic hip and knee. For the past two and a half years, I have dedicated my professional energies to assisting patients with osteoarthritis avoid or at least postpone the joint replacement.
I want to go on record; when a patient has altered function, unrelenting pain, and an image with a Kellgren/Lawrence Grade 4 osteoarthritic hip or knee, that patient needs a joint replacement. While I have called the readers’ attention to inherent risks of a joint replacement, the effected patient with medical approval will benefit from the joint replacement. On the other hand, the ever increasing evidence and my experience confirm that the patient with Grade 2 and 3 Osteoarthritis of a major joint may significantly benefit from a Bone Marrow Aspirate Concentrate /Stem cell intervention. The end result of an uncomplicated major joint replacement is pain relief, improved function, better motion, and correction of a deformity. The potential risks of a joint replacement gone badly require a revision or major reconstruction with major medical interventions for associated complications. The end result of a Bone Marrow Aspirate Concentrate /Stem Cell intervention is pain relief, improved function, better motion and continuation of or return to a very active recreational profile without risk of complication. While the stem cell procedure will not correct a deformity, it may alter the natural history of the arthritic process at the molecular level. Actually, the presence of deformity puts a patient in a Grade 4 setting and is an indication for a joint replacement; Grade 4 is a predictor of a poor result from stem cells.
Well it’s the week of Chanukah and Christmas so let’s celebrate this week of miracles with a wonderful stem cell story; it concerns hockey great Gordie Howe to be found in the Detroit Free Press. Freep.com:
http://on.freep.com/16AQIIO
Tags: arthritis, athletes, Benefits and Risk, Bone Marrow Concentrate, Hip Replacement, Interventional Orthopedics, joint replacement, Knee Pain Relief, Mature Athlete, Orthopedic Surgeon, Orthopedics, Osteoarthritis, Pain Management, Regenerative, Regenexx, Regenexx-SD, stem cells, treatment
