Dec 16, 2014
Let’s enter the new world of Cellular Orthopedics into which I graduated three years ago. Several months, ago, a long time friend was visiting his family in Chicago and stopped by to say hello. He told me about his skiing last winter and his hiking over the summer and fall. He also related he was seeing an orthopedic surgeon in the state where he now lived and that he had “bone on bone” in his knee. I launched into my customary spiel about his current level of athleticism, my cellular orthopedic initiative and the limits and risks of a knee replacement. Last week, a mutual friend told me that the out of state visitor had related “Mitch was right, I shouldn’t have done it”. He had undergone the Total Knee Replacement in spite of there being no limit in his recreational capacity and was now readmitted with an infected total knee prosthesis that might have to be removed to clear up the infection. Not being one to suggest “I told you so” but that’s what I am trying to get across to the patients I advise.
The Stem Cell Solution, Using the body’s almost magical repair kit to fix bad knees and hips-no surgery required is the title of an article appearing in the December, 2014, edition of The Saturday Evening Post, written by Sharon Begley, the senior U.S. health and science correspondent at Reuters. Last spring, the author had contacted me for an interview after having followed my Blogs unbeknownst to me. Ms Begley introduced herself and told me about an article she was writing for The Post to be published in June. I had forgotten about the interview until a patient came in last week and told me that she had read the article in the December issue. What I didn’t recognize at the time of the interview was that not only is the bone marrow a source of Adult Mesenchymal Stem Cells but of Growth factors and Cytokines as well that may be of equal importance. The opening of the article features my patient. In 2011,”I was in a bad way.” ”He was diagnosed with osteoarthritis, a degenerative disease eating away at the cartilage in his knees writes Begley.”The patient: ”and now I’m climbing stairs, have gone on two skiing trips, planning another, and playing golf in the summer.” “I am way beyond pleased.”
Tags: arthritis, athletes, Bone Marrow Concentrate, Concentrated Stem Cell Plasma, Hip Replacement, Interventional Orthopedics, joint replacement, Knee Pain Relief, Mature Athlete, Orthopedic Surgeon, Osteoarthritis, Pain Management, Regenerative, Regenexx-SD, stem cells, treatment
Dec 8, 2014
The majority of patients I see with knee pain either tell me “my doctor told me I have bone on bone” or “I have a torn meniscus”. They usually have already seen a physician and come in with the MRI. In a day and age when almost everyone over age 55 has MRI changes consistent with meniscal disease or has some joint space narrowing on the X-ray, I am still amazed as to how quickly a patient is willing to sign the informed consent for either arthroscopic meniscal surgery or a total knee replacement. “Referring patients to other physicians is one of the most fundamental and frequently performed tasks in clinical practice” according to an opinion in VIEWPOINT, an opinion section in The Journal of The American Medical Association appearing in the November 12, 2014 edition. The article concludes that the single most important factor for making the referral should be based on scientific evidence; not the usual and customary.
So what is the evidence supporting cellular orthopedics and not invasive surgery for meniscal pathology? The very essence of the response is to be found in the scientific evidence; you need the meniscus now so as to avoid degenerative joint disease later. It is one thing to have a “clunking” meniscus causing giving way and knee buckling; that’s the positive MacMurray sign. That’s a mechanical problem and not a pain problem usually resulting from trauma. The issue I am referring to is the almost every day patient presenting with knee pain The scientific evidence clearly documents worsening of a condition wherein surgical meniscectomy, be it open or arthroscopic, will worsen the symptoms and hasten the need for the knee replacement. Even in the younger population presenting with knee pain and devoid of mechanical symptoms, evidence based scientific orthopedics emphasizes saving the meniscus. For a better understanding check out http://www.regenexx.com/
By chance, while I was writing this Blog, the Radiologic Society was meeting in Chicago and here is an excerpt of a scientific presentation. “A popular surgery to repair meniscal tears may increase the risk of osteoarthritis and cartilage loss in some patients The findings show that the decision for surgery requires careful consideration in order to avoid accelerated disease onset, researchers said.”
“Meniscal surgery is one of the most common orthopedic procedures performed to alleviate pain and improve joint function,” said Frank W. Roemer, M.D., from Boston University School of Medicine in Boston and the University of Erlangen-Nuremberg in Erlangen, Germany. “However, increasing evidence is emerging that suggests meniscal surgery may be detrimental to the knee joint.”
“We found that patients without knee osteoarthritis who underwent meniscal surgery had a highly increased risk for developing osteoarthritis and cartilage loss in the following year compared to those that did not have surgery, regardless of presence or absence of a meniscal tear in the year before,” Dr. Roemer said.
All 31 of the knees that underwent meniscal surgery during the prior year developed osteoarthritis, compared with 165 (59 percent) of the knees with meniscal damage that didn’t have surgery. In addition, cartilage loss was much more common among knees that had undergone surgery: 80.8 percent of knees with surgery showed cartilage loss, compared with 39.5 percent of knees with meniscal damage and no surgery.
Cellular Orthopedics offers the alternative to surgery, preserving the critical meniscus with Bone Marrow Aspirate Concentrate and Mesenchymal Stem Cells
Tags: arthritis, athletes, Benefits and Risk, Bone Marrow Concentrate, Interventional Orthopedics, medicine, meniscus injury, Osteoarthritis, Pain Management, Regenexx, stem cells, treatment
Nov 24, 2014
Patient dissatisfaction following total knee replacement is a growing concern. An article appearing in the November issue of the Bone and Joint Journal focused on a questionnaire in the United Kingdom attempted to quantify the degree of patient satisfaction and residual symptoms following knee replacements. I decided to focus on this subject after having completed a consultation for a 70 year old woman who four years ago, had undergone a bilateral total knee replacement that went on to fail in 24 months. She then underwent a bilateral revision or repeat total knee replacement and is left with inability to fully straighten either side or bend the right and left knee more than 80 degrees. She is severely handicapped. I don’t know what her arthritic impairment had been prior to the original surgery but there really isn’t much to offer her now. What an awful situation.
The article to which I alluded above reports that somewhere between 35 to 54% of those surveyed reported residual symptoms and functional problems and general dissatisfaction. Those who regularly read my Blog might remember a similar result that I reported about in a Canadian survey of patients who had undergone Total Knee Replacement five years earlier. In the current study, neither the use of contemporary prosthetic designs or custom cutting guides improved patient perceived outcomes. The data clearly shows a degree of dissatisfaction and residual symptoms following Total Knee Replacement and those recent modifications in implant design and surgical technique have not improved the current situation
Activity Levels and Functional Outcomes of Young Patients Undergoing Total Hip Arthroplasty
In yet another journal reviewing Hip Replacement Outcomes, appearing this month in Orthopedics, patient dissatisfaction described greater hip symptoms and poorer hip-related quality of life in those under age 50 undergoing Total Hip Replacement than anticipated. It only makes sense to postpone a joint replacement until there is advanced arthritic impairment. Until then, our evidence in the laboratory and in the office clearly document that Bone Marrow Aspirate Concentrate has the potential to relieve pain, improve function, increase motion, and alter the actual molecular progress of the arthritic process.
Tags: arthritis, Bone Marrow Concentrate, Hip Replacement, Interventional Orthopedics, joint replacement, Knee Pain Relief, Mature Athlete, medicine, Orthopedic Surgeon, Osteoarthritis, Pain Management, Regenerative, stem cells
Nov 17, 2014
Nadal to get stem cell treatment
Updated: November 10, 2014, 2:18 PM ET
Associated Press
BARCELONA, Spain — Rafael Nadal‘s doctor says the 14-time Grand Slam winner will receive stem cell treatment on his ailing back.
Angel Ruiz-Cotorro told The Associated Press by phone on Monday that, “we are going to put cells in a joint in his spine” next week in Barcelona.
The Spanish tennis star was already sidelined for the rest of the season after having his appendix removed last week.
Ruiz-Cotorro, who has worked as a doctor for Nadal for the past 14 years, said Nadal’s back pain is “typical of tennis” players and that the treatment is meant to help repair his cartilage and is similar to stem cell treatment Nadal received on his knee last year.
He said Nadal is expected to return to training in early December.
Several NFL players and baseball players have received stem cell treatment. Nadal’s fellow Spaniard Pau Gasol, center of the Chicago Bulls, received stem cell treatment on his knee in 2013.
Stem Cell Treatment: Out from the Shadows, Onto the Cutting Edge
From Muscle and Medicine by Jenny Vrentas
Wed Jul. 30, 2014
The Jets’ Chris Johnson is one of hundreds of NFL players who’ve turned to stem cells to aid in recovery from injury. It may be the next big breakthrough in the treatment of sports ailments, but for now the use of such therapy is strictly limited in the U.S.—and questions about effectiveness outweigh the answers
New Jet Chris Johnson had stem cells from his bone marrow reinjected into his knee to augment January surgery for a torn meniscus. The hope is that it would boost healing and perhaps rebuild cartilage. (AP)
He’s 28. He has five 1,000-yard NFL rushing seasons to his name, one 2,000-yarder and a burning desire to prove he’s the same speedster he’s always been. So when Chris Johnson visited orthopedic surgeon James Andrews in January to fix his ailing left knee, he liked the sound of two intriguing words: Stem cells.
The veteran running back tore the meniscus in that knee in Week 3 of the 2013 season—his last with the Titans before being cut—but never missed a game. The injury to the knee’s natural shock absorber also caused other damage in the joint, and Andrews presented an option that might augment what surgery alone could do. The plan: Take stem cells, the body’s universal building blocks, and deliver them directly to the construction site.
“When I tore my meniscus and played the season out, through the wear and tear, I lost a lot of cartilage,” says Johnson, who was signed by the Jets to bring explosiveness to their offense. “When you put the stem cells in, it might be able to help rebuild that cartilage in your knee. Hopefully, it makes your knee better for even more years.”
For more Information on the Aging Adult and Regenerative Medicine:
312-475-1893 or 312-475-1893
Tags: arthritis, athletes, bone marrow, Bone Marrow Concentrate, Concentrated Stem Cell Plasma, Interventional Orthopedics, Mature Athlete, medicine, Orthopedics, Osteoarthritis, Pain Management, Regenerative, Regenexx, stem cells, treatment
Nov 13, 2014
What’s new for the musculoskeletal care of the aging athlete? First, let me define an athlete; or better put, the recreational interests of aging boomers, masters and seniors. This week, I undertook the knee care of a 67 year old woman from North Dakota whose major interest was a return to her twice a week bowling league. Then there is the 40 year old one time marathon runner from Madison whose knees are preventing him from continuing his athletic pursuit. When I left my house this morning, I had to brush some snow from my back window and I could have predicted the first phone call. “Dr. Sheinkop, I am afraid my arthritic hip will keep me from skiing this year, can you help me?”
The outcomes data that Regenexx posted on its web site these last several weeks as well as my own data base allow me to say “yes” to all of these aspiring athletes no matter the age or the sport/hobby/interest/fitness demand. Arthritis need not be followed by a joint replacement. Until the advent of Cellular Orthopedics, all treatment of the arthritic joint has been directed to relieving symptoms. The only means of actually intervening in the arthritic process was a joint replacement. While they work most of the time, there are risks involved in surgery, time off from work, facing the future of a revision, and little chance of genu flexing enough to bowl or ski down a black or blue run with a total hip or any run with a total knee. There is absolutely no chance of ever running again with a prosthetic joint unless you want a second surgery in less than five years. The orthopedic literature clearly documents that more than 60% of joint replacement recipients have given up all recreational and fitness pursuits within fewer than five years of undergoing said surgery.
Returning to the lead question in the first paragraph, it is Cellular Orthopedics; that is Bone Marrow Aspirate Concentrate containing the positive growth factors, Cytokines, Mesenchymal Stem Cells; and as yet undescribed, multiple agents that alter the bio-immune environment of the arthritic joint. The potential is to not only relieve your pain from the anti-inflammatory effect, restore motion by the reversal of scarring but actually postpone or eliminate the need for a joint replacement by altering or actually reversing the arthritic process.
Now if you will excuse me, after having spent the last week out of the office, I am heading off to the fitness center and begin the preparation for the skiing season
Tags: arthritis, athletes, bone marrow, Bone Marrow Concentrate, Hip Replacement, Interventional Orthopedics, joint replacement, Knee, Mature Athlete, medicine, Orthopedics, Osteoarthritis, Regenerative, Regenexx, stem cells
