Aug 29, 2017
Patients receiving either Hyaluronic Acid (HA- Synvisc, Supartz, Euflexxa) or Platelet Rich Plasma (PRP) injections will experience modest-term pain relief according to an article appearing in Orthopedics Today, August, 2017. In the study reviewed, Ultrasound Guided injections were given weekly for three weeks and patient-reported outcome measures (PROMS) were recorded for up to one year. “Both the PRP and HA groups demonstrated an improvement in PROMS at 24 weeks that declined to near baseline levels at one year” according to the article. “Patients with lower grade Osteoarthritis and lower weight responded more favorably to intra-articular injections”. The effect of both Hyaluronic Acid and Platelet Rich Plasma appeared to be modest and temporary.
Why I chose this topic this week for my Blog has to do with my preparation for the upcoming talks I am invited to give September 21st and 22nd in St. Petersburg, Russia at the meeting of 1200 orthopedic surgeons from Russia, Ukraine and neighboring countries both in Europe and Asia. As I indicated last week, this will be the first time a non-operative intervention of a cellular orthopedic, regenerative nature, as I practice, will have been introduced into this region of the world. While Hyaluronic Acid and Platelet Rich Plasma may offer short term pain diminution for individuals limited in function by the symptoms of Osteoarthritis, it becomes clear by scrutinizing my data base that not only does concentrated bone marrow afford long term relief, the Mesenchymal Stem Cells and Growth Factors found in bone marrow when concentrated participate in regenerative possibility thereby delaying and perhaps even avoiding a joint replacement. My presentations will be evidence based without the false news and unsupported marketing claims ever present in the media.
What we have learned about Amniotic Fluid (AF) from my role as principal investigator in several multisite studies is that AF does have concentrated Hyaluronic Acid and therein may offer six to 12 months decrease in symptoms and increase in function, the effect is limited in duration; and with no viable stem cells in Amniotic Fluid Concentrate, there is no regenerative potential. Owing to the absence of inherent absence of stem cells and hence regenerative potential, I will not include amniotic fluid in my presentations.
As a scientific invitee, my responsibility is to introduce that for which we have scientific support and clinical evidence. If you want to gain a better understanding of Regenerative Medicine and Cellular Orthopedic and learn how you may postpone or perhaps avoid a joint replacement for the symptoms and limitations imposed by osteoarthritis, make an appointment, visit my web site and watch my webinar.
312-475-1893
www.sheinkopmd.com
www.ilcellulartherapy.com
Tags: arthritis, hyaluronic acid, Interventional Orthopedics, Knee Pain Relief, Orthopedics, Osteoarthritis, PRP, Regenerative, stem cells
Jun 26, 2017
Five years ago, I “graduated” from a 37-year career as an orthopedic surgeon with a practice based on hip and knee replacement surgery for arthritic joints. Trading my scalpel for a needle, I entered the new discipline of Cellular Orthopedics with a goal of helping patients delay, at times avoid a joint replacement for the arthritic hip and knee joint. In my transition, I introduced the same integration of research, patient care, and education into Regenerative Medicine that I had pioneered as the head of a joint replacement program at a major-medical center in Chicago, helping that center emerge as one of the five most recognized programs in The United States.
At the beginning and continuing to this day, Cellular Orthopedics has been based on the use of a patient’s own Platelet Rich Plasma and Bone Marrow Concentrate as the source for providing pain relief and functional improvement to a patient experiencing impairment from an arthritic joint. I have almost five years of outcomes data to support my therapeutic recommendations. Platelet Rich Plasma offers healing and pain relieving promise for the patient; while the Stem Cells and Growth Factors in Bone Marrow Concentrate offer regenerative potential in addition, all this while FDA compliant.
Over the past year however, there has been an explosion in the marketing of untested and unproven alternatives continually introduced under the Regenerative Medicine umbrella. Web sites make unsubstantiated claims, purchased media campaigns become a source of false advertising and courses both live and on-line promise expertise credentialing in 48 hours.
As a response to this chaos, I have founded The Center for Orthobiologic Clinical Trials whereby I am able to validate or challenge the plethora of claims and assist my patients in decision making based on scientific evidence; while at the same time, contributing to the emerging discipline of Interventional Orthopedics. I now have gathered the largest Data Base with long term follow-up of which I am aware documenting the Outcomes of Bone Marrow Concentrate, Amniotic Fluid Concentrate and mechanically emulsified, Adipose Derived, Lipogems.
The next step is to study the outcomes of combining cellular orthopedic interventions into the joint with the added step of injecting Bone Marrow Concentrate and Platelet Rich Plasma into the bone adjacent to the joint. I am currently recruiting patients for the latter trial. For those who meet inclusion criteria, there is a discount for said care. Interested patients should call (312) 475-1893 on Monday or Thursday.
If you want to become better informed, browse my website www.sheinkopmd.com.
You may watch my webinar at www.ilcellulartherapy.com or call central schedulaing at (312) 475-1893 for a new patient consultation.
Tags: Amniotic Fluid Concentrate, Bone Marrow Concentrate, cellular treatment, Hip pain, joint replacement, knee pain, lipogems, mechanically emulsified Adipose Derived, Mesenchymal Stem Cell, Osteoarthritis, PRP, regenerative medicine
Jan 27, 2017
There are approximately 2,500 Adult Mesenchymal Stem Cells per mL of Bone Marrow Concentrate on average according to the work of Dr. Phillipe Hernigou in Paris. It leads me to conclude that unconcentrated bone marrow aspirate doesn’t have enough MSCs per unit volume to contribute to a therapeutic potential in a consistent manner. The way MSC counts are done is by assaying Colony Forming Unit-Fibroblasts (CFU-F) from samples taken from the BMC at the time of an arthritic intervention. This is a retrospective look as the CFU-F assay is done by culturing for seven to ten days with a sample of the injectate at the time the intervention with concentrated bone marrow is completed.
Is this too much information? Many patients ask me relevant questions so I thought I would try to clarify. Why don’t I just inject bone marrow concentrate into a vein? Mice were injected in a laboratory using both a vein or an artery and the cells were tracked over time. When using a vein, a significant entrapment of cells was found in the lungs. When using an artery, the entrapment of cells was at a site of injury or disease but not in a joint. Finally, delivering cells directly to the arthritic joint kick starts the repair process offering the best possible outcome.
Why don’t I use or even recommend cultured cells? If cultured cells are used, this procedure goes beyond the realm of minimal manipulation and proves contrary to FDA guidelines. In addition, culturing cells can potentially alter the properties of the cells. It is also important to remember that Mesenchymal Stem Cells have better homing capabilities, compared to their culture-expanded counterparts.
Why is Bone Marrow Concentrate so much more effective than Platelet Rich Plasma? Recent publications have documented that interleukin 1 receptor antagonist protein (IL1-ra), an anti-inflammatory protein is over 22 times higher in BMC than PRP. Additionally, the immune capacity of bone marrow is such that infection is rare when Bone Marrow Concentrate is used.
We are dedicated to providing patients the best possible care in regenerative medicine. The laboratory I use is registered with the FDA. The process I employ has cleared two FDA audits with no issues. Based on the platform I employ, we offer our patients customized interventions, since each preparation is analyzed for platelets, red blood cells and white blood cells (among 27 parameters) which I review prior to injection. The knowledge allows me to make adjustments based on almost five years of experience in Interventional Orthopedics and 37 years as a joint replacement surgeon. No other Regenerative Medical program or practice may make this claim.
To learn more call (312) 475-1893 to schedule a consultation
View my web site at www.sheinkopmd.com
Watch my webinar at www.ilcellulartherapy.com
Tags: Bone Marrow Concentrate, PRP, stem cells
Jan 6, 2017
In reviewing the plethora of proliferating Regenerative Medicine web sites, I found one with multiple points of service in metropolitan Chicago offering platelet rich plasma, fat graft, adipose derived stem cells and bone marrow derived stem cells in an office setting for the treatment of ALS, Alzheimer’s, Erectile Dysfunction, Alopecia, Autism, Cerebral Palsy, Aesthetic improvement and so on and more. There was no end to the promises advanced. At no time was there any evidence of success posted and absolutely no data.
For the first 37 years of my orthopedic practice, I collected outcomes data for every patient in whom I performed a hip or knee replacement. Prior to a surgical procedure, I provided the patient with meaningful outcomes data concerning success and length before a revision surgery might be required. That scientific documentation was scientifically published and used globally for informed consent by orthopedic surgeons around the world. Anticipating the future, actually the present if you live in Alabama, not only do I quantitate that which is injected into an arthritic joint, I am able to qualitate the injectate. I refer to Alabama because that State requires a physician to know exactly what is being injected into a patient when a she or he administers such or the physician is not complaint with that state’s law. With the incorporation of Abbott’s Ruby hemoanalyzer into my Cellular Orthopedic practice, I meet ethical, moral, legal and scientific guidelines and anticipate what I believe will shortly become an FDA compliance requirement. My practice is limited to that which has data to support my recommendations for a symptomatic, arthritic joint; while at the same time documenting the quality and quantity of the combination of Bone Marrow Concentrate, Growth Factors and Platelet Rich Plasma I am injecting.
There is the beginning of an initiative to comply with an anticipated more stringent oversite by the FDA concerning the developing subspecialty of Interventional Orthopedics and I am thrilled to be part of that small group. The FDA is a governmental agency responsible for the well-being, health and safety of the public. While likesome charlatans might get by in the short term, I am thrilled to be part of this initial group of responsible Board Certified Orthopedic Surgeons, Physiatrists and Pain Management specialists providing scientifically supported, FDA compliant, Cellular Orthopedic and Regenerative Medicine options in Sports Medicine and for management of an arthritic joint.
You may schedule an appointment by calling 312 475 1893
My Website is reached at www.Sheinkopmd.com
You may watch my webinar at www.ilcellulartherapy.com
Tags: Bone Marrow Concentrate, Clinical Trial. Mitchell B. Sheinkop, Concentrated Stem Cell Plasma, Knee Pain Relief, Platelet Rich Plasma, PRP, stem cells
Dec 19, 2016
I use bone marrow derived stem cells because they have been proven to be most effective at treating orthopedic conditions when compared to adipose derived stem cells. There have been 13 papers published showing bone marrow superiority to adipose tissue in regards to treating orthopedic conditions and to the best of my knowledge, none reporting adipose derived results for arthritis. In addition to Adult Mesenchymal Stem Cells, bone marrow has 1,000-10,000x more hematopoietic stem cells than adipose tissue; the former is necessary for muscle repair. Recently, we learned that bone marrow also has osteochondral reticular cells which are not found in adipose tissue and serve as orthopedic repair cells. While adipose tissue and bone marrow both have stem cells, the skeletomuscular specific cells only found in bone marrow make it the best at treating orthopedic conditions. I don’t have a stake in doing bone marrow derived stem cells, I practice evidence based medicine and do what’s been shown to provide the best results. If with continued research something superior to bone marrow derived stem cells becomes available, then I will gladly adopt that protocol.
http://www.regenexx.com/fat-vs-bone-marrow-stem-cell-video/
- As I have reported on this Blog many times, research has shown the amniotic fluid samples being marketed as having stem cells actually do not have any viable stem cells when received and viewed in the laboratory. I do use amniotic fluid concentrate from time to time for its concentrated hyaluronic acid effect.
http://www.regenexx.com/amniotic-stem-cells-great-deception/
- Since we manually process bone marrow when aspirated, I am able to customize PRP which we call SCP or super concentrated platelets. The ubiquitous beside centrifuge only has one setting for volume and concentration so those using this approach are treating every patient without concern for individual differences. With the addition of the Abbott Ruby Hemocytometer, I am able to customize the treatment of the individual patient. We can concentrate our SCP from 3-40X over baseline-with or without red or white blood cells. From my outcomes data base, I know what volume and concentration works best for treating the various body parts.
- We’ve developed HD BMC or high dose bone marrow concentrate which is far superior to that produced with bedside centrifuges used by most claiming expertise in Regenerative Medicine
- I perform BMAs in compliance with the peer-reviewed literature recommendations as well as in keeping with my internal best practices research to maximize MSC yield. As stated, I count cells and know the quality in addition to the quantity of the injectate. Most doctors don’t count cells and have no idea what dose they are giving their patients
Tags: adipose tissue, amniotic fluid, arthritis, BMA, bone marrow, Bone Marrow Concentrate, Clinical Studies, Clinical Trial. Mitchell B. Sheinkop, Interventional Orthopedics, Mesenchymal Stem Cell, MSC, PRP, Regenerative, SCP, stem cells
