Oct 18, 2018
We are speaking of stem cell therapy integrated with clinical research, and the resultant evidence-based stem cell intervention. Osteoarthritis is becoming more prevalent as I am seeing younger patients with arthritis as a consequence of sporting injuries such as ACL tears. The baby boomer population is experiencing accelerated onset of arthritis; their joints are prematurely aging in large numbers. At the same time, the master population is aging and living longer. As a result, I continually research biologic interventions to best address the ever-increasing number of those effected.
Why should a patient choose an orthopedic surgeon to manage their Osteoarthritic related symptoms and functional impairment? Our world is evidence based.
Study Observes Better Outcomes for OA Patients Treated by an Orthopaedic Specialist
In a retrospective study published online in BMC Musculoskeletal Disorders, shoulder osteoarthritis (OA) patients received faster and more invasive treatment when they received a new diagnosis from an orthopaedic specialist (OS) versus a nonorthopaedic physician (NOP). Patients with shoulder OA (n = 572) received care from either an OS (n = 474) or NOP (n = 98) on the date of their index shoulder visit. OS patients received their first treatment significantly quicker than the NOP cohort (16.3 days versus 32.3 days, respectively). The OS group also had higher rates of operative treatment within one year following their initial visit.
Study: Patients Report Similar Improvements for Nonobstructive Meniscal Tear with PT and Early Surgery
Physical therapy (PT) may not be inferior to early operative treatment of arthroscopic partial meniscectomy (APM) for improving knee functionality in patients with nonobstructive meniscal tears, according to a study published online inJAMA. The randomized clinical trial included 321 patients with nonobstructive meniscal tears aged 45 to 70 years who were treated at nine hospitals in the Netherlands between July 17, 2013, and Nov. 4, 2015. Patients were treated with APM (n = 159) or a predefined PT protocol (n = 162) that included 16 exercise therapy sessions over eight weeks. PT sessions focused on coordination and closed kinetic chain strength exercises. At 24-month follow-up, knee functionality in the PT group improved by 20.4 points compared to 26.2 points in the APM group. The difference did not exceed the noninferiority margin.
In order to maximize the benefits, Orthobiologics, that is stem cell therapy must be integrated with clinical research, and the resultant evidence-based stem cell intervention followed long term. In my practice, I am researching biologic interventions to address the ever-increasing number of those effected, not one and done. To learn more or schedule a consultation, Call (312)475-1893. You may visit my web site and read my blogs at www.sheinkopmd.com
Tags: ACL tear, arthritis, Cartilage, cellular orthopedic, joint pain, joint replacement, knee pain, MCL tear, meniscus tear, menisectomy, orthobiologics, orthopedic surgen, Osteoarthritis, Physical Therapy, PRP, regenerative medicine, stem cell
Oct 5, 2018
After reviewing a CT scan of the right knee where a Total Knee Replacement had been done provided by a patient who sought my opinion for stem cell treatment of her arthritic left knee, I called her to discuss the possible reasons that the right Total Knee Replacement that she had undergone over ten years ago was never satisfactory. At the time of the right TKR for arthritis, she had elected for what seemed at the time as a logical intervention for a painful, arthritic, right knee. The outcome was at first complicated by a lot of postoperative swelling and pain; at one-year post-operative, the patient had never been pain-free nor had she ever regained her preoperative range of motion and that adverse outcome has persisted for over ten years. Fast forward a decade and the right knee has continued to be a source of pain and limited motion; so much so that the patient decided to seek consultation for a Stem Cell treatment for her now arthritic left knee.
Her first question was basically “does stem cell therapy for knees work?”. Our data collected on patients treated in this office over the past six years, since I started my practice, is compatible with an 85% patient satisfaction rate. We have not recorded one complication. To be forthright, not every patient has a perfect result; but the vast majority experience marked reduction in pain, increased motion and a significant improvement in functional capacity. Unlike a failed outcome of a Total Knee Replacement, our stem cell injections may be repeated at anytime if the benefits of the initial intervention do not last.
When it comes to the cost of a stem cell intervention, while the Total Joint Replacement is more often than not covered by some type of insurance, our fee schedule is in keeping in line with the deductible a patient has to pay out of pocket for the major surgery. If you do the math and additionally compare the risks and benefits of a stem cell intervention with a total knee replacement, you will note:
- Remote to little risk of complication with a stem cell procedure
- Comparable cost comparing my charges for a stem cell intervention with the inherent deductible obligation for a Total Joint Replacement
- Rapid recovery with a stem cell intervention versus the risks of an adverse outcome as experienced by the patient seeking consultation for stem cells
To seek consultation call (312) 475-1893. You may visit my website at WWW.sheinkopmd.com
Tags: cellular orthopedics, ct scan, joint health, joint replacement, knee pain, knee replacement, Osteoarthritis, regenerative medicine, stem cell treatment, TKA
Sep 17, 2018
Seems strange that I would start thinking about the upcoming winter season but conditioning is sports specific and it will take about eight weeks to get ready. This past weekend, I increased my conditioning program with more cycling and strength training. It is now about nine months since I underwent cellular orthopedic interventions to both on my knees followed by both of my hips. The results have been most gratifying allowing me to extend my recreational lifestyle indefinitely; so here I am planning ahead for the upcoming ski season even though the Chicago temperature prediction is for a high of 87 degrees. Last year at this time, I questioned whether my skiing days were over. The reasoning behind much of my autobiographical, recreational subject matter is so the reader will better understand what is possible through stem cell, growth factor and platelet intervention for those with pain and limitations inherent in osteoarthritis. While an orthopedic surgeon does not need to break his or her own bones to better enable that surgeon to treat a fracture, given the number of clinics now advertising stem cell treatment, the patient choosing a regenerative medicine provider might take note of the fact that not only have I been playing a prominent role in the evolution of this expanding specialty of Cellular Orthopedics by introducing evidence based care over five years ago, I can tell you what works best from the standpoint of a patient.
There is an ever-increasing number of good and some excellent outcomes logged into our database. To be quite frank, there are some who have not fared as well. By continued surveillance and monitoring of outcomes, I am able to identify those who would improve their results by some means of augmentation be it a Platelet Rich Plasma follow-up or a repeat stem cells intervention. Let me paraphrase a message received from a patient in whose knees I have completed several cellular orthopedic interventions over the past three years. This mid 50s farmer is back to regularly playing age related group basketball several evenings each without limitation and without recurrence of symptoms the following day. Concerning yet another patient, this one in his early 90s from a patient who happens to be a family acquaintance, “I watched your patient painting the side of his garage the other day.”
Yes, these are anecdotes and so is my story; however, I think you get the message.
To learn more, you may call (312) 475-1893 to schedule a consultation. Access my web site at www.sheinkopmd.com.
Tags: cellular orthopedics, chicago, Osteoarthritis, Plate Rich Plasma, regenerative medicine, stem cells
Sep 13, 2018
I rode my bike this past Saturday and Sunday through the Chicago Forest Preserve bike trails and I had some time to reflect. Just as in fly fishing, cycling is meditation time. I tried to answer questions that came to mind such as how could Abraham have fathered both Izsak and Ishmael in his late 90s? Was it the triumph of stem cells or something more? I reflected on this through the Monday service without resolution other than we are still dealing with the ramifications.am
On Tuesday morning, the usual and customary ad in the Chicago Tribune paid for by the Stem Cell Institutes of America appeared inviting readers to a seminar to learn more about their approach to pain from arthritis and assuring the reader that their techniques are FDA compliant. Their approach is based on Amniotic Fluid injection. What I do know is FDA compliance requires that the stem cells must be yours (autologous) and that amniotic fluid once processed, sterilized, frozen and fast thawed has no viable stem cells. I also am cognizant of the large body of scientific evidence supporting the notion that pain of arthritis is generated by the supporting bone as cartilage has no nerve supply. How does a single and costly injection of amniotic fluid result in long term benefit? I have to deal on a daily basis with the fallout of this marketing campaign.
Next the Wednesday, September 12, addition of the Chicago Sun Times carried an ad sponsored by The Pain Relief Institute headlining Stem Cell Recruitment. As I understand the approach, Amniofix, a placental derivative, micronized, is reconstituted and injected into the arthritic joint. Reader please note that the first bullet states “FDA Regulated”. Of interest is the fact that I refused and still refuse to use Amniofix in my practice as there are no evidence based clinical trials to support any clinical claims. Those trials are taking place now. Amniofix is a product rushed to market before there was scientific proof to support use. You may learn more about Amniofix by searching the product online. If you don’t count cells with a hemoanalyzer, how could you know what is being “recruited”?
My commitment is to stand up for my patient in this regenerative medicine chaos. I resolve to do better in the upcoming year with introspection and ongoing review of the discipline.
With best wishes for a happy and healthy 5779
You may visit the website at www.sheinkopmd.com
Schedule an appointment by calling (312) 475-1893
Tags: amniofix, amniotic fluid, autologous, cellular therapy, FDA, regenerative medicine, stem cell
Aug 30, 2018
Evidence for the efficacy of Platelet Rich Plasma, a blood-derived formulation, and bone marrow derived biologics in osteoarthritis continues to grow in the orthopedic community. On the other hand, as I continually monitor the current landscape of indiscriminate and sometimes inappropriate marketing and use of biologics by the non-orthopedic opportunists, I doubt if the charlatans and camp followers have an overview of what is known about these agents. The increased presence of clinics Is driven by the popularity of PRP and its biologic cousins:
- consumer demand
- aggressive marketing
- a low regulatory bar for many of these regenerative medicine clinics
- the autologous nature that makes many approaches largely safe
- positive data from centers such as ours demonstrating functional and symptom modification
PRP works by activating cellular pathways; more than 3,000 genes are related to these and other pathways, suggesting that PRP probably acts by inducing a transitory inflammatory event, which then triggers tissue regeneration. Bone Marrow Concentrate, does more and addresses the subchondral bone when appropriately injected as well as initiate joint preservation and possible regeneration.
Taking aim
I use a hemoanalyzer to characterize a dose of PRP or Bone Marrow Concentrate allowing me to quantify the composition and biologic activity of these agents. Soon, I will begin pretreatment assessment of the synovial fluid of the arthritic joint so as to best determine who is the optimal candidate for a particular procedure
What do we know?
- Knee osteoarthritis: white blood cell-poor PRP has a positive effect on symptoms, not structure; while Bone marrow Concentrate affects symptoms and structure. I identify what I am putting into the patient. My goal is to have reliable predictors of outcome; that is, do the composition and biologic activity of the material implanted in the patient predict the clinical/imaging outcomes? My PRP contains a high concentration of anti-inflammatory cytokines and anabolic growth factors whereas my use of Bone Marrow Concentrate inside the bone adjacent to the joint in addition to the joint itself is improving the outcomes of the patients I treat.
- To learn more, call my office to schedule an appointment at (312) 475-1893
- You may view my Web site at WWW.Sheinkopmd.com
Tags: anit-inflammatory, biologics, bone marrow, cellular orthopedic, cellular therapy, cytokines, knee osteoarthritis, Orthopedic Surgeon, PRP, regenerative medicine, stem cell
