“My doctor told me that I have bone on bone”

It is the most banal, recurring, boring, ordinary and meaningless phrase that my assistant and I have to listen to on the phone or at every office setting. Osteoarthritis is a disease that affects almost all persons to some extent as they age. It may affect one joint, some joints or many joints. The causes may include genetic predisposition, trauma, or any of varying diseases at different ages. No matter the causation be the arthritis primary or secondary, the presentation is progressive pain and decreasing function. The X-ray is diagnostic in most cases: loss of cartilage joint space, subchondral sclerosis and osteophyte formation. The pain generator is inflammation and not bone on bone. Images help with diagnosis; but the degree of arthritic change on X-ray does not necessarily correlate with the severity of the symptoms or the functional impairment.

A normal joint has a bony support, a cartilage interface, a synovial lining, a capsular envelope, stabilizing ligaments and surrounding muscle. All these anatomic structures are affected by the inflammation associated with degenerative changes on a bio-immune basis. When a physician undertakes the care of an arthritic joint, the management is based on addressing the inflammatory pain generators and not until the subchondral bone is severely altered and the cartilage gliding surface has been severely destroyed is a joint replacement indicated (Grade 4 OA). Until that time the classic approach has been weight loss, anti-inflammatories either by mouth or via injection, bracing, strength training, range of motion therapy; that is, until the new world of cellular orthopedics came into being.

My initial approach in my practice is to address pain and altered function from inflammation of osteoarthritis, not “bone on bone”. By a combination and concentration of platelets and growth factors, I now have the ability to reverse the pain generating arthritic inflammation and alter the bio-immune basis for degeneration of the joint; this is called joint preservation. On the other hand, my initiative for joint regeneration is based on autologous bone marrow concentrate; the latter containing in addition to platelets and growth factors, adult mesenchymal stem cells, precursor cells, hemopoietic stem cells and more. The attempts at joint regeneration are directed both to the joint itself by intraarticular injection and subchondral injection; the latter to help repair the supporting bone.

There is a lot to process here so let me address your needs best and answer your questions following an office assessment and a review of images. Call (847) 390-7666 to schedule a consultation. You may learn more on my website www.Ilcellulartherapy.com where you will find our webinar

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A Regenerative and Restoration Milestone

A Regenerative and Restoration Milestone

It happens every year since the day I was born, there is a birthday celebration in my home and it happens again this week. Sure, I have a little more graying of my hair; but fortunately, I have my hair. I also have an activity level that would not have been possible, given the arthritis in my knees and hips, unless I had undergone restorative and regenerative intervention taking advantage of Bone Marrow Concentrate and Platelet Rich Plasma Offerings as I write about in these blogs. 

To give you some insight of what is possible no matter your age and before you become a couch potato owing to pain and functional limits imposed by arthritis, let me describe what I have planned for the Memorial Day weekend. You might recall that I was experiencing progressive functional limitation until a regenerative procedure was completed on my knees, December, 27, 2017 followed by a similar procedure in my hips on January 11, 2018. On this upcoming Thursday, I will begin planting a relatively large vegetable garden in the mid-day when we arrive in Southwest Wisconsin followed by a late afternoon 30-mile bike ride. First, we stop at the Amish Greenhouse in our neck of the woods to collect the vegetables and Herbs. On Friday the cycling and planting will continue; Saturday will be a half day of fly fishing followed by more planting and then another 30-mile bike ride. Sunday will be a repeat of Saturday after the evening outdoor barbecue. Monday morning is another half day of fly fishing, then planting of the herb plot after which we return to Chicago and office patients on Tuesday.

I felt your pain until I took advantage of the possibility for functional restoration and joint regeneration that I offer my patients. No more kvetching from me. The way I want to live is the way I practice.  I am not ready to slow down even though birthdays are being celebrated each year; and I don’t have to alter my way of life; having enjoyed symptom relief and functional restoration via Bone Marrow Concentrate and Platelet Rich Plasma offerings.

To learn about how you might continue to enjoy or perhaps return to an active, symptom free lifestyle, call (847) 390-7666 To schedule an appointment. You may visit my blog at HTTP://www.ILcellulartherapy.com where you may watch the webinar

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It’s been a busy week for our Cellular Orthopedic practice

On Wednesday, I completed several bone marrow concentrate procedures for patients with arthritic knees. You will recall that Concentrated Bone Marrow contains living Adult Mesenchymal Stem Cells, Growth Factors, Platelets, Exosomes, Precursor Cells and more allowing for pain relief, improved function and possible regeneration in those afflicted by arthritis. In the afternoon, four patients underwent Autologous Platelet and Growth Factor interventions; two in the hip and two in their knees. An example of the outcome, now four months following intervention in my own knees and hips, I spent last weekend hiking along several spring creeks, fly fishing in Southwest Wisconsin in the morning and planting over 150 Lilly bulbs in the afternoon. Admittedly, I slept well on Saturday and Sunday night but visited the health club on these past Tuesday and Wednesday evenings for my fitness routines.

On Monday, we finalized and edited a manuscript reporting the results of 56 patients with arthritic knees, followed for 2 to 4 years having received Bone Marrow Concentrate. Using the same outcome metrics and statistical tabulation methods I had employed as a joint replacement surgeon, this study is one of the most significant trials ever completed and to be published in Cellular Orthopedics. Our study not only will help determine the indications for a “stem cell” procedure, but also assist in determining how long the benefits will last, and provide a road map for when adjunct or repeat interventions are indicated. Now the physician will be better prepared to help a patient decide between a Total Joint Replacement and a Cellular Orthopedic intervention on an evidence based knowledge.

I am writing this Blog while flying to San Jose, California where I am partaking in advanced training that will allow me to expand my regenerative medicine practice to the low back. Again and again, patients ask as to what I might offer to address low back pain and disc disease now that I have successfully intervened in an arthritic hip or knee. Indications and techniques for addressing the lumbar spine will make up the curriculum enabling me to add discogenic and degenerative arthritic conditions of the low back to my scope of regenerative care by mid May.

To the patient who called, “I heard through the grapevine that it doesn’t work”, you may avoid falling victim to the Fake Stem Cell claims in newspaper ads or via celebrity testimonials; those in amniotic fluid are dead on arrival to you. Seek scientific evidence at (847) 390-7666 or learn more on my web site where you may watch my webinar www.Ilcellulartherapy.com.

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What next?

You no longer will even need a physician, and I have been wasting my Blog space crusading about quality assurance; making certain your Regenerative Medicine specialist is Board Certified and willing to provide outcomes data.  According to a recent email I received, all one needs is “Online Training” to practice Regenerative Medicine:If you believe this is FDA compliant, no longer does stem cell treatment need to be done by a highly trained, highly experienced specialist; you won’t even have to use a physician.“Everything gets commoditized, including training to do stuff” (personal communication).

I believe the most effective approach is to direct a patient with joint pain to my credentials—37.5 years of joint replacement experience, Board-certified, Emeritus Professor, four and a half years of Cellular Orthopedic experience, the largest most comprehensive outcomes data base on which to base my recommendations for care, while introducing an analytical program based on a FDA-audited analytical laboratory for assessing the quality of regenerative preparations. As for the latter point, I am now working with a team using a FDA consultant to create approved text that I will post on my website, highlighting the standards I have adopted for all phases of therapy.

I hate to conclude that the current practice of interventional orthopedics and regenerative medicine ultimately comes down to how flashy the website may be or a free lunch from the camp followers.

To watch my Webinar, access www.ilCellulartherapy.com

To make an appointment, call 312 475 1893

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A Word on the Future of Cellular Orthopedics

A Word on the Future of Cellular Orthopedics

Actually, that future started last week when we used a more aggressive PRP adjunct at the time of two Bone Marrow Concentrate/ Stem Cell interventions; one for an arthritic hip and the other, in an arthritic knee. More accurate and descriptive would be a Bone Marrow Concentrate/Adult Mesenchymal Stem Cell/ Hematopoietic Stem Cell/ Growth Factor Concentrate/Platelet Rich Plasma/Interleukin-1 Receptor Antagonist cellular orthopedic intervention to an arthritic joint but even I get confused, so I will stick to cellular orthopedics and Bone Marrow Concentrate.

It would seem from current Regenerative Medicine Science, that while concentrated and activated Platelet Rich Plasma alone has not been provided a predictable and reliable independent approach to arthritis, when aggressively used in conjunction with stem cell interventions, PRP significantly enhances the results in the short term. It will require another several years to determine if what we are seeing in the short term will continue to improve our outcomes in the long run. I am not waiting as concentrating and activating the platelets will cause no harm; and if there is the promise of long term benefits when used as an adjunct both at the time of the Bone Marrow collection, concentration and intervention as well as again in two to five days, there is no reason not to proceed.

What about the future? While we have been great advocates of counting cells at the time of the stem cell intervention, new tools are being introduced to allow us to better customize that which we inject after concentrating and processing of the bone marrow. We now will be able to get a more accurate count of that which is present in the concentrated and processed injectate prior to the intervention and add bone marrow or platelets if indicated.

Are Mesenchymal Stem cells really Stem Cells? Professor Arnold Caplan of Case Western Reserve is widely considered the father of mesenchymal stem cells. He now takes the view that MSCs aren’t stem cells and that he should have never given them that name. He also believes that the primary function of these cells is paracrine, so he calls them “medicinal signaling cells”. To save you the trouble, paracrine is defined as “a form of cell-cell communication in which a cell produces a signal to induce changes in nearby cells.” I am not negating the importance of mesenchymal stem cells, rather I want the reader to better understand the role of each component involved with regenerative medicine. It was Professor Caplan’s prodding that in part is responsible for my having entered the discipline of interventional orthopedics. Long ago, we became friends as team mates of the Roosevelt High School championship football team in Chicago; and our professional paths, while parallel, he in basic orthopedic research while I chose orthopedic surgery finally crossed again five years ago.

To learn more about the basic science behind Cellular Orthopedics or to find out about how you might postpone or avoid a Total Joint replacement for an arthritic joint, schedule a consultation (312) 475 1893

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Special Announcement - Now Enrolling for FDA Approved Stem Cell Study
Dr. Mitchell Sheinkop has completed training and is credentialed for the first of its kind FDA approved stem cell clinical trial for knee arthritis. Our clinic is now enrolling patients in this trial. Contact us at 312-767-5761 for details. Click here to learn more.