Oct 20, 2014
We have been inundated with the fear of Ebola infections; the media has treated this as if each posting is to be a sensational headline in the National Inquirer. If the truth be told, your chance of acquiring an Ebola infection here in the US is about as likely as my winning the mega jackpot in the lottery. Fear Strikes Out was a marvelous film from the 50’s about a ball player overcoming mental disease; caution, you are being given mental disease by the sensationalism regarding Ebola and will succumb if not careful. What you should really be frightened about are hospital acquired infections. It has been estimated that in excess of one million MRSA infections take place in the US each year with in excess of 100,000 deaths. That doesn’t include the community acquired MRSA infections estimated last year at an additional 14%. The cost of Methicillin Resistant Staph Aureus infection last year exceeded 45 Billion Dollars Now what about C-Diff infections superimposed on those receiving antibiotics for hospital acquired infections, over 14,000 deaths last year according to governmental sources?
Regenexx published a study earlier this year in which not one single deep infection could be attributed to the minimally invasive methodology associated with a stem cell or similar cellular orthopedic procedure. In my practice, not only have I not recorded a deep infection, there hasn’t even been a superficial one reported. That’s not to say it may not happen in the future as I deal with Diabetics from time to time and patients with other immunosuppressive disorders; but I haven’t seen an infection yet in what is now approaching 400 procedures. I perform Bone Marrow Concentrate/ Stem Cell and related Cellular Orthopedic-Regenerative interventions in a surgi-center with all fluid manipulations in a sterile environment and under a sterile hood with a fully gowned RN. A joint replacement carries with a known infection rate. That incidence no longer is accurately recorded as the patient is promptly discharged from the hospital and the subsequent readmission for infection is not reported as associated with the recent joint replacement surgery
I have posted my results of Bone Marrow Aspirate Concentrate /Stem Cell interventions in this Blog on many occasions and compared the 18 month results to those of a knee replacement noting a lot more activity and recreational pursuits in the Cellular Orthopedic recipient group being realized. When a patient has advanced arthritis, a joint replacement is the treatment of choice. For those who want to continue or return to the highest possible age related profile, why not consider a stem cell procedure?
Tags: arthritis, Benefits and Risk, Bone Marrow Concentrate, Concentrated Stem Cell Plasma, FDA, Hip Replacement, Interventional Orthopedics, joint replacement, Knee Pain Relief, medicine, Orthopedic Care, Orthopedic Surgeon, Orthopedics, Osteoarthritis, Pain Management, Regenerative Pain Center, Regenexx, stem cells, treatment
Jun 9, 2014
Thickening and increase of area of cartilage have been proposed as two alternative mechanisms of cartilage functional adaptation. The latter has been reported in endurance sportsmen. In weightlifters, extreme strain applied to the articular surfaces can result in other forms of adaptation. The aim of this research is to determine whether cartilage thickness is greater in elite weightlifters than in physically inactive men. Weightlifters (13) and 20 controls [age and body mass index (BMI) matched] underwent knee Magnetic Resonance Imaging (MRI). A single sagittal slice of the knee was taken and cartilage thickness was measured in five and six regions of the medial and lateral femoral condyles, respectively. The analyzed segments represented weight-bearing and non-weight-bearing regions. The tibia cartilage in the weight-bearing area was also measured. The time of training onset and its duration in the weightlifter group were recorded. The cartilage was found to be significantly thicker in weightlifters in most of the analyzed regions. The distribution of cartilage thickness on the medial and lateral femoral condyles was similar in both groups. The duration of training was not associated with cartilage thickness, but the time of training onset correlated inversely with cartilage thickness. It is possible that in high-strain sports, joint cartilage can undergo functional adaptation by thickening. Thus, mechanical loading history could exert a postnatal influence on cartilage morphology. Clin. Anat., 2014. © 2014 Wiley Periodicals, Inc.”
Although, many physicians warn against jogging, to the best of my knowledge, there is no scientific evidence that running or jogging injures cartilage. Now there is evidence that loading cartilage is beneficial. Certainly, there is still much to be learned about maintaining joint health when it comes to the musculoskeletal care of the aging athlete. Remember, as I have stated many times in my Blogs, cartilage is only part of what makes up the joint. The cartilage joint space as determined by the space between bones is hyaline in nature. Then there is meniscal cartilage that is of a different cellular and chemical makeup. The lining of the joint is synovium and this can become a source of chronic inflammation. Next are the ligaments and capsule so injury and arthritis affect the entire joint and not just what is seen or not seen in an X-ray; arthritis is the result of a bio-immune response and not simply mechanical injury. That’s where stem cells may come to the rescue along with weight loss and strength training. Stem Cells seem to have a place in influencing the well being of the joint at any age; first as an anti-inflammatory, then as an immune modulator. What about cartilage regeneration? I don’t know for sure yet, there is probably an inverse relationship with the potential for cartilage regeneration and age. On the other hand, if a bone marrow aspirate concentrate intervention in an injured or arthritic joint helps maintain the well being of the mature athlete, I am not concerned about the MRI 18 months later.
Tags: arthritis, Cartilage, Clinical Trial. Mitchell B. Sheinkop, Hip Replacement, Interventional Orthopedics, Knee, Osteoarthritis, Regenerative Pain Center, stem cells
May 27, 2014
Last week, I performed Bone Marrow Aspirate Concentrate Stem Cell Interventions on two patients; one was 76 and the other 79. The outcomes research at Regenexx has shown that age is not an obstacle to a successful Mesenchymal Stem Cell procedure for postponing or avoiding a knee replacement. Both patients were healthy and wanted to remain active. Both patients met Body Mass Index requirements for inclusion in our clinical stem cell interventions; most important, the nucleated cell count in both patients exceeded 400 million. Nothing I have described guarantees success; but I have to pause and congratulate both patients for their respective attitudes and desire to not become victims of a particular age category.
Aging is something we can’t control but the aging process may be modified by diet and exercise. When injury or arthritis intervenes, the options are to succumb, undergo a joint replacement or possibly postpone or avoid a joint replacement with Cellular Orthopedic intervention (Bone Marrow Aspirate Concentrate containing your own stem cells). As I have indicated, in recent Blogs, the research at Regenexx suggests that it isn’t your birthday that influences a successful outcome but rather the number of nucleated cells found in your marrow, an indirect indicator of the number of Colony Forming Units (mesenchymal stem cells).
Last weekend we celebrated Memorial Day by giving pause to remember. I received my commission as a First Lieutenant in the United States Air Force on the sixth day of November, nineteen hundred and sixty-seven. Times have changed and we age but there is little reason not to try and stay active. Over the years when there were no alternatives, I sought to improve the quality of a patient’s life by replacing an arthritic hip or knee with a prosthesis. Now I myself have aged but believe that the higher you climb the more you can see. You are never too old to stay active. The outcomes data continually documents the patient satisfaction now up to five years at Regenexx with our own objective data base indicating, not only patient satisfaction, but return to or continuation of a high level of athletic activity and fitness participation following a cellular orthopedic intervention for a musculoskeletal injury or impairment from an arthritic joint.
Stay Active My Friend.
Tags: arthritis, Bone Marrow Concentrate, Clinical Trial. Mitchell B. Sheinkop, Hip Replacement, Knee, Mature Athlete, Osteoarthritis, Regenerative Pain Center, stem cells
May 20, 2014
In the last week, I have become aware of four companies developing new regenerative medicine product for Musculoskeletal Care of the Aging Athlete. What I find extremely interesting is the fact that two years ago, when I entered the practice of using bone marrow aspirate concentrate in an attempt to postpone or possibly avoid a joint replacement in an arthritic knee or hip, the orthopedic community was very critical telling patients that regenerative medicine was still ten years away. Fast forward two years and four new initiatives into the emerging field of regenerative medicine have come to my attention; underwritten by orthopedic surgeons or companies that have produced prosthetic joints for over 30 years. All of the product in development has not yet been approved by the FDA and many developing products are still being tested in Europe. What we at the Regenerative Pain Center offer is within FDA guidelines and approved by all regulatory agencies of the government. At the same time, I am very much aware of what is taking place nationally and internationally; when a newer regenerative medicine product is made available and FDA approved, we at the Regenerative Pain Center will be aware and closely evaluate as to whether it should be incorporated into our service line.
Let me be candid, our success rate is not 100 per cent. There have been three or four hip patients that have not provided the outcome the patient sought or that I hoped to provide; namely, avoidance of a hip replacement. On the other hand, the vast majority of hip bone marrow aspirate concentrate procedures are still allowing the patient a very full return to activities with about 70% percent patient satisfaction at a minimum of one year. When it comes to those who sought help for an arthritic knee, we have done even better with an 85% patient satisfaction outcome at a minimum of one year. Several of those patients had reached a plateau at six months but realized a marked improvement in the pain score with a Platelet Rich Plasma refresher. When a patient elects to under go a bone marrow aspirate concentrate hip or knee intervention at the Regenerative Pain Center, that patient may be assured that what we are doing is based on FDA guidelines and our clinical outcomes research. In addition, each patient should recognize that Regenexx continually statistically reviews our outcomes data. Last week, we recognized that those who underwent Cellular Orthopedic interventions for an arthritic knee did best when the cell count of mononuclear cells exceeded 400 million. Be aware that we count the cells in every Regenerative Medicine procedure. Our approach is no longer “this is the way we do it.” Our approach is based on experience and outcomes research, the same that I used in a long joint replacement career.
Tags: arthritis, Benefits and Risk, Bone Marrow Concentrate, medicine, Orthopedic Surgeon, Regenerative, Regenerative Pain Center, Regenexx, stem cells
Apr 29, 2014
We do not quit
Playing because
We grow old;
We grow
Old because
We quit playing.
– Oliver Wendell Holmes first half of 19th century
Last Monday, I took my first early morning, outdoor, cycling ride of the spring along the Chicago lakefront. It was a perfect morning and with so few on the bike path, I was able to let my mind wonder. I thought about this past Saturday and Sunday spent on the spring creeks of Wisconsin wading up a stream in search of the brown trout with a fly rod in hand. I thought about my on going training days in the health club where I run on the treadmill, row on the Concept 2 ergometer, and mix in some strength training. I thought about the several weeks of skiing this past winter in the fabulous powder I found in Colorado. Why the reminiscence? It’s my birthday this month.
That Oliver Wendell Holmes Sr. certainly got it right. Yet everyday I read about and listen to the diabetic epidemic in the world and the associated obesity, hypertension, renal failure, vascular dysfunction, etc., etc., etc. You don’t have to be a diabetic to be a victim of all the above. There is something though you can do about it: loose weight, get fit.
While there might or could be a congenital or inherited contribution to your arthritis, and while you may have sustained a trauma, the vast majority of arthritis in the hip and knee is either caused by or worsened because of the extra weight you carry.
My professional ethos is the Musculoskeletal care of the aging athlete. Your world is weight reduction and getting fit; my world is enabling you to improve your well being through Regenerative Medicine/ Cellular Orthopedics and I have professional company. The professional company is illustrated by an article published April 17: Growth Factor May Help Arthritic Knees. In the Swedish study, Fibroblast Growth Factor was used to stimulate cartilage repair in arthritic knees. A significant difference was found when compared with placebo when Sprifermin, an agent that specifically activates fibroblast-growth-factor-3 receptors in cartilage to promote chondrogenesis, cartilage matrix formation and cartilage repair was injected at high dose. While at 12 months, the cohort receiving Sprifermin didn’t show an increased joint space, when compared to the placebo group, they didn’t loose thickness.
We do more with our Bone Marrow Aspirate Concentrate stem cell intervention than inject one agent though our bone marrow derived Mesenchymal Stem cell preparation certainly contains the agent used in the Swedish study. The point, while stem cells may not regenerate the joint after a yet to be determined age, there is continuing evidence that the stem cells will alter the arthritic progression.
Tags: arthritis, athletes, bone marrow, Bone Marrow Concentrate, Concentrated Stem Cell Plasma, Hip Replacement, Interventional Orthopedics, Knee, Mature Athlete, Regenerative Pain Center, stem cells
