Jun 15, 2017
It was difficult for me to sit and listen to so many “show and tell” presentations not supported by scientifically overseen outcomes data. Too much anecdote about unproven methodologies; many not compliant with FDA guidance. Basically, it was frequently repeated false news. I was taken aback by what so called physicians are injecting into the joints of their patients. Florida seems to lead the way in the cook book approach to arthritis followed closely by California. Illinois is guilty as well but not the medical community. Despite my negativity about the absence of science, this gathering certainly did not begin to approach the science and integrity of presentation found in the discipline of orthopedic surgery; of particular interest to me was the universal agreement that there is no regenerative potential in Amniotic Fluid Concentrate. A matter of fact, there was not one outcomes paper presented concerning amniotic fluid. It becomes ever so important that a patient choose an experienced, scientifically oriented, regenerative medicine specialist when seeking a non-surgical option for an arthritic knee, hip, ankle or shoulder. The patient must bear in mind that the specialist’s goal is to improve function, diminish pain and postpone, possibly avoid a joint replacement for an arthritic joint. When the arthritis has reached end stage, there are those who should have a joint replacement; only a specialist is equipped to properly advise a patient.
In the orthopedic world, scientific papers are not considered to have significance unless the outcome results have been followed for a minimum of two years and more. Furthermore, the articles in order to be considered authoritative must have statistical significance. It seems that the charlatans and camp followers are offering patients an intervention that is neither FDA compliant nor for which there is scientific outcomes data. The one exception to all the fake news was the presentation by Dr. David Karli of Greyledge Orthobiologics who introduced The Method of Ratios for Assessing PRP and BMC Theraeutic Potential. This novel approach to quantitating and qualitating the injectate I am sure will soon become a standard of care for cellular orthopedics so I will quickly introduce into my practice. The Method of Ratios will allow the clinician to better understand what will be injected into a joint.
The appropriate method of advising an arthritic patient as to whether surgery may be postponed or even avoided begins with a specialty consultation including a comprehensive intake, a physical examination including functional testing, and review of images. Only those with specialty training, board certification and experience both in surgery and in regenerative medicine are able to properly advise the patient. I will again underscore the importance of choosing the Cellular Orthopedic expert and not determining what may be best for you by surfing the cloud.
If you want to become better informed, browse my website www.sheinkopmd.com.
You may watch my webinar at www.ilcellulartherapy.com or call to schedule a consultation (312) 475-1893.
Tags: Amniotic, amniotic fluid, arthritis, BMC Theraeutic Potential, bone marrow, cellular orthopedics, Clinical Studies, Clinical Trial. Mitchell B. Sheinkop, Concentrated Stem Cell Plasma, Dr. David Karli, Greyledge, Interventional Orthopedics, Knee Pain Relief, OrthoBiologic Institute, Platelet Rich Plasma, Regenerative, stem cells
May 11, 2017
Last week, my associate attended a continued medical education course held in a venue near the Wisconsin-Illinois border; a site frequently used by the Stem Cell Institute of America to host amniotic fluid marketing seminars. My colleague overheard a conversation between several physical therapists touting the success of amniotic fluid in regenerating cartilage on their patients, “you can see the increased joint space on the x-ray when we see the patient in follow-up”. I have addressed the issue of the absence of viable stem cells in amniotic fluid ad-nauseam (borrowing a recently expressed symptom from the Director of the FBI) but I am continually amazed at how false news when repeated takes on a fantasy of its own. Additionally, my patients frequently ask to repeat the imaging so they might see if the cartilage is growing.
Much of the current research effort pertaining to cartilage is experimental and has to do with the MRI techniques known as T2 mapping and delayed gadolinium enhanced MRI of cartilage (dGEMRIC). In addition to MRI techniques, optical coherence tomography (OCT) may allow arthroscopic evaluation of cartilage by performing microscopic cross-sectional imaging of articular cartilage. In the final analysis, the only present clinical cost effective, non-invasive means of quantitating and qualitating the patient response to an intervention are exactly the parameters I measure in my office; the only comprehensive methodology of its kind in the clinical field of Regenerative Medicine.
When a patient asks me how do I know whether an intervention is a success, I don’t point to an increased joint space on the X-ray as it is not there to be seen. I review patient specific outcomes including pain scores, activity scores, subjective input, and objective measurements and compare the pre-intervention findings with the latest scoring.
In the interval between starting to write this Blog and now, I received an unsolicited update from a patient who had attended the Stem Cell Institute of America seminar. He had asked so many questions during the seminar, the chiropractors running the seminar gave him the PalinGen Flow brochure (their source of amniotic fluid) as my patient had challenged their evidence beyond the speakers’ ability to respond. My patient, who eventually underwent a bone marrow concentrate intervention with my assistance, read the document and learned that PalinGen Flow makes no mention of stem cell content in their literature.
To schedule an appointment call (312) 475-1893
To visit my web site go to www.sheinkopmd.com
To watch my webinar visit www.ilcellulartherapy.com
Tags: arthritis, bone marrow, Bone Marrow Concentrate, Clinical Trial. Mitchell B. Sheinkop, Concentrated Stem Cell Plasma, Interventional Orthopedics, joint replacement, Mesenchymal Stem Cell, Regenerative, regenerative medicine, stem cell treatment
May 5, 2017
NON-INTERVENTIONAL MEANS OF MANAGING KNEE ARTHRITIS
A PUBLIC SERVICE ANNOUNCEMENT
PUBLIC RELEASE: 2-MAY-2017
Weight loss can slow down knee joint degeneration
CREDIT: RADIOLOGICAL SOCIETY OF NORTH AMERICA
OAK BROOK, Ill. – Overweight and obese people who lost a substantial amount of weight over a 48-month period showed significantly lower degeneration of their knee cartilage, according to a new study published online in the journal Radiology.
According to the National Institutes of Health, obesity is a risk factor for osteoarthritis. Being overweight or obese can place extra pressure on joints and cartilage, causing them to wear away. In addition, people with more body fat may have higher blood levels of substances that cause inflammation in the joints, raising the risk for osteoarthritis.
“For this research, we analyzed the differences between groups with and without weight loss,” said the study’s lead author, Alexandra Gersing, M.D., from the Department of Radiology and Biomedical Imaging at the University of California, San Francisco. “We looked at the degeneration of all knee joint structures, such as menisci, articular cartilage and bone marrow.”
The research team investigated the association between weight loss and the progression of cartilage changes on MRI over a 48-month period in 640 overweight and obese patients (minimum body mass index [BMI] 25 kg/m2) who had risk factors for osteoarthritis or MRI evidence of mild to moderate osteoarthritis. Data was collected from the Osteoarthritis Initiative, a nationwide research study focused on the prevention and treatment of knee osteoarthritis. Patients were categorized into three groups: those who lost more than 10 percent of their body weight, those who lost five to 10 percent of their body weight, and a control group whose weight remained stable.
The results showed that patients with 5 percent weight loss had lower rates of cartilage degeneration when compared with stable weight participants. In those with 10 percent weight loss, cartilage degeneration slowed even more.
Not only did the researchers find that weight loss slowed articular cartilage degeneration, they also saw changes in the menisci. Menisci are crescent-shaped fibrocartilage pads that protect and cushion the joint.
“The most exciting finding of our research was that not only did we see slower degeneration in the articular cartilage, we saw that the menisci degenerated a lot slower in overweight and obese individuals who lost more than 5 percent of their body weight, and that the effects were strongest in overweight individuals and in individuals with substantial weight loss,” Dr. Gersing said.
Light to moderate exercise is also recommended to protect against cartilage degeneration in the knee.
“Our study emphasizes the importance of individualized therapy strategies and lifestyle interventions in order to prevent structural knee joint degeneration as early as possible in obese and overweight patients at risk for osteoarthritis or with symptomatic osteoarthritis,” Dr. Gersing said. [end]
If you want to learn more about postponing or perhaps even avoiding surgery for a joint that alters your quality of life, call 312-475-1893.
To learn more, check out my web site at www.Sheinkopmd.com
View my webinar at www.ilcellulartherapy.com
Tags: arthritis, Bone Marrow Concentrate, Clinical Trial. Mitchell B. Sheinkop, Interventional Orthopedics, joint replacement, Knee Pain Relief, Osteoarthritis, Regenerative
Apr 20, 2017
My clinical practice mission is to use autologous concentrated marrow-derived mononuclear cells for the care and treatment of a joint afflicted by degenerative arthritis so as to assist a patient in postponing, perhaps avoiding a joint replacement. I then follow the patient using osteoarthritis outcome scores to measure pain control, activity improvement, and quality of life impact. The knee society score, an orthopedic surgeon’s vehicle, (KSS) also demonstrates a significant improvement of on the symptoms subscale and function subscale in most patients who undergo a Bone Marrow Concentrate procedure in my office. What about Stem Cells? Please note at the end of the first sentence and the beginning of the second, my emphasis on autologous concentrated marrow-derived mononuclear cells; not “Stem Cells”. That bone marrow concentrate is made up of Platelets, Growth Factors, and Mononucleated cells. It has been estimated that somewhere between .0017% and .034% of the mononucleated cells are actually adult mesenchymal stem cells. My point is that when you see the ads for stem cells on the many web sites, in the print media and now on outdoor advertising signs as the one I noticed on Clinton and Monroe in Chicago this past Monday, you may fall victim to marketing and not science. Chiropractors, non-board certified physicians, family practitioners and the entire realm of camp followers have embraced the exploding discipline of Regenerative Medicine. Patient beware as I point out in the next paragraph using a recently published study from the Mayo Clinic.
Many patients come to Mayo Clinic for a second opinion or diagnosis confirmation before treatment for a complex condition. In a new study, Mayo Clinic reports that as many as 88 percent of those patients go home with a new or refined diagnosis – changing their care plan and potentially their lives. Conversely, only 12 percent receive confirmation that the original diagnosis was complete and correct. Given what I have seen evolving in the field of Regenerative Medicine, I am not surprised. Few practices offering “Stem Cells” have any idea what is involved and what is in the bone marrow concentrate. Many mislead the public with a stem cell presentation using amniotic fluid product wherein it has repeatedly demonstrated there is an absence of stem cells in amniotic fluid once processed, frozen and fast thawed. What about adipose derived stem cells? For one, to liberate the stem cell from the adipocyte, there has to be a cycle of enzymatic degradation. The latter violates FDA requirements. What about platelets and growth factors in adipose derived materials? Given the relative absence of blood supply in fat, I have yet to find a scientific publication suggesting there are growth factors in adipose tissue.
The cover story in the April 2017 AARP.ORG/Bulletin is titled “How to Stop Fraud, The Ultimate Guide to Protect Yourself from Scammers and Crooks” While not directed to Regenerative Medicine, the warning applies. As suggested by the Mayo Clinic referenced article above, the best protection is a second opinion.
To schedule call: 312 475-1893
You may visit my web site at www.SheinkopMD.com
Or watch my webinar at www.ilcellulartherapy.com
Tags: Benefits and Risk, Bone Marrow Concentrate, Orthopedic Surgeon, Regenerative, regenerative medicine, Regenexx-SD, stem cell treatment
Mar 27, 2017
I am an orthopedic surgeon. The new focus for the arthritic joint is restoration and not replacement. Almost five years ago, I joined that emerging initiative after a 37-year professional career of having replaced joints. One of the recent problems emerging in this discipline of regenerative medicine is that marketing is inaccurate. There is no quick fix be it a replacement or an interventional orthopedic procedure. What stem cells do not risk is a joint replacement failure requiring a repeat procedure (revision), a significant occurrence of infection, a blood clot or a nerve injury. As a surgeon, I replaced arthritic joints because the original cartilage had degenerated and the bone surfaces degraded. My effort now is to restore and not replace. This is an evolving field using stem cells derived from bone marrow, using inflammatory blockers, and growth factors.
Finding a good interventional cellular orthopedist is partly a numbers game. Research shows a regenerative specialist must do a minimum of 50 interventions a year to provide a consistently satisfactory end result. Five years ago, the orthopedic surgical community including my past associates were all nay-sayers. Today, they are embracing that which I pioneered. While there are of this time, no true standards and regulatory bodies outside the FDA, in my office, I have pioneered a standardization initiative via qualitative analysis of that which we aspirate and then inject. The meeting of the American Academy of Orthopedic Surgeons in San Diego ending last week dedicated a relatively large part of the educational and scientific agenda to regenerative medicine and interventional orthopedics. All this being said, the patient seeking out one of America’s fastest growing procedures must assure the provider is experienced, knowledgeable and be prepared to meet a patient’s expectations. The explosive growth of those holding themselves out to be capable of delivery an excellent or at least a good regenerative outcome is not supported by evidence or experience. To repeat what I indicated above, all doctors are not the same. If you want the evidence, make an appointment. If you want a procedure by those who market themselves as treating Alzheimer’s, Alopecia, facial wrinkles, Arthritis, so on and so forth all under the same roof, I am not the that clinician.
To learn more, check out my web site at www.Sheinkopmd.com
View my webinar at www.ilcellulartherapy.com
Or call for an appointment 847 390 7666
Tags: arthritis, bone marrow, Clinical Trial. Mitchell B. Sheinkop, Concentrated Stem Cell Plasma, Interventional Orthopedics, Mesenchymal Stem Cell, Regenerative, regenerative medicine, stem cell treatment
