Musculoskeletal Care of the Mature Athlete
Cartilage injured by trauma or affected by age has limited capacity to regenerate. Current methods address small chondral defects via arthroscopic debridement, marrow stimulation techniques (micro-fracture) and restorative treatment, including osteochondral grafting and autologous chondrocyte implantation. Larger defects are managed with total joint replacement. It is universally agreed that the future lies in biologic solutions through cartilage regeneration. At Regenexx, the future is now. While regenerated cartilage may be derived from various cell types including chondrocytes, puripotent stem cells and mesenchymal stem cells, it is the borne marrow derived mesenchymal stem cells that have the greatest advantage and the least disadvantage in the process of cartilage tissue engineering. It is the Platelet Rich Plasma that contains the common growth factors used in cartilage regeneration. Platelet derived growth factor not only promotes the formation of cartilage, it suppresses the formation of IL-1B thereby halting cartilage degradation. If we now add to the discussion, the role of synovial stem cells in joint regeneration, the reader will have an understanding concerning the three steps in the SD-Regenexx procedure.
Dr. Sheinkop, what will you achieve with a Bone Marrow Aspirate Concentrate (BMAC)/STEM CELL SD procedure intervention for my arthritic joint? Will the cartilage re-grow? Let me address the question by laying out a foundation of principles:
1) Cartilage Regeneration
2) Elimination of Pain
3) Improved Range of Motion
4) Increased Functional Capacity
5) Delay or Avoidance of a Joint Replacement
6) Reversal of the Arthritic Progression
BMAC/Stem Cells provide the most physiologic basis for addressing the six bullets I listed under goals of care. Said treatment is available, here and now. While accompanied by an out of pocket financial responsibility, the risk of complication is pretty much non-existent. Compare that to the risks, pain and lengthy rehabilitation following a joint replacement. At the same time the worst possible scenario is that the stem cells are only partially successful. We now know that a timely PRP additional booster may significantly increase the percentage of successful outcomes. Compare that information to the risk of a revision surgery following a failed joint replacement or the lack of satisfaction and limitations inherent in a joint replacement