Jan 21, 2014 | Articles by Body Part, Knee, News and Events, Regenerative Treatments, Stem Cell Procedures
A nice article was recently published at snocountry.com, questioning whether stem cell treatments for the ACL are a “quantum shift” in medicine. Stem cell therapy has shown promising results when compared to traditional surgeries for non-retracted ACL tears and injuries. We are proud to be on the leading edge of these new treatments and articles like these will become more commonplace as athletes become more aware of less invasive alternatives to heal common injuries.
Bob Wislow, 68; Bruce Snyder, 42; and Jacob Gillis, 19, all sought an alternative to surgery that enabled them to regain their high level of activity and remain pain free.
Snyder is a runner, cyclist, and weekend warrior, who tore his meniscus playing soccer. Colorado University student Jacob Gillis, 19, was skiing last spring when he landed awkwardly and heard a “pop” in his knee. An MRI of the ACL (anterior cruciate ligament) showed a partial tear.
Read the complete article at SnoCountry Online
Jan 2, 2014 | PRP, Spine and Neck
Video: Treating Whiplash with Platelet Rich Plasma
[youtube id=”lfdm3qPPqvY” width=”600″ height=”350″]
Recent studies found that chronic neck pain is a serious problem. It affects anywhere from 13% to over 25% of the general population[1]. Of this percentage, 37% contribute their pain to a motor vehicle accident[2], where a whiplash-type injury is very common.
Whiplash can cause neck and shoulder pain, and another recent study[3] found that it can also be attributed to headaches, dizziness, visual impairment and nausea. It is caused when stationary neck joints rapidly and violently shift and then return to their original position. In the case of a car accident, typically joints on the top of the neck shift back, while joints on the bottom of the neck go forward. Ligaments, which hold the joints in place, are stretched as a result. Potentially severe pain now exists, as there is increased motion in the joints after the injury. Muscles in the neck become tense to compensate for the loose ligaments and hold the joints in place. A patient suffering from whiplash can have both tense muscles and pain in the ligaments and in neck joint capsules.
Whiplash: How it’s treated
The good news is that 90% of patients can heal from a whiplash injury in just a few months through a combination of physical therapy and anti-inflammatories. But in the other 10%, the ligaments are stretched too far, or the joint itself is damaged and cannot heal on its own. To find the root cause of pain with these patients, a local anesthetic or nerve block is administered at the injury site to accurately pinpoint whether the joint is the source of pain. If pain is relieved, it confirms the diagnosis. Once diagnosed, a treatment plan can be developed to jump start healing.
Treating a Whiplash Neck Injury: The Platelet Rich Plasma Process
Platelets initiate tissue repair by releasing growth factors. These growth factors start the healing process by attracting cells that repair us, including critical stem cells. Platelet Rich Plasma (PRP) therapy intensifies this process by delivering a higher concentration of platelets. The therapy involves a small sample of the patient’s blood placed in a centrifuge to separate the platelets from the other blood components. The concentrated PRP is then injected into and around the point of injury, significantly strengthening the body’s natural healing. Our process for PRP is much different and sets us apart. Because our samples are all hand processed, we are able to produce PRP that is free of contaminating red and white cells, which can inhibit repair. This same special process also allows us to customize the concentration and volume for each individual and each injury type. This greatly improves outcomes.
PRP treatment typically takes about an hour, and the patient will go home that same day. Recovery from the injection is usually within 1 week of the procedure. On average, 3-4 treatments are necessary to heal a whiplash injury. Once the joints and tendons heal, then tension in the muscles will relax and the patient can experience significant improvement.
Pain from a whiplash injury should never be accepted as the “new normal.” Real help is available, even when traditional treatments fail. PRP is a solid answer for those 10% of whiplash patient still seeking relief.
[1] Bovim G, Schrader H, S and T, “Neck Pain in the General Population,” Spine, (1994), 19:1307–9
[2] Freeman, M, Croft, A, Rossignol, A, Centeno, C, Elkins, W, “Chronic Neck Pain and Whiplash: A Case-Control Study of the Relationship between Acute Whiplash Injuries and Chronic Neck Pain,” Pain Research and Management, (2006 Summer), 11(2): 79–83, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2585479/?report=classic#b28-prm11079
[3] Ishikawa S, Yokoyama M, Mizobuchi S, Hashimoto H, Moriyama E, Morita K, “Epidural Blood Patch Therapy for Chronic Whiplash-Associated Disorder,” Anesthesia and Analgesia, (September 2007), 105(3):809-14, http://www.ncbi.nlm.nih.gov/pubmed/17717243?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
Jan 2, 2014 | Knee, Platelet Lysate, Prolotherapy, PRP, Stem Cell Procedures
Pain Relief through Superior Technology
At StemCell ARTS, we often see patients who have had problems associated with knee surgery, such as a torn meniscus needing repair, surgery to correct an ACL injury or a procedure associated with osteoarthritis. Many of these patients did not experience the results they were hoping for and feel that the surgery has failed. In many cases, the surgery actually did not fail; it just did not go far enough into resolving all of the problems that the patient’s knee joint was experiencing.
Take the example of a torn meniscus surgery. The surgery may have been successful in removing the piece of meniscus that was torn, but it did nothing to address the additional instability in the knee, cartilage wear, or potential tendonitis that the patient might have. These types of issues can cause just as much knee pain as what the patient was experiencing from the initial injury.
Video: Treating Failed Knee Surgeries:
[youtube id=”AjlF-T8VZ0s” width=”600″ height=”350″]
How We Find Additional Knee Issues
The physicians at StemCell ARTS can help diagnose additional knee issues that might still exist after surgery. To confirm the existence of further knee injuries, a local anesthetic or nerve block can be administered to accurately pinpoint whether a certain area is the source of the pain. If pain is relieved, it contributes toward confirming the initial diagnosis. The final diagnosis is confirmed through a review of patient history, a physical examination and other innovative diagnostic procedures. Once diagnosed, a treatment plan, utilizing part or all of the following, can be developed to promote healing.
Stem Cell Therapy: The Process
Stem Cell therapy can be used to help complete the final stages of healing within a knee injury. Stem Cell Therapy makes use of the supply of stem cells available in the body to help repair injured and degenerated tissues. The easiest place to harvest these stem cells is from the back of the hip area, under ultrasound or x-ray guidance. This harvesting procedure is well-tolerated by patients and not considered difficult as many patients claim it is not painful.
After bone marrow blood is drawn, it is centrifuged to concentrate and purify the stem cells, as each stem cell specimen is custom designed to meet the needs of the specific injury. Utilizing either fluoroscopy or ultrasound, the stem cells are precisely injected into the injured site to improve the likelihood that stem cells will adhere to the damaged area and promote healing. After the stem cells are placed, concentrated platelets and other adjuvants are injected to stimulate the stem cells to multiply, and then transform into the repair cells needed to regenerate new cartilage. The platelets are injected again two to five days later to keep the stem cells activated and promote additional healing.
Platelet Rich Plasma
Platelets initiate tissue repair by releasing growth factors. These growth factors start the healing process by attracting cells that repair injuries, including critical stem cells. At StemCell ARTS, our Platelet Rich Plasma Therapy (PRP) intensifies this process by delivering a higher concentration of platelets. The therapy involves a small sample of the patient’s blood, placed in a centrifuge to separate the platelets from the other blood components. The concentrated PRP is then injected into problem areas such as weakened ligaments, injured joints or poor muscle attachments, thus significantly strengthening the body’s natural healing tendencies. StemCell ARTS process for PRP is much different and sets us apart from all others. Because our samples are all hand-processed, we are able to produce PRP that is free of contaminating red and white cells, which can inhibit repair. This same special process also allows us to customize the concentration and volume for each individual and each injury type. This greatly improves patient outcomes. Sometimes just a single injection of PRP will help the knee go through the final stages of repair.
Platelet Lysates
Platelets in the blood release tissue growth factors that aid in the healing process. Normally this occurs slowly over time, but a Platelet Lysate solution that is high in concentration of growth factors can be released immediately into the body. The result is a targeted, faster healing process.
Prolotherapy
Injected three to five days before the stem cells, Prolotherapy contains a solution of concentrated dextrose and a local anesthetic (steroids are not used). This Prolotherapy solution stimulates the body’s natural ability to repair damaged tissue, encouraging new growth and creating a positive environment into which the stem cells are placed.
By introducing additional growth factors, the hidden knee damage that might be present after a failed surgery can finally be encouraged to heal. These treatments can be the key to finally relieving knee pain in a way that marks a real transformation in the patient’s level of mobility and a return to normal life.
Jan 2, 2014 | Hip, Osteoarthritis, Stem Cell Procedures
An orthopedic surgeon recently compared patients suffering from hip arthritis, where he performed traditional hip replacement surgery on one group and used the latest stem cell treatment on another group. He found that the patients receiving stem cell treatments experienced more range of motion a year after receiving treatment than patients receiving hip replacement surgery. He also found that 73% of the patients that received the stem cell treatment were able to return to sporting activities. In terms of overall functional scores, patients receiving stem treatments were very similar to the surgery group, with the surgery group receiving a slightly better score for pain management[1]. However, when you compare the invasiveness of surgery to stem cell therapy, the advantages of stem cell treatments are striking.
Traditional surgery: What are the risks?
Traditional hip surgery can range from removing the ball of the femur and replacing it with a metal ball to a total hip replacement. With a complete hip replacement, the entire head of the femur is removed and a metal prosthesis is hammered into place on the hip bone as well as the socket on the pelvis. Risks with these types of surgical procedures include:
- Risk of infection
- Increased risk of stroke and heart attack
- Allergic reaction to the metal used in the implant
- Wear particles from the implant causing high levels of metal ions in the blood stream
- Risk of blood clots in the legs (DVT) and/or lungs (PE)
- Painful post-surgical recovery
- Prolonged rehabilitation
- Recurrent hip dislocations if the replacement is not placed properly
- Failure of the hip prosthesis
After a hip replacement, the materials involved wear down over time, meaning that a hip revision surgery might be required at some point to replace failing implants. This surgery can be longer and even more involved that the original procedure.
Biologic regenerative treatments, such as Stem Cell Therapy, are much less invasive procedures with a quicker return to normal daily activity when compared to surgery. To maximize healing, Stem Cell treatments are used with other leading treatments in the field including Prolotherapy, Platelet Rich Plasma (PRP) and Platelet Lysate therapy. In certain cases, a patient’s unique medical condition or circumstance may preclude utilizing the benefits of all treatments used together. In this case, a customized plan is developed using one or more of the treatments to obtain the best patient outcomes possible. While sometimes there is no good alternative to surgical repair, most often biologic repair offers a better option.
Stem Cell Therapy: The Process
Stem Cell therapy makes use of the supply of stem cells available in the body to help repair injured and degenerated tissues. The easiest place to harvest these stem cells is from the back of the hip area, under ultrasound or x-ray guidance. This harvesting procedure is well tolerated by patients and not considered difficult as many patients claim it is not painful.
After bone marrow blood is drawn, it is centrifuged to concentrate and purify the stem cells, with each stem cell specimen custom designed to meet the needs of the specific injury. Utilizing either fluoroscopy or ultrasound, the stem cells are placed on the injured site precisely to improve the likelihood that stem cells will adhere to the damaged area and promote healing. After the stem cells are placed, concentrated platelets and other adjuvants are injected to stimulate the stem cells to multiply, and then transform into the repair cells needed to regenerate new tissue. The platelets are injected again 2-5 days later to keep the stem cells activated and promote additional healing.
Prolotherapy
Injected 2-5 days before the stem cells, Prolotherapy contains a solution of concentrated dextrose and local anesthetic (steroids are not used). This solution stimulates the body’s natural ability to repair damaged tissue, encouraging new growth and creating a positive environment into which the stem cells are placed.
Platelet Rich Plasma
Platelets initiate tissue repair by releasing growth factors. These growth factors start the healing process by attracting cells that repair us including critical stem cells. Platelet Rich Plasma therapy intensifies this process by delivering a higher concentration of platelets. The therapy involves a small sample of the patient’s blood placed in a centrifuge to separate the platelets from the other blood components. The concentrated PRP is then injected into and around the point of injury, significantly strengthening the body’s natural healing. Our process for PRP is much different and sets us apart. Because our samples are all hand processed, we are able to produce PRP that is free of contaminating red and white cells, which can inhibit repair. This same special process also allows us to customize the concentration and volume for each individual and each injury type. This greatly improves outcomes.
Platelet Lysates
Platelets in the blood release powerful tissue growth factors that aid in the healing process. Normally this occurs slowly over time, but through the creation of a Platelet Lysate solution, a high concentration of growth factors can be released immediately into the body. The result is a targeted, faster healing process. Additionally, there are areas of the body where using traditional PRP may cause too much inflammation. Platelet Lysates are a better option where inflammation may become an issue.
While additional study is needed[2], the results of biologic regenerative treatments are too promising to ignore. This can be a real solution to alleviate the pain and loss of function from hip arthritis without the drastic approach of surgically cutting open a patient to replace the entire hip.
[1] Mitchell, B. Sheinkop, MD, The Orthobiologic Institute, “BMAC Intervention Versus Joint Arthroplasty for Arthritis,” results presented to LA Orthobiologic Conference on June 7th, 2013; http://www.regenexx.com/wp-content/uploads/2013/06/11-MITCHELL-B-SHEINKOP1.pdf
[2] It should be noted in the Sheinkop study that this was a comparison of patients treated in 2007 with surgery and patients treated in 2011-13 with stem cells. It was not a randomized controlled trial, as that type of study has not yet been conducted for stem cell treatments. It should also be noted that Dr. Sheinkop is a member of the Chicago Regenexx Network, Regenexx is the same treatment offered by Stem Cell Arts.
Jan 2, 2014 | Prolotherapy, PRP, Shoulder / Rotator Cuff, Stem Cell Procedures
Stem cell and platelet procedures can be used to help heal rotator cuff injuries and degenerative shoulder conditions
Recent Studies cited by the American Academy of Orthopaedic Surgeons show the potential benefits of regenerative treatments such as Stem Cell therapy and Platelet Rich Plasma (PRP) [1]. Also, a recent case history cited a patient with a severely debilitating rotator cuff injury—a case where the patient was going to lose her job due to the injury—experiencing a 90% improvement in rotator cuff pain, function and mobility after approximately 7 months of treatment[2]. While this example may be above normal expected results, it is indicative of just how far these treatments have come in healing this type of injury.
Surgery is a common treatment option following a rotator cuff injury. But according to the American Academy of Orthopaedic Surgeons, possible complications of surgery include nerve injury, infection, deltoid detachment, permanent stiffness or loss of motion and a re-tear of the tendon.[3] The advantage of regenerative treatment is that they are minimally invasive compared to surgery, and they have the ability to actually heal the injury without scalpels, and the physical stitching together of tendons and tissue.
[accordion title=”Most Commonly Treated Shoulder Conditions:” is_open=”no”]
Below is a list of the most common shoulder and rotator cuff injuries and conditions that we treat with stem cells or platelet procedures. This is not an all-inclusive list.
- Rotator cuff tears
- AC Joint Separation
- Arthritis of the shoulder joint
- Labral tears or degeneration
- Thoracic outlet syndrome
- Rotator cuff tendonitis
- Recurrent shoulder dislocations
[/accordion]
To maximize healing, Stem Cell treatments are used with other leading treatments in the field including Prolotherapy, Platelet Rich Plasma (PRP) and Platelet Lysate therapy. In certain cases, a patient’s unique medical condition or circumstance may preclude utilizing the benefits of all treatments used together. In this case, a customized plan is developed using one or more of the treatments to obtain the best patient outcomes possible. While sometimes there is no good alternative to surgical repair, most often biologic repair offers a better option.
Video: Treating the Shoulder and Rotator Cuff Non-Surgically with Regenerative Biologic Treatments:
[youtube id=”lLGP74H7EHc” width=”600″ height=”350″]
Stem Cell therapy makes use of the supply of stem cells available in the body to help repair injured and degenerated tissues. The easiest place to harvest these stem cells is from the back of the hip area, under ultrasound or x-ray guidance. This harvesting procedure is well tolerated by patients and not considered difficult as many patients claim it is not painful.
After bone marrow blood is drawn, it is centrifuged to concentrate and purify the stem cells, with each stem cell specimen custom designed to meet the needs of the specific injury. Utilizing either fluoroscopy or ultrasound, the stem cells are placed on the injured site precisely to improve the likelihood that stem cells will adhere to the damaged area and promote healing. After the stem cells are placed, concentrated platelets and other adjuvants are injected to stimulate the stem cells to multiply, and then transform into the repair cells needed to regenerate new tendon. The platelets are injected again 2-5 days later to keep the stem cells activated and promote additional healing.
Injected 2-5 days before the stem cells, Prolotherapy contains a solution of concentrated dextrose and local anesthetic (steroids are not used). This solution stimulates the body’s natural ability to repair damaged tissue, encouraging new growth and creating a positive environment into which the stem cells are placed.
Platelets initiate tissue repair by releasing growth factors. These growth factors start the healing process by attracting cells that repair us including critical stem cells. Platelet Rich Plasma therapy intensifies this process by delivering a higher concentration of platelets. The therapy involves a small sample of the patient’s blood placed in a centrifuge to separate the platelets from the other blood components. The concentrated PRP is then injected into and around the point of injury, significantly strengthening the body’s natural healing. Our process for PRP is much different and sets us apart. Because our samples are all hand processed, we are able to produce PRP that is free of contaminating red and white cells, which can inhibit repair. This same special process also allows us to customize the concentration and volume for each individual and each injury type. This greatly improves outcomes.
Platelets in the blood release powerful tissue growth factors that aid in the healing process. Normally this occurs slowly over time, but through the creation of a Platelet Lysate solution, a high concentration of growth factors can be released immediately into the body. The result is a targeted, faster healing process. Additionally, there are areas of the body where using traditional PRP may cause too much inflammation. Platelet Lysates are a better option where inflammation may become an issue.
In the case history mentioned above, the patient previously tried cortisone injections, acupuncture, physical therapy and taking 2400mg of Ibuprofen daily. The result was that her pain consistently intensified. After losing range of motion in her shoulder, she developed pain and muscle spasms in her neck. She felt that she was unable to continue her career or participate in sports. After receiving regenerative care, she experienced 60-70% improvement in overall pain function and mobility after just 5 months. Two months later, this number jumped to 90%[4]. Regenerative biologic treatment is a real solution to negate the effects of a rotator cuff injury without the risks associated with more invasive surgical procedures, and can finally bring relief to a patient where other treatments have failed.
[1] T. Sean Lynch, MD, “The Role of Biologics in Rotator Cuff Repairs,” AAOSNow; August 2013; Volume 7, Number 8; American Academy of Orthopaedic Surgeons (AAOS); http://www.aaos.org/news/aaosnow/nov11/clinical3.asp
[1] Donna D. Alderman, DO, Sean C. Robbins, BA, “Platelet Rich Plasma Prolotherapy for Rotator Cuff Tears,” Practical Pain Management, September 2012; 21-23
[1] “Rotator Cuff Tears: Surgical Treatment Options,” OrthoInfo; American Academy of Orthopaedic Surgeons (AAOS); http://orthoinfo.aaos.org/topic.cfm?topic=A00406
[1] Donna D. Alderman, DO, Sean C. Robbins, BA, “Platelet Rich Plasma Prolotherapy for Rotator Cuff Tears,” Practical Pain Management, September 2012; 21-23
