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Too much of a good thing?

Advances in technology have enabled us to see things on MRIs today that we would never have been able to see even 10 years ago.

For cancer patients, that can mean the opportunity to seek treatment earlier with better outcomes. But in the field of orthopedics, in some cases, better imaging might be considered too much of a good thing.

This may be especially true for those for whom an MRI reveals a tear in their hip labrum. The labrum forms a lip around the socket part of the ball-and-socket hip joint and helps stabilize the structure. Similar to the meniscus in the knee, it can tear—often as the result of wear and tear as we age.

Yet it is important to note that labrum tears do not necessarily cause hip pain. Some patients with tears do not report any pain. And although numerous studies have demonstrated this, many patients whose MRIs reveal a tear are told they need surgery.

Even those patients who do report hip pain might be surprised to learn that a labral tear is not the cause of their pain anyway.

Other Causes of Hip Pain

The musculoskeletal system is a complex network of interconnected parts. In the hip region, this includes the sacroiliac (SI) joint, hip girdle muscles, ligaments, tendons and nerves. When there is instability in the three sacroiliac joints at the back of the hip (where the hip meets the sacrum or tailbone), patients may report hip pain or the sense that their legs are wobbly or loose.

The hip joint requires strong ligaments to help distribute forces from the leg to the spine. If these ligaments are damaged, their strength is compromised. In addition, all of the body’s lower extremities are supplied by nerves that branch off of the spinal column in the lower back. Issues such as a herniated or bulging disc, arthritis, degenerated disc or spinal stenosis could affect those nerves and cause pain from the hips down.

So before you are talked into surgery to repair a torn hip labrum, contact us. If you are experiencing pain, we will do a thorough exam and determine if the source of the pain is the tear itself or other issues. In many cases, we will recommend platelet rich plasma injections from Regenexx®, which use a concentration of your own blood products to jump-start and significantly strengthen the body’s natural healing processes in the injured tissue(s) that may be the actual source of your pain.

 

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Patients Experiencing Pain After Total Joint Replacements

One of the main questions that we get asked, is if our procedures are able to help those who have been recommended by their physician to receive a total joint replacement, and the answer is yes! Many people are afraid of the complications and hardware that accompany surgical procedures, which is understandable. We see many patients who are still experiencing pain after their total joint replacement.

Studies on Post-Surgical Pain

In a peer-reviewed journal published in 2011, researchers surveyed 632 total knee (TKR) and total hip replacement (THR) patients. 44% of total knee and 27% of total hip replacement patients reported experiencing pain (of any severity) months to years after their procedure.; with 15% of TKR and 6% of THR patients experiencing severe to extreme, persistent pain. Major depression, and referred pain in other body parts was found to be common in patients with severe pain. Total joint replacements are not small medical procedures, so while it is common for some patients to feel some pain, more persistent and severe pain can occur in others and affect mood and other body parts.

StemCell ARTS Solution

At StemCell ARTS, we are able to provide patients with minimally invasive alternatives to surgery. We are seeing more patients actively trying to avoid total joint replacements, and we hope that we can help! Our stem cell and platelet procedures contain powerful growth factors to help heal sprains, tears, and slow down the progression of arthritis. Make our appointment with us today, to see if you are a good candidate to avoid surgery!

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Stem Cells for Frozen Shoulders

Adhesive capsulitis, also known as ‘frozen shoulder’ is a common condition that affects about 3% of the population. It affects the joint capsule and ‘freezes’ it so range of motion is greatly diminished. Often, frozen shoulders clear up within a year, for those with permanently restricted ROM, there are few treatments out there for them, especially if they suffer from arthritis as well.

Solutions Offered at StemCell ARTS

Those who wish to receive stem cell treatments and are diagnosed with adhesive capsulitis, do not make the best candidates. However, our physicians here at StemCell ARTS use a technique called “joint expansion injections” in an attempt to expand the joint in order for stem cells to proliferate in the joint. Expansion injections are typically performed in a set of three, one injection for three weeks. Patients come into the office where our physician injects the affected joint with 30cc or more of a saline and anesthetic solution under fluoroscopic guidance. The idea of these injections is to break the cycle of inflammation and contraction of the joint. No more than 2 hours afterwards, patients attend a physical therapy session where the therapist works on stretching and expanding the joint. This would typically be fairly uncomfortable, but the anesthetic from the injection helps counter the pain. After the series is complete, patients are often considered better candidates for the stem cell series because most, if not all, of their range of motion has returned.

Check out our website to see if we can help with your shoulders!

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Regenexx Helps College Athletes Avoid Surgery!

Collegiate and even high school athletes are intense. They practice and train extensively in hopes of obtaining scholarships or getting signed to a professional league. However, pushing a growing body to its limits has a downfall; they are more prone to injuries. Although their bodies heal faster, they are more likely to keep training on an injury despite their physicians and parents’ protests. This can ultimately exacerbate, the body part and cause more serious harm.

Treatment Plans

Athletes require non-invasive procedures that will allow them to return to training with little to no downtime. At StemCell ARTS, we are able to offer treatments that get these young athletes back into their sport within a few weeks! Experienced physicians here are able to create customized treatments plans with patients’ intense practice schedules in mind. Our doctors will also provide detailed rehab protocols post-procedure so patients do not overexert themselves. Minor sprains, strains and tears are often able to be treated with Prolotherapy or Platelet Rich Plasma. For those with more extensive injuries, our physicians might recommended our Stem Cell series.

See how our Regenexx procedures were able to help heal a college hurdler, who was given the surgery ultimatum!

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StemCell ARTS and Platelet Rich Plasma Featured in Prominent Northern Virginia Fashion and Lifestyle Blog

52Thursdays is prominent fashion and lifestyle blog, covering both the east and west coasts. The blog has been featured in Northern Virginia Magazine and Brightest Young Things, among many others. The blog focuses on style, beauty, fitness, and travel. Sarah Phillips, co-founder of 52Thursdays, is located in the Northern Virginia area. She shares her experiences with local businesses, physical fitness, etc. with her followers. When reading her blog posts, it is easy to see that Sarah is a big fan of staying fit. Her go to source of activity includes CrossFit. However, she participates in numerous other physical activities to keep herself healthy. Her active lifestyle was threatened when she began to experience pain and locking in her hip area.

Sarah sought medical attention and was recommended a MRI to evaluate the pain in the hip. Sarah was discouraged when the MRI findings showed that she had suffered a labral tear. Hip labral tears are common injuries among athletes. Hyperflexion and squatting motions can result in mechanical injury to the labrum. Since squats are nearly unavoidable when participating in strength training, Sarah’s injury had begun to impact her exercise and fitness routine. Sarah decided to explore her options for treating the hip labral tear. She looked into Physical Therapy, activity modification, and met with some orthopedic surgeons to discuss surgical interventions. Her research led Sarah to Platelet Rich Plasma (PRP) and StemCell ARTS. Sarah has undergone two PRP treatments and is chronicling her experience with the procedures and StemCell ARTS. Sarah is showing signs of improvement and will follow up with StemCell ARTS six weeks following her last PRP treatment to evaluate her progress and determine next steps in treatment, if any further treatments are required. To read Sarah’s, more detailed, account of her injury and experience with StemCell ARTS, click the link below.

All Day I Dream About Squats

 

 

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2013 Patient Outcome Data for Same Day Stem Cell Procedures

Click here to view the complete data by body part

As Regenexx Network Physicians, we’re part of the only stem cell treatment network to publish this type of analysis of patient outcome data. The analysis is made possible thanks to the massive numbers that have been accumulating for years in the Regenexx patient registry.

This patient outcome data is not part of a controlled trial. Every patient becomes part of a registry to track outcomes and any complications. This data is a compilation of patient input to the Regenexx Patient Registry at regular intervals following their Regenexx Procedure.

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Stem Cell Treatments Demonstrated to Help 73% of Patients Return to Sporting Activities

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.

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SI Joint Dysfunction

Painful Low Back Issue Responds To Advanced Treatment

One of the many causes of low back pain is related to injuries of the sacroiliac (SI) joint and ligaments. Most common in young and middle aged women, this condition can make sitting and standing quite painful. SI joint dysfunction is difficult to detect, but with precision diagnostics and effective, non-surgical therapy, a board certified specialist can help you obtain significant long-term, potentially permanent relief.

A complex condition
The SI joints connect the pelvic bones to the lowest part of the spine. Small and very strong, SI joints provide structural support and stability, functioning as shock absorbers for the pelvis and the lower back.

Not a lot is known about why SI joints become painful, but current medical consensus is that a change in the normal motion of the joint may be the source. Too much or too little movement may cause pain in the ligaments and joints, as well as spasms in the supporting back and pelvic muscles. It may be the result of direct trauma such as a car accident or as simple as a missed step when descending stairs. The stress of childbirth can also weaken the SI joint and other supporting pelvic structures causing pain and instability. Sitting, standing and bending at the waist aggravates the pain. When SI joint dysfunction is severe, there can be referred pain into the hip, groin and leg.

SI joint dysfunction is difficult to diagnose because currently there are no radiologic tests available that consistently detect abnormal motion of the joint. Experienced pain specialists, familiar with the mechanics of the SI joint, can conduct a precise musculoskeletal examination of the spine and pelvis. This type of exam can often detect SI joint dysfunction. Tests such as x-rays, MRI, CT scan and bone scan may be used to rule out other causes of back pain, but they generally are not helpful with diagnosing SI joint injuries.

Long-lasting relief without surgery
Simple, non-surgical techniques have proven to be very effective in resolving SI joint pain. Injections of anti-inflammatory medication and local anesthetic in the SI joint and ligaments can greatly reduce pain and discomfort for extended periods of time. Radiofrequency neurotomy creates a longer lasting result through denervation – obstructing the nerve supply to the SI joint. Advanced regenerative treatments, such as prolotherapy and platelet rich plasma therapy, may also show excellent clinical benefit. These treatments specifically promote natural healing of the joint and ligaments. By improving strength and stability, regenerative therapies may offer longterm and potentially permanent pain relief.

Safely performed in a sterile, office- based setting, these therapies offer the potential for significant pain relief without surgery, general anesthesia, hospitalization or prolonged recovery periods.

 

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