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!
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.
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!
Stem cell and platelet treatments are currently in the spotlight due to their high popularity within the professional sports community. And what’s not to love about them?! Regenerative therapies are minimally invasive, and the recovery and down time is minimal when compared to surgical procedures. These athletes depend on their ability to train hard, and an injury or long recovery is detrimental to their careers. Regenerative procedures give them the option of forgoing more invasive orthopedic procedures (if possible). For example, a standard ACL surgery could have a recovery time of up to six months with the need for rehab, six months of bracing and physical therapy in between. After this surgery, there are also higher chances of early onset arthritis in the knee.
With the procedures offered here at Stem Cell ARTS, we are able to provide athletes with platelet and stem cell injections that will help the body heal itself, with little to no down time! A recovery from our stem cell procedure would require a patient to be non-weight bearing for 48 hours after the stem cells are injected into a weight bearing joint. A brace might be required if deemed necessary by the physician and worn for up to 4 months afterwards. Patients are usually able to go back to the gym for low impact exercises just two weeks post stem cell series. We ask that our patients follow up in six weeks, and typically they are back to their normal physical activities by then!
Who’s Getting Our Procedures?
We are seeing patients of all different ages, backgrounds, and activity levels here in our clinics. More and more young, high school-aged athletes are coming to us after their sports injuries. They are hoping to continue their athletic careers into college and hopefully professionally as well. Years ago, a torn meniscus or ACL would automatically require surgery and, at their young age, there is a higher risk of re-injury. The popularity of CrossFit has (unfortunately) helped us expand our patient base. The intensity of exercise craze has created many common problems such as torn labrums and rotator cuff tendinitis. There has also been an influx of elderly active patients that want to keep their active lifestyles. We have seen patients as young as 90 who have gone back to running marathons after just a few treatments!
The Future of Sports Injuries
It would be an ambitious statement to say that one day, regenerative treatments will replace surgical procedures, but our goal is to help as many people avoid surgery as possible. We are aware that surgery means downtime, and we want to spread the word that there are alternatives out there for you if you want to get back outside in this beautiful weather just in time for spring sports!
Read Dr. Christopher Centeno’s post regarding all the amazing athletes they have treated at our headquarters in Broomfield, Colorado!
Our Success Stories
Potential patients are often curious about our success rates and the outcomes of previous patients. This is a valid concern, as patients want to know if these treatments are actually working for every day people like them. We have treated a wide variety of patients ranging from tri-athletes, weekend warriors, student athletes, to those in their 90s! With our state-of-the-art lab, we are able to provide customized regenerative therapies, tailored to every lifestyle and age in order to help patients get back to the activities they love. Each success story is different, but hearing patients recall their stories and how they have improved is always a joy!
Prolotherapy and Platelet Rich Plasma Treatment
Nick Caparelli’s story echoes most of those seeking treatment here at StemCell ARTS. He was very active, but injured himself during one of his physical activities and was recommended surgery by an Orthopedist. He considered his surgical options, but was concerned about the recovery and downtime it would include. A friend recommended he explore regenerative therapies for his shoulder. He was evaluated by a physician here at StemCell ARTS, and suggested a treatment plan of Prolotherapy and Platelet Rich Plasma. Prolotherapy is an injection of Dextrose-based solution into the problem area in order to help stimulate your body’s repair cells. Platelet Rich Plasma requires a blood draw, and after your platelets are concentrated and processed in our lab to the specificity of the doctors, it is re-injected to the site of injury in order to help heal minor sprains, strains and tears. Mr. Caparelli’s treatments were scheduled four to six weeks apart, and after just a few treatments, he is back to lifting weights and teaching martial arts!
Read about his story and many others on our StemCell ARTS blog. Contact our office to see if you can be our next success story!
For those interested in getting involved in an exercise routine, it is hard not to come across the world of CrossFit. Over the past couple years, there has been a significant increase in this fitness regime that combines resistance and aerobic exercise. Unfortunately, CrossFit often gets a bad rap due to its perceived propensity to cause injury. Shoulder injuries are particularly common due to the athletes performing snatches and other complex overhead movements. Typically, when one sustains shoulder injuries, such as rotator cuff tears, the first visit is to a surgeon. Research has shown that surgery may not be the answer. Fortunately, StemCell ARTS offers patients suffering from shoulder injuries an alternative to treating their shoulder conditions, while avoiding invasive surgical procedures.
Why is this so important to CrossFit athletes? Or anyone, for that matter?
Avoiding surgery also allows the patient to avoid the downtime and recovery that is typically associated with shoulder surgery. Patients are able to get back to the activities that they love, sooner than the patients who undergo surgical procedures. For CrossFit athletes, this means getting back in the gym faster and the ability to keep improving on their fitness. For patients outside of CrossFit, they are able to continue their day to day activity, without much interruption following a regenerative procedure.
Below, you will find a link to an article that features a CrossFit athlete treated by one of the physicians at StemCell ARTS. Bill, a high-level CrossFit athlete was able to avoid surgery to repair his rotator cuff by electing to proceed with the stem cell procedure offered at StemCell ARTS. Click the link below to read more about how Bill is doing following his stem cell procedure and learn more about why shoulder surgery may not be the way to go.
The July 15th 2014 episode of The Doctor’s features a former two time Olympic pairs figure skater medalist, Lloyd Eisler who has had a failed rotator cuff surgery. Lloyd injured his shoulders while spending a lifetime lifting his skating partners and had a surgery several years ago. Now a father and active Hockey player, he reinjured his rotator cuff and was told he needed another surgery. His wife (the original Buffy the Vampire Slayer actress – Kristy Swanson) knew an actor colleague who used the Regenexx procedure to successfully treat his rotator cuff, so Lloyd chose a non-surgical route this time.
The show features Dr. Centeno, the developer of the Regenexx procedures as well as Dr. Blecher, the Regenexx network physician who treated this patient near their home in Los Angeles. Dr. Centeno explains how the procedure works in the studio with Dr. Travis and then the piece cuts to the procedure with Dr. Blecher. The piece ends with a discussion of the procedure with Dr. Centeno and Lloyd and a plea from his actress wife to avoid yet another shoulder injury!
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.
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) . 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. 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. 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.
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 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%. 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. 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  Donna D. Alderman, DO, Sean C. Robbins, BA, “Platelet Rich Plasma Prolotherapy for Rotator Cuff Tears,” Practical Pain Management, September 2012; 21-23  “Rotator Cuff Tears: Surgical Treatment Options,” OrthoInfo; American Academy of Orthopaedic Surgeons (AAOS); http://orthoinfo.aaos.org/topic.cfm?topic=A00406  Donna D. Alderman, DO, Sean C. Robbins, BA, “Platelet Rich Plasma Prolotherapy for Rotator Cuff Tears,” Practical Pain Management, September 2012; 21-23