Sep 1, 2015 | Osteoarthritis, Procedure Outcomes, PRP, Stem Cell Procedures
There are so many positive aspects to stem cell therapy. One of the most exciting developments in stem cell treatment is its use for treating arthritis in the knee. For decades, the standard treatment for debilitating knee pain has been knee replacement surgery, which utilizes a metal and plastic prostheses to replace lost cartilage and damaged bone. Regenerative medicine therapies, such as stem cell and platelet treatments (PRP) applied at StemCell ARTS, encourage the growth of new tissue utilizing the body’s natural healing systems. These techniques make regenerative medicine therapies a noninvasive option that can achieve pain relief results as good as, or better than, standard knee replacement surgery.
Prior to selecting the use of stem cell therapy, one question that many candidates ask is: Will my age affect whether or not I can or should have this procedure? The answer is simple. No. When conducting stem cell therapy treatments on patients, age does not matter. That’s right. Patients who are good candidates for regenerative medicine such as stem cell and platelet therapies are suitable candidates regardless of their age.
Over the past 4 years, Regenexx has gathered data on over 1000 cases of knee stem cell treatments on patients to help them understand how well these regenerative procedures impact knee osteoarthritis. The data has shown, in terms of the success and benefits of regenerative treatments, there is “no association between age and doing better or worse” (1). So age does not matter! At StemCell ARTS, we utilize the Regenexx protocols for stem cell treatments with all our patients to ensure these positive results.
The data from the registry looked at two different age groups, those under age 45 and those 45 or older, at intervals of 1, 3, 6, 12, 18 and 24 months. Across all intervals, the success rates were consistent regardless of the age of the patients. It is important to note that the treatment registry is not the equivalent of a controlled clinical study. Nevertheless, the data shows that patients are reporting good results from the Regenexx procedure.
Why Doesn’t Age Matter?
Because stem cell therapy uses the patient’s own stem cells as a catalyst for healing, these stem cells act as a ‘booster’ for the body’s natural healing process, encouraging the body to do what it has been designed to do naturally. This extra boost is a huge benefit to older patients, since in most cases the speed and strength of the body’s natural healing ability has slowed with age.
Age is typically not a factor in our regenerative procedures because the Regenexx treatment protocols call for changes that take into consideration the patients age. This means that each patient receives a customized approach specific for their age. Other factors such as the type of injury, the severity of the injury, the activity demands of the patient also call for changes in the standard protocols. All of this makes the Regenexx protocols the very best treatments available to help your body heal. No matter what your age!
If you are suffering from knee arthritis or any of the other orthopedic injuries treatable with stem cell therapy, you are encouraged to speak with one of our doctors. A regenerative procedure could give you the pain relief you are looking for.
Sources:
- Regenexx – https://stemcellarts.com/wp-content/uploads/2015/09/Regenexx-SD-Infographic-Does-Older-Age-Impact-Knee-Outcome.pdf
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 | 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: 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 tendon. 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.
Regenerative Treatments Deliver Solid Results
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
Jan 2, 2014 | Knee, Prolotherapy, PRP, Stem Cell Procedures
A recent clinical study found that Regenerative Injection Therapy (RIT) delivered significant improvement in knee function and pain to those suffering from knee osteoarthritis. The study found that study participants receiving RIT treatment experienced an 29.5% improvement in knee pain, stiffness and function measured according to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC score).[1]
This treatment is just one of many new options available in the fight against knee osteoarthritis. Osteoarthritis of the knee usually occurs in knees that have experienced trauma, infection, or injury. The articular cartilage, which acts as a protective cushion, begins to deteriorate. What these new biological treatments accomplish is assisting and stimulating the growth of new cartilage. It’s an approach that does not simply mask the symptoms, but addresses the root cause of the condition.
[youtube id=”4ZcfslvNPJA” width=”600″ height=”350″]
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 cartilage. The platelets are injected again 2-5 days later to keep the stem cells activated and promote additional healing.
Prolotherapy
With Prolotherapy, a solution of concentrated dextrose and local anesthetic (steroids are not used) stimulates the body’s natural ability to repair the cartilage, encouraging new growth and creating a positive environment into which the stem cells are placed. Prolotherapy treatments are usually scheduled every two to six weeks until the cartilage is regenerated.
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.
A Real Solution to Regain Knee Function
These regenerative treatments are a promising revolution in the treatment of knee osteoarthritis. While not a “cure,” these treatments can slow the progression of the disease, significantly reduce pain and restore knee function and mobility to the patient. When combined with short term knee bracing and physical therapy, the effects of this approach can be greatly magnified even further to restore quality of life to most patients.
[1] Richard Dumais, MD, Catherine Benoit, MD, Alex Dumais, MD, Lise Babin, MD, Rachel Bordage, BScN, Claire de Arcos, BScPT, Jacques Allard, PhD, Mathieu Bélanger, PhD, “Effect of Regenerative Injection Therapy on Function and Pain in Patients with Knee Osteoarthritis: A Randomized Crossover Study,” Pain Medicine 2012; 13; 990-999; Wiley Periodicals, Inc.
Jan 2, 2014 | Knee, Prolotherapy, PRP, Stem Cell Procedures
According to a study published in the American Journal of Sports Medicine, out of 295 knee surgeries for Meniscus repair that occurred over a 9-year period, 37 needed subsequent surgeries to correct a failed repair. After a review of medical literature, the study found that the failure rate for this type of surgery could range anywhere from 5-45%[1].
One of the problems with this type of surgery is that when trying to repair these tears, surgeons are often removing Meniscus tissue surrounding the tear. The reason is if the location of the Meniscus tear is on the interior of the knee, the lack of proximity to a blood supply means that the tear may not heal properly. This approach unfortunately can lead to complications including increased arthritis in the knee in the future.
The Meniscus is living tissue acting as a shock absorber in the knee, which is why biologic regenerative treatments hold such promise to actually heal the injury instead of attempting to carve it out. The result is a less invasive procedure, 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
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 the 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.
Eliminate the Risks of Surgery
Another recent study demonstrated that a group of patients receiving stem cell treatment experienced double the pain relief compared to a control group in the study over a 2 year period. In particular, one physician from the Mayo clinic monitoring the study noted that there were no adverse events related to the treatment[2]. That fact alone makes biologic regenerative treatments a very attractive option to patients dealing with a Knee Meniscus tear.
[1] Nicolas Pujol, MD, Olivier Barbier, MD, Philippe Boisrenoult, MD and Philippe Beaufils, MD, “Amount of Meniscal Resection After Failed Meniscal Repair,” The American Journal of Sports Medicine; August 2011; vol. 39 no. 8; http://ajs.sagepub.com/content/39/8/1648.abstract
[2] John Gever, Senior Editor, MedPage Today, Reviewed by Zalman S. Agus, MD, Emeritus Professor
University of Pennsylvania School of Medicine and Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner “Stem Cells Show Promise for Meniscal Tears,” MedPage Today; Feb 10, 2012; http://www.medpagetoday.com/MeetingCoverage/AAOS/31131
