Placement of Cells is Everything

Placement is Everything

Currently there are  numerous ways in which stem cells are being administered.

When injected intravenously a majority of the stem cells are trapped in the lungs.

When treating cartilage defects, does it matter how the cells are injected?

Koga et al.,clearly demonstrated that it does matter.  He  injected cells in a variety of ways including into the joint vs directly into the cartilage defect.  Cells placed directly into the cartilage defect resulted in more than 60% of the stem cells adhering to the area of damage and significant cartilage growth at 24 weeks.

A Colorado practice utilizes intermittent x-ray to inject autologous mesenchymal stem cells directly into areas of cartilage damage.  This technique avoids the risks and time associated with traditional surgical approaches. MRI images before and after stem cell therapy tell the story.

Stem Cells 101

 

Stem cells are the foundation cells for every organ, tissue and cell in the body. They are like a blank microchip that can ultimately be programmed to perform particular tasks. Stem cells are undifferentiated or “blank” cells that have not yet been fully developed or specialized. Under proper conditions, stem cells begin to develop into specialized tissues and organs.

Adult stem cells, unlike fetal or umbilical stem cells, are more limited in regard to their growth potential.  Differentiate means to change into.  For example, a caterpillar differentiates into a butterfly.  Some caterpillars differentiate into blue butterflies whereas others change into red and yellow colors.  The same applies to stem cells.

 There are two principal types of adult stem cells: hematopoietic and mesenchymal.

Hematopoietic stem cells are adult stem cells found mainly in bone marrow which differentiate into blood cells such as lymphocytes, red blood cells, white blood cells and platelets.

Mesenchymal stem cells are adult stem cells which can differentiate into fat, cartilage, bone, tendon and ligaments and muscle cells.  Unlike most other human adult stem cells, mesenchymal stem cells can be obtained in quantities appropriate for clinical applications, making them good candidates for use in tissue repair. Mesenchymal stem cells have demonstrated the ability to repair long bone fractures, rotator cuff tears and reduce protrusions in the lumbar spine.

Origins of the Regenexx Procedure

Continued frustration and disappointment over the persistent failure of many surgical procedure to improve the pain and level of function of our patients led to the quest for an alternative.

Sakai was our first inspiration.  He recognized that disc degeneration was a relentlessly progressive phenomenon with no currently available effective treatment.  Working with rabbits, Sakai transplanted  mesenchymal stem cells into degenerative disc  to determine if stem cells were capable of repairing degenerated discs.  While mesenchymal stem cells are available from many sources, Sakai obtained cells from bone marrow.  The Regenexx procedure also uses bone marrow derived stem cells.

At 24 weeks, utilizing MRI and another methods, Sakai demonstrated that transplantation of mesenchymal stem cellss effectively led to regeneration of degenerative discs.

And the quest began……..

BMI and Road Wear

BMI not BMW.

BMI is statistical measurement which compares a person’s weight and height.  It can be a useful tool to estimate a healthy body weight.

A recent study examined the knees of 336 overweight patients over 30 months.  20.2 % of the patients showed a slow loss of knee cartilage and 5.8% had rapid cartilage loss.  The Boston University researchers concluded that for every one-unit increase in body mass index, the chances of rapid knee cartilage loss increased 11%. Bottom line: stay lean.

If you have knee pain knee as a result of cartilage loss, there are non-surgical options.  Mesenchymal stem cell therapy involves the use of a patients own stem cells, avoids all of the risks associated with srugery and anesthesia and does not require extensive rehabilitation commonly associated with surgical procedures.

Balance Problems After Injury

We all take balance for granted.

Maintaining balance while standing in the stationary position relies on three major inputs:

1. Joint position sense (proprioception). 
2. Inner ear
3. Vision

Balance can be maintained if two of the three inputs are intact.

Romberg test is a neurological test to assess balance.  The patient stands with their feet together and hands by their sides.   Patient movement is then observed first with their eyes open and then with their eyes closed.  romberg test is positive when there is swaying or inability to stand erect when a patient’s  eyes are closed.

A positive test, which suggests loss of proprioception, is commonly observed in patients with conditions affecting the dorsal columns of the spinal cord,  conditions affecting sensory nerves( peripheral neuropathies)  and injuries to the joints in the cervical spine that are rich in nerve fibers that convey joint position.

Cervical facet joint are commonly injured in motor accidents. 

Cervical facet joint

 They are rich in fibers that provide us with spatial information.  If you sustain an injury to your neck while skiing, kite boarding or driving on the highway and have balances problems, remember the Romberg test and cervical facet damage.

Colorado Stem Cell Therapy Makes News

Colorado based Regenerative Sciences was the focus of a recent New York City news segment.  Dr. Max Gomex discussed the Regenexx procedure where a patient uses their own stem cells to heal a variety of orthopedic conditions.  Examples outlined included non-surgical therapies for rotator cuffs tears, mensical tear, loss of cartilage in the knee and hip as well as degenerative lumbar discs.  Dr. Gomex also discussed the opportunity to bank stem cells for future use.

New treatment opportunites now exist in the Rocky Mountains…..

NSAID’s and Alzheimer’s Disease

Non steroidal anti-inflammatory medications (NSAID) are one of the most commonly used and prescribed class of medications.  As a staff physician at Fort Bragg, Motrin was the most commonly dispensed medication.  Soilders would receive large vials containing 60 to 100 tablets of Motrin to manage the aches and pains of forced road marches, night air drops and survival drills.  Common examples of NSAID’s include Motrin, Alleve, Celebrex and Naprosyn.

Unfortunately a recent publication demonstrated a strong link between NSAID’s and Alzheimer’s disease.  2,736 patient were studied over a 12 year period illustrating a strong correlation between NSAID’s and the onset of Alzheimer’s Disease.

There are other significant health concerns associated with the use of NSAID’s.

Celebrex increases your cardiac risk about the same as if your were diagnosed with diabetes.

NSAID’s when taken for 60 days or more are associated with a 1 in 1,200 death rate, typically due to GI bleed.

What is the alternative? Omega-3 fish oil.  Dr. Joe Maroon, the team physician for the Steelers and neurosurgeon at UMPC demonstrated that by using omega-3 fish oil,  he was able to discontinue NSAID’s in 60% of his patients. 

Yoga bear had it right…….

Yoga avoided NSAID's

Stem Cells Can Stop the Progression of Lumbar Degenerative Disc Disease

Degenerative disc disease is a common disease which affects millions of people.  Fan et. al. recently demonstrated that mesenchymal stem cells can stop the progression of lumbar disc degeneration.  Furthermore, the authors demonstrated that injected mesenchymal stem cells led to significant regeneration of the central portion of the disc.  Regenerative Sciences has been utilizing this same cell line in their lumbar disc procedures. Please see MRI of a patient who underwent Regenexx therapy.