Stem Cell Therapy for Hip and Knee Osteoarthritis: Presentation to Florida Academy of Pain Medicine

On August 20, 2011 Dr. Schultz presented a Stem Cell Therapy Lecture to the Florida Academy of Pain Medicine.

The lecture highlighted the clinical results of a recent study conducted at the Centeno-Schultz Clinic that examined the effectiveness of culture expanded stem cell treatments in patients with hip and knee osteoarthritis.

 148 knee patient and 54 hip patients participated in the study.  These patients sought  alternatives to knee and hip replacements.  Many of the patients were frightened by the complications associated with joint replacement surgery.

The study demonstrated that culture expanded stem cells injected into either the knee or hip-joint were associated with better improvement in pain and function when compared to untreated controls.

The different outcomes between hip and knee patients have been previously discussed on the Regenexx blog.

Culture

Hip Osteoarthritis: Successful Stem Cell Treatment

Osteoarthritis is the most common type of joint disease, affecting over 20 million individuals in the United States.  Osteoarthritis of the hip commonly results in pain, restriction in range of motion and diminished participation in activities.

CH is an active 51y/o patient with a longstanding history of  hip osteoarthritis who came to the Centeno-Schultz Clinic searching for an alternative to hip replacement.  He underwent stem cell treatments and notes agreater thanb 75% improvement.  He chose stem cell treatments as he wanted to avoid the complications associated with total hip replacement.

He underwent stem cell treatments in July 2010(Regenexx C) and Regenexx SD in  August and November 2010.

Hip outcomes have been previsouly discussed in Dr. Centeno’s blog.

CH has returned to backpacking and recently sent this e-mail:

“I am happy to report on my progress following Regenexx C/SD on my hip.  Prior to treatment, my last backpacking trip was January, 2009.  Since then, I went through the stages of semi-immobility with osteoarthritis.  Last weekend I went on my first  Post-Regenexx backpacking trip of 32 miles in two days in Great Smoky Mountain National Park.  This represents long daily mileage for advanced hikers in this terrain.  Although I was apprehensive about trying such a long distance on my first trip out, I did fine.  Just a few small blisters on my toes and sore muscles the day after I got back.  I had a great time!

Sacroiliac Joint Pain: Not limited to Back and Buttock

The sacroiliac joint (SI) is the joint between the sacrum, the base of the spine, and the ilium of the pelvis. 

Frequently it is a cause of pain in patients who have undergone lumbar fusions and traumatic injuries.

ST is 47 y/o active patient with 4 year history of left buttock pain which was constant in duration, progressive in nature with radiations into the left lateral thigh extending down calf and into the fourth and fifth digits of left foot.  Buttock pain was aching and throbbing whereas  the leg pain is ‘nerve’ like with intermittent sharp electrical sensations. Patient is active in volleyball and cycling.  Physical examination was significant for positive  Fortin test and patrick test.

ST was surprised of by the diagnosis of SI joint dysfunction.  Surely this was irritation of the nerve root caused by a protruding lumbar disc.

Can SI joint be responsible for lower extremity pain?

Yes !

Slipman demonstrated that SI joint pain is not limited to the lumbar region and buttock.  50 patients were evaluated who had confirmed Si joint dysfunction. 94 % of patient described buttock pain whereas 50% of patients had lower extremity pain, 28% had leg pain distal to the knee and 14% reported foot pain.

Not all lower back, buttock and leg pain arises from disc disease.

At the Centeno-Schultz Clinic we are committed to making the correct diagnosis.  Treatment options for sacroiliac joint dysfunction includes prolotherapy, PRP and bone marrrow derived stem cells.

Is Local Anesthetic Toxic to Cartilage Cells?

Our tap water is filtered for toxic elements such as lead and mercury.

Our food is inspected and is free of toxic bacteria and harmful micro organisms.

Is the same true about common orthopedic injections?

Local anesthetics (numbing medications) are commonly used in knee and other joint injections. Typically they are used in conjunction with steroids. The two most common local anesthetics are Marcaine (Bupivacaine) and Lidocaine.

Are they toxic?

A recent study has demonstrated the Marcaine is toxic to cartilage cells.   Chu demonstrated that 6 months after a single intra-articular injection of Marcaine there was a 50% lower density of chondrocytes (cartilage cells) compared with cartilage in control joints.

What about Lidocaine?

Jacobs demonstrated that  Lidocaine was significantly more toxic to mature human articular cartilage cells than a saline 0.9% control group.

What about local anesthetics when mixed with steroids?

Farkas demonstrated the combination of glucocorticoids(steroids) and local anesthetics have an adverse effect on articular cartilage.

At the Centeno-Schultz Clinic we acknowledge the toxicity of local anesthetics and steroids.  We abandoned the use of Marcaine in our clinic three years ago.  The association of apoptosis and steroids led to our discontinuation of  high does steroids.

Remember:

Please be responsible.  Don’t let friends or family members get steroid and local anesthetic injections.  There are other options available at the Centeno-Schultz Clinic.