Stemcelldoc's Weblog

October 30, 2011

Tears in The Rotator Cuff: Articular and Bursal Sided Tears

Stem cell therapy is an alternative to shoulder rotator cuff surgery.

Shoulder surgery is associated with risks.  Extensive rehabilitation is often needed after a rotator cuff repair surgery due to the immobilization needed to help the sewn rotator cuff muscle or tendon to heal.  A recent study demonstrated that less mobilization and faster rehabilitation is better.

Woman have more problems with rotator surgery in part due to differences in stem cell numbers.  Regenexx C is an option that can increase the total number of stem cells at a site of injury.

The rotator cuff is compromised for 4 major muscles and tendons: the supraspinatus, infraspinatus, subscapularis and teres minor.

Most rotator cuff tears involve the supraspinatus tendon.  The anterior aspect of the distal supraspinatus is a common site of injury.  Accurate localization of the tendon tear is essential.  At the Centeno-Schultz Clinic MSK ultrasound and MRI are used to identify rotator cuff injuries.  Most tears are on either  the articular or bursal surface.  This is illustrated below in both longitudinal and  transverse views.

October 23, 2011

Risk Factors For Knee Replacement

What does the future hold for you and your knee pain?

Knee pain can be disabling and progressive.  The pain can led to restriction in level of activity, reduced exercise, reduced recreation, isolation, weight gain and changes in quality of life.

A recent NIH study examined the prognostic factors indicating risk of future knee replacement in patients with or at high risk for osteoarthritis of the knee .

4796 patients were followed for three years.

Three factors were identified which predicted rapid progression to knee replacement:

-Prior knee surgery

-Pain with active knee flexion

-Knee flexion contracture (inability to fully bend the knee)

Stem cell therapy is an alternative to knee replacement.  Knee surgery is associated with risks.

Bottom line:  keep the knee joint active with full range of motion and avoid surgery.  Stem cell therapy has been successful in the treatment many knee injuries including meniscal tears, loss of cartilage, tendinosis and laxity of ligaments including the ACL(anterior cruciate ligament).

October 12, 2011

When in Doubt, Cut it Out

Patients are seeking alternatives to shoulder replacement surgery with increasing frequency.  Patients are concerned with complicationsdeath and signficant downtime associated with shoulder replacements. 

The shoulder is a complex joint composed of tendons, ligaments, muscles and cartilage on the articulating surfaces.  Pain can arise from any or all of these structures.  At the Centeno-Schultz Clinic we are committed to identifying the principal source of pain in patients so a successful treatment regimen can be implemented.  Regrettably this is a universal practice.  DS is a case in point.

DS is an active 62 y/o rancher who sought a second opinion.  He had a 6 month history of left shoulder pain which was constant in duration, progressive in duration, principally located in the posterior shoulder without any radiations.  Aggravating factors including lifting whereas alleviating factors included rest and sleep.  DS had been evaluated by a surgeon and was identified as a suitable candidate for total shoulder replacement. DS had not undergone any conservative to date: no physical therapy, massage or myofasical deactivation.  X-ray was signficant for narrowing of the joint space.

DS and I were concerned that no conservative therapy had been undertaken.  Additionally the only study to date was an x-ray which examines bone and does not evaluate tendon, ligament or cartilage.  An MRI was ordered which was signficant for severe tendinosis of two of the rotator cuff tendons and arthritis of the shoulder joint.  DS declined the replacement and underwent two MSK US guided injections into the rotator cuff tendons and reports 65% improvement to date.  He is scheduled for additional treatment but remains active on his ranch without signficant limitations. 

Bottom Line:  Pain can arise from many different structures and can often times be treated successfully with non surgical regenerative treatments.

October 9, 2011

Complications Associated with Knee Replacement

Knee replacement is increasing in frequency as means of treating symptomatic degenerative changes.

Over the last 10 years the number of partial and total knee replacements among patients 65 years and older has increased 100% ( 178,653 in 2008 to 357,472 in 2008).

Based on upon these numbers one would assume that knee replacements are safe and without  significant complication.

Unfortunately that is not the case.

Mohomed identified the following complications in patients who underwent knee replacement in 2000.

4670 cases of pneumonia

2788 pulmonary emboli.  blood clots

2908 heart attacks


Previous blogs have discussed complications associated with knee replacement surgery including wear particles, MOM and death.

Stem cell therapy is an alternative to traditional  knee orthopedic surgery.  In a peer-reviewed publication,  202 patients underwent stem cell treatment with no serious complications.  Furthermore stem cell therapy is not associated with time-consuming physical therapy and significant restrictions which can cause muscle weakness and impaired range of motion.  Regenexx is  an advanced stem cell therapy utilizing a patient’s own stem cells to treat different orthopedic knee conditions.

October 5, 2011

Regenexx-C Discussed in ESPN Magazine

Peyton Manning, Bartolo Colon and Terrell Owens all left the United States to receive orthopedic stem cell treatments.

Patients are looking for alternatives to orthopedic surgeries and joint replacements.  Many patients are fearful of the surgery and the complications.

ESPN the Magazine featured the Regenexx stem cell procedure and the treatment of NFL player Jarvis Green at the Centeno-Schultz Clinic.

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