Stemcelldoc's Weblog

April 29, 2014

Successful Treatment of AVN of Femoral Head with Stem Cell Therapy

Avascular necrosis of the femoral head is bone death thought to arise from interruption of the blood supply.

Progression of the disease is characterized by flattening of the femoral head with eventual collapse of the hip joint.

Stem cell therapy is a non surgical option in the treatment of AVN of the femoral head.

MFH is a 50y/o active female initially evaluated at the Centeno-Schultz Clinic with ARCO stage 2 AVN of the femoral head.

On 4.2009 she underwent core decompression where bone marrow derived stem cells were injected directly into the area of necrosis.

Clinically patient has done extremely well as reflected in her 5 year follow up questionnaire which she permitted us to share.

Her hip x-rays demonstrate successful treatment of AVN with Regenexx treatment.  Note that the contour of the femoral head has not changed, flattened or collapsed.

MFH AVN

 

 

 

April 27, 2014

Successful Platelet Epidural Treatment for Severe Leg Pain

Helicopter skiing in Canada.

helicopter skiing canada

Skiing the trees in Aspen.

Surfing in California.

california-surfer

 

These are activities that BC enjoyed after undergoing specialized platelet epidural injection at the Centeno-Schultz Clinic.

Regenexx PL-Disc utilizes a supercharged collection of platelet growth factors that are injected under x-ray around the irritated nerve roots and lumbar disc.

Regenexx PL-Disc is differs from traditional platelet rich plasma (PRP) as it created by a cell biologist, has reduced white and red cell contamination and higher concentration of platelet growth factors.

High steroid epidural steroid injections have significant side-effects and platelet injections are a viable alternative as discussed in video below.

 

CB is  39 y/o outdoor enthusiast who presented to the Centeno-Schultz Clinic with a 20 year history of right leg pain that was progressive in nature originating in the buttock extending down to the lateral aspect of the foot.   Aggravating factors included coughing, sneezing and prolonged sitting.   Treatment to date had been extensive and included heat, ice, physical therapy, massage, chiropractic care and high dose epidural steroid injections.  Patient had undergone a L4/5 laminectomy and decompression due to disc herniation in 1991.

MRI was significant for facet hypertrophy and right-sided disc bulge at L4/5 with impingement of the L4 nerve root.

CB underwent two x-ray guided injections of the right L3-S1 facets and the right L4 and L5 nerve roots and epidural space with Regenexx PL-M over 2 months.

These treatments allowed him to engage in a 14 day 3 state epic trip.

I saw CB in clinic post trip and he continued to feel great with no leg pain or restrictions.

Congratulations !

 

 

 

 

 

April 17, 2014

Anterior and Posterior Cruciate Ligament Injection of Stem Cells Under X-Ray

At the Centeno-Schultz Clinic accuracy is a cornerstone of our practice.  Accordingly we perform all injections under either x-ray or MSK ultrasound guidance.

The Anterior and Posterior Cruciate ligaments (ACL and PCL) are critical stabilizers of the knee.

LL is a 35 y/o athletic male from Indonesia who sustained tears into both the ACL and PCL and rejected traditional surgery.   Today we injected bone marrow derived stem cells into both ligaments with precision utilizing x-ray guidance.  Below is the image demonstrating the injection of contrast into both the ACL and PCL.  a small amount of contrast is injected prior to the stem cells to confirm accurate needle placement.  The PCL is outlined in yellow whereas the ACL is in red.

Anterior and Posterior Cruciate Injection

 

March 25, 2014

ACL Tear Stem Cell Study: Free Care for Those Who Meet Criteria and can Travel

tree with clouds

The Centeno-Schultz Clinic is a research based medical practice that acknowledges the importance of research.

Our publications to date are multiple and easily identified in the U.S. Library of Medicine.

Stem cell therapy is a successful alternative to traditional surgery in the treatment of ACL tears.

Successful cases of ACL repairs have been discussed in prior blogs with comparisons of pre and post MRI’s illustrating the healing afforded by autologous stem cell treatment.

Regenexx currently has an ACL stem cell study which is available for patients that qualify and can travel to our Broomfield clinic.

Full Inclusion criteria is listed on web site and includes:

  1. Physical examination consistent with lax ACL ligament (Anterior Drawer Test)
  2. Abnormal Telos Arthrometer measurement
  3.  Positive diagnostic MR imaging of the affected knee with at least 1/3 of the ACL ligament at any area along its length having high signal on MRI PDFS/Fat Sat images.

Exclusion criteria is also listed and includes:

  1.  A massive ACL tear or one that includes more than 2/3’rds of the ligament that’s retracted.
  2.  Previous surgery to the affected ACL
  3. Concomitant meniscus tear or cartilage injury that occurred at the same time as the as the ACL tear and which is considered a pain generator.

If you or family or friends are interested please contact us at 303 963-9528 or complete the Regenexx candidacy form.

 

 

 

 

March 17, 2014

Regenexx ACL Procedure Featured in Outside Magazine

outside magazine logo

Regenexx ACL procedure is dynamic new technology that enables a patient to use their own stem cells to heal ACL tears.  This procedure was featured in Outside Magazine.

Extreme skier and founder of DPS Ski, Stephan Drake, tore his ACL while skiing a steep face in Alaska.  He rejected surgical repair and opted for Regenexx ACL at the Centeno-Schultz Clinic in Colorado.

Regenexx ACL is a alternative to traditional knee surgery.  Bone marrow derived stem cells are injected under direct visualization into the ACL.  Patients are fitted with knee brace and undergo 4 weeks of physical therapy.

Complications of ACL surgeries have been discussed previously and include graft failure, infection and acceleration of arthritis.

Successful clinical cases with detailed pre and post treatment MRI’s outlining improvement have been presented in previous blogs.

It is a new day in orthopedic medicine with new opportunities.  Not long ago open heart surgery with bypass and coronary grafting was the standard of practice.  Then interventional cardiology with a new skill set including balloon angioplasty became the new standard of care making coronary bypass surgery a less prevalent and less attractive procedure.

March 12, 2014

Supercharged Platelet Rich Plasma

The Centeno-Schultz Clinic utilizes a special advanced platelet rich plasma (PRP).

The injection of platelet rich plasma is a successful treatment option for joint, tendon, ligament, muscle and joint injuries.  The concentrated blood platelets contains critical growth factors that increase the body’s ability to repair itself.

In most clinics and hospitals and clinics, PRP is created by a bedside centrifuge that separates the plasma and concentrates the platelets.  Bedside centrifuges typically create a PRP with platelet counts of 3-5 times the normal.  Unfortunately they also contain white and red  blood cells which can cause inflammation.

bedside

Are there differences in PRP treatments?

YES!

Regenexx has a superior PRP  called Regenexx SCP (Super Concentrated Platelets).  It is created by cell biologists in a state of the art laboratory and results in a 10-20 fold concentration of platelets.  Higher concentration of platelets has been shown to have a positive effect on the stem cells responsible for repairing damaged tissue.

White and red blood cells within platelet rich plasma can result in excessive inflammation, pain, restriction in range of motion and inhibition of  repair cells.

Bedside centrifuges are not adept at removing white and red blood cells whereas cell biologists at Regenexx are very capable of separating these cells. The image below demonstrates the cardinal difference.  The PRP on the left is red in color due to the red blood cells whereas the Regenexx SCP on the right is amber in color due to the successful removal of most red and white blood cells.

scp_vs_prp

PRP is an effective treatment of many ligament, tendon, joint and muscle injuries.  There are differences in platelet rich plasma concentrates.  Regenexx SCP which is produced in a state of the art lab by a cell biologists affords a much higher level of platelets with reduced red and white blood cell contaminates which ultimately results in  best possible outcomes.

March 2, 2014

Successful Repair of Anterior Cruciate Ligament Tear with Stem Cells

At the Centeno-Schultz Clinic we recognize that tears of the Anterior Cruciate Ligament (ACL) can be game changers.  Surgical repair is associated with significant complications which include infection, graft failure and alteration of biomechanics.  Many patients who undergo surgical repair do not return to high level competition.

Stem cell therapy is a viable alternative to traditional surgical repair.   The Regenecxx  SD procedure enables a patient to forgo surgery, the lengthy rehabilitation and utilize their own stem cells to heal tears in the ACL.

HK is a case in point.  He is a 44 y/o athletic weekend warrior who sustained a hyper-extension injury with near complete tear of the ACL.  He declined surgical repair and underwent Regenexx SD.  6 months post injection of his stem cells he had complete return to normal activities and sports.  His professional and scholastic endeavors delayed follow-up MRI which accounts for the gap in pre and post imaging.

Pre and post stem cell treatments are posted below.  The pre-injection images are on the left and the post injection images are on the right.  The first images are taken from the side (sagittal) whereas the second set are frontal (coronal).

The thigh bone is on top (femur) and the tibia is below.  The ACL stretches across the knee-joint and prevents excessive forward motion.  The ACL is outlined in dashed yellow lines.  On the pre-injection images note the disorganized quality of the ACL fibers and the disruption of the ACL towards the top.  On the post injection images the ACL fibers are well-organized, tight and uniform extending from the tibia to the femur.  The formal MRI report post stem cell injection notes no tear in the ACL which is consistent with HK’s clinical results.

Keel Successful ACL Stem Sag

Keel Successful ACL COR

In 2014 stem cell treatment is an alternative to traditional surgery for tears of the ACL.

February 21, 2014

Autologous, Allogenic and Artifical Stem Cells

Opening Flower Bud

At the Centeno Schultz Clinic we utilize a number of regenerative therapies which include bone marrow derived stem cells.

Regenexx utilizes a patient’s own bone marrow derived stem cells to treat common orthopedic conditions which include:

Knee osteoarthritis

Knee meniscus

Hip osteoarthritis

ACL injuries

Non-Union fractures of long bones.

Stem cells can be divided into two principal classes:  autologous vs allogenic.

Autologous cells are a patient’s own stem cells.  One individual is both  the donor and  the recipient

Allogenic cells are cells that are from someone else.

Artificial embryonic stem cells from natural cells are receiving increased attention.  There are two principal methods to create artificial stem cells:  IPSC(induced Pluripotent Stem Cells)  and STAP (Stimulus-Triggered Acquisition of Pluripotency) which are discussed in Dr. Cenento’s video.

January 29, 2014

Pitfalls of ACL surgical reconstruction: Consider Stem Cell Therapy

ACL tear illustration

At the Centeno-Schultz Clinic we understand that injury to the anterior cruciate ligament (ACL) can be a game changer.

Repair of anterior cruciate ligament (ACL) tears with stem cells  is an alternative to traditional surgery.

Regenexx SD utilizes a patient’s own stem cells to repair ACL injuries.  Case reports have demonstrated the successful repair of ACL injuries without surgery utilizing a patient’s own stem cells.

The anterior cruciate ligament is the most commonly injured ligament in the United States with a prevalence of 100, 000-200,000 case per year.  There are in excess of 150,000 ACL reconstructions performed per year.

A surgically repaired ACL is not like the original ACL.

What are the risks associated with surgical repair of ACL tears?

-Infection

Graft failure ranges from 3-27%.

Development of osteoarthritis ranges from 51-78%

-Failure to restore movement back to pre-injury baseline.

Increased cartilage load and higher risk of re-injury

-Significant postoperative physical therapy

Bottom Line:  Know that there are non operative options utilizing your own stem cells to repair ACL injuries.

November 30, 2013

Another ACL Tear Successfully Treated With Stem Cells

The Centeno-Schultz Clinic has previously reported on the successful treatment of ACL tears with stem cell therapy.

Stem cell treatments are an alternative to traditional knee surgery.

S.D. is 38 y/o world-class extreme skier who sustained a complete tear of his ACL and declined surgery.  He underwent 5 prolotherapies in Mexico with minor improvement.

drake stephan

On 7.31.2013 S.D. underwent the Regenexx SD procedure where bone marrow derived cells were injected into the torn ACL.  Due to abnormal neurologic examination and history of intermittent lower back pain also underwent Regenexx PL-Disc where concentrated platelet growth factors were injected around the exiting spinal nerve roots and lumbar discs.

On 9.13.2013 S.D. underwent a booster injection with Regenexx cSCP  injected into the ACL under direct x-ray guidance.

A new MRI was recently performed approximately 4 months post stem cell therapy.

The pre and post treatment images are posted below.  The ACL is outlined in yellow.  Note that the ACL fibers are disorganized and loose in the pre treatment images whereas post treatment the ACL fibers are uniform and tightly organized.  This is consistent with his clinical progress as he reports a reduction in pain and increase in stability.  Muscle weakness remains an issue but is improving with MAT techniques.

Drake. ACL pre and post 2013.sagittal

Drake. ACL pre and post 2013.Coronal

Congratulations to SD who declined surgical repair and opted to utilize his own bone marrow stem cells to repair his torn ACL.  Updates to follow as snow continues to fall and the depth of the powder increases.

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