Successful Stem Cell Therapy for Hip Pain

Nonsurgical treatment options are becoming more prevelant and attractive.  Both surgery and anesthesia have risks.  Surgery is often followed by extensive, time-consuming painful physical rehabilitation.

CH is an 50y/o athletic patient with  2yr histoyr of left hip who was an candidate for total hip joint replacemtn.  MRI of the left hip was significant for loss of cartilage, bone spurs and bruising of the bone.   CH rejected surgery and elected to use his own mesenchymal stem cells at the Centeno-Schultz Clinic.

Treatments included Regenexx-C, Regenexx SD and myofasical deactivation. 

Six months post stem cell injection CH writes:  ” I believe I am about 80% healed.  Pain is greatly reduced and some days I hardly notice it at all.  One of my favorite activities prior to the arthritis was hiking and backpacking.  I have been on two hikes of 4 and 7 miles on mountain trails post treatment and did fine.  I plan to go on a backpacking trip soon as well.”

Advances in the treatment of common orthopedic conditions have allowed CH and other patients to forgo total joint replacment and return to their passions.

New Perspective: Ortho 2.0

Everyone told Christopher Columbus that the world was flat.   

 Friends told the Wright brothers that birds were the only creatures capable of flight.  

    

A paradigm shift was required.  This also applies to medicine. The time has come to focus not on joint replacement but on joint restoration and repair.     Dr. Centeno has termed this Ortho 2.o.   Ortho 2.0 has a bigger focus beyond just fixing one part of the musculoskeletal system (bone, joints, muscles, tendon, and ligaments).   When the focus shifts to repair, the amount one needs to know about the joint increases exponentially.  There are four principal elements which are addressed when evaluating a gvien joint: (S.A.N.A.)   

ORTHO 2.0 : S.A.N.A.

  S: stabilization   

A: articulation   

 N: neurologic   

 A: alignment   

 Injection of magic stem cells alone is not sufficient for joint restoration.  Multiple studies have shown that just injecting stem cells into a joint blindly is not that effective.  For the best clinical outcomes, each of the factors listed above must be evaluated and treated. At Regenerative Sciences and The Centeno-Schultz Clinic this is the standard.  Case examples utilizing the S.A.N.A. paradigm will be in future blogs.   

It is truly a new day:)    

Safety of Implanted Mesenchymal Stem Cells

Fantastic publication today.

A four year study which examined 227 patient demonstrated no evidence of tumor growth in patients who had mesenchymal stem cells injected for orthopedic applications. Prior to injection, the mesenchymal stem cells has been expanded for a limited time. This differentiates them from those cells used in BMAC (bone marrow aspirate concentrates).  The findings are consistent with other reports which found  no evidence of tumor growth.  What is unique about the current study is the time frame ( 4 years) and number of patients.  Congrats to Dr. Centeno and other team members 🙂

Potency: Stem Cell Growth

Potency refers to the inherent capacity for growth and development.

Stem cells have potency.  Like anything that has  growth potential there are various outcomes.

Multipotent stem cells have the potential to give rise to multiple cells within a specific family.  For example,  blood stem cells can develop into white blood cells, red blood cells and other type of blood cells but it cannot develop into liver  or heart cells.

Pluripotent stem cells have more opportunities.  They can more develop into multiple cells within different families.  Pluripotent stem cells can create all cell types except egg and sperm.

Mesenchymal stem cells are multipotent.  They can develop into cartilage, bone and ligament.  Mesenchymal stem cells, utilizing the Regenexx procedure, offer an non-surgical option for the treatment of various orthopedic disorders which include loss of cartilage in the knee and hip, non-healing fractures and repair of lumbar disc protrusions.

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Stem Cell Therapy for Non-Union Fractures

Today I saw a patient back in clinic who was quite upset 9 months ago.  He had fallen and fractured his tibia and fibula which required a surgery invovling  placement of a rod and two screws.  Despite surgery and a bone stimulator, the fracture did not heal.  He was so upset at the prospect of undergoing another surgery where they had planned on removing the existing  hardware and re-breaking the bones in an effort to stimulate healing.  Fortunately the surgery was not needed.

The patient utilized his own stem cells through the Regenexx procedure to heal the fracture.  He is out of his wheelchari and has no leg pain.  Regenerative Sciences enable patients to utilize their own stem cells to heal a variety of orthopedic conditions.

Sex and Mesenchymal Stem Cells

Many factors play role a role in the healing process.    Mesenchymal stem cells have a repair function in bone, ligament, cartilage and intervertebral  discs.

In previous blogs, I have referenced medication interactions on mesehcnymal stem cell function.

Clinically there is often a difference among woman and men.

Strube et al, examined whether there was a gender difference in bone healing and  whether this process was associated with a difference in the total number of mesenchymal stem cells.    In this study,  females demonstrated compromised healing and radiographically delayed bone formation  when compared to males.  These differences were associated with a reduced number of mesenchymal stem cells which were postulated to be  the possible cause of poor bone healing.

Stem cell function, interactions with medications, gender and age related differences are areas of keen interest.  Regenexx, which utilizes a autologous mesenchymal stem cells for orthopedic applications, has an extensive data base tracking these variables.  This  database hopefully will continue to shed light on these critical factors.

Enthesopathy: Fire in the Joint

Tendons are fibrous connective tissue that attach a muscle to bone.

Ligaments attach bone to bone.

Inflammation of tendons and ligaments at their point of attachment onto bone are referred to as enthesopathies.  These can be very painful and lead to changes in gait and posture.

Common examples include golfer’s elbow and jumper’s knee.

Therapy is directed at reducing the increased tension in the affected muscle and decreasing the inflammation at the site of attachment of the tendon.  Unfortunately, all too often steroids are injected which may provide temporary relief but can weaken the ligament.  Repeat injections can lead to rupture.

At the Centeno-Schultz Clinic, enthesopathies are treated prolotherapy to strengthen the ligament.  Many patients who undergo stem cell therapy have enthesopathies which have contributed to their orthopedic conditions.  A complete and thorough evaluation and examination is our standard.

regenexx.mesenchymalstemcell.stemcelltherapy.kneecartilagetherapy.Centeno-Schultz Clinic.

Let It Grow: The Role of VEGF

 

 

Everyone knows that a seed will not grow without sufficient nutrients and water.

So to with stem cells when implanted in an area that is low or deficient in nutrients.  Blood flow is the key to cellular growth.  No blood flow, no growth.

Lumbar discs have poor blood supply.  One of the growth factors derived from platelets has been utilized to enhance blood flow to lumbar disc and the stem cells which have been implanted in them.  The growth factor is VEGF :Vascular Endothelial Growth Factor.  It has the capacity to create new blood vessels (angiogensis) thereby enhancing nutrient flow.

A case series of patients who underwent implantation of autologous mesenchymal stem cells into the symptomic disc had injections of concentrated VEGF.  66% of patients had a significant reduction in pain.  The before and after stem cell therapy MRI’s clearly demonstrate a reduction in the size of the disc protrusions.

Regenexx.Regeness.MSC.

Results of Stem Cell Therapy Presented at National Meeting

A case series outlining the results of patients who underwent stem cell therapy for symptomic lumbar disc protrusions was recently represented at the National American Society of Interventional Pain Physicians. The abstract is #8. Patients utilized their own stem cells which were expanded and then re-injected into the painful disc. A majority of the patients had a significant reduction in their symptoms as well as changes on MRI.

The Regenexx procedure affords patients an alternative to the risks of surgery and anesthesia. In contrast to conventional surgery, there is no significant down time or need for extensive rehabilitation.

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.