Stem Cell Therapy in the United States: A David & Goliath Story

The story of David and Goliath demonstrates that with righteousness on your side, one can defeat even the most enormous threats.

The battle is given in 1 Samuel,  chapter 17.   David, an Israelite and the youngest of eight sons fights a giant named Goliath.  Goliah was one of the largest and strongest Philistines.  Twice a day for 40 days Goliah challenged the Isaelites to send forth a warrior.  David steps forward with his staff and sling while Goliath is cloaked with armor and shield.  The battle ensues.

Forbes describes a 21th century David & Goliath story in their recent article:  “Stem Cells and the Lawsuit“

Jarvis Green and Stem Cell Therapy

Knee arthroscopy and trimming of the meniscus are intended to reduce pain and increase function.  Unfortunately this is not always the case.

Jarvis Green a two-time super bowl champion failed surgery therapy for his knee pain.  Rather than undergo an additional surgery he elected to undergo the Regenexx procedure which enabled him to use his own mesenchymal stem cells.  At the Centeno-Schultz Clinic we examine factors which were responsible for the initial injury.  Loose ligaments are tightened with prolotherapy and platelet concentrates.  Irritation of lumbar nerves roots which led to weakness in the knee and leg are treated with x-ray guided epidural injections with platelet derived growth factors.

Four months after stem cell injections, Jarvis notes a 70% improvement.  A post injection MRI of the knee was significant for an increase in the amount of  knee cartilage behind the knee cap (patella) as reported by the radiologist.

Professional athletes are recognizing stem cell therapy as a viable non-surgical option.

Stem Cells, PRP and Prolotherapy: Accurate Diagnosis is Essential

Stem cells, platelet rich plasma (PRP) and prolotherapy are powerful therapies which can provide dramatic results when appropriately applied.  When stem cells, PRP are not appropriately utilized, clinical results are often compromised.  The correct diagnosis and an understanding of what biomechanical forces led to an injury and pain is essential.  This is the cornerstone of the Centeno-Schultz Clinic. Ligament stability, muscle function and neurologic function are  some of the areas reviewed  when making a diagnosis.

JQ is a 79 y/o dentist who had a 15 year history of bilateral ankle pain who was interested in the Regenexx procedure whereby he could use his own mesenchymal stem cells.  None of the surgical options were attractive given the extensive rehabilitation and risks associated with both anesthesia and surgery since he had multiple medical conditions including hypertension. The pain was constant in duration, 7/10 in severity and progressive in  nature.  JQ had strained his ankles years ago and never received therapy.  As a dentist, JQ had intermittent lower back pain. Physical examination was significant for right leg limp secondary to pain, limited flexion and extension of lumbar spine, abnormal neurologic exam  in lower extremities, weakness in the foot muscles and loose and painful ankle ligaments.  MRI of the right ankle was significant for osteoarthritis and strain of the supporting ligaments. 

An MRI of the lumbar spine was obtained given his significant findings of physical examination.  The study was significant for two level disc disease, disc bulges, arthritic changes and irritation of the existing nerve roots. 

 A diagnostic low volume injection of local anesthetic into the lumbar spine resolved 90% of his bilateral ankle pain.  Subsequent therapies included platelet derived growth factor injections into the lumbar spine along with prolotherapy of the ankle ligaments.  The patient did not require stem cell therapy into his ankle because the majority of his ankle pain arose from the lumbar spine. Bottom line:  accuracy is everything.

Off Shore Stem Cell Report Card

The International Cellular Medicine Society is an independent nonprofit organization dedicated to the advancement of safe and effective adult stem cell therapies through research, education and oversight.

The ICMS  publication is a first of its kind report on off shore stem cells clinics. The report provides a summary of cells used, diseases treated and treatments costs of nearly a dozen non-US based stem cells clinics. The report also details the specific procedures, methods and practices of each clinic and evaluates them against the ICMS clinical and lab practice guidelines.

Regenexx makes Headlines Again

Regenexx was featured in the Broomfield Enterprise .  Click here for full article.

Is there a Cancer Risk with Stem Cell Therapy?

Mesenchymal stem cells can differentiate into many types of tissue including muscle, bone, cartilage and tendon.

Because mesnechymal stem cells are multipotent, there has been concern that implanted stem cells could form cancer cells.

Studies have demonstrated chromosomal abnormalities in mesenchymal stem cells that have been cultured for extended periods of time.  Other studies have demonstrated that mesnenchymal stem cells expanded  for less than 60 days poses no detectable risk of cell changes or cancer formation.

The critical question is whether mesenchymal stem cells are safe ?

Centeno et. a.l. have shown that they are safe.

Centeno, in a prospective study examined 227 patients and found no evidence of cancer formation at re-implantation site.  This finding is consistent with others who failed to find any evidence of cancer formation in mesenchymal stem cells culture expanded for limited periods.

Landmark study.  Stem cell therapy has a green light!

SAFE TO PROCEED

 

The Regenexx procedure utilizes minimally expanded autologous meenschymal stem cells to treat common orthopedic conditions.  This affords patients a non-surgical option with no extensive rehabilitation or the risks associated with anesthesia and surgery.

Resolution of Thumb Pain with Stem Cell Therapy

LK is 60 y/o patient who presented with a 1 year history of bilateral thumb pain, constant in duration, 4/1o in severity, progressive in nature localized at the base of the thumb.  Pain was sharp and stabbing in character and preventing him from buttoning his shirt.  Prior therapies had included a trial of NSAID and chiropractic care.  MRI of the thumbs was significant for moderate to advanced arthritic changes at the base on the thumb(CMC joint).  LK was told that surgery was his only option:  fusion of one joint and tendon wrap at the other.  Both surgeries are significant with extensive rehabilitation and poor outcomes.

Patient elected to proceed with the Regenexx procedure which allowed him to use his own mesenchymal stem cells.  At six months post injection of his own stem cells,  LK reports a 90% reduction in pain and  increase in range of motion.  Friends and work associates have stopped asking him about his swollen thumbs.  Buttoning a shirt is no longer an issue.

 Through the use of his own stem cells, LK has had significant reduction in his thumb pain, increase his range of motion and avoided a significant surgery. The time has come to embrace joint restoration instead of all therapies directed at joint replacement.

Effectiveness of Platelet Rich Plasma Injections

Regenerative medicine therapies include prolotherapy, platelet rich plasma injections and stem cells.

Platelet rich plasma (PRP) involves the use of platelet derived growth factors in the healing of tendon and muscle injuries.  The process includes collection of a patient’s blood with isolation and concentration of the platelets.  The concentrated platelets are then injected into the damaged tissue accelerating the healing process.

PRP therapy has made the headlines and utilized by many professional athletic teams.

Does it work?

According to Robert J. de Vos, M.D., in his recent publication in the Journal of American Medial Association, PRP injections did not significantly improve pain or activity level in patients with long-standing history of Achilles tendon irritation.  What this article did not discuss was the therapeutic effect of simply irritating the tendon (percutaneous tenotomy) which has been demonstrated to be effective.

Regenerative medicine has an increasing number of tools.  At the Centeno-Schultz Clinic it is our goal to utilize the appropriate regenerative therapy for the best possible clinical outcome.

Regenerative Sciences Heads to South America

Regenerative Sciences, a Colorado based autologous mesenchymal stem cell therapy clinic focused on orthopedic applications, signed a licensing agreement with industry leader Stematix to bring the Regenexx procedure to various parts of South america.  From the press release:

David C. Bonner, Ph.D., Chairman and CEO of Stematix, said, “We at Stematix are excited to be working with Regenexx, the leaders in applied regenerative medicine for orthopedic. We anticipate that this cutting edge, proven treatment will provide needed care for many patients in clinics established in Latin America. We are working toward a first clinic in Argentina during 2010. The expertise and experience of Dr. Centeno and Dr. Schulz will be invaluable in establishing our clinic in Argentina, and we look forward to incorporating advances in the treatment methodology that the Regenexx clinic in Denver will lead. “

First Practical Stem Cell Conference

The International Cellular Medicine Society (ICMS) will host it’s first annual conference in Las Vegas on 11/5/09.  What separates this conference from every other conference on stem cells is that this one will feature physicians who use cellular therapies everyday as part of their medical practices.  In the past, conferences have focused more on theoretical concerns.  Lectures will include: basic stem cell science by Henry Young, PhD-a scientist with 35 years of experience in culturing stem cells; the use of stem cells in Orthopedics by Christopher Centeno, M.D.;  the use of stem cells to treat degenerative disc disease by John Schultz, M.D.  and  regulatory issues for stem cell use as the practice of medicine by Christine Humphrey. Agenda can be reviewed here

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