May 22, 2018
It happens every year since the day I was born, there is a birthday celebration in my home and it happens again this week. Sure, I have a little more graying of my hair; but fortunately, I have my hair. I also have an activity level that would not have been possible, given the arthritis in my knees and hips, unless I had undergone restorative and regenerative intervention taking advantage of Bone Marrow Concentrate and Platelet Rich Plasma Offerings as I write about in these blogs.
To give you some insight of what is possible no matter your age and before you become a couch potato owing to pain and functional limits imposed by arthritis, let me describe what I have planned for the Memorial Day weekend. You might recall that I was experiencing progressive functional limitation until a regenerative procedure was completed on my knees, December, 27, 2017 followed by a similar procedure in my hips on January 11, 2018. On this upcoming Thursday, I will begin planting a relatively large vegetable garden in the mid-day when we arrive in Southwest Wisconsin followed by a late afternoon 30-mile bike ride. First, we stop at the Amish Greenhouse in our neck of the woods to collect the vegetables and Herbs. On Friday the cycling and planting will continue; Saturday will be a half day of fly fishing followed by more planting and then another 30-mile bike ride. Sunday will be a repeat of Saturday after the evening outdoor barbecue. Monday morning is another half day of fly fishing, then planting of the herb plot after which we return to Chicago and office patients on Tuesday.
I felt your pain until I took advantage of the possibility for functional restoration and joint regeneration that I offer my patients. No more kvetching from me. The way I want to live is the way I practice. I am not ready to slow down even though birthdays are being celebrated each year; and I don’t have to alter my way of life; having enjoyed symptom relief and functional restoration via Bone Marrow Concentrate and Platelet Rich Plasma offerings.
To learn about how you might continue to enjoy or perhaps return to an active, symptom free lifestyle, call (312) 475-1893 To schedule an appointment. You may visit my blog at HTTP://www.ILcellulartherapy.com where you may watch the webinar
Tags: autologous injection, autologous platelet and growth factor concentrate, autologous platelet concentrate, Bone Marrow Concentrate, cellular orthopedics, cellular therapy, Hip Arthritis, Hip pain, joint health, joint regeneration, joint replacement, joint restoration, knee arthritis, knee pain, Platelet Rich Plasma, Regenerative Pain Center, Regenexx
Apr 16, 2018
My team dedicates an inordinate amount of time answering questions and attempting to clarify the misunderstanding of patients when it comes to Platelet Rich Plasma; actually, the entire subspecialty of “Stem Cell Therapy” but let’s start with PRP. As an orthopedic surgeon who introduced Cellular Orthopedics to the Midwest five years ago, I am in a unique position to help define the problem. Does PRP have a role in treating a painful or injured part of the musculoskeletal system? In an attempt to help clarify misconceptions and better define the term Platelet Rich Plasma, I sat down and wrote this Blog.
Platelets circulating in the blood play a fundamental role in blood clotting and are a natural source of growth factors. Platelet rich plasma (PRP), also termed autologous platelet gel, plasma rich in growth factors (PRGF), platelet concentrate (PC), is essentially an increased concentration of (autologous) your platelets suspended in a small amount of plasma after centrifugation. Although it is not exactly clear how PRP works, laboratory studies have shown that the increased concentration of growth factors in PRP can potentially speed up the healing process.
The amount of PRP necessary to achieve the intended biologic effects still remains unclear.; but we know PRP contains growth factors in high concentrations. Precise predictions of growth factor levels based on the platelet counts of whole blood or PRP are limited. In our office, we use a hemocytometer to count platelets and the different white blood cells contained in the preparation. Knowing there are different sources for growth factors (platelets, leukocytes, plasma), we assume the higher number of platelets and leukocytes counted in the hemocytometer, the higher the concentration of growth factors in the preparation. Treatments using these autologous platelet growth factors are an important reason to improve methods for isolating platelet-rich plasma (PRP) and that is why I am involved in an initiative to correlate counts with clinical outcomes.
PRP proponents assert that concentrated Platelet Rich Plasma fails to successfully treat symptoms in some cases because of differences in PRP formulation. There is no standardization thus leading to variables, such as PRP preparation methods, the amount of PRP injected, and the frequency of injections. These inconsistencies result in issues raised by patients: “PRP didn’t work for me” and “I had 15 PRP injections to my knee and I still have pain”. In addition to studying the numbers and monitoring results, I am involved with initiatives to filter and concentrate the growth factors in PRP so as to improve outcomes as well.
1)Platelet Rich Plasma
2)Concentrated Platelet Rich Plasma
3)Concentrated Stem Cell Plasma
4)Autologous Platelet and Growth Factor Concentrate
When you call (312- 475- 1893) to schedule a consultation or watch my webinar at www.Ilcelulartherapy.com, you will avail yourself of the aforementioned Platelet Rich Plasma treatment options in addition to our entire Cellular Orthopedic menu of regenerative care.
Tags: autologous injection, autologous platelet and growth factor concentrate, hemocytometer, injection, leukocytes, Platelet Rich Plasma, PRGF, PRP, Stem Cell Plasma
Apr 10, 2018
Every year at this time, we each recall and celebrate several significant events of historic, cultural and spiritual importance. No matter what your roots or upbringing or present belief, these past eight days usually involve a gathering of friends and family to jointly read and remember that which happened long ago and still impacts us today. Whether done in a house of worship or in the home, somehow, we ask similar questions and teach our children and grandchildren that which befell us in ancient days. To underscore those similarities, some years ago, when my son had his Bar Mitzvah at the Western Wall, a Franciscan Monk who I had come to know invited us the next day to a Pre-Easter service at the Church of the Holy Sepulchre. Other than The Gregorian chants and the frankincense, the superstructure of the 90-minute service was quite familiar.
I use this yearly celebration to reflect and meditate; it also initiates the spring cleaning ritual in our house. Having grown up in Humboldt Park and later Albany Park to parents who left Europe in time, Passover meant it was time to clean and wash the kitchen cabinets, recycle, and dispose of certain foods. On Division Street, we lived near my orthodox grandparents; in Albany Park, they lived with us, so the everyday plates and silverware were taken to the basement and exchanged for special settings reserved for this time of year.
Certainly, times have changed and we have assimilated; but my wife still prepares the appropriate meals for the week and makes sure the house is immaculate. Then the family and company visits end and we are challenged by the need to address the residual back scuffs on our wood kitchen floor; lots of them and pronounced. Here is where the ultimate test of the cellular orthopedic intervention to my own hips and knees, now almost four months ago comes into play.
With the coverage varying between the Masters, Cubs, and Sox games in the background, we genuflexed, spread the Murphy Oil Soap and started rubbing away with microfiber wipes. This exercise lasted about two hours, admittedly with several breaks. Nevertheless, we accomplished our mission and I got up unassisted to head to the health club for my strength training respite.
This morning, Section one of the Chicago Tribune carried three full pages, in color, competing ads concerning Regenerative Medicine; none giving much information about science or outcomes but certainly employing one-time prominent athletes as spoke persons. Is it worth a free lunch to become a marketing dupe? As readers of my Blog know, I myself had Cellular Orthopedic intervention to my knees at the end of 2017 and to my hips at the start of 2018. This morning I scheduled two ski trips in 2019 to Vail; on Saturday morning, I am headed to Southwest Wisconsin for a long weekend to bike and fly fish; and I am on standby at any time to genuflex and spread that murphy oil soap.
So as advertised on Friday night Cable, you may receive a $250 gift certificate for attending a Stem Cell Seminar, or you may get examined and receive counsel from this orthopedic surgeon focusing on Cellular orthopedics. For the latter call 312 475 1893 to schedule an appointment, one on one. You may access my web site and watch the webinar at www.Ilcellulartherapy.com
Tags: arthritis, genuflex, Hip pain, Hip Replacement, knee arthritis, knee injury, knee pain, Osteoarthritis
Oct 20, 2017
Well, it is really an internal debate as to whether I should have a concentrated platelet rich plasma procedure or a bone marrow concentrate procedure as I get ready for the upcoming ski season. While it is true that I exercise five to six days a week rotating between outdoor cycling, strength training and rowing, the demands of skiing on the knees are such that I need to rethink my approach. I share this personal flow of conscience to provide guidance and council for readers of this blog. As for so many of us senior recreational participants, each activity has unique demands so we must anticipate each activity from a separate approach. While generalized fitness improves the quality of life and even well-being, maybe even prolonging life, if you want to ski with arthritic knees, now is the time to plan ahead.
Let me share with you my plan based on an observation of the outcomes in over 1500 patients in whom I have intervened with Cellular Orthopedic alternatives over the past five years. In the next several weeks, I will undergo a concentrated PRP intervention ultrasound guided into both of my knees. I will be using the upgraded methodologies for preparation of injectate and customize the PRP with our soon to be activated cell counter. This will provide me with a 20x dosage over that which has been available up until the present; and yes, I too have to pay for the methodology. I will then wait until mid-December, and if I am not satisfied, I will undergo a Bone Marrow Cell Concentrate procedure for both of my knees.
Below are two reasons received in the last 48 hours as to why I believe Cellular Orthopedic is exciting:
“My uber-condensed version, though, is that on almost all days in the last 8 months, I’ve had virtually no knee pain with daily activity. That’s a massive improvement from even the 12-month follow-up visit. I first started to suspect things were improving at about 10 months post-op. At 12 months, I was hopeful but still skeptical. At 14 months things, rapidly improved and have mainly remained there ever since. So, on the whole, I’m vastly improved. I suppose any number of factors could have contributed to that improvement, but Regenexx certainly seems to have helped tremendously.”
“Attended the company golf outing this past weekend. Last year I was concerned so I took an Advil before we started and ended up taking another halfway through the 18 holes. The last four holes I didn’t even leave the cart (to sore/tight to get in and out).
This year I fully intended to bring the Advil again but forgot it. Turned out I did not need it. Finished the 18 holes like nothing. Felt fine after and the next day.
Believe we can consider this a win!!!!”
Do you want to enjoy relief from arthritic symptoms and limitations?
Call 312 475 1893 to schedule a visit or visit my website to watch my webinar www.Ilcellulartherapy.com
Tags: arthritis, Clinical Trial. Mitchell B. Sheinkop, Knee Pain Relief, Orthopedics, treatment
Oct 6, 2017
Assume that you schedule an office assessment for knee pain, altered function and a slight limp. I complete the examination and review the radiograph only to find it “normal”. The examination excludes referral from the low back and hip so the next step is an MRI. 48 hours later I am able to diagnose a Bone Marrow Lesion (BML) as the cause of the problem. The Bone Marrow Lesion is an abnormal area of defect inside the bone. Also called Bone Marrow Edema (BME), they are defects typically found below or adjacent to a joint. They appear a hazy white area on the MRI against the background of darker, unaffected bone and bone marrow. Pathologists have shown that the BML represents a healing response as a result of a bone injury that doesn’t heal properly. In other cases, the MRI finding may be consistent with a stress reaction that forms from overuse or poor joint mechanics.
Obesity and poor diet are thought to increase the likelihood of developing BML. They are more commonly found in middle-aged patients rather than younger patients. Patients with poor joint alignment (bow legs or knock knees) are more likely to develop BML. Adults who quickly increase activity may develop Bone Marrow Lesions or Edema.
As in most initial diagnoses, a course of conservative treatment should be instituted so as to allow the body to heal itself. If the lesion doesn’t heal with medications, braces, non-weight bearing, injections and physical therapy, then an intraosseous injection into the lesion is indicated. Left untreated, the problem may result in the loss of joint support and the development of osteoarthritis.
I treat the symptomatic, non-responsive BML with an intraossous, intralesional procedure called a subchondroplasty whereby Bone Marrow Concentrate rich in stem cells and growth factors is injected into the non-healing insufficiency fracture. Fluoroscopy is used (intraoperative X-ray) to guide the placement of a special drillable cannula into the bone defect. At times, should the BML be of sufficient size as to cause me to be concerned about a possible fracture, I will use a Calcium Phosphate preparation in addition to the Bone Marrow Concentrate. The engineered Calcium Phosphate readily fills the subchondral defect and mimics the properties of cancellous bone eventually being resorbed and replaced with new bone.
Most Orthopedic Surgeons believe that Chronic Bone Marrow Lesions will not heal without intervention. Additionally, the pain generator in osteoarthritis diagnosed by narrowing of a joint space may in fact be secondary to a BML. Bone Marrow Edema and lesions were among the topics I reviewed during my Instructional Programs in St Petersburg, Russia, two weeks ago. To learn about chronic joint pain with a “normal “or even abnormal X-ray, call for a consultation and evaluation.
312 475 1893
Or visit my website and watch the webinar Ilcellulartherapy.com
May 18, 2017
Also known as degenerative joint disease, osteoarthritis is the most common joint disorder, and continues to be the leading cause of impaired quality of life in the United Sates. While OA is defined as the progressive loss of cartilage structure and function; that definition has most recently been expanded to include changes to bone, tissues within and around the joint and changes in alignment.
While trauma, disease, infection, genetics, gout, and neuropathy may lead to secondary osteoarthritis, primary OA is the result of a degeneration that occurs with normal use. This wear and tear of the joint becomes more prevalent with advancing age.
Changes to Cartilage
The progressive loss of cartilage is a process that involves three overlapping stages: cartilage matrix (surroundings) damage, cartilage chondrocyte (cell) response to tissue damage, and decline of chondrocyte synthetic response (ability to maintain its environment)
Changes to Bone
As cartilage degenerates, there is increased exposure of the bone supporting the joint (subchondral bone). With time, the subchondral bone becomes dense (sclerosis) with cyst formation. Cartilage does not regenerate on its own starting about age 40. With time the aborted reparative process may result in osteophyte formation (spurs).
Changes to Periarticular Soft Tissues (in and around the joint)
Synovitis develops (inflammation of the joint lining) because of the release of inflammatory factors by the chondrocytes. A vicious cycle continues with further break down of cartilage followed by thickening of the joint capsule and shortening leading to loss of motion. Muscle undergoes atrophy (shrinkage and weakening) with the relative inactivity of the joint because of pain leading to instability
Changes to Alignment
Abnormal hip-knee-ankle alignment can accelerate structural changes; varus malalignment (bowed leg) increases medial compartment (inner side of the knee) disease fourfold, and valgus (knock knee) malalignment increases lateral (outer) disease twofold. Whether malalignment is associated with development of osteoarthritis or if malalignment is a result of OA is still a subject of debate. However, it has been demonstrated that malalignment can affect more than cartilage because malalignment predis- poses the patient to bone marrow lesions (nonhealing stress fractures).
Treatment of Osteoarthritis
Life style modification, rehabilitation (physical therapy), complementary and alternative therapy, pain relievers, intraarticular injections (cortisone, hyaluronic acid gels), arthroscopic and joint replacement surgery, and now, regenerative intervention.
Regenerative Intervention (an injection, not an incision)
Cellular intervention is what I do. Biologic solutions through cartilage regeneration is the goal of my practice. My stem cell source is the patient’s own bone marrow. Equally important are growth factors; the latter found in bone marrow and in platelets.
To learn more, visit my web site www.sheinkopmd.com
You may watch my webinar www.ilcellulartherapy.com
Then schedule an appointment 312 475 1893
Tags: arthritis, Clinical Trial. Mitchell B. Sheinkop, Interventional Orthopedics, Knee Pain Relief, Orthopedic Care, Osteoarthritis, regenerative medicine
