Jun 1, 2017
It is now over four years since I began the most comprehensive outcomes clinical trial ever undertaken in which Bone Marrow Concentrate was used to reduce pain, improve function, increase activities and alter the progression of osteoarthritis in a knee joint. At the start, it was generally believed that the adult mesenchymal stem cells would reproduce themselves and emerge as cartilage therein regenerating the joint. Continued scientific investigation has taught us that the adult mesenchymal stem cell acts as the conductor of a complex bio-immune process in conjunction with growth factors. One such growth factor is an endogenous polypeptide molecule, Transforming Growth Factor -Beta (TGF-ẞ). There are many other growth factors derived from the Bone Marrow Concentrate that play a role but that discussion is beyond the scope of this Blog. Additionally, be aware that Platelet-derived growth factor attracts mesenchymal stem cells and can stimulate proteoglycan production and chondrocyte proliferation. Incidentally, should you decide to seek consultation with one of the plethora of so called regenerative medical specialists populating the internet and advertising in the media, before you go, print my blog and ask them relevant questions pertaining to the science. You make be surprised to learn you as a potential regenerative consumer know more about the subject than the highly visible marketing provider.
Getting back to the clinical trial, the recruiting process of 50 patients ended two years ago and now we have two to four year of outcomes data to statistically analyze; that scientific process will be completed next week and presented at the Orthobiologic Institute meeting taking place in Las Vegas, June 8 to 10. For the first time, real outcomes data having been analyzed using the same criteria I used in my 37- year career as a joint replacement surgeon and head of a joint replacement program at a major medical center in Chicago will be presented to the regenerative medicine community. Unfortunately, I am unable to control the charlatans and camp followers who will attend the meeting and even try to use my data for their marketing. I choose to share my data as a challenge to those who seek to market and advertise stem cells for every malady known to mankind.
If you want to become better informed, you may access my website www.sheinkopmd.com.
You may watch my webinar www.ilcellulartherapy.com or call to schedule a consultation 312 475 1893.
Tags: bone marrow, Clinical Trial. Mitchell B. Sheinkop, Concentrated Stem Cell Plasma, Growth Factors, Mesenchymal Stem Cell, proteoglycan, stem cells, Transforming Growth Factor -Beta
Apr 20, 2017
My clinical practice mission is to use autologous concentrated marrow-derived mononuclear cells for the care and treatment of a joint afflicted by degenerative arthritis so as to assist a patient in postponing, perhaps avoiding a joint replacement. I then follow the patient using osteoarthritis outcome scores to measure pain control, activity improvement, and quality of life impact. The knee society score, an orthopedic surgeon’s vehicle, (KSS) also demonstrates a significant improvement of on the symptoms subscale and function subscale in most patients who undergo a Bone Marrow Concentrate procedure in my office. What about Stem Cells? Please note at the end of the first sentence and the beginning of the second, my emphasis on autologous concentrated marrow-derived mononuclear cells; not “Stem Cells”. That bone marrow concentrate is made up of Platelets, Growth Factors, and Mononucleated cells. It has been estimated that somewhere between .0017% and .034% of the mononucleated cells are actually adult mesenchymal stem cells. My point is that when you see the ads for stem cells on the many web sites, in the print media and now on outdoor advertising signs as the one I noticed on Clinton and Monroe in Chicago this past Monday, you may fall victim to marketing and not science. Chiropractors, non-board certified physicians, family practitioners and the entire realm of camp followers have embraced the exploding discipline of Regenerative Medicine. Patient beware as I point out in the next paragraph using a recently published study from the Mayo Clinic.
Many patients come to Mayo Clinic for a second opinion or diagnosis confirmation before treatment for a complex condition. In a new study, Mayo Clinic reports that as many as 88 percent of those patients go home with a new or refined diagnosis – changing their care plan and potentially their lives. Conversely, only 12 percent receive confirmation that the original diagnosis was complete and correct. Given what I have seen evolving in the field of Regenerative Medicine, I am not surprised. Few practices offering “Stem Cells” have any idea what is involved and what is in the bone marrow concentrate. Many mislead the public with a stem cell presentation using amniotic fluid product wherein it has repeatedly demonstrated there is an absence of stem cells in amniotic fluid once processed, frozen and fast thawed. What about adipose derived stem cells? For one, to liberate the stem cell from the adipocyte, there has to be a cycle of enzymatic degradation. The latter violates FDA requirements. What about platelets and growth factors in adipose derived materials? Given the relative absence of blood supply in fat, I have yet to find a scientific publication suggesting there are growth factors in adipose tissue.
The cover story in the April 2017 AARP.ORG/Bulletin is titled “How to Stop Fraud, The Ultimate Guide to Protect Yourself from Scammers and Crooks” While not directed to Regenerative Medicine, the warning applies. As suggested by the Mayo Clinic referenced article above, the best protection is a second opinion.
To schedule call: 312 475-1893
You may visit my web site at www.SheinkopMD.com
Or watch my webinar at www.ilcellulartherapy.com
Tags: Benefits and Risk, Bone Marrow Concentrate, Orthopedic Surgeon, Regenerative, regenerative medicine, Regenexx-SD, stem cell treatment
Mar 27, 2017
I am an orthopedic surgeon. The new focus for the arthritic joint is restoration and not replacement. Almost five years ago, I joined that emerging initiative after a 37-year professional career of having replaced joints. One of the recent problems emerging in this discipline of regenerative medicine is that marketing is inaccurate. There is no quick fix be it a replacement or an interventional orthopedic procedure. What stem cells do not risk is a joint replacement failure requiring a repeat procedure (revision), a significant occurrence of infection, a blood clot or a nerve injury. As a surgeon, I replaced arthritic joints because the original cartilage had degenerated and the bone surfaces degraded. My effort now is to restore and not replace. This is an evolving field using stem cells derived from bone marrow, using inflammatory blockers, and growth factors.
Finding a good interventional cellular orthopedist is partly a numbers game. Research shows a regenerative specialist must do a minimum of 50 interventions a year to provide a consistently satisfactory end result. Five years ago, the orthopedic surgical community including my past associates were all nay-sayers. Today, they are embracing that which I pioneered. While there are of this time, no true standards and regulatory bodies outside the FDA, in my office, I have pioneered a standardization initiative via qualitative analysis of that which we aspirate and then inject. The meeting of the American Academy of Orthopedic Surgeons in San Diego ending last week dedicated a relatively large part of the educational and scientific agenda to regenerative medicine and interventional orthopedics. All this being said, the patient seeking out one of America’s fastest growing procedures must assure the provider is experienced, knowledgeable and be prepared to meet a patient’s expectations. The explosive growth of those holding themselves out to be capable of delivery an excellent or at least a good regenerative outcome is not supported by evidence or experience. To repeat what I indicated above, all doctors are not the same. If you want the evidence, make an appointment. If you want a procedure by those who market themselves as treating Alzheimer’s, Alopecia, facial wrinkles, Arthritis, so on and so forth all under the same roof, I am not the that clinician.
To learn more, check out my web site at www.Sheinkopmd.com
View my webinar at www.ilcellulartherapy.com
Or call for an appointment 847 390 7666
Tags: arthritis, bone marrow, Clinical Trial. Mitchell B. Sheinkop, Concentrated Stem Cell Plasma, Interventional Orthopedics, Mesenchymal Stem Cell, Regenerative, regenerative medicine, stem cell treatment
Mar 6, 2017
Blog: Dr. Sheinkop , let’s pick up where we ended at the last interview. You were going to tell us about the hip labrum?
Sheinkop: Recently, there has been an increased frequency of diagnosis pertaining to an acetabular labral tear when a patient presents to a physician with groin pain. The cause may be attributed to trauma or it may be spontaneous in nature. While only an orthopedic surgeon really understands how to properly examine the hip joint, I am observing the next step in every and all patients with “hip” or “groin” pain is an MRI prescription. While a torn acetabular labrum is best diagnosed on the MRI after arthrogram, even that exercise may not result in a proper diagnosis. There are anatomic variants that are frequently mistakenly diagnosed as a tear and there are positive findings for a labral tear that when surgically addressed do not result in clinical improvement. In general, unless there are mechanical signs such as snapping, clunking or giving way, pain alone is not justification for arthroscopic hip surgery. In the presence of arthritis, arthroscopy is almost never indicated in the new world of evidence based medicine.
Blog: If I am not mistaken, the way you responded to the labral question is how you have responded in the past to a “positive” MRI of the knee and a diagnosis of a torn meniscus (cartilage).
Sheinkop: You are correct. The scientific evidence clearly identifies the fact that a pain generator must be identified before a surgical procedure. Even if the MRI is compatible with a torn labrum or meniscus, in the presence of arthritis, arthroscopic surgery will make things worse over six months. Surgery in said circumstances should be reserved for mechanical symptoms and not pain.
Blog: Then what is a patient with pain in the groin or knee to do?
Sheinkop: First and foremost, my job is to identify the cause of the pain and treat the patient, not the image. In the absence of clunking, snapping and giving way (joint instability), Interventional Orthopedics based on Platelet Rich Plasma and Bone Marrow Aspirate derived stem cells and growth factors provide the surgical alternative-remember the needle and not the knife.
Blog: I learned this week that you have been invited to St. Petersburg, Russia, this September to present non surgical alternatives for arthritis, at an international orthopedic meeting focused on joint replacement.
Sheinkop: Your information is correct. The role for Interventional and Cellular orthopedics, basically regenerative medicine, is in grades two and three osteoarthritis; while a patient is quite functional and not yet sufficiently impaired to justify the risks inherent in a joint replacement. On the other hand, there is a large patient population with advanced osteoarthritis of a major joint wherein the joint replacement option is to great a medical challenge and may risk survival. The evidence I have gathered over almost five years is not only of interest in the United States but has global potential impact.
To learn more call (312) 475-1893 to schedule a consultation
View my web site at www.sheinkopmd.com
Watch my webinar at www.ilcellulartherapy.com
Tags: arthritis, Bone Marrow Concentrate, Clinical Trial. Mitchell B. Sheinkop, hip surgery, joint replacement, knee surgery, Orthopedic Surgeon, Pain Management, Platelet Rich Plasma, stem cell treatment, torn labrum, torn meniscus
Feb 28, 2017
When it comes to cellular orthopedics, for me, it is a matter of honor and self-interest.
If you aren’t aware of the bogus stem cell claims or “false news”, read the LA Times article that appeared last week http://www.latimes.com/business/hiltzik/la-fi-hiltzik–oz-stem-cell-20170213-story.html
The article followed a Dr. Oz television expose where he focused on charlatans victimizing the public with false information at extremely outrageous fee schedules. The egregious behavior stemmed (no pun intended) from mostly California based clinics but Texas was another state exposed. For those who read this Blog, you are familiar with the false advertising of “Stem Cell Clinics” highlighting regenerative medicine via Amniotic Fluid for arthritis in Illinois, that I have repeatedly taken to task. To repeat, while there may be living cells when amniotic fluid is harvested, following collection, processing, sterilizing, irradiating, freezing and fast thawing, there are no living or viable stem cells in the pat being offered as a regenerative alternative. Dr. Oz took his expose a lot further calling attention to false claims without medical evidence wherein the so called regenerative medicine clinics he exposed offer treatment for every and any affliction of the human body.
Since the innovations introduced by Regenexx 10 years or so ago, interventional orthopedics has become an evidence based approach to sports medicine related injuries and as an alternative to a major surgical reconstruction or replacement for an arthritic or chronically injured bone or joint. I am a member of the Regenexx network and, have continued to compile and contribute scientific evidence to support the Regenexx mission. Our menu of surgical alternatives is directed to afflictions of the musculoskeletal system.
A patient attempting to postpone or avoid a major orthopedic procedure for an arthritic joint and return to a relatively symptom free functional quality of life may find legitimate, well intentioned and evidence based regenerative medicine and interventional cellular orthopedic initiatives. I am proud to be one of those clinical settings
Next week, I will complete my interview with Dr Mitchell Sheinkop, part two-focusing on common athletic injuries amenable to cellular orthopedics and joint condition amenable to stem cell intervention.
To schedule an appointment call (312) 475-1893
To visit my web site go to www.sheinkopmd.com
To watch my webinar visit www.ilcellulartherapy.com
Tags: Bone Marrow Concentrate, Clinical Studies, Clinical Trial. Mitchell B. Sheinkop, Concentrated Stem Cell Plasma, Interventional Orthopedics, Mesenchymal Stem Cell, regenerative medicine, stem cell treatment
Feb 20, 2017
Blog: “Please explain Interventional Orthopedics?”
Dr Sheinkop: “Five years ago, after 37 years of performing hip and knee replacements at a major medical center in Chicago, where I served as director of the Joint Replacement program, I exchanged the scalpel for a needle. Having achieved my surgical goals, I elected to help pioneer the emerging subspecialty of interventional orthopedics, introducing clinical research so that regenerative medicine in the musculoskeletal system would be evidence based. Instead of a long incision, lengthy rehabilitation, potential major complications, and potential infection, I use bone marrow and growth factor concentrate through a needle to help a patient reduce or eliminate pain from an arthritic joint, improve motion and increase functional capacity.”
Blog: “Why did you take this route?”
Dr Sheinkop: “My clinical joint replacement research initiatives, wherein every patient on whom I had operated was closely monitored and followed, made me realize that patients under 60 were too prone to early revision surgery; that is a repeat replacement in a relatively short time. I became aware of the potential of the stem cells and growth factors in bone marrow concentrate to assist a patient with grades two and three arthritis of a major joint in postponing, perhaps avoiding a major joint replacement. As well, for older patients with grade four osteoarthritis who have too many co-morbidities and aren’t safe surgical risks, Bone Marrow Concentrate is a reasonable option.
Blog: “What evidence have you accumulated?”
Dr Sheinkop: “80% of our patients are very satisfied after four years. At the knee, only 7 % have gone on to have a joint replacement. At the hip, that number is about the same. I now have about four percent of patients who have undergone or are scheduled to undergo a repeat Bone Marrow Concentrate procedure after three to four years. Equally important is the comparison of activities after a Bone Marrow/ Growth Factor intervention versus a Total Joint Replacement. I have arthritic knees, grade three. I underwent an intervention on my left side 18 months ago. Last weekend, I went fly fishing for two days in Southwest Wisconsin walking along the creeks, at times in the spring creeks. This week, I am going skiing in Vail with my family. None of this would be possible with a joint replacement.”
Blog: “This is fascinating information; so much so that I want to continue this interview into next week. I want to ask you in particular about the acetabular labrum which seems to be receiving all kinds or attention, arthroscopic knee meniscectomy in the presence of arthritis, non-surgical alternatives for a torn ACL, and subchondroplasty”
Tags: arthritis, Bone Marrow Concentrate, Clinical Trial. Mitchell B. Sheinkop, Interventional Orthopedics, Orthopedic Care, Regenerative
