Aug 4, 2017
Most readers know that I “graduated” from joint replacement surgery into an emerging field of Regenerative Medicine about five years ago. Prior to that time, I had dedicated 37 years to Reconstructive Orthopedic Surgery and played an active role in a joint replacement practice combining research with education as I improved the quality of life for my patients. By the end of my surgical career, I had authored more than 90 scientific papers in the field of hip and knee replacement as well serving in the leadership of the joint replacement program at a major medical center in Chicago.
That was “back in the day” of joint replacement surgery; but rather than live in the past, I have elected to partake in the present and advance Cellular Orthopedics into the future. I now have the largest and most comprehensive clinical outcomes data base in the United States concerning Bone Marrow Concentrate, Mechanical preparation of Adipose Graft, and Amniotic Fluid injection used in the treatment of knee arthritis. This information has allowed me, up until now, to make a scientifically based recommendation as to the best regenerative option for dealing with an arthritic joint.
In my initiative to advance the discipline of Cellular Orthopedics, the next innovation will be to offer a prior analysis of the stem cell content for the patient seeking the regenerative option as a means of postponing or avoiding a joint replacement. Should a patient present with osteoarthritis seeking to determine if she, he or hir will benefit from Adult Mesenchymal Stem Cells and Growth Factors, I am able to offer the equivalent of a bone marrow biopsy and determine the amount of viable cellular orthopedic content available in that individual’s bone marrow. My recommendations then would be based on actual number of cells and not on age related or disease influenced averages or estimates. Predictability of an individual’s outcome in determining whether to proceed with the regenerative intervention would be customized and not generalized. Where this scientific leap forward would be of particular interest includes patients over age 70, those who have received immune altering systemic management for a co-morbidity or for patients whose medication requirements up until now would have eliminated them from a regenerative consideration.
To learn more schedule an appointment 847 390 7666
You may access my web site and watch my Webinar at www.Ilcellulartherapy.com
Tags: arthritis, Bone Marrow Concentrate, cellular orthopedics, Orthopedic Surgeon, Osteoarthritis, regenerative medicine, stem cell treatment
Jul 31, 2017
“Haven’t spoken with you in a few months so I thought you might be interested to hear about my knees since the January injections. Things are definitely better. The most important of which is my really bad left knee doesn’t lock up when I roll over in bed. It hurt so bad that it used to wake me up. That’s completely gone. As is the swelling even after walking 18 holes of golf and riding my bike 20 miles. It’s not completely without pain though. It tightens up. But I never have any residual pain in the mornings, even after walking 10 miles and cycling 70!
So, I just started a vegan diet. Was told by my new doctor (she’s in Chicago and does this concierge thing) that it’s anti-inflammatory and might help me get off cholesterol medicine. So far, it’s eliminating my knee pain and I’ve only been at it a week! Fingers crossed. I’ll let you know how things go. It’s not easy being vegan, but certainly easier in SF with a vegetarian wife than it would be in Chicago with a meat eater for a mate! Thanks again.”
Earlier this week, I received this message from a patient who I have been caring for over the last 24 months. It is very rewarding to my team and me when I learn about continued improvement following the initiation of cellular orthopedic interventions as an alternative to a major joint surgical reconstruction with the inherent risks of an adverse outcome. My practice is Outcome Focused based with a serious commitment to the clinical research required to continually confirm the efficacy of our menu of services. It is important that I maintain a leadership role in advancing the clinical science of the regenerative products that I use in my practice. As I have written before and about which I am constantly reminded, the regenerative process requires time. Sometimes it requires weeks and sometimes it takes months. On occasion, it may require more than one intervention.
The testimonial this week suggests a change in diet allowed my patient to discontinue statins with a resultant significant diminution in pain. Many patients inquire about supplements and foods that may make a difference. In addition, I find that those who partake in athletics and fitness, also contribute to their well-being and success of a regenerative intervention.
To join our team, call 847 390 7666
Or access our web site and watch the webinar ilcellulartherapy.com
Tags: arthritis, Bone Marrow Concentrate, Interventional Orthopedics, stem cells
Jul 20, 2017
We now are approaching five-year outcomes regarding the use of Bone Marrow Concentrate for Osteoarthritis of the hip, knee, shoulder and ankle. Bone Marrow contains Adult Mesenchymal Stem (MSC) cells and Growth Factors. In the beginning, the entire informed consent process focused on the MSC in bone marrow as the agent responsible for diminishing pain, improving motion, stopping, at times reversing the progression of osteoarthritis, and potentially regenerating the joint itself. Now we know that equally important to the MSC are the growth factors produced and stored in the bone marrow. Some of the key proteins (Growth factors) include Interleukin-1 Receptor Antagonist Protein (IRAP), Alpha-2-Macroglobulin (A2M), fibrinogen, PDGF, VEGF, and TGF-B to name a few.
The reason we directed our clinical initiatives to Bone Marrow Concentrate is that while Amniotic Fluid contains Hyaluronic Acid, once harvested, sterilized and fast thawed for clinical application, there are no living stem cells left, so Amniotic Fluid Concentrate has no regenerative potential. When it comes to Adipose Derived Stem Cells, in order to liberate the stem cell from the adipocyte, an enzyme, collagenase must be employed. The latter is not approved by the FDA. Additionally, there is no evidence of Growth Factor content in adipose derived tissue.
While I have blogged about the superiority of Bone Marrow Concentrate over all other non-surgical approaches for arthritis, the introduction of the intraosseous adjunct, subchondroplasty, is resulting in even superior outcomes when compared to those who were treated prior to this contemporary version of Cellular Orthopedics. It has been nine months basically since I started injecting Bone Marrow Concentrate into the marrow adjacent to the joint in addition to the intraarticular approach. We already are seeing a better outcome in those who availed themselves of the Intraosseous adjunct. Up until eight weeks ago, my ability to offer contemporary and improved treatment options was limited by preexisting contractual obligations; but now unrestricted, I have expanded my scope of offerings including elevation of subchondroplasty from a clinical trial status to usual and customary adjunct standard of practice option. As well, I now offer an increased opportunity for participation in other clinical trials for the arthritic joint when a patient meets obligatory inclusion criteria determined by the trial sponsor.
If you want to postpone, perhaps avoid a major surgical replacement for an arthritic joint, call for a consultation 847 390 7666
You may visit my web site at IlCellulartherapy.com where you may watch my webinar.
Tags: arthritis, Benefits and Risk, bone marrow, Bone Marrow Concentrate, Clinical Studies, Clinical Trial. Mitchell B. Sheinkop, Interventional Orthopedics, Microfracture surgery, Orthopedics, Osteoarthritis, Pain Management, stem cells, treatment
Jul 13, 2017
Last week, we traveled to Israel to celebrate the wedding of our youngest son. Israel became the destination for the event as Eric and Judith had met there while his music business was subcontracting to Coke and Judith led the International Marketing initiatives for Coke. The event took place on July 5th, at an organic farm in the outskirts of Jerusalem. In such a majestic and historical setting prior to and after the ceremony, there took place several organized tours including one of Jerusalem, another at the Dead Sea and for several, a trip to Petra. It was a relatively small group of the attendees; one in particular, a very close and long-time friend has been the subject of my Blog in years past as I described his return to skiing, biking and fly fishing following a Bone Marrow Concentrate/Growth Factor Concentrate/Stem Cell concentrate intervention. Prior to those procedures, he had been forced to give up his athletic passions for several years because of the limitations imposed by arthritis of both knees.
Above is his activity score from Monday, July 3, when Bob and his wife toured Jerusalem’s Old City including a hike on the ramparts of the wall surrounding the Christian Quarter, the stop and prayer at the Temple Mount and a shopping spree at the Arab Suk (bazaar).
What Bob represents is the potential for continued improvement over several years following a regenerative intervention, a process of which I am continually reminded as time passes and I have a longer follow up of my patients. Our mission and ethos is to help patients with arthritic joints enjoy an active life style and postpone, perhaps avoid joint replacements when arthritic impairment ensues. The documentation from the patient above is one of improving outcome as time passes. While his is an anecdote, our data base increasingly reflects similar happenings for the majority of our patients.
There are now many providers for those with arthritic impairment seeking improved function and less symptoms; and who are not candidates for a joint replacement or who do not want to undergo the major surgical undertaking. In your choice of an Interventional Cellular specialist, inquire about her or his long-term outcomes; not just “will I get a free lunch if I attend a seminar?”
To learn more, call for a consultation 847 390 7666
You may watch my webinar and learn more by visiting my website at Ilcellulartherapy.com
Tags: arthritis, Bone Marrow Concentrate, Clinical Trial. Mitchell B. Sheinkop, Interventional Orthopedics, joint replacement, Knee Pain Relief, Orthopedic Surgeon, Regenerative, stem cells
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
May 11, 2017
Last week, my associate attended a continued medical education course held in a venue near the Wisconsin-Illinois border; a site frequently used by the Stem Cell Institute of America to host amniotic fluid marketing seminars. My colleague overheard a conversation between several physical therapists touting the success of amniotic fluid in regenerating cartilage on their patients, “you can see the increased joint space on the x-ray when we see the patient in follow-up”. I have addressed the issue of the absence of viable stem cells in amniotic fluid ad-nauseam (borrowing a recently expressed symptom from the Director of the FBI) but I am continually amazed at how false news when repeated takes on a fantasy of its own. Additionally, my patients frequently ask to repeat the imaging so they might see if the cartilage is growing.
Much of the current research effort pertaining to cartilage is experimental and has to do with the MRI techniques known as T2 mapping and delayed gadolinium enhanced MRI of cartilage (dGEMRIC). In addition to MRI techniques, optical coherence tomography (OCT) may allow arthroscopic evaluation of cartilage by performing microscopic cross-sectional imaging of articular cartilage. In the final analysis, the only present clinical cost effective, non-invasive means of quantitating and qualitating the patient response to an intervention are exactly the parameters I measure in my office; the only comprehensive methodology of its kind in the clinical field of Regenerative Medicine.
When a patient asks me how do I know whether an intervention is a success, I don’t point to an increased joint space on the X-ray as it is not there to be seen. I review patient specific outcomes including pain scores, activity scores, subjective input, and objective measurements and compare the pre-intervention findings with the latest scoring.
In the interval between starting to write this Blog and now, I received an unsolicited update from a patient who had attended the Stem Cell Institute of America seminar. He had asked so many questions during the seminar, the chiropractors running the seminar gave him the PalinGen Flow brochure (their source of amniotic fluid) as my patient had challenged their evidence beyond the speakers’ ability to respond. My patient, who eventually underwent a bone marrow concentrate intervention with my assistance, read the document and learned that PalinGen Flow makes no mention of stem cell content in their literature.
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: arthritis, bone marrow, Bone Marrow Concentrate, Clinical Trial. Mitchell B. Sheinkop, Concentrated Stem Cell Plasma, Interventional Orthopedics, joint replacement, Mesenchymal Stem Cell, Regenerative, regenerative medicine, stem cell treatment
