Sep 1, 2016
You may be the first to see the preview
A web-i-nar according to the dictionary, is a seminar that takes place over the internet.
Dr. Sheinkop’s Webinar on Regenerative Medicine
While not yet ready for prime time, it will go live in 45 days, but readers of this Blog may view it now by clicking the above. My purpose in creating this educational endeavor is and was to better inform the prospective patient as to the scope of my regenerative practice, to allow the new patient to become better informed, and to facilitate review of the informed consent process should you chose to avail yourself of my services. The webinar plays for about 30 minutes but you don’t have to watch it all in a single session. One of the advantages of this form of communication is watching at your own convenience plus the option to return as you chose.
In planning and editing this undertaking, I took into account that which I have experienced over a four year plus regenerative medicine practice emphasizing and repeating wherever I deemed appropriate. The majority of the patients I treat present with grades two and three osteoarthritis of one or two joints. Of over a thousand I have treated, the majority have received Bone Marrow Concentrate/Stem Cell approach. For those who present in an earlier stage of osteoarthritis no longer responding to cortisone and hyaluronic acid, I do explain the Multicenter Amniotic Fluid Concentrate Clinical Trial for which I am the Principal Investigator. By the same token, for those patients who have advanced arthritic changes, that is grade four, and who otherwise would require a total joint replacement, I cover cellular orthopedic options as well although not necessarily bone marrow derived. One major possibility in the webinar format once accessed through the internet will be the opportunity to post questions and I will do my best to respond in 24 to 48 hours. Another area of explanation is the subchondroplasty for which there continues to be increasing evidence that both intraarticular (inside the joint) and extra-articular (the bone supporting the joint) options should be employed when treating arthritis of a major joint. I want to emphasize, the main treatment on which I base my practice is Bone Marrow Concentrate containing stem cells, anti-inflammatory Cytokines and Growth Factors owing to the potential to regenerate the joint, eliminate or reduce pain and increase functional capacity while, on a molecular basis, halting, maybe reversing the arthritic process.
Tags: arthritis, athletes, Benefits and Risk, bone marrow, Clinical Studies, Clinical Trial. Mitchell B. Sheinkop, Concentrated Stem Cell Plasma, Hip Replacement, Interventional Orthopedics, joint replacement, Knee, Orthopedic Care, Orthopedic Surgeon, Osteoarthritis, Pain Management, Regenerative, Regenexx-SD, stem cells, treatment
Aug 4, 2016
There are now available six month follow up Outcomes Data regarding 20 patients who underwent a fat graft harvest, micro-fracture of the fat graft and intervention in an arthritic knee, the latter so severe that the original recommendation to the patient had been a Total Knee Replacement. 85% of this group are very satisfied at this time with the post intervention pain relief and functional improvement. One patient did elect to undergo a Total Knee Replacement eight weeks after the initial intervention. While six-month Data is very preliminary and doesn’t lend itself to a scientific journal publication, I am told the results will become the subject matter of a White Paper, an authoritative report, while the outcomes of the 20 patients will continue to be monitored.
As I have previously reported, I personally am taking a Principal Investigator role in a Clinical Trial centered on the most contemporary ortho-biologic methodology for processing Amniotic Fluid Concentrate. What piqued my interest is the continued marketing placements in our media: ”Stem Cell therapy is an exciting new therapy option that treats arthritis”. “Free Educational Seminar”. “Stem cell regeneration utilizes amniotic stem cells”. I am reminded of the prank I used as a child on my playmates “Pete and Repeat were sitting in a boat, Pete fell out, who was left?” As I have written on my Blog multiple times, there are no viable stem cells in amniotic fluid once processed, irradiated, frozen and fast thawed. That is not to say that AFC may not act as an anti-inflammatory eventually replacing visco-supplementation in attempting to improve the well-being of patients affected by arthritis; but it has no regenerative potential. My interest in leading a Multi-Center Clinical Trial -no out of pocket expense for those who meet the inclusion criteria-is to learn appropriate dosage and duration of effect if any. Subchondroplasty continues to be a subject of increasing interest in the orthobiologic world. I will be serving as a Principal Investigator in a stem cell based subchondroplasty clinical trial as soon as there is IRB approval toward the end of August. I hope to determine if a combined intraarticular and extra-articular Bone Marrow Concentrate approach will result in superior outcomes when contrasted to the standard intraarticular approach.
Be advised and reminded the Regenerative Medicine discipline is evolving and the over seer is the FDA. Make sure that should you decide to pay unreasonable amounts for unproven therapies, those marketing such are doing so under an IRB regulatory methodology. To learn more, schedule an appointment:
312 475 1893
Tags: Amniotic, arthritis, athletes, Benefits and Risk, Bone Marrow Concentrate, Clinical Studies, Clinical Trial. Mitchell B. Sheinkop, FDA, Hip, Hip Replacement, Interventional Orthopedics, joint replacement, Knee Pain Relief, medicine, Orthopedic Care, Orthopedic Surgeon, Orthopedics, Osteoarthritis, Pain Management, Pilot Study, Regenerative, Regenexx, stem cells, Subchondroplasty, treatment
Jun 30, 2016
Out is routine Medicare and insurance coverage indemnification of hyaluronic acid injections for osteoarthritic joints other than the knee. Additionally, several insurance carriers are now requiring pre-certification to determine if they will even cover hyaluronic acid injections of the knee. The phenomenon was first reported in Florida but now the reduction in coverage is spreading across the country including Illinois. A physician may decide to proceed with the single, thee part or at times five part injection series but it would be at the expense of the patient if insurance and Medicare deny coverage. The reason behind the decision has to do with long-term studies that fail to validate the claims of the many advertisements you may see on television or find in the newspaper concerning the various forms of hyaluronic acid as a gel.
Increasingly in is Amniotic Fluid Concentrate for Osteoarthritis even though not covered by Medicare or Insurance. The clinical trial regarding outcomes for said therapy are incomplete; and to the best of my knowledge, the only source of Amniotic Fluid Concentrate providers seriously investigating results is MiMedx, out of Marietta, Georgia. Nevertheless, there seems to be an ever-increasing presence of Amniotic Fluid Concentrate offerings in the medical marketplace; unfortunately with unsupported claims of a stem cell content. There does seem to be a benefit from amniotic fluid concentrate in relieving the symptoms of an osteoarthritic joint but we have to wait for completion of current clinical trials to understand proper dosage and the length of action.
If you are a regular reader of this Blog, you will have become familiar with the term Subchondroplasty, an adjunct that I have been offering on occasion in conjunction with Bone Marrow Concentrate/Stem cell procedures into the joint. The successes of Subchondroplasty are such that the attention to the bone supporting the joint when working inside the joint is a subject gaining increased attention on a national basis. It looks like the future will be an increasing combination of both intra-articular and extra-articular intervention. While no one is able to confirm why the decompression of the bone adjacent to a joint relieves pain and why the adjunct of biologics improves longer-term outcomes, attention to bone defects in the area around the joint is proving to make a major difference in outcomes for arthritis. The question now is whether the best approach is Bone Marrow Concentrate inside and outside the joint or Bone Marrow Concentrate inside the joint with a synthetic augment outside the joint?
Tags: Amniotic, arthritis, athletes, Benefits and Risk, bone marrow, Bone Marrow Concentrate, Clinical Studies, Hip Replacement, Interventional Orthopedics, joint replacement, Knee, Knee Pain Relief, medicine, Orthopedic Care, Orthopedic Surgeon, Orthopedics, Osteoarthritis, Pain Management, Regenerative, Regenexx-SD, stem cells, Subchondroplasty, treatment
Jun 13, 2016
Just as I hope to improve patient activity with delivery of Bone Marrow Concentrate (BMC), Stem Cells and Concentrated Growth Factor for grades 2 and 3 osteoarthritis, might the success of a surgical procedure at the time of the initial trauma be significantly improved by the adjunct of BMC, Stem Cells and GFC thereby heading off a suboptimal response to an initial trauma surgery? Clearly, being driven as medical practice is in the US; that is to assess pain and then determine the anatomical treatments to relieve that pain has to change. It would make more sense for the surgeon to examine the “flaws” in anatomy, and judiciously treat with BMC before the flaw leads to frank pain and other issues. There is a need for the preemptive integration of Cellular Orthopedics in both the early arthritis and traumatic environments.
Bone bruises and bone edema are grossly under treated in the current orthopedic paradigm. If we would offer patients a Bone Marrow Concentrate intervention at the time of injury or in conjunction with surgery, it is possible, actually likely, that progression to higher arthritic scores will be greatly delayed.
To put things in a proper perspective, most patients expect an improvement of physical activity after total knee replacement. In a Feature Article How Much Improvement in Patient Activity Can Be Expected After TKA?, from a major university center in Germany, only 22% of TKR recipients met health-enhancing physical activity (HEPA) guidelines and only 31% achieved an active lifestyle. In contrast, our data indicates that greater than 70% of our patients who have undergone a bone marrow concentrate/stem cell intervention for osteoarthritis are active in recreational athletics and fitness pursuits including skiing, cycling, golfing, dancing, hunting, fly fishing, basketball, etc.
You the patient have to determine how to proceed and become an advocate for your own arthritic care be it interventional or preemptive. Clearly, the orthopedic surgical and sports medicine communities are behind in integrating orthobiologics into treatment protocols. To stay ahead and learn more be it arthritis or a recent injury requiring surgical repair, consider a cellular orthopedic consultation 312-475-1893 to schedule an appointment.
Tags: arthritis, athletes, Benefits and Risk, bone marrow, Bone Marrow Concentrate, Concentrated Stem Cell Plasma, Hip Replacement, Interventional Orthopedics, joint replacement, Knee Pain Relief, Mature Athlete, medicine, Orthopedic Care, Orthopedic Surgeon, Osteoarthritis, Pain Management, Regenerative, Regenexx, Regenexx-SD, stem cells, treatment
Jun 8, 2016
In the late summer of 2015, I was featured on a Fox cable news segment featuring a patient on whom I had performed a Bone Marrow Aspirate Concentrate –Stem Cell intervention coupled with a subchondroplasty procedure. The patient had experienced a poor result from a right Total Knee Replacement years earlier and was seeking a means of improving function and minimizing her left knee pain resulting from arthritis. Cartilage does not have a nerve supply so scientists and clinicians have long sought a clear understanding of the pain generator in osteoarthritis. While there still is not a clear-cut consensus, many clinicians are looking at the bone marrow lesions seen on an MRI when taken of an arthritic joint as the possible cause of pain associated with arthritis.
In the case of my patient, the combined BMAC-Stem Cell procedure coupled with the subchondroplasty had resulted in a very satisfactory outcome and such maintains at this time to the best of my knowledge. What was unique about my patient was the use of Bone Marrow Concentrate-Stem Cells to serve as the catalyst to effect healing of the bone marrow lesions. Up until that time, surgeons were using a synthetic calcium phosphate material to fill the defects above and below a joint surface with a mandatory three months of protected weight bearing and six months of altered physical activity. The introduction of Bone Marrow Concentrate with Stem cells required 48 hours of crutch support and six weeks of restricted physical activity.
My patient who received media attention served to foster a debate in the medical device industry as to the superior methodology serving as an adjunct to a subchondroplasty. First came the initial trial using a subchondroplasty procedure and synthetic filler with the inherent need for prolonged altered function and assisted ambulation. Now there are several clinical trials in development pertaining to an arthritic joint and the minimally invasive, percutaneous subchondroplasty comparing the synthetic filler to the Bone Marrow Aspirate Concentrate-stem cell adjunct; with the latter used both inside the joint and in the adjacent subchondral bone.
Are your arthritic joint changes affecting both the cartilage and the supporting bone? Is the actual source of your joint pain, the supporting bone or bone marrow lesions adjacent to the hip, knee, ankle or shoulder? It would require a complete examination and review of X-rays and an MRI for me to answer the question and advance the most appropriate therapeutic recommendation. Could it be that the failure of a regenerative intervention wasn’t a failure of the stem cells but rather a failure to address the real pain generator, subchondral bone?
Call for an assessment 312 475 1893 and I will try to answer that question.
Tags: arthritis, athletes, Benefits and Risk, bone marrow, Bone Marrow Concentrate, Clinical Studies, Clinical Trial. Mitchell B. Sheinkop, Hip, Hip Replacement, Interventional Orthopedics, joint replacement, Knee, Knee Pain Relief, Mature Athlete, Microfracture surgery, Orthopedic Care, Orthopedic Surgeon, Orthopedics, Osteoarthritis, Pain Management, Pilot Study, Regenerative, Regenexx, Regenexx-SD, stem cells, Subchondroplasty, treatment, Ultrasound Guided Injection
May 19, 2016
From the AMA Morning Rounds May 16, 2016
Today’s Medical News Prepared Exclusively for You
Leading News
“Exercise linked to reduced risk of several cancers”
ABC World News Tonight (5/16, story 11, 0:25, Muir) reported, “The
National Cancer Institute confirms that moderate exercise, all the way
up to intense exercise, lowers the risk of” cancer “in many forms.”
The Los Angeles Times (5/16, Healy) reports that the research,
published in JAMA Internal Medicine, suggests, “exercise is a powerful
cancer-preventive.” Investigators found that “physical activity worked
to drive down rates of a broad array of cancers even among smokers,
former smokers, and the overweight and obese.”
US News & World Report (5/16, Esposito) reports that
investigators “analyzed data from participants in 12 US and European
study groups who self-reported their physical activity between 1987
and 2004.” The researchers “looked at the incidence of 26 kinds of
cancer occurring in the study follow-up period, which lasted 11 years
on average.” The data indicated that “overall, a higher level of activity
was tied to a 7 percent lower risk of developing any type of cancer.”
TIME (5/16, Park) reports that “the reduced risk was especially
striking for 13 types of cancers.” Individuals “who were more active
had on average a 20% lower risk of cancers of the esophagus, lung,
kidney, stomach, endometrium and others compared with people who
were less active.” Meanwhile, “the reduction was slightly lower for
colon, bladder, and breast cancers.”
Historically, I have directed my Blog to fitness, improved activities of
daily living, and recreational endeavors. The Leading News report
quoted above introduces an additional goal. Considering the significant
progress in research and management of different cancer types, after
mesothelioma explained, I am not going to suggest
that you will prevent cancer by undergoing a cellular orthopedic
intervention to an arthritic hip or knee; but, I am introducing the
concept that by my improving your activity level and functional
potential with a cellular orthopedic intervention for the symptoms of an
arthritic hip or knee, I will improve your exercise capacity and your
exercise tolerance with the inferred inherent health care benefits be it
cancer prevention, heart health, etc.
Tags: arthritis, athletes, Benefits and Risk, bone marrow, Bone Marrow Concentrate, cancer and exercise, cancer statistics, Clinical Trial. Mitchell B. Sheinkop, Concentrated Stem Cell Plasma, Dr. Sheinkop, Hip, Hip pain, Hip Replacement, improve joint pain, joint pain, joint replacement, Knee Pain Relief, Mitchell B. Sheinkop MD, national cancer institute, Orthopedic Care, Osteoarthritis, Regenerative, Subchondroplasty
