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
Dec 19, 2016
I use bone marrow derived stem cells because they have been proven to be most effective at treating orthopedic conditions when compared to adipose derived stem cells. There have been 13 papers published showing bone marrow superiority to adipose tissue in regards to treating orthopedic conditions and to the best of my knowledge, none reporting adipose derived results for arthritis. In addition to Adult Mesenchymal Stem Cells, bone marrow has 1,000-10,000x more hematopoietic stem cells than adipose tissue; the former is necessary for muscle repair. Recently, we learned that bone marrow also has osteochondral reticular cells which are not found in adipose tissue and serve as orthopedic repair cells. While adipose tissue and bone marrow both have stem cells, the skeletomuscular specific cells only found in bone marrow make it the best at treating orthopedic conditions. I don’t have a stake in doing bone marrow derived stem cells, I practice evidence based medicine and do what’s been shown to provide the best results. If with continued research something superior to bone marrow derived stem cells becomes available, then I will gladly adopt that protocol.
http://www.regenexx.com/fat-vs-bone-marrow-stem-cell-video/
- As I have reported on this Blog many times, research has shown the amniotic fluid samples being marketed as having stem cells actually do not have any viable stem cells when received and viewed in the laboratory. I do use amniotic fluid concentrate from time to time for its concentrated hyaluronic acid effect.
http://www.regenexx.com/amniotic-stem-cells-great-deception/
- Since we manually process bone marrow when aspirated, I am able to customize PRP which we call SCP or super concentrated platelets. The ubiquitous beside centrifuge only has one setting for volume and concentration so those using this approach are treating every patient without concern for individual differences. With the addition of the Abbott Ruby Hemocytometer, I am able to customize the treatment of the individual patient. We can concentrate our SCP from 3-40X over baseline-with or without red or white blood cells. From my outcomes data base, I know what volume and concentration works best for treating the various body parts.
- We’ve developed HD BMC or high dose bone marrow concentrate which is far superior to that produced with bedside centrifuges used by most claiming expertise in Regenerative Medicine
- I perform BMAs in compliance with the peer-reviewed literature recommendations as well as in keeping with my internal best practices research to maximize MSC yield. As stated, I count cells and know the quality in addition to the quantity of the injectate. Most doctors don’t count cells and have no idea what dose they are giving their patients
Tags: adipose tissue, amniotic fluid, arthritis, BMA, bone marrow, Bone Marrow Concentrate, Clinical Studies, Clinical Trial. Mitchell B. Sheinkop, Interventional Orthopedics, Mesenchymal Stem Cell, MSC, PRP, Regenerative, SCP, stem cells
Dec 16, 2016
You no longer will even need a physician, and I have been wasting my Blog space crusading about quality assurance; making certain your Regenerative Medicine specialist is Board Certified and willing to provide outcomes data. According to a recent email I received, all one needs is “Online Training” to practice Regenerative Medicine:
If you believe this is FDA compliant, no longer does stem cell treatment need to be done by a highly trained, highly experienced specialist; you won’t even have to use a physician.“Everything gets commoditized, including training to do stuff” (personal communication).
I believe the most effective approach is to direct a patient with joint pain to my credentials—37.5 years of joint replacement experience, Board-certified, Emeritus Professor, four and a half years of Cellular Orthopedic experience, the largest most comprehensive outcomes data base on which to base my recommendations for care, while introducing an analytical program based on a FDA-audited analytical laboratory for assessing the quality of regenerative preparations. As for the latter point, I am now working with a team using a FDA consultant to create approved text that I will post on my website, highlighting the standards I have adopted for all phases of therapy.
I hate to conclude that the current practice of interventional orthopedics and regenerative medicine ultimately comes down to how flashy the website may be or a free lunch from the camp followers.
To watch my Webinar, access www.ilCellulartherapy.com
To make an appointment, call 312 475 1893
Tags: bone marrow, Bone Marrow Concentrate, Concentrated Stem Cell Plasma, joint replacement, Orthopedics, Osteoarthritis, Regenerative, Regenerative Pain Center, stem cell certification, stem cells, training
Dec 9, 2016
I started the day by reading the Steve Chapman article appearing in the Perspective Section of the Chicago Tribune, Thursday December 8. The title of my Blog this week is influenced by the header of his article and I admit I am paraphrasing some of that content. While his intent was not necessarily directed at the discipline of Regenerative Medicine, his statement” since the advent of the internet, truth doesn’t have a chance” really resonates with me. He goes on to state that in many of these internet claims, the idea of objective reality is obliterated. “The chief product is fiction masquerading as fact.”
Unfortunately, while Chapman was rendering his opinion in the political arena, what he opines is just as applicable in the world of Regenerative; but there are exceptions. As many readers of this Blog are aware, I have an existing web site www.sheinkopmd.com. I have tried to continually emphasize and repeat the Regenexx message; namely, that which we do is based on data, the integration of a clinical practice with a clinical research initiative. Yesterday, we forwarded our two-year outcomes data to Regenexx for statistical analysis. That data has been compiled in a clinical knee trial over the past four years wherein the Regenexx SD procedure was used in 50 patients with grades two and three osteoarthritis of the knee who met the inclusion criteria. Once statistically analyzed, I will submit that data for scientific publication, scientific presentation and it will be published on the Regenexx and my web sites.
To emphasize why it is so important for a patient experiencing arthritic related limitations be fully educated, let me share with you a relevant research letter recently published:
Survey: Many treatments prescribed despite little evidence of high value to patients.
Information from a research letter published in the Dec. 6 issue of the journal Annals of Surgery wherein researchers randomly surveyed 5,000 members of the American College of Physicians found that many prescribe costly treatments despite a lack of evidence supporting their use.
In surveying the internet this morning to see how badly fiction is masquerading as fact, I didn’t have to surf too far. The number of camp follower, non-specialist stem cell related web sites are of great concern. I hope the FDA shares my opinion. You can find treatment for arthritis, cancer, aesthetics, hair loss, sexual enhancement, and neurologic diseases all with one stop shopping. The web sites offer adipose derived stem cells and amniotic fluid containing stem cells. Missing from the offerings are outcomes data, scientific support and FDA compliance. Regenexx does it and so do I; namely, practice cellular orthopedics on a scientific basis under IRB oversite (a function of the FDA) with all intervention recommendations supported by scientific evidence.
To learn more, schedule an appointment 312 475 1893. You may view my webinar at ilcellulartherapy.com
Tags: arthritis, Bone Marrow Concentrate, Clinical Trial. Mitchell B. Sheinkop, Concentrated Stem Cell Plasma, Platelet Rich Plasma, Regenerative, regenerative medicine
Oct 20, 2016
Aging is known to contribute to a multitude of systemic changes including those of the musculoskeletal system leading to decreased health, mobility and function. Most changes in well-being are exacerbated by inactivity. It has been scientifically documented that physical activity and exercise may slow or even reverse these deleterious effects thereby improving health, mobility and function.
In particular, ligaments, tendons and joint capsules become stiffer with age as elastic fibers decrease and cross-links between collagen fibers increase. As connective tissue surrounding the joint changes, so too does the synovial fluid within the joint making movement more difficult. Not only do changes occur within the joint, they also occur in the muscles. The loss of muscle mass and strength also known as sarcopenia, increases with age. Then there is the fatty infiltration of muscle that comes with aging and lack of use.
Recognizing the value of Bone Marrow Concentrate derived Stem Cells, Cytokines and Growth Factors in dealing with his arthritic hip when the alternative was a joint replacement, seven months ago, a 58-year-old man underwent a cellular orthopedic intervention. Over the past many months, the patient committed himself to a minimum of 30 minutes a day, five days a week at moderate intensity aerobic exercise alternating with three days a week at vigorous intensity. In addition, he partook in resistance exercise a minimum of two days a week at a moderate high intensity focusing on 10 exercises at each session targeting most major muscle groups, with 10 to 15 repetitions for each exercise performed thus adding an additional 20 to 30 minutes to the commitment. Then there are the benefits of his additional flexibility and stretching. When this individual came to me at his first visit, his stated goals were to return to a high level of recreational enjoyment with a particular interest in ball room dancing. As of last week, he had reached those goals but he has no intention of failing to comply with his exercise prescription.
The obvious message of my Blog is to let you know I am unable to reach a desired goal without your commitment. I may introduce Stem Cells, Cytokines and Growth Factors into an arthritic joint but to reach your desired goal or delay or perhaps avoid a joint replacement, those many changes that occur with aging can be slowed and even reversed by a combination of cellular orthopedics and exercise.
If you want to learn about the evidence, schedule an appointment 312 475 1893
Tags: arthritis, athletes, Benefits and Risk, bone marrow, Bone Marrow Concentrate, Concentrated Stem Cell Plasma, Growth Factors, Hip, Hip Replacement, Interventional Orthopedics, joint replacement, Knee Pain Relief, Mature Athlete, Orthopedic Care, Orthopedic Surgeon, Orthopedics, Osteoarthritis, Pain Management, Regenerative, regenerative medicine, Regenexx, stem cells, treatment
