REGENERATIVE MEDICINE: THE FUTURE OF MEDICINE IS NOW HERE.
Regenerative medicine often referred to as orthobiologic, is a rapidly evolving field, which gives physicians new tools to treat conditions in ways that would have been thought as impossible just a few years ago. Patients who were contemplating years of suffering or limitation of their activities, or even surgical interventions with the all associated risks, costs, and long recoveries, are now offered alternatives treatment options which are less invasive and currently showing better results than many of the traditionally conservative and surgical treatments available today. It is no wonder that more and more people including top athletes and celebrities are choosing regenerative medicine.
WHAT IS REGENERATIVE MEDICINE?
It is a new field of medicine which consist of augmenting our own healing abilities to completely heal injuries and conditions which would typically take much longer to heal or not even heal at all. Most current treatments such as corticosteroids and anti-inflammatory conditions consist of trying to decrease the inflammation. On the other hand, regenerative therapy promotes a healing inflammatory response to increase the activation of the growth factors and other bioactive molecules, which will eventually result in the migration, activation, and differentiation of our own adult stem cells resulting in the removal of the damaged tissues and the laying down of new tissue
HOW DOES THE BODY NORMALLY HEAL ITSELF?
When an injury occurs, the body will go through a variety of steps to heal the injured tissue. For example, a cut through our skin will lead ultimately to the laying down of new skin cells. In the early stage, the focus of the body will be to limit bleeding from the cut, and platelets will flood the injured area to form a clot that will stop the bleeding. Then, bioactive proteins such as growth factors, are released to promote migration and differentiation of stem cells into new skin cells at the injury site. Growth factors will also promote the formation of a new blood vessel which will help bring in oxygen and nutrients. This process happens everywhere in our body, and it is the primary mechanism by which injuries are being healed.
However, our self-repair mechanism can be deficient at times. As we age our ability to form new vessel to our tendons, discs, muscles and other tissues tend to diminish, which can lead to longer recovery times or inadequate recovery. Sometimes there is just too much damage for the injury to heal. Our own self-repair mechanism can be restored to our younger years by either magnifying the strength of the healing response, by injecting our own stem cells directly at the injury site or by doing both.
The use of anti-inflammatory medications such as ibuprofen as well as cigarette smoking, obesity and diabetes also limits our ability to recruit stem cells.
WHO SHOULD RECEIVE PLATELETS INJECTION AND STEM CELL THERAPY?
Many people suffer from chronic orthopedic and painful chronic conditions, which can be treated successfully with cell therapy injections. If you have failed conservative treatments such as rest, icing, heat, physical therapy, anti-inflammatory medications, acupuncture or if you are considering surgery, then you really should consider regenerative medical treatment. Example of conditions treated successfully with cell therapy include chronic tendinopathy (Achilles’ tendinitis and partial tearing, rotator cuff injuries, joint arthritis, tennis and golfer elbow, tendinitis, ligament injuries, disc injury, arthritis including arthritis of the spine, etc.…), bursitis, osteoarthritis (joint pain in the knee, hip, shoulder, spine, elbow, etc.…), disc pain, labral tear as well as muscle tears.
PLATELET RICH PLASMA: THE POWER OF YOUR OWN GROWTH FACTORS
Platelet Rich Plasma (PRP) is a solution containing a high concentration of our own platelets. It was first used clinically in the USA in 1987 to facilitate wound healing after cardiac surgery. Since then, other medical fields have used successfully this technology, including dentistry, wound care, ophthalmology, maxillofacial surgery, and cosmetic surgery. In the past decade, we have witnessed a large increase in the successful use of PRP treatment for sports injuries and musculoskeletal chronic conditions (tendinitis, bursitis, osteoarthritis, spine pain, muscle injuries).
Until recently, platelets were typically thought off as being used for hemostasis (to stop the bleeding when you injure yourself). However, we know now that platelet’s role extends far beyond their hemostatic role, and in fact, platelets contain little granules full of bioactive substances such as growth factors and bioactive proteins which play an important role in the healing of injured tissue. When an injury occurs, these bio-substances are released in abundance in the damaged area, which helps facilitate the recruitment of stem cell into the damaged area. They also promote the stem cells differentiation into their intended cell targets. The growth factors also help promote the formation of a new blood vessel to the damaged area which helps bring essential nutrient and oxygen. Platelets also release macrophages and fibroblast which helps with the removal of the injured tissue. These actions must take place to have a successful recovery.
The most recent research and clinical studies have demonstrated consistently that, by injecting a higher concentration of a patient’s own platelets into diseased tissue, that it will promote and augment the body’s own natural healing response. For example, in someone with chronic Achille’s tendinitis, who has not responded well to conventional treatments, the injection of a PRP solution will help facilitate the healing process, which leads to complete healing of the injured tendon. Unlike steroid injections, which reduce inflammation, a PRP solution will promote the “good” type of inflammatory response, which will, in turn, lead to the creation of new tendon cells. This approach has been convincingly shown to be effective for many chronic tendinopathy-type of conditions such as tennis elbow, golfer’s elbow, plantar fasciitis, rotator cuff tendinopathy, and so on and so forth. It has also been used successfully for other chronic conditions such as bursitis, joint arthritis including spine OA and disc injuries as well as muscle injuries. It is not an accident that many professional athletes are currently receiving these types of treatments to return sooner to competition.
WHY SHOULD YOU RECEIVE STEM CELL THERAPY?
If you are suffering from chronic joint arthritis and if you are considering joint replacement, then you should really consider adult stem cell therapy. Many patients are now able to avoid joint replacement by injecting directly into the joint their own stem cells. Post adult stem cell injection MRI images have shown regrowth of cartilage a few months post injection. Cell therapy is also showing great outcomes with tendons, ligaments, disc injuries. Post stem cell injection MRI images in torn tendons and ligaments have also shown complete healing of the injuries. Similar results are now being observed with disc tears in the spine. These injuries typically do not heal on their own with or without conservative care such as physical therapy or medication. Surgery can be an option at the time, but it is much more traumatic and risky than receiving an injection, and you will most likely have to take time off to recover. Additionally, surgical outcomes have so far not shown to be superior to stem cell therapy outcomes when cell therapy is used for the appropriate condition.
THE STEM CELL PROCEDURE
The procedure is an outpatient procedure that takes about one hour to complete. Most of that time spent is waiting for the specialized centrifuge to separate and concentrate the stem cells from the rest of the bone marrow solution. On the day of the injection, the patient is brought to our procedure area. Blood was drawn for PPR with stem cell. If the patient chooses to receive IV sedation to help with the discomfort and the pre-procedure anxiety, then an IV is placed in an IV sedation is given. Then, the patient is surgical prepped over the iliac crest (hip bone in the back). Then a long-lasting local anesthetic is injected through a very small needle too deeply numb the area. At that point, the physician will wait for a few minutes to make sure that the numbing medication has time to work. Then under XR or US guidance, a needle is advanced into the patient’s posterior iliac crest. Typically, this part of the procedure is not painful, but pressure can be felt. A small amount of bone marrow is then aspirated, and the needle is removed. The bone marrow is then placed into a specialized centrifuge which will allow the doctor to separate the stem cells from the rest of the bone marrow and to concentrate the cells. This process usually takes about 30 minutes. Then the area which is to receive the stem cell is then surgically prepped. Once again, the area is anesthetized using a very small needle. Then, under XR or ultrasound guidance the stem cells are injected into the diseased tissue. The needle is removed. The patient is then taken to the recovery area. Based on the injected area, the patient may be instructed to use crutches for a limited period of time or to do avoid certain activities. At times, a brace is dispensed to allow for a quicker recovery. Specific discharges instructions are given to each patient after their procedure.