Some smart researchers at the University of South Carolina are looking at enzymes in our blood that may be important in the healing cascade and in putting stem cells into an “activated” state.
These MRIs are from patient #17 in our ongoing study. At 6 months his cuff tear is smaller…he is having no pain and is back to all activities. We are following patients for a full year in this study. We need 4 more patients to complete our enrollment of 25.
The routine knee surgery for a torn meniscus (a type of cartilage in between the bones of the knee) when there is already arthritis in the knee often leads to a result not better than just waiting for the knee to “settle down”. The problem? It can take a long time for knee function and pain to return to normal….which is why sometimes the surgery is indeed the smart thing to do for someone to return to work and other activities sooner.
For problems where just an injection in the office won’t be enough, we can still harness the power of PRP or stem cells to try to improve surgical results. Here is a picture from a recent mensicus repair surgery where we are using PRP to try to get the entire torn meniscus to heal after being surgically repaired.
Another example of the pseudo-science in stem cells. Despite their website, The Lung Institute cannot get stem cells for treatment from peripheral blood….none of us humans can! The second problem? Using stem cells from any source (whether autologous or allograft) has been deemed a non-homologous use by the FDA as of November 2017 …..meaning that in order to do that a clinic or doctor has to have approval from the FDA to make and use an Investigational Drug on Humans. (IND/BLA) So if the Lung Institute does not have an approved IND/BLA with the FDA, they could be sent a Warning Letter to stop treating people with an unapproved drug. Hopefully the FDA has seen this web site!!
This patient is now 2.5 years out from a single in office injection of bone marrow derived stem cells. He has done fantastic and wants another in office procedure. He has happy to have avoided or at least significantly delayed a knee replacement surgery…which is what he had been told he needed.
The guy in the middle has a total knee replacement on one knee and has done very well from it…..14 years out…no problems…done by an expert joint replacement surgeon (not me). With the left knee, he failed to get symptom relief with medications and steroid shots (couple rounds) and viscosupplementation. He is now a golfer and ex pro baseball player and front row Lakers fan in this picture from the Staples Center last night.
This patient has a 50% tear of the supraspinatus tendon. He was treated with a single ultrasound guided injection of autologous bone marrow derived stem cells from a posterior iliac crest marrow aspiration done in the office under local anesthesia.
We had a nice evening last night at the Winewood restaurant sponsored by Konica Minolta and Emcyte. MSK ultrasound gives the clinician the ability to see soft tissues and joints in real time. I think it is a great diagnostic tool and many times can replace MRI scans so we can make an instant diagnosis for patients. Saves people time and money! If we decide to use Platelet Rich Plasma or bone marrow derived Stem Cells, then we use ultrasound to make sure we are putting these expensive biologic injections exactly where they need to go.
Currently, I am at the 2018 Interventional Orthopedic Foundation meeting which is a multidisciplinary collection of clinicians interested in advanced the field of interventional orthopedics and in the science and application of orthobiologics. One of my faculty assignments was to discuss the many reasons why centrifuging and concentrating bone marrow aspirate makes good clinical sense when compared to just using bone marrow aspirate alone as a treatment. Below is a summary of my talking points!