My recent Regenerative Medicine podcast with Dr. Andrew Dold is now available! Dr. Dold is an orthopedic surgeon who has a sports medicine podcast just started on iTunes and Soundcloud. The first episode was with well known sports medicine orthopedic surgeon, Dr. Jim Andrews. In this episode 2 Dr. Dold and I talk about the growing use of orthobiologics in sports medicine to help patients recover from injuries with or without surgery. Have a listen! We are always trying to improve upon surgical and nonsurgical outcomes by augmenting our own native healing processes with orthobiologics.
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We use bone marrow derived Stem Cells or PRP(platelet rich plasma) for elbow conditions like tennis elbow, golfer’s elbow, ulnar collateral ligament tears….
Here is another example of how we analyze and document every single PRP injection in the office so that we can develop dosing criteria for specific orthopedic applications. Two weeks ago this young baseball athlete had a BMC (bone marrow derived stem cell) injection for a partial ulnar collateral ligament tear. Today’s PRP was given to further stimulate and promote a healing response. He has already been told that the only option is surgery since he has been symptomatic thru rehab and rest. We are trying to give him a chance to heal with orthobiologics and avoid the surgical theater with the uncertainty and rehab that involves with a 16 year old student athlete. The hematology analysis is done in our office and for this PRP confirmed a 8X concentration, leukocyte poor PRP (LP-PRP), no red blood cells, and a platelet dose of 1472 10(3)/mm(3)…..and we delivered a total of 4 cc all around the UCL under ultrasound guidance.
As a patient, if you are considering orthobiologics for arthritis or sports injuries or back pain, please make sure you ask lots of questions….
1. doctor training (is it a MD/DO?)
2. orthobiologic experience
3. stem cell source(they need to come from your own body!)
4. Ultrasound or fluoroscopy guidance?
5. is the PRP or stem cell product analyzed?
6. Price? Number of treatments?
If you don’t get good answers, give us a call 🙂
Want to get off of narcotics? Consider Orthobiologics
Click link below for patient testimonial!
One of our best options to fight the opioid epidemic (in orthopedics) is with orthobiologics. At the Dallas PRP and Stem Cell Institute we use platelet rich plasma and bone marrow derived stem cells for patients with chronic, painful orthopedic conditions like osteoarthritis. There is clinical evidence of orthobiologic efficacy compared to steroid shots, viscosupplementation, and even surgery! Cost is a significant concern. We have PRP injections down to $500 for some indications and often they work where steroids and “gel” injections don’t work or last long enough in the knee. With bone marrow derived stem cells, we do an in office procedure in 1 hour (start to finish) or less….and we have the cost down to $2500 for some applications. Costly? yes. But compared to a surgical alternative or a potentially harmful or noneffective injection of something like steroids or “gel shots”…..I like having the orthobiologic option. Patients do too. See below for an example of a patient only 2 months post stem cell injection for shoulder arthritis…she has significantly decreased her opioid use in this short time already.
Fascinating story about Stem Cell Research and Academic Fraud at Harvard University
On October 15, 2018 Gina Kolata of the NY Times published an article detailed Harvard University’s retraction of dozens of articles by cardiologist Dr. Piero Anversara. Dr. Anversa has published about 31 studies detailing how mesenchymal stem cells from bone marrow could be injected to regenerative cardiac (heart) muscle tissue. If true, the scientific find would have been revolutionary as a potential new treatment for patients who suffer heart attacks or other cardiac diseases. However, after a review that started in 2013, Harvard Medical School and Brigham And Women’s Hospital ultimately had to agree to pay $10 million dollars to the federal government to settle accusations that Dr. Ansera submitted fake data to get federal research funding. The additional issue was that no other reputable lab could ever repeat the amazing results reported by Dr. Ansera. The articles have essentially all been retracted and even co-authors have verified that the data they generated did not match reports published. Unfortunately there are still companies selling stem cell therapy as a treatment for injured hearts and there is even a National Heart, Lung, and Blood Institute clinical trial still enrolling patients to have stem cells injected as a treatment for heart failure.
Click the link for the NY Time s article:
https://www.nytimes.com/2018/10/15/health/piero-anversa-fraud-retractions.html
What to do with a degenerative meniscal tear?
30 second example of an obstructive meniscal tear that often continues to cause knee dysfunction despite nonsurgical treatment. The degenerative tears have been shown in multiple studies to get better most of the time without surgery, orthobiologics, or anything more than physical therapy. A meniscus tear diagnosis on a MRI reading is not a reason for any invasive procedure….rest, rehab….time…will allow most patients to return to their “baseline” knee function.
With orthobiologics, although there may be a degenerative meniscal tear…we are usually treating the joint milieu by chronic inflammation and the chondral catabolic processes.
Just the first 30 seconds of this video!: https://lnkd.in/e5tTvV3
Another reason to avoid any products that don’t come from your own body
On September 28, 2018, the Liveyon company started a product recall of their umbilical cord blood products produced by Genetech in San Diego because of contamination with E. coli. There is no reason to use a riskier allograft orthobiologic when there are more studied, cheaper, safer alternatives that come from our own bodies!
The FDA press release is here:
https://www.fda.gov/BiologicsEBloodVaccines/SafetyAvailability/Recalls/ucm622190.htm