Category: General Info

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 🙂

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. 

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

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

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

Don’t get scammed by a clinic selling “umbilical cord blood as a living stem cell”. The clinic in question has been in Plano and Arlington Texas for a long time defrauding patients….

Hello XXXX XXXX, DC, I saw a patient today to whom your clinic was attempting to sell a knee stem cell injection from umbilical cord blood for osteoarthritis. There are no living stem cells in umbilical cord blood which is why these products are registered as section 361 products with the FDA. If there were actually living stem cells in the product, then your clinic would be noncompliant with FDA regs by injecting an allograft stem cell product in a non homologous use into a non 1st/2nd deg. relative, without a RMAT designation or an IND/BLA with the FDA. I have now had 3 former patients asking if I will support a potential consumer fraud lawsuit against your clinic. Selling 1-2cc of umbilical cord blood as a FDA compliant living stem cell injection is indeed fraudulent in my opinion and is harmful to patients seeking out your clinic for professional care. I am taking the time to write you because I think these people have the truth and are angry at the deceit and fraud. You and your partners should realize the medico-legal liability you are assuming in case you didn’t have a clue before.

We had a good example yesterday of how important it is to quantify the orthobiologic and also how much variance there can be in the same patient on the same day. Our first draw resulted in 12.43X LP-PRP with a nice shift away from granulocytes(decreased). The patient decided they wanted to treat an additional region so we drew more blood. About a 30 minute time interval max. Exact same tech, same doc, same centrifuge, same hematology machine, etc…. and this time the PRP was 7.29X LP-PRP with a shift away from granulocytes again. Both times we delivered 5-6cc of PRP so our total platelet counts were very high…well over 5 million platelets for each end product. As we get more data correlating results to platelet counts or even to LP-PRP with differentials or LR-PRP with differentials….having product quantification will be even more critical.