REGENERATIVE MEDICINE

STEM CELL THERAPY

Scientists and doctors have made tremendous advances to make tissue regeneration a reality in treating many diseases. Through regenerative medicine, a person can take advantage of their body’s ability to heal itself by using the healthy stem cells that can be found throughout the body. Laboratory and clinical research has shown that it is possible to use stem cells to restore lost, damaged or aging cells and effectively regenerate tissue in the body.

Stem cells help to create new cells in existing healthy tissues and may help to repair tissues in those structures that are injured or damaged. They are the basis for the specific cell types that makes up each organ in the body.

When stem cells divide they create progenitor cells. Unlike stem cells, progenitor cells can become cells with more specialized functions, such as components of specialized tissue such as bone or cartilage.

Orthopaedic and pain physicians have focused their attention on mesenchymal stem cells. Unlike embryonal stem cells, mesenchymal stem cells are obtained from living adult tissue.

Bone marrow stromal cells are mesenchymal stem cells that, in the proper environment, can differentiate into cells that are part of the musculoskeletal system. They can help to form bone, tendon, cartilage, ligaments and part of the bone marrow.

Adult stem cells were once believed to be more limited than embryonic stem cells, only giving rise to the same type of tissue from which they originated. But new research suggests that adult stem cells may have the potential to generate into other types of cells, as well. For example, liver cells may be coaxed to produce insulin, which is normally made by the pancreas. This capability is known as plasticity or transdifferentiation.

What are adult stem cells?

Stem cells were discovered over 40 years ago when researchers found that cells derived from bone marrow had the ability to form various tissues. They are responsible for everyday tissue remodeling and turnover.

There are several types of “adult stem cells” and the main workhorse for this therapy are called Mesenchymal Stem Cells (“MSCs”).

MSCs are tissue-based stem cells and found throughout the body in all or most vascular tissues. They do not circulate through the blood stream but are attached to the blood vessels (known as pericytes). When an injury or trauma occurs, MSCs either mechanically detach because of the trauma or receive chemical signaling from the microenvironment to go off and respond to an injury.

Activated MSCs naturally works to reduce inflammation, prevent cell death, prevent infection, and generate new blood vessels.

Why is it more difficult to recover and heal from injuries or trauma as we get older?

As we get older, we produce less and less stem cells. When trauma or an injury occurs, there just simply aren’t enough stem cells available to do the work as when we were younger.

Another reason is there are some areas of injuries that do not have blood vessels close by or lack a sufficient “scaffold” to rebuild and remodel the area, like the knee joint.

And sometimes some conditions, like those that dealing with degenerated cartilage, cannot overcome the inflammation stage of healing.

By undergoing an adult stem cell procedure, you are taking your stem cells from an area of high concentration, like your hip bone, and transplanting them directly to the site of injury for them to start addressing the entire microenvironment.

How many stem cells do I need for an effective treatment?

Published clinical data, like Hernigou’s rotator cuff and avascular necrosis studies, analyzed the concentrations of MSCs (CFU-F), showed that the number of MSCs returned back to the patient to treat the site of injury had a strong correlation to the patient’s outcomes. The numbers aren’t in the millions, but rather in the thousands.

Are my stem cells grown in a lab?

Adult stem cell therapy is a point-of-care procedure which means the harvest and injection occur on the same day. It does not involve growing stem cells in a lab. Clinics who are offering this service may be subject to FDA scrutiny if they do not comply with regulations.

How much does an adult stem cell procedure cost?

The average cost of an adult stem cell procedure ranges between $4000 to $7000, and is generally based upon the joint being treated.

Currently, private insurance, Medicare, Medicaid, and Workers Compensation do not cover these procedures. Please contact Axis Spine to learn more about ways to finance your procedure.

Is this therapy cleared by the FDA?

Doctors draw bone marrow from your hip and then concentrate it using an FDA-cleared device. Unlike procedures which process fat with enzymes or use living foreign cells like amniotic products, bone marrow concentration is carried out using your own cells with minimal manipulation at point-of-care, which meets the FDAs definition of the practice of medicine.

Where do adult stem cells come from?

In adults, stem cells are present within various tissues and organs. The most common sources are bone marrow and fat (or adipose) tissue. At present, the majority of adult stem cell procedures utilize bone marrow derived stem cells.

How are adult stem cells obtained, prepared, and delivered?

A bone-marrow derived stem cell therapy generally takes 45-minutes. During your procedure, the physician will use a needle to withdraw bone marrow from the hip (5 minutes). A trained nurse or technician then uses specifically designed equipment to concentrate the adult stem cells and growth factors present in the bone marrow (15 minutes). Finally, the physician will deliver your concentrated stem cells back to the targeted area(s).

How do I prepare for an adult stem cell procedure?

Prior to your procedure, your physician will ask you to withhold anti-inflammatory medications (Advil, Aleve, Naproxen, Motrin, Ibuprofen, Aspirin) at least 7 days prior to the injection.

Because of the nature of stem cells, the area being treated needs to be in its most natural state in order for them to appropriately address the injury and how to best respond.

What is the recovery period like?

After a joint injection, you can typically go back to work immediately. It is advised to avoid load-bearing activities for at least 2 weeks. After a disc injection, you should rest for 2-3 days and try to stay off your feet. In any stem cell procedure, anti-inflammatory medications (NSAIDS) should be withheld for one week pre-procedure and one week post-procedure.

How long will it take until I feel relief or gain functionality?

Every patient is different, and the different areas being treated produce different results. Physicians have reported at emerging Regenerative Medicine conferences that some patients feel relief from a knee or other joint within 3 weeks; for disc injections (spine), around 3 months.

This therapy is not like a steroid injection, which tends to show a rapid effect. Autologous bone marrow concentrate stem cells need time to address the microenvironment that is causing the pain, and then determine the best way to respond.

How long will I feel relief or maintain functionality after an adult stem cell therapy procedure?

Every patient’s condition is different, so every outcome will inherently be different. Published studies have shown that utilizing adult stem cells to treat a condition or add to a surgical intervention produce better outcomes than traditional treatments and surgical methods.

A recent study published in International Orthopaedics showed that 21 out of 26 patients who received an autologous bone marrow concentrate stem cell injection to treat 1 to 2 level degenerating discs were stable and had lower pain scores past 2 years. (Pettine et al, 2015)

Also published in International Orthopaedics, Hernigou et al showed that bone marrow-derived stem cell injection added to a rotator cuff repair “enhanced the healing rate and improved the quality of life of the repaired surface…” (Hernigou et al, 2014)

THERE ARE 3 BASIC STEPS TO A TYPICAL ADULT STEM CELL PROCEDURE

1 The physician removes a small amount of bone marrow from an easy-to-access point on your hip using a syringe

2 The procedure team separates the adult stem cells from the rest of the bone marrow material

3 The physician returns the concentrated adult stem cells to the part of your body that needs to heal

You’ll be given some time to rest, and then return with a customized personal rehabilitation and after-care program to help you recover.

 

PLATELET-RICH PLASMA

Platelet-rich plasma, or PRP, is a revolutionary and conservative approach to natural healing for numerous orthopedic conditions and athletic injuries. PRP therapy may make it possible to avoid surgery and return to sports and work sooner.

What is Platelet-Rich Plasma?

Platelet-rich plasma is a therapy that promotes healing using your own blood. We collect a sample of your blood and spin it down to separate out the plasma, which contains a high concentration of platelets. Platelets play a critical role in healing wounds, soft tissue injuries, and fractures by activating stem cells in order to regenerate new, healthy tissue. An injection of platelet-rich plasma gives your body a natural boost to accelerate the healing process. Some patients report pain relief in addition to rapid healing.

In summary platelets:

  • Promote the growth of specific types of cells and tissues
  • Increase development of new blood vessels
  • Accelerate bone regeneration
  • Initiate connective tissue

 

What Are the Benefits of PRP Therapy?

PRP therapy is a low-risk, non-invasive treatment. It can heal orthopedic conditions like arthritis, tendon injuries, and ligament injuries. It also benefits people who are not candidates for surgery or want to avoid surgery due to age, health, or other concerns. Other benefits include:

  • Pain relief and healing
  • Regeneration of healthy tissues
  • Fewer complications than surgery
  • Minimal down time
  • No incision, no scarring

 

Does PRP Therapy Treat My Condition?

PRP therapy uses your own blood cells to stimulate the natural healing process. It is typically effective in orthopedic conditions such as:

  • Tendonitis
  • Partial Rotator Cuff Tears
  • Sprains and strains
  • Joint Capsular Laxity
  • Plantar Fasciitis
  • And much more

 

What is the Procedure Like?

First, we draw a small amount of blood and spin it in a specialized FDA-approved device to separate the platelets, growth factors, and white blood cells. The concentrated platelets found in PRP contain large reservoirs of growth factors that are essential to initiate and accelerate tissue repair and regeneration.

Using ultrasound guidance for targeted placement, we then inject the platelets and growth factors into the damaged tissue. The high concentration of platelets signals the body that there is injured tissue to be healed and attracts healing cells to the area to accelerate repair process.

Am I a Candidate for PRP Therapy?

Only you and your doctor can decide if PRP is right for you. Schedule a consultation to discuss further.

Unfortunately PRP is not covered by insurance.