Sep 25, 2020
What are Exosomes?
Exosomes are microscopic bubbles packed full of proteins and genetic material such as DNA and RNA. When released from cells they allow those cells to communicate with each other. The molecules and genetic material direct cell behavior such as cell growth or differentiation.
In the past decade, interest in exosomes has exploded for several reasons. First, they allow communication between cells and aid in tissue repair and regeneration. Second, they have been proposed to be useful vehicles for drugs and could be used as therapeutic agents. Third, they can be useful biomarkers of disease which aids in diagnoses and prognosis.
What is the difference between Exosomes and Stem Cells?
Stem cells are living things that have the ability to renew themselves and to turn into different kinds of cells. They contain thousands of molecules known to decrease inflammation, regenerate tissue and fight infection. Exosomes are substances secreted by all cells, including stem cells.
During the repair process, different kinds of cells or molecules are needed at the different stages of healing. The stem cells act like the conductor in an orchestra, directing cells where to go and what to do. They organize the complex symphony of cellular activity that leads to tissue healing. Different types of exosomes are produced by the stem cells and released at different times depending upon the needs of the body.
Can we use manufactured products that contain exosomes to treat orthopedic conditions?
There are currently no FDA approved exosome products. These products require FDA approval before they can be marketed for use in patients. Their safety and efficacy have not yet been proven. Although they have the potential to repair injuries and regenerate tissues, there is still much to be learned about their behavior in the body. Patients should avoid exosomes until research studies prove they are safe and effective.
Sources:
https://bmcbiol.biomedcentral.com/articles/10.1186/s12915-016-0268-z
https://www.fda.gov/vaccines-blood-biologics/consumers-biologics/consumer-alert-regenerative-medicine-products-including-stem-cells-and-exosomes
https://www.sciencedirect.com/science/article/abs/pii/S1931524418300070
Sep 22, 2020
A patient of Dr. Christopher Rogers, Kristi Plume, has had successful PRP injections for two separate injuries. A torn rotator cuff was healed within 2 months of receiving the injection, by healing the tendon. Within 2-3 after the injection, Ms. Plume was pain free and able to resume full use of her shoulder and arm.
Only months later, Ms. Plume underwent PRP injections to treat osteoarthritis in both of her knees. The injections allowed her to get back to doing what she loves:
I’ve received PRP treatments from Dr. Rogers twice now for 2 different injuries. The first injury, a torn rotator cuff, completely healed within 2 months of receiving the PRP injection. It was quite fascinating to see the “before” and “after” ultrasound pictures, whereas the “before” showed a moderate tear and the “after” showed nothing but a healed tendon. Moreover, I was pain free and able to resume use of my shoulder/arm within 2-3 weeks from the date of the procedure. The first procedure was so successful, I underwent a PRP procedure again a few months ago for osteoarthritis in both of my knees. The PRP treatments have quite literally changed my life by allowing me to return to the active lifestyle I’ve always enjoyed. In addition, I avoided costly surgery, long-recovery times, and permanent, long-term pain and discomfort. I have full use of both my shoulder and knees without pain or discomfort. Dr. Rogers has a flawless bedside manner and he and his team of professionals deliver first class service to make their patients feel truly cared about. I cannot recommend San Diego Orthobiologics Medical Group enough.
Kristi Plume has use of her shoulders and knees without any pain or discomfort.
Sep 18, 2020
The field of Regenerative Medicine is based on the principle that the human body can heal itself. Scientific discoveries in cellular biology, genetics and tissue engineering have been translated into treatments for previously untreatable conditions. The American Association of Blood Banks (AABB), an international association representing individuals and institutions involved in cellular treatments, describes regenerative medicine as “the process of replacing or regenerating human cells, tissues or organs to restore or establish normal function.”.
In the United States, Regenerative Medicine is a rapidly emerging field. Yet the foundations of this practice date back to ancient civilizations where human anatomy was studied and documented. Their findings were essential to the work of 18th and 19th century scientists who made huge breakthroughs in cellular biology. Cellular research completed in the 1700s and 1800s has lent a great deal to our understanding of how cells divide and proliferate. This knowledge continues to guide the advancements in the 21st century.[i]
Using cells to heal:
Since the first bone marrow cell transplant for the treatment of leukemia in 1968[ii], scientists and researchers have explored new ways to use Regenerative Medicine for the treatment of other medical conditions such as arthritis, disc degeneration and tendon injuries.
These regenerative treatments involve the use of a patient’s own cells to heal their injuries. Orthopedic medicine physicians treat injuries of the joint, ligament, tendon and bone. Platelet rich plasma (PRP) is the most commonly used orthopedic regenerative medicine treatment. PRP is produced by concentrating the platelets in a sample of a patient’s own blood. Platelets contain hundreds of growth factors that decrease inflammation and stimulate healing.
Another regenerative therapy is by using Cells that are derived from a patient’s own bone marrow and fat tissue. These Adult stem cells called Mesenchymal stem cells (MSCs) are found in these tissues and have the ability to develop into bone, tendon or cartilage cells and are important to support growth and development. In the body, they have been shown to stimulate cell growth, prevent cell death and inhibit pain or inflammation.
Prolotherapy is a form of regenerative therapy that does not involve the use of your own cells, but instead uses sugar water (dextrose) to stimulate a healing response in ligaments, tendons and joints.
These treatments do much more than simply relieve pain caused by conditions such as tendon injuries, disc degeneration or arthritis. They target the root cause of the pain and stimulate healing. This gives new hope for patients wishing to avoid medications or surgery for the treatment of their painful sports injuries and chronic degenerative conditions.
Orthopedic Conditions treated with Regenerative Medicine:
Regenerative therapies have been studied in a variety of orthopedic conditions including:
- Knee pain – arthritis and patellar tendon tears
- Hip pain – arthritis and gluteal or hamstring tendon injuries
- Shoulder pain – arthritis and rotator cuff tendon tears
- Low back pain – disc degeneration, facet joint and sacroiliac joint arthritis
- Neck pain – pinched nerves and facet joint arthritis
- Elbow pain – tennis elbow and golfer’s elbow
- Ankle and Foot pain – plantar fasciosis and arthritis
- Wrist and hand pain – carpal tunnel syndrome, tendon injuries and arthritis
Is it Safe?
Regenerative treatments use a patient’s own cells and can be performed safely, without the risk of disease transmission or immune reaction. Advanced equipment is used to concentrate the cells and cellular molecules in the blood, bone marrow or fat tissues. In the hands of a skilled physician, the use of ultrasound and digital x-ray image guidance permits the precise placement of the cells in the injury site, making the procedure safe, comfortable and effective. Dozens of published scientific articles have documented the safety of cell therapy with some tracking patients’ outcomes for more than 10 years.
However, there is a big difference between a board certified Regenerative Medicine specialist and “stem cell” clinics who merely sell umbilical cord blood, amniotic tissue or exosomes. The use of these donor birth tissue products are not permitted by the FDA because they have not been tested for safety or efficacy. They are typically sold by healthcare providers who do not have any Regenerative Medicine training and dozens of patients have been hospitalized with infections after the use of these contaminated products.
We recommend that you seek a board certified, fellowship trained physician who specializes in your medical condition and has extensive experience treating patients, conducting research and training other physicians. Ask your physician about his or her Regenerative Medicine training experience and their use of evidence-based therapies. These physicians conduct cell therapy research and track their patients’ outcomes in published regenerative medicine registries.
The work they are doing today will help shape the future of Regenerative Medicine, just as their predecessors did hundreds of years ago.
Drs. Christopher J. Rogers and Mary A. Ambach of San Diego Orthobiologics Medical Group together have successfully treated thousands of patients with cell based therapies for more than three decades. They are published authors and cell therapy researchers. Their facility in Carlsbad contains the most advanced Regenerative Medicine technology in San Diego and offers same day treatments with the highest level of safety and efficacy.
[i] https://www.unmc.edu/regenerativemed/about/whatis/history.html
[ii] https://www.sciencedirect.com/science/article/pii/S2213879X1500053X
Sep 11, 2020
What’s the Difference Between Platelet Rich Plasma and Cell Based Therapies?
Regenerative medicine therapies are increasingly being used for people with painful orthopedic conditions. Commonly used orthobiologics include platelet rich plasma (PRP) and other cell based therapies.
Platelet rich plasma therapy includes the concentration of platelet cells from a patient’s own blood. These cells deliver hundreds of growth factors which facilitate the body’s ability to control inflammation, decrease pain and promote tissue healing.
Adult Stem Cells are found in every tissue in the body. A patient’s own bone marrow and fat tissues contains precursor cells called mesenchymal stem cells that have the ability to develop into new cells and repair damaged tissues. These cells also reduce pain and inflammation.
So What’s the Difference?
Many patients ask, “If both platelet rich plasma and adult stem cell therapy help with healing and inflammation, why choose one over the other?”
The fact of the matter is each treatment offers unique benefits. An experienced regenerative medicine specialist knows that several key factors are important when determining which treatment will provide the best outcome for you.
These considerations include:
· The severity of the medical condition being treated (e.g. mild, moderate or severe)
· The location of the injury (e.g. spine or joint)
· The type of tissue requiring treatment (e.g. bone, tendon, cartilage, disc or muscle)
· The patient’s age and overall health, including any other medical conditions.
Knowing How PRP is Different Than Cell Based Therapies
Many clinics claim to offer stem cells or platelet rich plasma treatments, however, the effectiveness of these treatments and experience level of the physicians varies widely from one clinic to another.
· Treatments that use donated tissues such as umbilical cord blood, amniotic tissue and exosomes are not permitted under current FDA guidelines. These products are NOT to be used in orthopedic conditions, because they have not been tested for safety or efficacy.
Only autologous biologics such as your own blood, bone marrow and minimally manipulated fat are compliant with current FDA guidelines for safety and efficacy.
· Dose matters. The number of cells obtained is determined by the method used. The best results are achieved when your physician uses advanced tissue processing methods to produce highly concentrated platelet rich plasma or mesenchymal stem cells. It takes your physician years to master the skill of cell harvesting for maximal benefit.
· To ensure the safe, effective and comfortable delivery of cells into the damaged tissues, a fellowship trained physician should use advanced image guidance using diagnostic ultrasound or x-ray (fluoroscopy). Physician assistants, naturopathic doctors, chiropractors and nurses do not complete this level of training.
When considering treatment with regenerative medicine, it’s important to understand the pros and cons of the different options. Be aware that treatments vary among different clinics and outcomes are determined by physician experience and the methods used to deliver these treatments. Be sure to ask your physician about their training, experience and whether or not they document their patient outcomes.
When done properly, cell based therapies significantly help patients to heal quickly and completely allowing them to enjoy an active life without pain.
Drs. Christopher J. Rogers and Mary A. Ambach of San Diego Orthobiologics Medical Group have successfully treated thousands of patients with platelet rich plasma and other cell based therapies for more than a decade. Their facility in Carlsbad contains the most advanced Regenerative Medicine technology in San Diego and offers same day treatments with the highest documented levels of safety and efficacy.
Sources:
Aug 28, 2020
The liquid portion of blood called plasma has been used for several years to help patients facing life-threatening conditions such as immune deficiency disorders and organ transplantation. Because it has helped treat so many chronic and rare diseases, it has been referred to as “the gift of life.”[i]
More recently, physicians have discovered that a patient’s own plasma and its’ cells can help expedite the recovery from orthopedic injuries. Platelet rich plasma treatments, known as PRP, use the healing power of platelets to harness growth factors and other proteins that are essential for healing.
How Platelet Rich Plasma Treatment Works
Blood is comprised of red blood cells, white blood cells,platelets and plasma. The plasma contains hormones, electrolytes and nutrients that are needed to nourish cells during the healing process.
During platelet rich plasma treatment, the patient’s own blood is drawn and placed in a centrifuge machine where the platelets are separated and concentrated. This results in a PRP solution that contains up to 10 times more platelets than that typically found in blood.[ii] With its super-charged healing capabilities, platelet rich plasma can be used to treat a number of orthopedic conditions, including:
· Joint arthritis (knee, shoulder, hip, thumb or spine)
· Injured tendons like rotator cuff tendon, Tennis elbow and Achilles tendon
· Ligament sprains in the wrist, ankle or sacroiliac joints
· Carpal tunnel syndrome
· Degenerated discs, mild spinal stenosis and sciatica
Not All PRP Treatments Are the Same
When it comes to platelet rich plasma treatment, one size does not fit all. Several factors can influence the success rate of treatment:
· The patient must receive an accurate diagnosis.
· Image guidance with ultrasound or fluoroscopy (x-ray) for targeted delivery to the injured tissues is necessary.
· The PRP formulation must be customized to the specific injury being treated.
· The initial injury severity must be considered.
When administered appropriately and in the right formulation for the specific injury, most patients begin to experience results within four to eight weeks after platelet rich plasma treatment. About 10% of patients will feel relief within days.
PRP treatments are performed on an out-patient basis in the physician’s office. There is no need for hospitalization or lengthy rehabilitation. The entire procedure takes less than an hour and patients may typically resume normal activity within days.
Dr. Christopher Rogers of San Diego Orthobiologics Medical Group performed one of the first PRP treatments in San Diego in 2009. He and Dr. Mary Ambach are experts in the field of regenerative therapy for orthopedic injuries. They have successfully treated thousands of patients with PRP and other orthobiologics.
Sources:
[i] Donating Plasma: What is Plasma
[ii] OrthoInfo: Platelet Rich Plasma
Aug 11, 2020
When: Wednesday, Aug 19, 2020
Time: 12:00 pm PST
“Neck and Low Back Pain: Using Your Own Cells to Heal Your Body” Presented by Dr. Christopher Rogers and Dr. Mary A. Ambach
Join our free webinar to learn about non-surgical therapies to treat neck pain and low back pain. Gain information on cutting edge treatments like platelet-rich plasma (PRP) and other cell-based therapies. Get answers to your questions from experts in the field of Regenerative Medicine.
Your hosts:
Dr. Mary Ambach specializes in non-surgical orthopedics, regenerative therapies and interventional pain management. As a key thought leader in the field of Regenerative Medicine, Dr. Ambach conducts research, trains physicians and lectures at international medical conferences.
Dr. Christopher Rogers is one of the world’s leading experts in orthopedic regenerative medicine and a renowned speaker at national medical conferences. He has developed new approaches for the treatment of tendon injuries, osteoarthritis and disc degeneration which provide a safe and viable alternative to surgery.
Register for the FREE Webinar Here
