Nancy is an active woman in her 50s who suffered from shoulder pain after undergoing rotator cuff surgery. Dr Ambach treated her with Platelet Rich Therapy (PRP) and now Nancy has full range of motion and is living pain free!
I spent year dealing with chronic pain and flair ups. The PRP with Dr. Ambach and then my work with Megan at Evolve Physical Therapy has been life changing.
When: Wednesday, May 6, 2020
Time: 12:00 pm PDT
Join us for a FREE webinar as Dr. Mary A. Ambach talks about regenerative cell therapies for orthopedic conditions, including osteoarthritis and tendon injuries. There will be an opportunity for participants to submit questions and have them answered by our presenting physician.
Dr. Mary Ambach specializes in nonsurgical orthopedics, regenerative injection therapies, and interventional pain management. As a key thought leader in the field of Regenerative Medicine, Dr. Ambach has published research, trained physicians, and presents at international medical conferences.
Register for the FREE Webinar Here
Orthobiologics research has come a long way since the earliest reports of platelet rich plasma (PRP) in the 1980s and stem cells in the 1960s. There has been exponential growth in the number of published scientific studies on PRP and stem cells in orthopedics over the past 10 years.
Regenerative medicine is a new medical specialty that uses advancements in the study of cells and tissue engineering to understand how the body heals itself. In the field of orthopedics, regenerative treatments have evolved to capitalize on the unique healing qualities of our own cells to stimulate healing, reduce inflammation and decrease pain for a variety of musculoskeletal conditions.
The demand for regenerative treatments continues to grow as patients discover how these treatments are successfully being used to treat acute musculoskeletal injuries and degenerative conditions. More and more patients have benefited from such therapies with reduction in pain and significant improvement in their quality of life.
Clinical trials and research in regenerative medicine has provided more ever increasing evidence for the safety and efficacy of cell based therapies when used in orthopedics such as osteoarthritis, tendon tears, ligament injuries, low back pain, sciatica and several others conditions.
The choice of regenerative treatment depends upon multiple factors including the type and severity of injury, medical comorbidities and other issues unique to each patient. San Diego Orthobiologics Medical Group offers a number of regenerative medicine options such as:
The field of regenerative medicine is continuously evolving and expanding. Cell based therapies are getting acknowledgement in orthopedic surgery and have been used to accelerate healing and improve outcomes. The combined use of cells and protein scaffolds (tissue framework) are utilized for cartilage, tendon, ligament and bone tissue engineering to accelerate healing and long lasting results. Surgery to repair bone fractures or bone defects have been supplemented with cell therapy to increase bone healing and mineralization.
Many other exciting potential applications for stem cell therapy are currently being studied, not just in orthopedics, but in other specialties. The idea that a patient can bank their own stem cells to store for future use is already a reality.
However, there is still more work to be done in order to make significant progress on this field. Although there are thousands of studies published in peer-reviewed scientific journals, there is a great need for more high-quality studies and clinical trials. Continued work on standardization of processes, reporting and treatment protocols is vital. Collection of data through registries is not only important to track patient complications and outcomes, but also to guide future decisions made by insurance companies and regulators. Collaboration with a multidisciplinary team of experts in physical medicine and rehabilitation, orthopedic surgery, sports medicine, cell therapy, molecular biology and others will continue to move the field forward at a rapid pace.
Drs. Christopher J. Rogers and Mary A. Ambach of San Diego Orthobiologics Medical Group are experts and leaders in the field of regenerative medicine. They are involved in clinical trials using cell-based therapies for knee osteoarthritis and disc degeneration in the lumbar spine. They have published in multiple medical journals and Regenerative Medicine textbooks. They serve as faculty members and lecturers at national and international medical conferences and serve on the board of directors for several regenerative medicine organizations.
Bone marrow is a rich source of many types of cells. Red blood cells, white blood cells and platelets are manufactured in the marrow and released into the blood. Stem cells, were discovered in bone marrow in 1988 and have been shown to have the remarkable potential to develop into many different types of cells and promote healing.
Bone marrow contains at least two kinds of stem cells. One population, called the hematopoietic stem cell (HSC), forms all the different blood cells in the body. A second population, the mesenchymal stem cell (MSC), has the ability to transform into different cell types such as:
Stem cells not only have the ability to become other types of cells, they also have powerful anti-inflammatory and immune system modifying properties to influence the healing response of injured tissues.
Bone marrow aspiration concentrate (BMAC), is a concentration of cells that is obtained from a patient’s own bone marrow. Bone marrow aspirate is collected using a minimally invasive procedure that uses a needle to obtain bone marrow from the bone, commonly in the pelvis. The procedure is performed under local anesthesia or light sedation for comfort. The bone marrow is minimally processed in our lab to separate and concentrate the cells using centrifugation. Bone marrow processing protocols vary widely and influence the number and quality of the cells. The resulting biologic product is then injected into injured tissues using imaging guidance such as ultrasound or fluoroscopy (“real time” x-ray). The entire process is performed on the same day and is well tolerated with minimal need for pain medications.
Bone marrow aspiration concentrate therapy is used for a variety of orthopedic conditions. It has been shown to decrease inflammation and aid in healing.
BMAC therapy may:
Patients considering BMAC stem cell therapy should seek qualified providers to provide their treatment. Stem cell therapies using a patient’s own bone marrow are compliant with current FDA regulatory guidelines.
However, other stem cell based products that contain umbilical cord blood, amniotic tissue or exosomes are not FDA compliant and should be avoided.
Dr. Christopher J. Rogers and Dr. Mary A. Ambach are board certified in Physical Medicine and Rehabilitation and have specialized training in Regenerative Medicine. They are experts in the use of Bone Marrow Aspiration Concentrate (BMAC) and other Orthobiologics for orthopedic conditions.
Tom Pernice, Jr., an American professional golfer who plays on the PGA Champions Tour, had injured his shoulder. In fact, he had a full thickness tear of his rotator cuff tendon, an injury that often requires surgery. The pain continued for months despite physical therapy and other medical treatments.
Pernice’s colleague, Dr. Greg Rose, co-founder of the Titleist Performance Institute (TPI), recommended that he consult with Dr. Chris Rogers at the San Diego Orthobiologics Medical Group. Dr. Rogers evaluated the large, retracted tendon tear with high-resolution ultrasound imaging. Conservative care had not been effective and the current standard of care would include an arthroscopic surgical repair. Given that Pernice was preparing to start the tour season, he preferred to avoid surgery and a potentially long recovery. At that time, Dr. Rogers shared his experiences using a patient’s own cells to stimulate tendon healing.
For more than 12 years, Dr. Rogers has used platelet rich plasma (PRP) to heal small tendon tears with good results. PRP uses cells from a patient’s own blood to stimulate healing. For larger tendon tears, regenerative cells obtained from a patient’s own adipose (fat) tissue via a mini liposuction procedure would often give good results. Dr. Rogers shared that he had treated several patients with similar injuries, but Pernice’s injury was severe and the tendon had retracted away from its insertion on the bone. After careful consideration of his options, Pernice elected to give cell based therapy a try.
In May 2019, only a few weeks after his treatment, Pernice had already noticed decreased shoulder pain and improved range of motion. After eight more weeks of physical therapy, he was able to compete and won the Legends of Golf at Big Cedar Lodge. “Surgery would have prevented me from playing altogether. This was a very special win,” stated Pernice.
Now, one year after treatment, Pernice notes, “I have no pain in my right shoulder, movement, range of motion… everything’s as good as it could be, or better than it was.” Dr. Rogers was pleased and surprised when his recent repeat ultrasound exam showed that the tendon was nearly completely healed. “This is a very remarkable outcome, a testimony to Tom’s hard work and this treatment’s ability to heal a very bad injury.”
You can see his full story here:
Richard is a 72-year old male who suffered from severe knee osteoarthritis in both knees. He is a patient of Dr. Ambach and had a successful treatments with fat-derived cell therapy and PRP. We are thankful for his testimonial and that he is living more comfortably!
I live on the beach and couldn’t walk very far on the beach without knees hurting. I had both stem cell and PRP treatments in both knees. I became pain free in 9 weeks! Oh, I used to have a problem going up and downstairs. No more. As I healed my knees because stronger and more flexible. For example, lowering myself to the floor and getting back up. Much better now. I am very thankful this treatments option was available.
