Dr. Christopher Rogers was honored to speak at the April 2021 La Jolla Golden Triangle Rotary Club meeting. Topics of the lecture included a history of stem cell therapy in San Diego and an update on FDA-approved clinical trials for knee osteoarthritis. To see a copy of the lecture, visit the San Diego Orthobiologics Medical Group YouTube channel or view the video linked below!
Turmeric, a spice from South Asia derived from the Curcuma longa root, has been used as a medicine for nearly 4000 years. Recent studies have shown that turmeric may help to relieve joint pain caused by arthritis because the active ingredient, curcumin, is now known to have anti-inflammatory properties. Curcumin has been shown to have similar efficacy to diclofenac, a non-steroidal anti-inflammatory drug, with fewer side effects. Similar improvements in pain severity and function were seen with curcumin and diclofenac in a randomized, controlled clinical study of 139 patients with knee osteoarthritis. Nineteen patients in the diclofenac group (and none in the curcumin group) required anti-ulcer medications at 28 day followup .
Turmeric for Joint Pain Relief
Curcumin has also been shown to have a strong antioxidant capacity. In a randomized double-blind placebo-controlled trial, patients with mild-to-moderate knee osteoarthritis were given the curcuminoid and were compared to a group that received a placebo for 6 weeks.  Researchers measured the levels of enzymes known to influence inflammation (e.g. superoxide dismutase (SOD) and malondialdehyde (MDA)). The treatment group showed significant changes in these enzymes suggesting that short-term supplementation with curcumin decreases oxidative stress.
Another randomized, double-blind, placebo-controlled trial of low or high dose bio-optimized Curcuma longa in 150 patients with knee osteoarthritis measured serum biomarkers of cartilage degradation (sColl2-1).  The high dose extract showed a transient but non-significant decrease in the cartilage degradation biomarkers. Moreover, pain improvement in the low- and high-dose extracts was better than in the placebo group after 90 days of treatment.
The effects of topical curcumin 5% ointment on osteoarthritis knee pain in patients older than 70 years was studied in a double-blind, randomized placebo-controlled trial. Subjects applied either the ointment or a placebo (Vaseline) twice a day for 6 weeks. The pain intensity was significantly lower in the group receiving the curcumin ointment than in the placebo group suggesting that this treatment may be considered for older adults with knee osteoarthritis.
 Shep D, Khanwelkar C, Gade P, Karad S. Safety and efficacy of curcumin versus diclofenac in knee osteoarthritis: a randomized open-label parallel-arm study. Trial 2019; 20:214.
 Panahi Y, Alishiri GH, Parvin S, Sahebkar A. Mitigation of systemic oxidative stress by curcuminoids in osteoarthritis: results of a randomized controlled trial. J Dietary Suppl. 2016;13(2):209–20.
 Henrotin Y, Malaise M, Wittoek R, Vlam K, et al. Bio-optimized Curcuma longa extract is efficient on knee osteoarthritis pain: a double-blind multi center randomized placebo controlled three-arm study. Arthritis Research and Therapy 2019; 21, 179.
 Jamali N, Adib-Hajbaghery M, Soleimani A. The effect of curcumin ointment on knee pain in older adults with osteoarthritis: a randomized placebo trial. BMC Complementary Medicine and Therapies, 2020, 20:305.
Join our free webinar to learn about PRP, an innovative non-surgical treatment option for osteoarthritis and other orthopedic conditions.
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.
You may have seen stories in the news about the potential of cell therapy to treat severe cases of COVID-19. One story in particular mentioned positive results of an experimental study of stem cells with the patient mortality rate decreasing from 85 percent to 15 percent.[i] Stem cell therapy has been shown to have regenerative, anti-inflammatory and immunomodulating properties. Although this patient sample was very small, this is yet another reminder that cell therapy has moved to the forefront of medicine.
Bone marrow transplantation for blood diseases has been in use for more than 40 years[ii], but more recently has been used to treat orthopedic injuries including joint degeneration and pain.
Why Do My Joints Hurt?
It is not uncommon to experience pain in the shoulders, elbows, knees or hips. Sometimes even the toe joints can hurt. Whether big or small, painful joints can make daily activities difficult and significantly impact your quality of life.
Pain in the joints may result from several different conditions. These include:
· Osteoarthritis: a condition that develops when the cartilage in the joints begins to break down. It often occurs as a result of trauma, aging, obesity or genetic factors.
· Tears or sprains to soft tissues surrounding the joint such as muscles, tendons and ligaments.
· Chronic inflammation due to autoimmune diseases such as lupus or rheumatoid arthritis.
The good news is that cell therapies that use a patient’s own blood, bone marrow or adipose (fat tissue) have proven to be effective at treating joint pain without surgery or extended rehabilitation.
Fat Cells or Bone Marrow Cells?
Cell therapy is derived from two major sources of cells, adipose (fat) cells and bone marrow cells. Each can be easily obtained in the clinic, but the two offer different healing properties.
Adipose-derived cells are taken from the abdomen, flank or thighs. These cells can repair and replace damaged or injured tissue. The specialized healing cells are called pericytes and they direct other cells to form new blood vessels, awaken stem cells and stimulate the growth of new tissues such as cartilage, bone and tendon. They also secrete powerful anti-inflammatory and pain relieving molecules.
Bone marrow cells can be used for injury recovery and more rapid healing. That’s because bone marrow contains cells that have the ability to improve circulation, decrease inflammation and regenerate healthy tendons, ligaments and cartilage.
How Effective is Cell Based Therapy?
Like all medical treatments, outcomes are significantly impacted by several factors, including:
· The extent of the damage being treated.
· The patient’s overall health prior to the procedure.
· How the orthobiologics are prepared for treatment.
· For many patients, however, using adipose and bone marrow cells to treat orthopedic injuries is highly effective and does not present many of the risks associated with traditional invasive surgery.
The procedure is performed on an out-patient basis in the physician’s office. Most patients require only a single treatment and many are able to resume their normal activities within days.
San Diego Orthobiologics Medical Group is one of only six clinics in the U.S. to participate in a first-of- its-kind FDA-approved clinical trial to treat knee osteoarthritis using a patient’s own fat-derived stem cells.
Drs. Christopher Rogers and Mary Ambach of San Diego Orthobiologics Medical Group were chosen based on their extensive experience with cell therapy to treat orthopedic conditions.
Pain and stiffness due to arthritis has long been considered something that normally comes with age. But new research indicates that the disease has affected younger people too at an increasing rate. The Arthritis Foundation reported that among those aged 18 to 64, nearly one in three have doctor-diagnosed arthritis and/or report joint symptoms consistent with a diagnosis of arthritis in both men and women.[i]
Osteoarthritis occurs when the cartilage that cushions the bones in the joints begins to break down. This is often a result of life-long wear and tear, but overuse from repetitive motions and activities may lead to earlier development of this painful condition.
Are You at Risk for Developing Osteoarthritis?
The odds of developing osteoarthritis increase with age and repetitive use, but there are several other factors that can increase a person’s risk for joint degeneration including:
- Genetics: Some people inherit a tendency to develop osteoarthritis.
- Gender: Women are more likely to develop osteoarthritis than men for ill-defined reasons.
- Obesity: Extra pounds put stress on weight-bearing joints, such as your hips and knees.
- Previous Injury: Joints injured by an accident or surgery, are more prone to developing osteoarthritis.
- Other medical conditions: Systemic diseases such as diabetes and hemochromatosis (a condition that causes the body to retain too much iron) are at higher risk too.
Addressing the Pain Without Surgery
The field of regenerative medicine has made great strides in the development of non-surgical treatments for patients suffering with painful joints due to osteoarthritis. These treatments use a patient’s own cells and tissues to stimulate the body’s ability to repair damaged joints and encourage the growth of new tissue, such as cartilage, bone and tendon.
These minimally-invasive treatments are performed using advanced image guidance to deliver cellular therapy to the affected areas with high precision. They are performed in the medical clinic allowing patients to return home within an hour or two of their treatment.
Such innovative therapies include:
- Prolotherapy which stimulates the body’s natural healing mechanisms to produce new tissue by employing a sugar based solution called dextrose.
- Platelet Rich Plasma (PRP) therapy that selectively concentrates platelets and growth factors in the blood to create a customized healing treatment.
- Bone Marrow Aspiration Concentrate (BMAC) which uses stem cells, platelets and other substances in the patient’s bone marrow that improve circulation, decrease excessive inflammation and regenerate healthy tissue.
- Lipogems that enables cells within the adipose (fat) tissue to work together as a functional unit and repairs, reconstructs and replaces damaged tissues.
- Master Protease Inhibitor (Alpha 2 Macroglobulin or A2M) which uses a substance found in a patient’s own blood to stop the progression of joint degeneration and decrease inflammation.
Which Treatment is Right for Me?
Arthritis sufferers who are considering regenerative treatments should consult with a qualified physician who has the training and skills to perform these procedures safely and effectively. These physicians are board-certified in physical medicine and rehabilitation (PM&R), sports medicine or orthopedics and have advanced training in regenerative medicine. They can help you determine which treatment is most appropriate based on your goals and specific medical condition.
Another important factor to consider is the source of the regenerative products. Practices that use autologous cells and tissue from a patient’s own body are permitted by the FDA when used in accordance with their guidelines. Clinics that use donor birth tissue products, such as umbilical cord blood, amniotic fluid or exosomes put their patients at risk for infection or immune reactions because these materials are foreign to a patient’s own body. The FDA does not permit the use of such products because they have not been proven to be safe or effective.
Those who once considered joint replacement surgery as their only option to manage the pain of osteoarthritis should carefully review these new regenerative treatment options. They can offer years of pain relief that can delay or even avoid surgery.
Drs. Christopher J. Rogers and Mary A. Ambach are recognized experts and leaders in the field of regenerative medicine. They have published in the scientific literature and have trained hundreds of physicians at medical conferences around the world. Because of their extensive knowledge of treating orthopedic conditions with regenerative procedures, San Diego Orthobiologics Medical Group is one of only six clinics in the United States selected to participate in an FDA-approved clinical trial to treat knee osteoarthritis with stem cells.
Exercise is important for all of us. Whether you are in perfect shape or have joint pain, it is important to tailor your workout routine to your body’s unique needs. Exercise is meant to nurture your body, not hurt your body. That said, if you have painful joints, don’t let this stop you from giving your body the workout it needs. In fact, regular exercise can help ease your pain. Research shows that regular exercise helps reduce inflammation and even increase pain tolerance. Here are some helpful workout tips for painful joints.
Always Warm Up
Jumping on a machine immediately after entering the gym can be detrimental to your joints. You must first warm up your body to loosen your muscles and tendons. Working out when they are tight can lead to joint pain. Your warm-up can be as simple as light movement for 5 minutes to get your blood flowing. Or perhaps try an easy walk.
The more you move, the less stiff your joints will be. If you are looking to get your heart rate elevated but want a low-impact exercise option, try swimming, bicycling, rowing, exercising on elliptical or even walking. These are the best options for protecting your joints.
In addition to these low-impact exercises, you might want to try practices like yoga and Pilates. These both help strengthen your trunk muscles, which ultimately help maintain balance and decrease the likelihood of a lower back injury.
Strengthen Your Muscles with Weights
Stronger muscles help to lessen strain on your joints. Add some weight training to your exercise routine. Weight machines, free weights and resistance bands are all helpful in getting stronger and building muscle mass. You should take things slowly at the start. Always listen to your body. Try to incorporate weight training 2-3 times per week and alternate between upper body and lower body workouts.
Change Things Up
Overuse injuries are another culprit of joint pain. To avoid this, try not to do the exact same routine every day. Mix up your workouts. Perhaps you could try swimming one day and biking the next.
It is important to keep your muscles and tendons flexible. After your workout, make sure to stretch all of the muscles you used that day. You’ll want to try and hold each stretch for up to 30 seconds.
Do you suffer from joint pain? San Diego Orthobiologics Medical Group offers the path to physical freedom with customized care and nonsurgical solutions. Give us a call at 760-909-2355 to schedule an appointment.