Oct 13, 2022
As one the largest joints in the body, the knees often suffer the most from the wear-and-tear that comes with a lifetime of use (or abuse). Whether damaged by an injury such as a ligament or tendon tear, or simply worn down by years of standing, running, jumping, lifting, etc., the result is often the same: chronic pain, inflammation, and reduced movement.
Depending on the extent of the injury or damage to the knee, patients can often gain some temporary relief from steroid injections that decrease swelling or from other interventional treatments such as hyaluronic acid injections that increase lubrication in the joint. But when these options have been expended, many look to surgery as their last, best hope to repair the damage and bring sought-after pain relief.
But now, non-surgical cellular treatments are providing long-term relief to patients with knee pain by putting the body’s own natural healing abilities to work to undo the damage brought on by injury or degeneration.
How Do Cellular Treatments Work?
Known as regenerative medicine, cellular treatments harness powerful healing properties within the body’s building blocks—its own cells—to help repair and, in some cases, replace injured tissues. These treatments promote healing of injuries to the cartilage in the knee joint, as well as soft tissues such as tendons and ligaments in the knee.
To adhere to Federal Food and Drug Administration (FDA) guidelines, only autologous (from the patient’s own body) cellular products can be used to treat orthopedic conditions. Donor products, including cord or amniotic cells, are not approved to treat knee osteoarthritis or soft tissue injuries in the knee.
Cellular products are taken from the patient’s own blood, bone marrow, or fat (adipose) tissues to maximize the benefits of their unique healing properties:
- Platelet Rich Plasma: Platelets in blood release growth factors and proteins that promote tissue repair, while the plasma carries the hormones, electrolytes and nutrients required to nourish cells during the healing process. Platelet rich plasma treatments can be customized to create specific formulations for each type of tissue being treated (muscle, tendon, ligament, cartilage).
- Cellular Therapy: Cells derived from the patient’s own bone marrow or adipose (fat) tissue called “pericytes” produce molecules that spur the production of new blood vessels, awaken other stem cells and encourage newly forming cells to produce collagen and other proteins essential for creating new healthy tissues. These specific cells can develop into the specific kind of cell needed, whether that be tendon, ligament, cartilage, or bone.
After these products are removed from the patient, they are concentrated and reinjected directly to the injured area to address the degeneration or injury.
Do Cellular Treatments for the Knees Work?
Regenerative medicine practitioners have scores of anecdotal evidence from satisfied patients that support the powerful pain-relieving and healing properties of cellular treatments for the knees.
But because the field of regenerative medicine is relatively new, until recently, there has been a limited amount of clinical data to bolster this anecdotal evidence. We believe the quantitative, controlled data that clinical trials will produce will not only further the use of cellular treatments for orthopedic conditions but will also confirm what hundreds of our satisfied patients have been telling us for years: cellular treatments have helped their bodies heal naturally while allowing them to resume the activities that help them regain their quality of life.
The experts at SDOMG help patients with knee injuries and knee osteoarthritis find the relief they need using expert technology and treatments. To learn more about cellular therapy for knee injuries, contact SDOMG using the form below.
May 27, 2022
Orthobiologics is a combination of words: “ortho” refers to the body’s musculoskeletal system (muscles, bones, joints, ligaments, and tendons), and “biologics” refers to naturally derived substances used to heal parts of the body. Orthobiologic treatments can be used to harness the body’s ability to heal itself to restore or establish normal function. Within the field of orthopedics, these specific treatments hold great promise for helping patients with injuries or degeneration in the musculoskeletal system.
When joints, ligaments, tendons, or discs are damaged, it can lead to chronic pain in the:
- Lower Back
- Knees
- Hips
- Neck
- Feet and ankles
- Hands and wrists
- Elbows and Shoulders
Orthobiologics promote healing and stimulate growth of new healthy tissues. When the underlying cause is treated, pain improves or resolves.
How Do Orthobiologics Work?
Orthobiologic treatments for orthopedic conditions use the patient’s own blood and cells (known as autologous products) to kick-start the body’s own healing processes. These biologic products are collected from the patient and concentrated to isolate the healing proteins, molecules, and nutrients they contain. These super-healers are then re-injected into the exact site of the damaged tissue to encourage new cell growth and healing.
Limitations on Cellular Treatments by the FDA
The U.S. Food & Drug Administration (FDA) does not allow the use of embryonic or blood cord products for treating orthopedic conditions. The FDA also banned certain language and vague advertising regarding these types of products that in the past have opened doors to illegal markets cell-buying and procedures that are potentially dangerous to patients.
Skilled certified physicians can use the following autologous (from your own body) cellular products to treat musculoskeletal problems, provided they follow the FDA’s guidelines for safety and efficacy:
- Platelet Rich Plasma: Platelets in the patient’s own blood release growth factors and proteins that promote tissue repair, while the plasma carries cytokines and nutrients required to nourish cells during the healing process.
- Cellular Therapies: A specific type of cells, called mesenchymal cells, taken from the patient’s own fat tissue (adipose) or bone marrow, have the unique ability to develop into the specific kind of cell needed to promote healing and possess molecules that direct other cells in the injured area to form new blood vessels, awaken other cells, and encourage newly forming cells to produce collagen and other proteins essential for creating new healthy tissues.
Because the platelet-rich plasma and mesenchymal cells are taken directly from the patient and delivered back to them, they do not present the risk of allergic reactions or some infections seen with donor products.
Are PRP and Cell Therapies Painful?
For many years, patients with unresolved chronic orthopedic pain were left to consider surgery as their best hope for long-term pain relief. But with advancements in regenerative medicine, some patients can avoid major surgery and lengthy rehab.
Orthobiologic treatments are conducted with needles. Blood plasma and mesenchymal cells are aspirated (removed via a needle) and reinjected through a needle. There are no large incisions, which means the risk of bleeding and infection is significantly reduced. It also means that the procedures can be performed on an outpatient basis, and recovery begins at home within hours of the treatment.
Best of all, patients can enjoy long-lasting pain relief and enjoy an improved quality of life without chronic pain.
Ask the Right Questions, Get the Best Results
When considering regenerative medicine to treat orthopedic conditions, patients should make sure:
- The physician performing the procedure is board-certified
- Advanced centrifuge technology is used to prepare the cellular products so that they offer the highest possible concentrations of healing properties.
- Treatments are given under fluoroscopic (X-ray) or ultrasound guidance to ensure precise delivery of the regenerative products to the exact site of the injury.
- The practice acknowledges and strictly follows FDA guidelines for the use of cellular products to treat musculoskeletal damage.
The best outcomes occur when the patient understands the benefits of regenerative treatments and knows the right questions to ask prior to the procedure.
SDOMG is a state-of-the-art practice focusing on Orthobiologics to treat orthopedic conditions. To learn more about the procedures they provide, visit their website or fill out the form below. We look forward to helping you regain your quality of life.
Nov 26, 2021
Medical research advances enable physicians to find new and innovative ways to use the body’s systems to fight disease and injury.
Regenerative medicine is a field of medicine that uses the body’s own cells and tissues to heal injuries and medical conditions. In the treatment of cancer the cells are used in immunotherapy, which involves modifying patient’s cells to fight the disease. In the field of orthopedics, regenerative medicine specialists use the patient’s own blood cells, bone marrow or adipose tissue to help the body boost its own natural healing properties. These are known as orthobiologics.
At the present time, FDA allows the use of autologous orthobiologics —which means the tissue or cells used must come from the same patient. Donor products are not allowed to be used in clinical setting unless it is used under the purview of a clinical trial. Read here on the FDA guidance on the use of human cells and tissues.
Cell-based Treatments for Orthopedic Conditions
There are two types of cell-based therapies that can be used to treat orthopedic conditions:
Bone Marrow Aspiration Concentrate (BMAC): Bone marrow-derived cells are collected from the back of the pelvic bone. The marrow contains mesenchymal stem cells which have the ability to renew themselves and differentiate into bone, tendon, cartilage and muscle cells. These make them an ideal therapy for treating orthopedic injuries such as tendon tears, worn cartilage, and degenerated disc disease. BMAC also contains important therapeutic cells, growth factors and proteins that stimulate the body’s natural ability to improve circulation, decrease inflammation and heal injured tissues.
Micro-fragmented Adipose Tissue (fat) Cells: Adipose-derived cells are collected from a fat sample usually from the buttock or abdomen. There is minimal manipulation of the tissue with no enzymatic digestion or addition of other biological or pharmacological agents. Fat or adipose tissue is rich in healing cells like mesenchymal stem cells or MSCs, growth factors and other proteins that can assist in healing tissues.
Why Consider Cell-Based Therapies?
There is increasing body of clinical research that demonstrates the safety and efficacy of Cell based therapies. A recent comprehensive report 1 based on actual clinical data collected from 65 physicians at 43 clinics in 25 states revealed that seventy percent of the patients treated with adipose tissue therapy reported a meaningful reduction in pain at 12 months following treatment and sixty-one percent of the patients treated with bone marrow aspirate reported a meaningful reduction in pain at12 months following treatment.
Micro-fragmented adipose tissue or bone marrow aspirate concentrate is a non-surgical treatment option that does not involve incisions, general anesthesia, hospitalizations or lengthy rehabilitation stays. This is an outpatient procedure performed in a doctor’s clinic using only local anesthesia.
Patients considering cell-based therapies should do their research in ensuring they get the best treatment. There are several important factors that can impact the effectiveness of these treatments. These include:
- Cellular product preparation: The patient’s bone marrow or fat tissue must be processed using FDA compliant devices and protocols. It must be prepared in a safe and sterile environment by medical personnel who are trained in the proper handling of these tissues.
- Delivery: The procedure must be performed by skilled physicians who are properly trained in this field. They must be able to perform these highly specialized injection techniques using imaging guidance to ensure that the cellular products are delivered to the site of injury.
- Experience: The field of regenerative medicine is changing daily and there are a limited number of specialists around the country who have the experience and technology to perform cell-based orthopedic treatments safely and effectively. Dr. Mary A. Ambach and Dr. Chris Rogers have decades of experience in using regenerative therapies and are nationally recognized experts in this field.
1Databiologics. An Overview of Regenerative Treatments for Orthopedic Conditions. 2021 Outcomes Report.
Jan 17, 2021
You may recall from your high school biology class that cells are referred to as the “building blocks of life”. When your body becomes injured or worn out, these building blocks break down leading to pain and loss of function. Yet, cellular therapy is the carpenter that repairs and replaces these broken cells and tissues.
Cell based therapy harnesses the powerful healing capabilities of cells in your body to repair damaged tissues and restore health. These are innovative therapies are based on concepts and scientific evidence that has emerged over the recent decades.
The world-renowned Center for Regenerative Medicine at the Mayo Clinic works closely with the Human Cellular Therapy Laboratories at campuses in Minnesota, Florida and Arizona to develop cellular therapies for more than a dozen medical conditions. These include ALS (Lou Gehrig’s disease), cancer, diabetes and orthopedic conditions such as osteoarthritis and degenerative disk disease [i]. San Diego Orthobiologics Medical Group is the premier regenerative medical center in San Diego providing therapies for orthopedic conditions. Drs. Christopher Rogers and Mary A. Ambach are recognized leaders in this field for their expertise in this exciting new medical specialty. Together, they have developed an extensive record of using Cell Based therapies to treat thousands of patients suffering from conditions such as painful arthritis or debilitating lower back pain. Many of these patients thought they had exhausted all of their treatment options and were concerned about resigning to a life of pain.
Cell Based therapies has given them a new lease on life.
All of the treatments offered at the San Diego Orthobiologics Medical Group are FDA-compliant and based on sound scientific evidence. We only use cells that are derived from the patient’s own body and processed in our state of the art laboratory using FDA-approved devices and methods. We do not use any donor stem cell products because these have not been tested for safety or efficacy.
These regenerative treatments contain restorative cells that are derived from a patient’s own blood, fat or bone marrow tissues. They help jump start the body’s own natural healing processes by encouraging the growth of healthy new cells and tissues to replace those that are injured or degenerated.
Dr. Christopher Rogers currently serves on the board of directors for the American College of Regenerative Medicine and has published and lectured extensively at national medical conferences on spine care, sports medicine, regenerative medicine and musculoskeletal ultrasound. He regularly teaches courses on regenerative cellular therapy throughout the country, including at the Regenerative Medicine Training Institute, the Interventional Orthopedics Foundation and the Orthobiologic Institute.
Dr. Mary A. Ambach is a clinical instructor at the University of California San Diego School of Medicine and also serves as a clinical instructor of medicine at the David Geffen School of Medicine at UCLA, clinical assistant professor of Physical Medicine & Rehabilitation at the Western University of Health Sciences and an associate professor at the Southern California University Sports Medicine Program. She has authored several published articles and book chapters in Regenerative Medicine and is actively involved in clinical research studying the effects of bone marrow-derived cells and platelet rich plasma for the treatment of low back pain due to degenerative disc disease.
Platelet rich plasma and other cell based therapies represent some of the most exciting advances seen in medicine in recent years. They offer patients options not previously available for conditions that were not previously treatable without surgery. Patients should do their homework and get the facts about how these treatments may help them to alleviate pain and restore a healthy, active life.
[i] https://www.mayo.edu/research/centers-programs/center-regenerative-medicine/shared-services/human-cellular-therapy-laboratory
Dec 16, 2020
In the last few years, there have been great advances in the field of Regenerative Medicine and Stem Cell Therapy. These treatments hold a great deal of promise for the treatment of a variety of orthopedic conditions. Most treatments are offered at your convenience in a medical clinic setting without the need for surgery.
What is Regenerative Medicine?
Regenerative medicine is a multi-disciplinary field that aims to restore damaged or diseased tissues by utilizing the body’s own natural healing process. By bringing together many different disciplines such as cellular biology, genetics, and tissue engineering, Regenerative Medicine has revolutionized the way physicians can treat orthopedic conditions. Stimulating our body’s natural ability to heal and promote tissue regeneration has replaced many traditional treatment options such as steroid injections or surgery.
Stem Cell Therapy
According to the International Society for Stem Cell Research’s (ISSCR) president, Douglas Melton, “Stem cell science is rapidly transforming how we think about the future of medicine. The field is actively working to address how we facilitate getting potential therapies from the lab to the clinic.”
Stem cells have the ability to develop into many different types of cells in the body, which is why stem cell therapy is important in the field of regenerative medicine. There is constant advancement of research in the use of stem cell for replacement of damaged tissue or transplants, drug testing and development and regenerative medicine.
How are Stem Cell Therapy and Regenerative Medicine Related?
There is a direct connection to stem cell therapy and the practice of Regenerative Medicine which harnesses the body’s ability to heal itself and regrow tissues. The different types of stem cells, namely embryonic, adult, and induced pluripotent stem cells, are used in the field of developmental biology to study how cells behave. Stem cells are also used to test new to drugs for the treatment of various diseases and medical conditions. In the field of orthopedics, adult stem cells play a crucial role in the cell-based therapies used to treat orthopedic injuries such as knee osteoarthritis.
What Orthopedic Conditions Can Be Treated with Cell-Based Therapies?
- Knee pain due to osteoarthritis or meniscus tears
- Shoulder pain due to rotator cuff tendon tears or tendinitis
- Carpal Tunnel Syndrome
- Golfer’s Elbow and Tennis Elbow
- Sciatica
- Chronic ankle ligament sprains
- Low back pain due to disc degeneration or sacroiliac joint ligament injury
Regenerative medicine has entered the world of clinical practice thanks to quickly evolving technology and advancements in the understanding of how stem cells work in the body. As research continues, the field of Regenerative Medicine and stem cell therapy will continue to grow, providing doctors and their patients the ability to treat many conditions that were previously untreatable.
REFERENCES:
NCBI: Regenerative Medicine
UNMC: Stem Cells and Regenerative Medicine
International Society of Stem Cell Research: Stem Cell Therapies and Regenerative Medicine
California Stem Cell Agency: The Power of Stem Cells
American Association of Blood Banks: Regenerative Medicine
