Regenerative Orthopedic Medicine

regenerative cell therapy

Bone Marrow and Fat Cell PRP Therapy

 

 

Regenerative Cell Therapy is the “Ferrari of Healing.” This therapy delivers regenerative cells directly to the injured site and healing starts at the time of injection. It is the best treatment for arthritic joint pain from cartilage loss.

Autologous regenerative cell injection therapy utilizes the patient's own bone marrow, fat or placenta tissues. All are rich sources of regenerative cells. These cells are collected, filtered, centrifuged and injected into the injured areas. This method, promises to be particularly advantageous in treating advanced arthritis, severely degenerated tendons, ligaments, cartilage, spinal discs and chronic fractures. Science is showing that the tissue regenerative potential of mesenchymal regenerative cells (MSRs) may be the most important weapon in offering patients with degenerative arthritis a real non-surgical solution to REBUILDING damaged tissue that was previously thought irreparable.

It is given together with Platelet Rich Plasma (PRP). A small amount of blood is taken from your veins in the elbow (like giving blood for lab work). The blood is then placed in a centrifuge which spins and automatically creates the PRP. The entire process takes 40 minutes and increases the concentration of platelets and growth factors to decrease inflammation and stimulate cell repair. PRP is injected into the damaged area with either the fat or bone marrow regenerative cells. Together this super regenerative cell “soup” stimulates repair in the tendon, ligament, joint, and cartilage, causing mild inflammation that triggers the healing cascade. As a result, new collagen begins to develop. As this collagen matures, it begins to shrink and causes the tightening and strengthening of the tendons or ligaments of the damaged area.

Autologous regenerative cells can be harvested from the patient’s own fat tissue or from the bone marrow of the crest of the hip bone. During this procedure, a small volume of the patient's bone marrow is extracted from their iliac crest near the base of the spine, then placed in a centrifuge and spun at a high rate of speed to separate the mesenchymal regenerative cells from other blood cells. The concentrated bone marrow is then injected with PRP into the targeted joint or tendon.

The fat regenerative cell is harvested by liposuction from the hip or lateral thighs. A total of 3 oz of fat is harvested, centrifuged, separated, and injected with Platelet Rich Plasma into the injured tissues. Typically the tissues that are targeted for stimulation to repair are articular cartilage but can be soft tissues structures such as ligaments and tendons.

Another regenerative cell therapy is placenta/ amniotic tissue. Placenta-derived stem cell comes from consenting donors and is processed at an FDA regulated lab. It is checked for all sorts of diseases prior to being accepted for use in others. Placenta /Amniotic stem cell injections offer the ability to heal damaged tissue naturally. The tissue regeneration and repair properties of the amniotic cell fluid are an anti-inflammatory effect that relieves pain and contains natural growth factors that assist in healthy tissue growth. Moreover, the hyaluronic acid that is also in amniotic fluid is an important component of the joint fluid that helps cartilage growth. Amniotic fluid is also a great source of regenerative cells, found in a much higher concentration than the adult bone marrow. And just like when one uses their own stem cells, the use of amniotic fluid doesn’t cause rejection or allergic reaction when injected into a patient. The placenta tissue is mixed with PRP and injected into the treatment areas.

It is important to understand that regenerative cells by themselves are unable to repair the injured area. These cells have to be properly directed, and the platelets perform the intended function. In effect, regenerative cells are construction workers and the platelets are their supervisors. Once they are activated, these regenerative cells perform a variety of valuable functions. Apart from repairing damage to the injured areas, regenerative cells help damaged cells repair themselves and participate in the repairing process. Regenerative Cell Therapy is a repair process that takes at least 4 weeks to months to complete.

Generally, the repair process takes three months to complete, but in most cases, improvement can be noticed by 2-4 weeks. About four to six weeks after the regenerative cell therapy, the patient receives a platelet-rich plasma injection into the affected area. These injections enable the regenerative cells to continue growth and multiply into cartilage tissue. Your healing and pain-free recovery time depend on what cells are used for your condition.

Dr. Truong will determine which regenerative cell therapy (bone, fat, placenta, PRP) is best for your condition. For moderate to severe arthritis, combination therapy of at least 3 or 4 tissues are used to treat your condition. Each treatment protocol is customized to your injury and recovery process.

There are various conditions that can affect the progress of regenerative cell therapy—some positively, others negatively. Patients undergoing regenerative cell therapy or platelet rich plasma treatments are advised to minimize intake of alcohol and tobacco, as consumption of these substances tends to impede the body’s ability to release stem cells. Conversely, some supplements increase the number of regenerative cells. These will be recommended to you by our office.
 


PLATELET-RICH PLASMA

Platelet-Rich Plasma stimulates bone, muscle and soft tissue healing. It is another treatment option in the event of a failed cortisone injection or other therapies. Sports injuries, arthritic joints (knee, shoulder, hips, ankle, foot), tennis elbow, rotator cuff tears, low back pain, plantar fasciitis and all may be effectively treated with PRP. It is a natural approach to healing ligament, tendon and joint injuries. The procedure is less aggressive and less expensive than surgery. It allows your body to heal itself using its own natural resource, your blood. PRP will heal tissue with minimal or no scarring and prevent further degeneration of the tissues. Essentially, the doctor put the good part of your blood (PRP) to help it heal. Without PRP the tissue continues to degrade or progress to complete tear, or in the case of joint arthritis, progression to the bone on bone stage. Recovery time from PRP is minimal, with a quicker return to work and exercise.

To prepare Platelet-Rich Plasma, a small amount of blood is taken from the patient. The blood is then placed in a centrifuge which spins and automatically creates the PRP. The entire process takes 40 minutes and increases the concentration of platelets and growth factors to decrease inflammation and stimulate cell repair. When PRP is injected into the damaged area, it stimulates the tendon, ligament, joint, and cartilage, causing mild inflammation that triggers the healing cascade. As a result, new collagen begins to develop. As this collagen matures, it begins to shrink and causes the tightening and strengthening of the tendons or ligaments of the damaged area.

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Research and clinical data show that PRP injections are safe with minimal risk of adverse reaction or complication. Studies have shown that cortisone injections may actually weaken tissue. Cortisone shots may provide temporary relief and stop inflammation, but may not provide long-term healing. Thus, pain may reoccur within months. PRP is delivered to the tissue in its inactivated form. The collagen in connective tissue activates the platelets, which then release their cytokines and growth factors (the good stuff). The regenerative cells then become cartilage, ligament, tendon or muscle cells as needed at the injury site.

At the same time, local inflammation is downgraded. Without this help, in a typical knee with osteoarthritis, it takes approximately five years from symptom onset to knee replacement, necessary when the cartilage is gone and the knee joint is bone on bone. The desired end result of PRP therapy is functional repair of an injured tendon, muscle or joint cartilage allowing it to bear greater mechanical stress during activity without pain. Patients can see a significant improvement in symptoms. This may eliminate the need for more aggressive treatments such as long term medication or surgery, as well as remarkable return of function. There are no side effects, as PRP comes from your own body to stimulate you to heal, but in a faster and concentrated way. You will start feeling less pain week 2-4 weeks, with maximum recovery by 12 weeks. The healing is permanent or until your body balance is more inflammatory than anti-inflammation.

While responses to treatment will vary, most people will require from one to three treatments. There is no limit to the number of treatments you can have if the treatments are spaced appropriately. The risks and side effects do not change with the number of injections.
 


PROLOTHERAPY

Benefits of Regenerative Prolotherapy

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Prolotherapy is a regenerative injection treatment used to stimulate the healing mechanism to repair damaged or injured areas in the spine and joints. Prolotherapy is considered a viable alternative to surgery and as an option to pain medications and anti-inflammatory injections such as cortisone and other steroids.

Treatment with Prolotherapy

Prolotherapy involves the treatment of two specific kinds of tissue: tendons and ligaments. Tendons attach muscles to bones and enable movement of the joints. Ligaments connect bones and create the stability of the joints. A strain is defined as a stretched or injured tendon; a sprain, a stretched or injure ligament. Once these structures are injured, the immune system is stimulated to repair the injured area. Because ligaments and tendons generally have a poor blood supply, incomplete healing is common after injury. This incomplete healing results in these normally taut, strong bands of fibrous or connective tissue to become relaxed and weak. The relaxed and inefficient ligament or tendon then becomes the source of chronic pain and weakness.

The greatest stresses to ligaments and tendons occur where they attach to bone, the fibro-osseous junction. The most sensitive structures that produce pain are the periosteum (covering of the bone) and the ligaments. It is important to note that in the scale of pain sensitivity (which part of the body hurts more when injured), the periosteum ranks first, followed by ligaments, tendons, fascia (the connective tissue that surrounds muscle), and finally muscle. Cartilage contains no sensory nerve endings.

If you are told that your cartilage is the cause of your pain, you have been misinformed; the cartilage cannot hurt because it does not contain any pain-sensing nerves. If there is cartilage damage, the ligaments are typically the structures that hurt. Ligaments are weakest where they attach to bone. The periosteum is the most sensitive area to pain and the ligaments second. It is in these specific painful areas where Prolotherapy injections are administered to eliminate the chronic pain of many conditions including arthritis, mechanical low back pain, degenerative disc disease, cartilage damage, and sports injuries.

Prolotherapy works by exactly the same process that the human body naturally uses to stimulate the body’s healing system, a process called inflammation. The technique involves the injection of a proliferant (a mild irritant solution) that causes an inflammatory response which “turns on” the healing process. The growth of new ligament and tendon tissue is then stimulated. The ligaments and tendons produced after Prolotherapy appear much the same as normal tissues, except that they are thicker, stronger, and contain fibers of varying thickness, testifying to the new and ongoing creation of tissue.

The number of injections varies based on the condition and the patient’s presentation.
 


PLACENTA/AMNIOTIC REGENERATIVE CELL THERAPY

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As research and science evolved over time, studies have shown that amniotic and placenta (stem) cells can have a revolutionary effect on the human recovery process.

Regenerative (Stem) cells are the basic components (cells) of our human body. One of their most amazing characteristics is that they can become almost any type of cell, from muscle to bone or skin cell.

Amniotic cells are obtained from the amniotic fluid, which is produced during a caesarean birth. During pregnancy, the amniotic fluid protects the fetus, and it feeds it with the necessary supplements needed to sustain life and development. A while back, this fluid was normally discarded, but once researchers got to understand its amazing therapeutic benefits, now it’s collected and stored because of its high concentration of pluripotent stem cells.

Amniotic derived stem cell fluid comes from consenting donors and is processed at an FDA regulated lab. It is checked for all sorts of diseases prior to being accepted for use in others.

Although stem cells have been used for decades, regenerative therapy is fairly new. Following the use of amniotic stem cell injections, more evidence reveals exciting results in muscle repair and pain relief which have made amniotic stem cells possibly the Holy Grail in treatment.

Amniotic stem cell injections offer the ability to heal damaged tissue naturally. The tissue regeneration and repair properties of the amniotic cell fluid are an anti-inflammatory effect that relieves pain and contains natural growth factors that assist in healthy tissue growth. Moreover, the hyaluronic acid that is also in amniotic fluid is an important component of the joint fluid that helps cartilage growth. Amniotic fluid is also a great source of regenerative cells, found in a much higher concentration than the adult bone marrow. And just like when one uses their own stem cells, the use of amniotic fluid doesn’t cause rejection or allergic reaction when injected into a patient.

Amniotic stem cell injections have been getting more attention since they have been openly used by prominent athletes with impressive results and even a few saved careers! The ability to safely and effectively treat painful and debilitating injuries and conditions of the knees, elbows, shoulders, ankles and the foot without lengthy rehabilitation or recovery time isn’t just appealing to professional athletes, but to anyone who wants relief from pain and to return to their favorite activities in about 4-6 weeks. Dr. Truong will determine which regenerative cell (fat, bone marrow, Platelet Rich Plasma, amniotic/placenta) will be appropriate for your condition. This is a customized treatment protocol designed for your body and activity level.

Amniotic cell injections work well for the following indications:

  • Tendonitis
  • Ligament Injury
  • Arthritis
  • Sports Related Injuries
  • Cartilage Defects

Schedule your consultation today.