Adult Stem Cells For Tissue Regeneration

Fibromyalgia and Stem Cells - How to get from here to there

Dan Busse MD — Tue, 30 Sep 2008 09:36:22 +0000

A fascinating new article, just published in the journal “Arthritis and Rheumatism” shows what our joint preservation clinic at the Centeno-Schultz Clinic and Regenerative Sciences have known for a while - that there is a definite relationship between pain and degeneration of one (or more) parts of the body, and the central nervous sysetm (your spinal cord).

To put the cart before the horse in this article, I’ll start with my conclusion:
Stem Cells as an alternative to traditional orthopedic surgeries, for conditions such as knee osteoarthritis, knee meniscus tears, hip arthritis and lumbar disc herniations, are likely an important step in treating fibromyalgia

In this study, it was chemically prooven that arthritis of a joint causes chemicals of inflammation (interluken 1B) to travel up nerves from the joint to the spinal cord. There, they inflame structures in the back and “crosstalk” with nerves nearby, causing regional back pain as well. What’s more, back pain and inflammation travels down nerves to joints and muscles causing pain there as well.

This has profound implications for fibromyalgia. Fibromyalgia is poorly understood by the medical community and ofter written off as some sort of psychiatric problem. Providers, and often the lay public have a hard time understanding that one person can have chronic pain in so many places.

Our Joint perservation perspective, now strengthened by this new research article, is that some sort of injury in the past, even a relatively minor one, resulted in inflammation which fed on itself and spread to multiple joints and places in the body.

So where do stem cells come in to play? As an alternative to knee surgery, hip surgery, and shoulder surgery - to name but a few examples, stem cells facilitate a re-growth of tissue in a minimally invasive manner. When a particular pain generator is treated, inflammation decreases. Both in the treated area, as well as areas upstream or downstream from the nerves connected to that area. In conjunction with other treatments- like IMS and physicial therapy, a person’s Fibromyalgia can be treated with stem cells .

Prolotherapy and Stem Cells

Dan Busse MD — Sat, 27 Sep 2008 18:27:34 +0000

As I have commented on before, joint pain is almost always multifactorial. While there may be arthritis or cartilage loss, such as knee meniscus tears, these problems are often worsened by, or even blamed for pain caused by muscle and tendon/ligament problems.

An example that came through our Stem Cell treatment clinic recently illustrates this:

A 46 year old male with painful cartilage loss and meniscus tears on his knee MRI. When time was taken to examine him, his leg muscles had trigger points, which we treated with IMS. His lateral collateral ligament (LCL) was also tender. This was treated with prolotherapy injection. Prolotherapy involves injecting an injured ligament or tendon with a substance that triggers inflammation. The patient’s painful ligament has a chronic low level of inflammation that causes pain, but does not heal the problem. The increased inflammation from the prolo “tips the scales”, so to speak, and causes the body to trigger it’s healing mechanism.

Our patient returned three weeks after prolo with a significant decrease in his outer knee pain. The stem cell injections he’ll receive as an alternative to knee meniscus surgery, will have a significantly better chance to heal his cartilage defects as a result.

Arthroscopic Knee Surgery Alternative - Part Two

Dan Busse MD — Wed, 24 Sep 2008 15:11:41 +0000

The concept of arthroscopic knee surgery to “clean up” loose tissue in order to reduce knee pain had come into question as early as 2002, when a New England Journal of Medicine article found that people who had arthroscopic surgery did not have less pain or more movement than people who underwent a “fake” knee procedure. As you can imagine, this was very controversial and never accepted by the surgical community.

A recent article published in the New England Journal shows again that “Arthroscopic surgery for osteoarthritis of the knee provides no additional benefit to optimized physical and medical therapy. (ClinicalTrials.gov number, NCT00158431 [ClinicalTrials.gov] .) ^“

An MSNBC article and Video nicely capture the essence of their conclusions.

As another blow to the arthroscopic knee surgery, another New England Journal study was just published showing that up to 60% of people who had meniscus tears on their MRI actually had NO KNEE PAIN. Of those with arthritis and knee pain, 63% had meniscal tears. It stands to reason, then, that many people who have knee pain, and get an MRI showing a meniscus tear, will have, and have had, unnecessary and ineffective arthroscopic knee surgery to repair that painless tear. These people may have had a multitude of non-surgical causes for their pain.

That is why, at Regenerative Sciences, we approach knee pain form the perspective of Joint Preservation. This means that MRI images are only a part of whole picture. Muscles near the painful joint, as well as in other parts of the body, are treated to reduce stress on the joint and minimize pain prior to performing the Regenexx procedure

Arthroscopic Knee Surgery Alternative - a Dr. Schultz reprint

Dan Busse MD — Wed, 24 Sep 2008 14:28:46 +0000

My colleague, Dr. John Schultz, recently posted a succinct blog on a culprit causing knee pain that may have you referred for a surgery. It’s such a good article, that I thought I’d re-print it here.

Knee pain can arise from many sources: osteoarthritis, torn ligaments, excessive wear of the cartilage and improper tracking of the knee cap due to muscle imbalance. All too often an x-ray is taken which demonstrates osteoarthritis and the patient is scheduled for knee arthroscopic surgery.

There are other causes of knee pain which need to be evaluated which include the bursa. Bursa are saclike structures between skin and bone or between tendons, ligaments, and bone. They are lined by synovial tissue, which produces fluid that lubricates and reduces friction between these structures. Bursitis occurs when the synovial lining becomes thickened and produces excessive fluid, leading to localized swelling and pain.

A very common cause of anterior knee pain is inflammation of the pes anserine bursa.

Pes anserine bursitis presents as pain, tenderness and swelling over the anteromedial aspect of the knee, 4 to 5 cm below the joint line. Pain typically increases with flexion of the knee and climbing of stairs.

The pes anserine bursa lies behind the medial hamstring, which is composed of the tendons of the sartorius, gracilis and semitendinosus (SGT) muscles. Because these 3 tendons splay out on the anterior aspect of the tibia and give the appearance of the foot of a goose, pes anserine bursitis is also known as goosefoot bursitis.

Treatment consists of decreasing the muscle tension of the affected muscles through IMS and possible prolotherapy both available at the Centeno-Schultz Clinic.

So the next time you are scheduled for knee arthroscopic surgery, knee ligament surgery or arthroscopic meniscus surgery, please make sure that the cause of your pain is not an inflammed bursa which can be easily treated without arthroscopic knee surgery.

Alternative to Knee Surgery

Dan Busse MD — Wed, 10 Sep 2008 21:57:42 +0000

“nothing heals like cold steel” and “to cut is to cure” says an orthopedist friend of mine.

One of the most common knee surgery procedures is Arthroscopic debridement. This involves inserting a camera and tools through several holes in your knee in order to “clean up” frayed and/or loose tissue.

To me, this makes little sense. Does frayed cartilage cause pain? No. Trimming the edges makes things look pretty on camera. But does removing this protective, joint fluid secreting tissue make people better. A study out of Canada says no

This speaks volumes about the fact that the future of knee treatment is the regeneration of tissue. Stem cell transplant has been shown to be an effective way to grow cartilage in meniscus and articular cartilage as an alternative to knee surgery

Avascular Necrosis

Dan Busse MD — Wed, 10 Sep 2008 14:03:02 +0000

Avascular Necrosis (AVN) is a condition where a joint does not get the blood supply it needs and, as a result forms bone cysts. It is estimated that doctors see about 10,000-20,000 new cases of osteonecrosis each year. Unfortunately this is treated by hip replacement surgery. This is a painful procedure with prolonged recovery time. The hip prostheses have limited lifespans, and as AVN is primarily a disease of the young, often requires a revision surgery.

An alternative to hip surgery for AVN is stem cell transplant. This eliminates the need for pain after hip surgery and hip surgery recovery. At Regenerative Sciences in Colorado, they are transplanting autologous mesenchymal stem cells as a treatment alternative to AVN

Back Surgery for a Herniated Disc

Dan Busse MD — Wed, 10 Sep 2008 09:27:09 +0000

“If you’re a hammer, everything looks like a nail”
This is common saying in the healthcare profession that today has become so specialized that practitioners do not often look beyond their own specialized knowledge base for diagnosis and treatment. As a result, going to see a particular type of specialist often sends you down a particular treatment pathway.

One common example of this is treatment of a lumbar disc herniation. As a disc degenerates, the soft inner gel in the disc can leak back into the spinal canal. This is known as disc herniation, or herniated disc. Once inside the spinal canal, the herniated disc material then puts pressure on the nerve, causing pain to radiate down the nerve leading to sciatica or leg pain (from a herniated disc in the lumbar or lower back) or arm pain (from a herniated disc in the neck).

Far and away, the recommended treatment for this is surgery. This can mean removal of the entire disc and fusing the backbones (discectomy and fusion) or trimming away part of the disc (micro discectomy). Either way, the process can be painful, involve a significant recovery period, and result in other problems later. It also makes little sense to trim away the supporting fibers of a disc, when this further weakens it and sets it up for further herniation.
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As the video below illustrates, autologous mesenchymal stem cells are a promising alternative to back surgery for a herniated disc

Microfracture For Knee Cartilage Repair

Dan Busse MD — Tue, 09 Sep 2008 21:14:55 +0000

Microfracture surgery is designed to be an alternative to knee replacement surgery in patients with knee cartilage loss.

Autologous mesenchymal stem cells, in recent years, have been shown to be more effective in cartilage repair for the type of knee injuries treated with microfracture.

Mesenchymal Stem Cells for Cartilage Repair

Dan Busse MD — Fri, 05 Sep 2008 07:04:16 +0000

In previous posts, I’ve refered to the use of autologous mesenchymal stem cells for the repair of cartilage and ligament tssue by Regenerative Sciences Inc out of Colorado. Here is a good Wikipedia entry that explains the science behind this new treatment as an alternative to traditional orthopedic surgery.
http://en.wikipedia.org/wiki/Autologous_Mesenchymal_Stem_Cell_Transplant_for_Cartilage_Growth

Thumb Surgery

Dan Busse MD — Mon, 01 Sep 2008 22:26:10 +0000

I’m thinking of renaming this blog “complaints of the over forty”.
In addition to knee pain, hip pain, shoulder pain and back pain, there’s now “Blackberry Thumb“. This is the common term for a condition called CMC arthritis. As our opposable thumbs are what separates us from the apes, we use them quite often in both fine and gross motor/ weight bearing motions. As a result, pain in this jont can affect us profoundly.

Unfortunately, there’s not a lot that can be done about this condition. One alternative, that doesn’t make much sense is a tendon graft surgery . Click on the link to read more about it.

One alternative to thumb surgery is autologous mesenchymal stem cell transplant into the CMC joint. There are several videos that can attest to the effectiveness of this procedure in relieving pain from thumb arthritis.