Stem Cell Therapy
Orthobiologics have created a renaissance in the treatment of orthopedic conditions, using procedures designed to enhance what the body does naturally… heal itself. The term refers to the use of naturally occurring biological substances that allow for regeneration of cells in our body to replace old and damaged ones. When used for orthopedic healing of bones, ligaments, tendons and cartilage, their use is referred to as "orthobiologics." The use of naturally occurring biologics in treatment of musculoskeletal conditions is an emerging field, but evidence of their success is mounting at an accelerated rate. Research that examines the biological mechanisms of cellular health and tissue regeneration is extensive, particularly the role of platelets, stem cells, and natural growth factors in the blood.
Stem Cells are present in all of us, acting like a repair system for the body. They are sometimes referred to as “master cells” in that they have the potential to become many different specialized cell types. Stem cells exist in tissue for localized use and divide throughout our lifetime to created the supply needed for normal cell replacement. With increased age or chronic injury, often the optimal amount of stem cells is not available. Healing of musculoskeletal injury requires that our bodies are able to supply the necessary healing units, much like an Emergency Response Team, with each unit doing its job in turn. “Dynamic Equilibrium” exists when cell degeneration is in equal ratio to cells available for regeneration. Injury, arthritis and poor cellular health disrupt this homeostasis. Adequate cells for repair are unable to keep pace with healing requirements. When this demand outpaces the supply, the body needs a little help.
Research has shown that therapy using mesenchymal stem cells (MSCs) is an especially good option for treating musculoskeletal conditions involving lost or damaged tissue. Concentrated stem cells, nutrients, and growth factors are injected into the site of injury to amplify the natural repair system, helping the body keep pace with demands to maintain healthy function of musculoskeletal tissue.
Stem Cell Therapy involves harvesting healthy cells from bone marrow, including stem cells, growth factors, and nutrients, and precisely relocating them to the injured area. Injured tissues begin to heal through increased regeneration of new cells.
Stem cells, one of several healing factors contained in the concentrate harvested from your body, help change the microenvironment of the injured tissue by activating a healing cascade:
- Promote anti-inflammation
- Induce cell proliferation
- Enhance the process of angiogenesis, the body’s natural formation of new blood vessels to help maintain supply of nutrients and removal of wastes.
- Trigger stem cell migration from other parts of the body
Orthobiologic treatments and their use in regenerative medicine hold almost infinite possibilities for curative treatments. Scientific advances in the understanding of how the body actually heals through tissue regeneration, combined with rapid developments in stem cell biology, have truly created a renaissance in medical treatment.
If you have an injury, or if you have tendons or ligaments that have become inflamed, stem cell therapy may help. It uses your body's own stem cells to help heal damage. It may help you avoid surgery.
Leader in orthobiologic treatment for musculoskeletal conditions
Dr. Minotti began performing Orthobiologic Therapy in 2007 and has treated hundreds of patients with amazing success. 86% of his patients have found significant relief from pain and restoration of musculoskeletal function. The use of orthobiologics in treatment of musculoskeletal conditions is an emerging field with evidence of its success accelerating rapidly. Research examining the complex biological mechanisms of cellular health and tissue regeneration is extensive, particularly the behavior of platelets, stem cells, immune system cells and natural growth factors in the blood. The clinical application of Regenerative Orthopedics has demonstrated promising results and a high safety profile.
Dr. Minotti is Board Certified and specialty trained in Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine by the American Board of Neuromusculoskeletal Medicine. He holds numerous certificates from the Interventional Orthopedics Foundation and is completing Interventional and Regenerative Orthopedic Medicine Certification (IROM-C) from the American Academy of Orthopedic Medicine and the Orthohealing Method.
Many scientists believe the concept of intrinsic healing is a new frontier. Medicine is changing. The wonders of the human body and its ability to balance and heal itself are at the center of this medical renaissance.
Applications
- Osteoarthritis. Traditional treatment has primarily been to mask the pain with drugs (eg, NSAIDS or cortisone) or other treatments. Cell-based therapy distributes to damaged tissue the cells naturally used by the body to regenerate or re-grow tissue, reducing further damage and accelerating healing. In many cases, cell-based therapy can prevent the need for replacement surgery.
- Ligament and tendon injuries. Damage to these tissues is generally difficult to treat as they have poor blood flow, which is apparent from their white color. Muscles, on the other hand, are red because they have a very good blood supply. The lack of adequate blood flow makes ligaments and tendons prone to incomplete healing from injury.
- Muscle tears. Muscle tissue heals more quickly and thoroughly when regrowth of tissue is enhanced with bone marrow aspirate concentrate, BMAC, injected into the injury. Acceleration of healing helps to prevent further tissue damage caused through natural use of the muscle.
- Osteoarthritis
- Degenerative joint disease
- Spine arthritis
- Meniscus tears
- Tendon tears
- Back pain
- Labrum tears
- Hamstring strains
- Ligament sprains, strains, and tears
- Tennis and golfers elbow
- Plantar fasciitis
- SI joint problems
- Tendon pain on thumb side of wrist (De Quervains Tenosynovitis)
Scientific advances in the understanding of how the body actually heals through tissue regeneration, combined with rapid developments in stem cell biology, have truly created a renaissance in medical treatment. Stem cells, like other medical products that are intended to treat, cure or prevent disease, require U.S. Food and Drug Administration (FDA) approval before they can be marketed. At this time, only cells harvested from the patient’s own body and that are only minimally manipulated have been approved by the FDA.
Live stem cells are allowed by the FDA under guidelines in Sections 361 and 351 of Public Health Service Act that establishes regulatory requirements for marketing biologics and human cells, tissues, and cellular and tissue-based products. Additionally, devices that allow physicians to minimally manipulate blood, bone marrow and adipose tissue for the treatment of orthopedic conditions also require FDA approval. NTXMSK recognizes and welcomes the FDA’s important role in assuring patient safety. All of our treatment protocols are compliant with the published FDA guidelines regarding the use of human cells, tissues, and cellular or tissue-based products.
BMAC: Procedure Snapshot
Bone marrow–derived MSC therapy, BMAC. First, a local anesthetic is applied to numb the area of extraction. The bone marrow is extracted from the back of the patient's pelvis or hip bone using a special needle developed for bone marrow extraction. The collected marrow is filtered and spun in a centrifuge to separate the platelets and stem cells to produce the bone marrow aspirate concentrate (BMAC). The cells are not altered with additives or manipulated.
The BMAC is then injected back into the patient's site of injury guided by ultrasound where MSCs are able to differentiate into all the different cell types within a joint and moderate the local inflammatory response. This same-day treatment takes about 1-2 hours. Typically 1 treatment, often with platelet-rich plasma given during the treatment or at follow-up, is sufficient.