For problems where just an injection in the office won’t be enough, we can still harness the power of PRP or stem cells to try to improve surgical results. Here is a picture from a recent mensicus repair surgery where we are using PRP to try to get the entire torn meniscus to heal after being surgically repaired.
Another example of the pseudo-science in stem cells. Despite their website, The Lung Institute cannot get stem cells for treatment from peripheral blood….none of us humans can! The second problem? Using stem cells from any source (whether autologous or allograft) has been deemed a non-homologous use by the FDA as of November 2017 …..meaning that in order to do that a clinic or doctor has to have approval from the FDA to make and use an Investigational Drug on Humans. (IND/BLA) So if the Lung Institute does not have an approved IND/BLA with the FDA, they could be sent a Warning Letter to stop treating people with an unapproved drug. Hopefully the FDA has seen this web site!!
This patient is now 2.5 years out from a single in office injection of bone marrow derived stem cells. He has done fantastic and wants another in office procedure. He has happy to have avoided or at least significantly delayed a knee replacement surgery…which is what he had been told he needed.
The guy in the middle has a total knee replacement on one knee and has done very well from it…..14 years out…no problems…done by an expert joint replacement surgeon (not me). With the left knee, he failed to get symptom relief with medications and steroid shots (couple rounds) and viscosupplementation. He is now a golfer and ex pro baseball player and front row Lakers fan in this picture from the Staples Center last night.
This patient has a 50% tear of the supraspinatus tendon. He was treated with a single ultrasound guided injection of autologous bone marrow derived stem cells from a posterior iliac crest marrow aspiration done in the office under local anesthesia.
We had a nice evening last night at the Winewood restaurant sponsored by Konica Minolta and Emcyte. MSK ultrasound gives the clinician the ability to see soft tissues and joints in real time. I think it is a great diagnostic tool and many times can replace MRI scans so we can make an instant diagnosis for patients. Saves people time and money! If we decide to use Platelet Rich Plasma or bone marrow derived Stem Cells, then we use ultrasound to make sure we are putting these expensive biologic injections exactly where they need to go.
Currently, I am at the 2018 Interventional Orthopedic Foundation meeting which is a multidisciplinary collection of clinicians interested in advanced the field of interventional orthopedics and in the science and application of orthobiologics. One of my faculty assignments was to discuss the many reasons why centrifuging and concentrating bone marrow aspirate makes good clinical sense when compared to just using bone marrow aspirate alone as a treatment. Below is a summary of my talking points!
Another example of the scam stem cell clinics in action. In this case, a chiropractor James Briggs presented himself as “Dr. Briggs” and charged this poor woman $5000 for a scam injection that was not even a real stem cell injection. This DC had already lost his license in one state and it was suspended in another state AND he had been arrested for Medicare fraud. Please do your homework….come see us for an honest eval and procedures that don’t violate current FDA rules and regulations.
Dr. Joel Singer is a plastic surgeon affiliated with the Cell Surgical Network, who has publicly announced he has treated NFL player(s) with IV adipose tissue for concussions or other neurologic disorders. According to the FDA guidelines, adipose tissue digested to make SVF or made into smaller adipose tissue pieces broken down by mechanical disruption is a biologic drug. Biologic drugs need to be registered and go thru a well defined and expensive and time consuming FDA process BEFORE being approved for human use. Dr. Singer doesn’t have an Investigational Drug License or a BLA on file with the FDA so apparently, according to the FDA…he is using and promoting an unapproved biologic drug.
The Dallas PRP and Stem Cell Center has now enrolled 16 patients in a study to determine if an office based bone marrow derived stem cell injection can help a partial thickness rotator cuff tendon heal. The study is expected to enroll a total of 25 patients who will be followed for 1 year after the stem cell treatment.
