Prolotherapy

Stem Cells and Orthobiologics

Small RhombusPersonalized Stem Cell and Orthobiologic injections for each patient.

Stem Cells and Orthobiologics

Scottsdale Regenerative Medicine & Wellness provides personalized Stem Cell and Orthobiologic injections for each patient. In the practice of Orthopedics, Orthobiologics is defined as substances that can facilitate the healing of cartilage, bone, muscle, tendon, ligament and nerve.

Because each of us are different, so are the recommendations for your individual pain condition. Recommendations will be made on a case by case basis dependent upon your own specific condition. One or more Orthobiologic types of treatments may be recommended. There is a strong synergy or supportive benefit to combing more than one Orthobiologic treatment. Because “one size does not fit all” your recommendation will be made to your specific condition. Also, realize that ONE treatment does not mean than is all you will need. Dependent upon the severity of the condition, some patients need more than one Orthobiologic treatment.

Common Conditions Treated with Stem Cells and Orthobiologics

  • Achilles Tear
  • Achilles Tendonitis
  • Ankle Pain & Arthritis
  • Ankle Sprains
  • Cartilage Damage
  • Cervical Radiculitis
  • Elbow Pain & Arthritis
  • Elbow Pain
  • Elbow Tendonitis
  • Foot Pain & Arthritis
  • Golfer’s Elbow
  • Tendonitis
  • Thoracic Pain
  • Hand Pain & Arthritis
  • Hip Arthritis
  • Hip Pain
  • Joint Laxity and Instability
  • Knee Pain & Arthritis
  • Knee Ligament Injuries
  • Knee Tendonitis
  • Ligament Tear
  • Low Back Pain
  • Neck Pain
  • Patellar Tendonitis
  • Tennis Elbow
  • Wrist Pain & Arthritis
  • Pelvic pain
  • Plantar Fasciitis
  • Rotator Cuff Tears
  • Rotator Cuff Tendonitis
  • Sacroiliac Joint Pain
  • Sciatica
  • Shoulder Pain & Arthritis
  • Spinal Disc Problems
  • Sprains & Strains
  • Other Conditions Not Listed

Stem Cells (BMAC)

Mesenchymal Stem Cells
Mesenchymal Stem Cells

Scottsdale Pain Rehabilitation & Wellness utilizes the patient’s own adult mesenchymal stem cells from the patient’s bone marrow for the treatment of orthopedic and degenerative musculoskeletal conditions. This is called bone marrow aspirate concentrate or BMAC. Mesenchymal stem cells are specialized cells in the body that have the ability to turn into many different kinds of cells:

 

Mesenchymal Stem Cells are extracted from the bone marrow of the iliac crest and have the ability to mature into different cell types:

Bone Marrow Mesenchymal Stem Cells

Mesenchymal stem cells promote healing and regeneration by secreting growth factors and molecules that reduce inflammation.

Ultrasound Guidance for Stem Cells
Ultrasound Guidance for Stem Cells From the Iliac Crest of the Pelvis

Site Selection
Mesenchymal stem cells (MSC’s) are gathered as a sterile procedure with ultrasound guidance from the patient’s iliac crest (pelvis) utilizing a local anesthetic so the patient experiences the least amount of discomfort. Studies have shown that Bone Marrow mesenchymal stem cells have a higher ability to form cartilage than adipose tissue mesenchymal stem cells and they have been studied more extensively than adipose stem cells.1 By using your own stem cells, there is no risk of rejection or disease transmission.

Age Related Stem Cells
According to a 2007 stem cell study, the authors conclude “irrespective of age and OA etiology, sufficient numbers of MSC’s can be isolated and that these cells possess an adequate chondrogenic differentiation potential. Therefore, a therapeutic application of MSC’s for cartilage regeneration of OA lesions seems feasible.” 2

Bone Marrow Stem Cells with PRP
Studies have shown benefits when Platelet Rich Plasma is combined with Bone Marrow Stem Cells. BMAC -PRP combination provided enhanced mechanical benefits when treating the shoulder.3 Another study showed the combined benefits of BMAC and PRP treatments for knee osteoarthritis (OA) for “positive effects on pain, functional status and quality of life”.4

Video: BMAC Patient Testimonial

Bone Marrow Mesenchymal Stem Cells:

  • May be used alone or with other orthobiologics such as PRP and amniotic tissue allograft.
  • Can offer significant pain reduction with minimal to no down time helping patients to avoid surgery.
  • Are independent of age or osteoarthritis
  • Are the patient’s own stem cells.
  • May need to be performed more than once.

Bone Marrow Stem Cell Therapy For The Knee Pain


References:
  1. Burke, John; Hunter, Monte; Kolhe, Ravindra; et. al, Therapeutic potential of mesenchymal stem cell based therapy for osteoarthritis, Clin Transl Med, 2016; 5: 27
  2. Reference: Scharstuhl Alwin, Schewe Bernhardt, Benz Karin, et al, Chondrogenic Potential of Human Adult Mesenchymal Stem Cells is Independent of Age or Osteoarthritis Etiology, Stem Cells, 2007;25:3244-3251
  3. Kim SJ, Song DH, Park JW, et al, Effect of Bone Marrow Aspirate Concentrate-Platelet Rich Plasma on Tendon-Derived Stem Cells and Rotator Cuff Tendon Tear, Cell Transplant, 2017, May 867-878.
  4. Subasi Volkan, Ekiz Timur, Bone Marrow concentrate and platelet-rich plasma in the treatment of knee osteoarthritis: a report of 3 case, complementary Therapies in Clinical Practice, Volume 34, February 2019, Pages 113-115.

Amniotic Tissue Allograft

The amniotic tissue is the innermost layer of the placenta. It has unique properties that make it useful for the treatment of painful musculoskeletal conditions. Amnion Tissue Allograft is a regenerative fluid that promotes regeneration and reduces pain. The different components include growth factors and cytokines that

  • Stimulate tissue remodeling
  • Stimulate blood vessel formation
  • Reduce inflammation
  • Stimulate antimicrobial activity
  • Stimulate cell growth/formation
Amniotic Tissue Vial
Amniotic Tissue: growth factors, cytokines, amino acids, carbohydrates, hyaluronic acid

The proteins in amniotic tissue may be used individually or in combination with other Orthobiologics to promote regeneration, reduce pain and provide a structural matrix for Bone Marrow Aspirate Concentrate (BMAC) and/or Platelet Rich Plasma (PRP). These proteins act as an anchor for the patient’s own cells and offers a scaffold for tissue reconstruction.

Advantages of Amniotic Tissue Allograft:

  • Noninvasive harvesting procedure needed
  • Immune Privileged with No Adverse Reactions
  • Contents found in Amnion-derived fluid are found naturally in the body
  • High growth factor production

The amniotic tissue allograft used by Scottsdale Pain Rehabilitation and Wellness is processed in accordance with all FDA guidelines and quality assurance measures in a controlled environment. All tissue products undergo strict safety screening and microbiological studies. This tissue is injected in and around a painful and degenerative joint to support and strengthen ligaments, tendons and cartilage.

It is controversial whether Amniotic fluid or tissue products contain living mesenchymal stem cell after the tissue has been commercially prepared. In a 2019 issue of The American Journal of Sports Medicine, the authors evaluated seven commercial companies that provide amniotic fluid stating “MCS’s could not be identified in the commercial AFPs (amniotic fluid preparation) or the unprocessed amniotic fluid. This study was unable to confirm that commercial AFP’s contain MSC’s”. 1

Reference:
  1. Panero Alberto, Hirahara Alan, Andersen Wyatt, et al, Are Amniotic Fluid Products Stem Cell Therapies? A Study of Amniotic fluid Preparations for Mesenchymal Stem Cells With Bone Marrow Comparison, The American Journal of Sports Medicine, March 2019.

Amniotic Tissue products do not appear to contain living mesenchymal stem cells; however, they do contain the components of these cells that promote regeneration and reduce musculoskeletal pain.

Alpha-2-Macroglobulin (A2M)

Alpha-2-Macroglobulin A2M

Alpha-2-Macroglobulin (A2M) is protein found in relatively high concentration in your own blood plasma. A2M is used in the treatment of osteoarthritis (OA) to reduce pain and inflammation, block the breakdown of cartilage when treating painful joints. A2M attaches to and removes the destructive enzymes, proteases, that damage cartilage cells and tissues in the joint or disc space.

Clinical studies have shown positive results in treating a variety of different musculoskeletal areas in the body including plantar fasciitis, shoulder conditions, knee OA, hip OA, lumbar discs, elbow pain, ankle OA and wrist OA. A2M is gathered in the same manner that Platelet Rich Plasma is gathered with extra filtering and concentrating. Once the serum is separated from the platelets it is filtered to obtain a yellow fluid rich In A2M.

Collection Procedure for Alpha-2-Macroglobulin
Collection Procedure for Alpha-2-Macroglobulin

This concentrated solution is then injected in or around the painful joint. A2M may be used as a single treatment or combined with PRP to reduce pain and promote healing regeneration.

Advantages of Alpha-2-Macroglobulin (A2M):

  • Reduces inflammation and pain
  • Prevents further breakdown of tissue
  • Restores joint health
  • Can be combined with PRP
  • Safe and noninvasive procedure

A2M is a new and exciting approach for the treatment of osteoarthritis and painful joint. This new treatment provides an alternative to traditional orthopedic approaches including different drugs and surgery that can have ineffective and sometimes dangerous side effects.

What Can I Expect?

Because “one size does not fit all” your recommendation will be made to your specific condition. Also, realize that ONE treatment does not mean than is all you will need. Dependent upon the severity of the condition, some patients need more than one Orthobiologic treatment.

An “achy” soreness may be felt at the site of injury, just a few hours following the injection. This “soreness” is a positive sign that the healing response has been set in motion. This effect can last for several days and gradually decreases as healing and tissue repair occurs. Most patients will begin to see improvement approximately 1 to 2 months after treatment has been completed. Increased stability and strength are typically reported along with the decrease in pain. Recovery time and outcome will be dependent upon the structure treated and how chronic the problem. It may take 6-9 months for full regeneration to take place and more than one stem cell or orthobiologic procedure may be needed.

Of course, there is also the possibility that there will be no change in to pain pattern of the area treated.

Ultrasound Guided Injections

Ultrasound Image of the Shoulder
Ultrasound Image of the Shoulder

Stem cell and Orthobiologic regenerative joint injections may be performed with ultrasound guidance. This allows for exact visual identification of the treatment area, placement of the solution and diagnosis of the underlying structures such as tendons, ligaments and cartilage.

Regenerative Joint and Tissue IV

Dr. Fred Arnold receiving a Regenerative Joint & Tissue IV
Dr. Fred Arnold receiving a Regenerative Joint & Tissue IV

This intravenous therapy (IV) is a specialized intravenous mixture of vitamins, minerals and amino acids to maximize the effects of Stem cell and all regenerative medicine injections. This specialized IV promotes the healing and regeneration of damaged and weakened tissues such as ligament, tendon and cartilage. With intravenous nutrition, the nutrients are delivered directly into the blood stream rather than being absorbed by the intestines. The time to complete the Prolo-PRP IV is 2 hours.



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