Regenerative Medicine:

Ortho-Biologics

Orthopaedics East offers natural non-surgical healing therapy for orthopedic injuries and arthritis that can cause pain and disability. Our goal is to help you get back to your everyday, whether it’s work or play.

Overview

Allowing the body to heal itself can take a long time, and surgery is not always the best option. Regenerative orthopedics uses the latest in science and technology to stimulate and accelerate the healing process. Depending on your age, health, and the severity of your condition, we offer stem cell therapy, also known as bone marrow concentrate (BMC), platelet-rich plasma (PRP) therapy, amniotic injection therapy, cortisone injections, viscosupplementation and physical therapy, to get you back to being active.

What Is Ortho-Biologics?

Ortho-biologics is an emerging treatment modality consisting of therapies that use the body’s own tissue and cells to help heal and regenerate. Treatments like platelet-rich plasma (PRP) and stem cell therapy, also known as bone marrow concentrate (BMC), are used commonly in the field of medicine for healing and regenerative treatment therapies.

 

Our practice has physicians specially trained in these treatments as a well as amniotic injection therapy, cortisone injections and viscosupplementation.

 

These therapies are often performed as a same-day, office-based procedure with minimal downtime. Although success may ultimately depend on the site and severity of the injury as well as understanding there is no cure for arthritis, we can often improve pain and function tremendously for years.

 

Benefits of Regenerative Orthopedics:

  • Long-term joint pain relief
  • Faster recovery time
  • Reduced time away from athletic or daily activities
  • Improved function
  • Diminished pain
  • Improved healing potential

Common Areas of Treatment:

  • Ankle
  • Elbow
  • Foot
  • Hip
  • Shoulder

Treatment Guidelines

Conditions That Can be Treated or Supported with Ortho-Biologics
  • Soft tissue injuries such as muscle, tendon and ligament injuries
  • Degenerative conditions such as arthritis and tendinitis
  • Fractures that have not healed properly or fully (nonunion and malunion)
  • Issues with poor tissue or bone quality
  • Chronic nonhealing conditions
Factors That Do Not Affect Outcome
  • Body Mass Index (BMI)
  • Gender
  • Mild or Controlled Diabetes
  • Use of Immunosuppressive Medications
Factors That Can Reduce the Effectiveness of Ortho-Biologics
  • Smoking
  • Diabetes (especially uncontrolled diabetes)
  • Immuno-compromised conditions
  • Having a cortisone injection within six weeks
  • NSAIDs
Contraindications or Cautions with Using Ortho-Biologics
  • Anemia
  • Low platelet count
  • Abnormal platelet function diseases
  • Ongoing or recurrent infections
  • Undergoing cancer treatment
  • Are pregnant or breastfeeding

More Information

PRP vs. BMC

PRP contains platelets and growth factors believed to improve the body’s own healing process. BMC contains stem cells that are thought to provide a regenerative process. BMC also contains a percentage of platelets, almost like a “PRP plus” injection.

Choosing which injection is right for you will be a decision between you and your doctor, based on your individual case. There are many factors to consider, including the condition being treated, medical history, current literature, and physician experience, which will help determine which treatment might provide the best outcome.

Platelet-Rich Plasma Injections (PRP)

Blood is composed of several parts, including red blood cells, white blood cells, and platelets. Each of these parts serves an important role. Red blood cells primarily carry oxygen. White blood cells are involved with the body’s immune system by fighting infections. Platelets have their own unique role.

For decades, scientists have known that platelets have many purposes in the body. The most commonly understood function is their role in clotting blood after injuries, but platelets also carry  various chemicals known as growth factors. These growth factors have been studied for more than 20 years, because they signal the body to start the healing process. Scientists have discovered how to get certain other cells to respond to the growth factors by growing, remodeling, or healing. Naturally, scientists and physicians involved have wanted to see how the growth factors in platelets could be harnessed to help people heal. Studies performed to isolate and concentrate an individual’s platelets for injection into injuries and other degenerative sites have been very telling. Early research shows successful treatment of tendon and ligament injuries, as well as even typical arthritis of joints, using concentrated platelet-rich plasma injections.

The Process:

  • For most patients, these procedures are relatively simple and well tolerated. Blood is drawn from a vein like any other blood laboratory test. That blood is separated into concentrated platelets using a special machine called a centrifuge. The centrifuge increases the concentration of platelets three to 10 times what they would be in blood alone. Other components of blood are also removed, although sometimes the white blood cells are left within the concentrate to play other roles in healing.

Is it Painful?

  • Pain is generally minimal. Local anesthetic techniques can be used on the skin. However, anesthetics are known to deactivate or decrease platelet activities, so clinicians purposely avoid putting them in the same place as the platelets. The final site of injection may have no or minimal pain.

One Injection or Multiple Injections?

  • This will be up to you and your physician. Some patients respond very well to just one treatment; however, 2-3 treatments may be necessary in some patients. Based on your responses, you and your physician will decide the appropriate medical course of action. Injections may be spaced several weeks apart.
Stem Cell Injections (Bone Marrow Concentrate)

One of the most promising breakthroughs in non-surgical treatments for arthritis and tendinopathies (tendonitis) is stem cells. Bone marrow and adipose tissue (fat cells) contain mesenchymal stem cells, otherwise known as stem cells. Stem cells have regenerative properties that can assist in healing your body in the most natural way.

Stem cells have the ability to become other cells in the body and can differentiate into a variety of cell types, including osteoblasts (bone cells), chondrocytes (cartilage cells), myocytes (muscle cells) and adipocytes (fat cells), which are regenerative in nature. Current research is looking at how these stem cells can delay progression of arthritis or possibly repair the body using its own natural response to damage. Since the cells can be harvested from your own body, they represent a natural way of healing.

Stem cell therapy has been recognized by the medical industry as one of the biggest breakthroughs in natural healing. When stem cells are injected into an area that needs healing, your body’s natural response is to accelerate the process and repair the damage. It is a non-surgical procedure that involves the removal and then injection of your own naturally occurring stem cells. We concentrate stem cells from bone marrow, or we use your own fat (adipose) tissue to harvest the stem cells.

The Process:

  • The procedure for most patients is well tolerated. This non-surgical procedure involves first extracting the bone marrow or adipose tissue to harvest the stem cells. The cells are then concentrated and prepared with specialized devices to remove any unneeded components and allow for optimal effect of the stem cells. The naturally occurring cells are then ready for injection into a joint, tendon, or bursa to assist healing.

Is It Painful?

  • Pain is usually minimal and generally well tolerated. Local anesthetic techniques are used on the skin. However, anesthetics are known to deactivate some components, so clinicians have to purposely avoid putting them in certain areas. The final site of injection typically has minimal pain.

What Happens Afterward?

  • Stem cell injections are designed to restart the healing process. Part of that process is restarting inflammatory actions. Therefore, most patients are sore for two to three days following the procedure. This can be a sign that the procedure is working. Icing for 10-minute periods, once per hour, may decrease soreness. Over-the-counter pain medicines like Tylenol can be used for patients who do not have contraindications to that medication. In rare cases, the provider will prescribe other pain medicines.
  • Most patients need to take two to three days away from any strenuous activity involving the area of the body where the procedure is performed.
  • Rehabilitation exercises may be prescribed to start a few days after the injection. This may be done at home or formally with a physical therapist.
Is PRP or BMC Right for Me?

If traditional therapies have not provided relief, then PRP or BMC therapy may be the solution. The procedures are less aggressive and less expensive than surgery. We have provided the following clinical reference sites if you wish to review more research supporting PRP therapy.

What Is the Cost?

Because PRP and BMC therapy are not approved by most insurance companies, Orthopaedics East only offers these treatments as self-pay options. Payment will be required before the procedure is scheduled. Our staff will not file a claim with your insurance company. We do hope in the future that third-party payers will begin providing this treatment as a covered service.

What Do I Do Before the PRP Injection or BMC Procedure?

Patients should avoid nonsteroidal anti-inflammatories (NSAIDs) for seven days before the procedure. It is believed that these medications can decrease the effect of the healing process that we are trying to stimulate.

In most cases, patients can drive themselves to and from the procedure. Plans may need to be made to avoid strenuous activities for a few days following the procedure.

  • STOP the following medications:
  • ALL NSAIDs and corticosteroids seven days prior to the injection. This includes Motrin, Advil, Aleve, naproxen, or prescription NSAIDs such as Mobic, diclofenac, Celebrex, etc.
  • Aspirin 14 days prior to the injection.
  • Anticoagulants – 14 days prior to the injection; must have clearance from your cardiologist prior to stopping. This includes Coumadin, Plavix, Eliquis, Pradaxa, etc.
  • Drink plenty of fluids to make sure you are well hydrated for the blood draw and/or procedure. Eat prior to the procedure when performed in the office and not part of a surgical procedure. Wear comfortable clothing.
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