Search Results for: regenerative medicine treatment ankle joint

Thought regenerating tissue was just for salamanders? It turns out that humans can regenerate certain tissues faster than others too.

A study authored by Duke researchers found that humans have the ability to regenerate cartilage in certain joints, though some are faster than others. These findings could potentially lead to new treatments for osteoarthritis, one of the worlds most common diseases.

The study, which included research going back more than a decade, outlined the discovery of an age gradient for different types of cartilage in humans. The researchers examined protein modifications and discovered that ankle cartilage had a higher rate of production than cartilage in the knees or hips.

That was a big surprise because most people think that all cartilage is the samesame proteins, same everything, said Professor of Medicine Virginia Kraus, the senior author of the study. We expected to be able to see a different turnover of different proteins, but the fact that it was changing by location, that was really surprising.

To contextualize these findings, Kraus and Ming-Feng Hsueh, a medical instructor in the department of orthopedic surgery and the studys lead author, went back millions of years to the evolution of a small lizard-like amphibian: the salamander. Salamanders are noteworthy in the animal kingdom due to their ability to completely regenerate lost limbsan ability that is shared by only a few other animals, such as zebrafish.

A study published in 2016 found that salamanders, zebrafish and another limb-regenerating type of freshwater fishall of which were separated by millions of years of evolutionhad essentially the same mechanisms for joint repair.

These mechanisms worked more effectively in repairing the parts of limbs that were closer to the torso compared to those that were farther away. This was a direct parallel to humans seemingly being able to repair cartilage in ankles much faster and more easily than in hips.

To Kraus and Hsueh, this signified that these regeneration mechanisms could be the same ones present in humans. This hypothesis was further bolstered by reports of children who could regenerate the distal parts of their fingertips. However, researchers dont know why or how this ability is turned off.

Limb regeneration is highly complex, Kraus said. Just looking back at [salamanders and zebrafish] with a fresh eye and trying to say, What is it about that process that we either share or we dont share? is how maybe we might be able to gain insights into what is lacking [in humans].

In fact, they found that this innate regenerative capability likely does exist in people.

From our study, we think that humans still have the ability [to regenerate limbs] or at least repair them to some level, Hsueh said. We think that the key factors to doing this are either missing or insufficient in humans. Our strategy for the future is to try to find the key factors that humans do not have enough of.

The factors that regulate the process of joint repair are known as microRNA. Hsueh explained that the answer to increasing repairability in joints afflicted by osteoarthritis is locating the microRNA that is in high abundance in ankles and increasing its level in other joints, such as the hip.

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However, beyond increasing the amount of beneficial microRNA, Kraus and Hseuh also noted that it is necessary to identify and turn off bad microRNA, which may inhibit collagen production and thus aggravate osteoarthritis. Just like every other system in the body, joint repair is about balance.

This study may lead to new ways of treating osteoarthritis, which occurs when the cartilage at the ends of bones wears down. It can cause severe joint pain, swelling and stiffness, and currently affects an estimated 27 million Americans as of 2018.

Kraus said that unlike rheumatoid arthritis, which has treatments to prevent the disease as well as put it into remission, there are currently no existing effective treatments for osteoarthritis.

Contrary to popular belief, osteoarthritis isnt just a geriatric disease.

We know that 50% of people who get an anterior cruciate ligament tear will get osteoarthritis at a young age. So any time I watch the Duke basketball team and somebody goes down, Im like this is terrible, Kraus said. They have a one in two chance of developing osteoarthritis in just a few years.

Kraus and Hsuehs short-term goal is to help boost cartilage repair in patients with osteoarthritis, sports injuries and amputated limbs. In the long term, they hope to eradicate osteoarthritis entirely.

I think [in 50 years] well be in an enviable position in the way rheumatoid arthritis is thought of now, Kraus said. I think therell be early identification, well have really robust treatments, [and] joint replacements will be rare. I think well treat joint injuries very seriously the way heart attacks are treatedimmediately, with something really effective.

The researchers said funding is the biggest problem going forward. Most of the support for the study came from the National Institutes of Health, but according to Hsueh, who has been working on the study since he was a graduate student, obtaining grants is constantly an uphill battle.

Its breaking new ground and its really hard to get old thinking to change, Kraus said. Its a hard sell.

Kraus and Hsueh believe there is much work that can be done outside the field of rheumatology and orthopedics to contribute to these advancements, including collaborating with developmental scientists, experts in salamanders and specialists in regenerative medicine.

By putting the right brains together so that theres more crosstalk, that would really facilitate the advancements, Kraus said. Thats the future.

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Regeneration race: Cartilage regrows faster in some joints than others - Duke Chronicle

To treat certain orthopaedic conditions, Tucson Orthopaedic Institute is now providing regenerative medicine procedures, including dextrose prolotherapy, platelet-rich plasma (PRP), and mesenchymal stem cell (MSC) injections. Our physicians have experience in both traditional and minimally invasive techniques.

Dextrose prolotherapy is a form of injection therapy designed to stimulate healing. It works by causing temporary, low grade inflammation that increases the level of growth factors at the injection sight and initiates a healing cascade. This healing cascade results in the repair of soft tissue structures, such as ligaments and tendons.Dextrose prolotherapy is a long-term solution to musculoskeletal injuries and pain. It is effective in ligament and tendon pathology and also helps to stabilize arthritic joints. For prolotherapy treatment, please schedule an appointment with Dr. Taduran.

Platelet Rich Plasma (PRP), like dextrose prolotherapy, is a form of injection therapy designed to stimulate healing.Unlike dextrose prolotherapy, PRP is produced after drawing blood from the patient and placing it in a special centrifuge that separates and concentrates the platelets.Platelets contain multiple growth factors that are critical for natural healing.Enhanced healing occurs when platelet concentration is increased with PRP.Our final PRP product produces greater than 4x the platelet concentration of normal circulating blood.The PRP is then injected into ligaments, tendons, muscle, or joints and a healing cascade occurs.PRP is a long-term solution to musculoskeletal injuries and pain, including arthritic joints. For PRP treatment, please schedule an appointment with Dr. DeWald or Dr. Taduran.

The Uniqueness of Stem CellsStem Cells have several unique abilities. They can transform into other cell types, such as bone, cartilage, muscle and tendon. And they also serve an important signaling functioning, recruiting other stem cells to the target area and triggering nearby cells to begin the repair process.

What are Adult Mesenchymal Stem Cells?

Stem Cellsare undifferentiated cells that have the potential to become other, more specialized types of cells. Stem cells are broadly categorized as either embryonic or adult. As the name implies, embryonic stem cells are derived from human fetuses, whereas adult stem cells are obtained from, well, adults!

Currently, there are over 70 proven therapies using adult stem cells, while there are none using embryonic stem cells. This is in part because scientists have had tremendous difficulty controlling how embryonic stem cells differentiate; they have a nasty habit of causing tumor formation, including teratomas. Adult stem cells, on the other hand, do not suffer from this pitfall.

Mesenchymal stem cells, orMSCs, aremultipotentstem cells that can differentiate into a variety of cell types, including:osteoblasts(bone cells),chondrocytes(cartilage cells) andadipocytes(fat cells). This has been demonstrated inex vivocultures andin vitroor in vivo. MSCs are obtained from the bone marrow, most commonly the back of the iliac crest (the hip bone)

How Are MSCs Obtained?

Harvesting MSCs for injection therapy is done right in the office. Stem cells can beobtained from the bone marrow or fat tissue. The skin is numbed first with lidocaine. Next, the hip bone is numbed with more lidocaine. A special needle is then passed through the cortex of the bone into the marrow cavity. This is a painless procedure in most cases. The liquid marrow is then very slowly drawn into a syringe. Once an adequate amount of liquid marrow is obtained, the needle is removed and a bandage applied.

To see a brief animated video of how the procedure is performed, click this here.The entire procedure takes about 20 minutesand it is minimally uncomfortable.

Fat Grafting

In the case of moderate-to-large tendon and muscle tears, such as rotator cuff, tennis elbow, and Achilles, stem cell treatment alone may be less effective because the liquid stem cell solution has less tendency to stay in the tear; it leaks out. In order to combat this, we often will combine stem cells with fat concentrate to create a gel that fills the defect and promotes more effective healing.

Likewise with more advanced joint arthritis, the fat acts a matrix to help hold the platelets in place and also helps activate them to release their growth factors more effectively. Think of a garden trellis that helps hold a growing vine in place. In fact, for moderate-to-advanced arthritis, our standard treatment is to combine the stem cell solution with the fat due to the fact that it seems to work that much better than stem cells alone.

The fat is harvested from the patients belly, buttocks, love handles, or hips using a gentle liposuction technique. The fat is processed while you wait to help liberate the stem cells and other supporting cells in the fat. The resulting gel fills the tear in the case of tendons/muscles and helps maintain more constant contact with the joint surfaces in the case of arthritis. An overview can be seen here.

How Are Stem Cell Injections Given?

All of our stem cell, PRP, and prolotherapy injections are given under direct ultrasound guidance. We first numb the skin with lidocaine. Then, using ultrasound, we guide the needle to the precise location and inject the stem cells. The ultrasound guidance ensures both accurate and safe injections.

Following injection, for weight-bearing joints (ankles/feet, knees, hip) patients need to avoid bearing weight for 24-72 hours. But it is critical that the joint NOT be immobilized. Gentle protected movement is critical to stimulate healing. For non-weight bearing joints, gentle protected movement is generally encouraged, but forceful or aggressive activity, such as sports, is prohibited. Your doctor will give you more specific post-injection activity guidelines.

What Conditions Might Benefit From Stem Cell Injections?

Stem cell injections are most commonly used for the treatment of conditions that have failed or responded incompletely to other more conservative treatments. Conditions include, but are not limited to:

Osteoarthritis of the joints

Chronic partial Rotator Cuff Tears

Persistent partial tendon tears, such as tennis elbow, plantar fasciitis, quadriceps and patellar tendon tears.

Partial muscle tears

Meniscal and labral (cartilage) tears in the knee, hip and shoulder

Chondromalacia patella (patellofemoral syndrome)

Are There Risks Associated With Stem Cell Treatment?

Any injection is potentially at-risk for causing infection, bleeding, nerve damage. Risks will also vary depending on the structure(s) being injected. However, because we are using your own cells, you cannot be allergic to the treatment! Also, because the injections are done under ultrasound guidance, the risks of damaging surrounding structures, or of injecting the wrong location, are almost completely eliminated. Your doctor will review the complete risks of treatment with you. Nonetheless, the risks of treatment are extremely low.

Are Stem Cell Treatments Covered by Insurance?

Currently stem cell injections are still considered experimental. Most insurance plans, including Medicare, do NOT pay for stem cell injections.

When Can I Expect to See Improvement?

On average, most patients start to see signs of improvement approximately 6-8 weeks after the completion of the complete treatment protocol. This can be less overall pain, an ability to do more activity before pain sets in, and/or faster recovery from pain.

What is the Success Rate?

Studies suggest an improvement rate as high as 80-90%, though some arthritic joints, namely the hip, do not respond as well. Some patients experience complete relief of their pain. In the case of tendon and ligament injuries the results are generally permanent. In the case of joint arthritis, how long the treatment lasts depends partly on the severity of the condition. Mild arthritis may not need another round of treatments. More advanced arthritis, on the other hand, may require a repeat course of treatment, usually in 1-3 years.

The anecdotal experience in our office closely mirrors that of published studies. Regarding arthritis, our experience is that knees and shoulders respond the best, with 80-90% of patients experiencing improvement. 70% of patients with hip arthritis have a positive response.

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Regenerative Medicine - Tucson Orthopaedic Institute

The Future of Medicine is Here!

Nothing is more painful and debilitating than persistent knee, hip or shoulder pain. Your shoulders, hips, and knees are a support system made up of ligaments, bone, fluid, and cartilage. These tendons and muscles work in harmony to make the shoulder, hip and knee joints move.

Unfortunately, any damage to the ligaments, cartilage or bone by way of injury or disease (such as osteoarthritis), can cause severe pain and difficulty walking or partaking in your favorite activities.

To help you return to the activities that you love, our professional team atTriad Regenerative Medicine now offers Allografts containing Stem Cells as a Regenerative Therapy, based on a 21st-century therapeutic procedures to help alleviate your shoulder, hip, and knee pain without relying on complex surgical procedures or medication.

An Allograft containing Stem Cells is one of the most effective treatments available today to help in the regeneration of tendon injuries, ligament damage, and osteoarthritis. This procedure is non-invasive and harnesses your bodys natural healing potential to combat shoulder, hip and knee problems. The whole procedure takes approximately one hour and has no known adverse side effects. The new cells will stimulate existing healthy cells and tissues to operate at a higher level of function, boosting the bodys repair mechanisms to aid in the healing process. These highly adaptive cells then remain in the body, continually locating and repairing any damage they encounter.

Using an Allograft containing Stem Cells is one of the safest and most advanced approaches to treating a wide variety of injuries and diseases within the human body.

Patients recovering from injuries will rapidly improve exhibiting a greater mobility and less pain, compared to the lengthy and exhaustive period of post-surgical healing and rehabilitation.

Regenerative Cellular Medicine has opened the door to medical advancements. We have only just begun to explore the amazing benefits. Praised notes of success thus far include the reduction or elimination of pain, increased strength and mobility, and quicker healing and recovery.

At Triad Regenerative Medicine, we look forward to providing our community with the highest quality of healthcare with cutting-edge technology. With the use of Allografts containing Stem Cells, our team has helped many of our patients at Triad Regenerative Medicine heal partial tears of the rotator cuff, biceps tendinosis, shoulder sprains, lateral and medial epicondylitis, patellar tendinosis, meniscal tears, Osgood-Schlatters, ankle sprain, Achilles tendinosis, plantar fasciitis, and osteoarthritis. If you or a loved one are suffering and would like to get back the quality of life you enjoy, call today and schedule that first meaningful consultation.

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Triad Regenerative Medicine - Greensboro, NC

Regenexxprovides various regenerative medicine options that facilitate healing, without surgical intervention. Dr. Henry Stiene (non-spine) and Dr. John Brannan (treatment of the spine) are the exclusive providers ofRegenexxtreatments in the Tri-State Area.

Beacon Orthopaedics currently has seven physicians that provide regenerative medicine for patients. These are non-invasive or minimally invasive options that can help patients heal faster without surgery. A popular regenerative medicine option is PRP (platelet rich plasma) therapy. PRP Therapy utilizes a patients own blood to rebuild and heal a damaged tendon or cartilage in the body. This type of regenerative therapy can help relieve pain in the affected area and also jump starts the healing process.PRP is most commonly used to treat patients with osteoarthritis in the hip, knee or shoulder. Patients seeking regenerative medicine for chronic tendonitis in the ankle or elbow often choose PRP treatments as well. More conservative methods of treatment are typically attempted first, such as rest, medication, physical therapy, etc., but when those methods fail, PRP is often a good solution.

Stem cells therapy is increasing in popularity. As with other forms of regenerative medicine, stem cell treatments can fix joint, tendon, or other pains without surgery.Stem cells are basic human cells that have the capability of creating new cells in the body. When applied to regenerative medicine, this means they can be used to create new healthy bone, tissue, etc. Stem cell procedures are now being used in orthopedics, often to treat bone fractures, healing ligaments or tendons, regenerating articular cartilage in arthritic joints, and replacing degenerative vertebral disks.

Prolotherapy (short for proliferant therapy) is a regenerative treatment used to treat pain arising from joints, tendons, ligaments, muscles, and the connective tissue that holds these structures together. Pain from these structures may be due to injury, overuse, normal wear and tear (degeneration) and nerve injury or irritation.

Prolotherapy uses solutions such as concentrated dextrose that produce a minor injury or inflammation to these structures. Connective tissue such as ligaments and tendon have a very poor blood supply and this severely limits the ability of these tissues to heal themselves as living tissue needs a healthy blood supply to maintain nourishment and repair itself.

Perineural InjectionTherapy (PIT) is a proven safe, effective treatment for patients who may not be goodcandidates for joint replacement surgery or biologic options such as stem cell injections or PRP. Perineural injections are used for treating inflamed and injured nerves causing chronic pain. This pain is often due to trauma, arthritis, sports, overuse, occupational, and surgical injuries. For additional information, please click here.

*Dr. Henry Stiene and Dr. John Brannan are the exclusiveRegenexx providers in the Greater Cincinnati Area. To schedule a consultation with either physician, please call (513) 354-3700.

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Regenerative Medicine - Beacon Orthopaedics & Sports Medicine