A few months ago I wrote about a revolutionary new technique that we developed at our center. We called this Artho-Lavage. Please refer to my initial blog concerning lavage. The word Artho-Lavage has both Greek and French origins. Artho is a Greek derived word which means joint. Lavage is a French derived word which means to wash or clean. So essentially we have a cleansing of the joint. I know a number of copycats physicians out there will try to do the same but good luck! They may be able to "wash" the joint out. However, they will not be able to decipher which growth factors were utilized to disable the "bad' growth factors in the joint. Even if they were to get the list of ingredients it is a proprietary blend. It is not only what they are but also very specific ratios. We will probably make this blend available to certain select doctors in the future.
The other intriguing aspect of what we have accomplished is the production of Lubricin. This happened serendipitously. We noticed that the fluid in the lavage seemed to have a property that a it had a lubricant in it. This confirmed what the patients have been saying. Not only is their pain much better but their knee feels much looser and they do not get a grinding sensation. The results were as if we injected the knee with a type of hyaluronic acid.
The results we have have obtained have been excellent. This process has worked on every patient. We find after lavage essentially every patient has relief of pain. The lavage period is usually between 5 and 10 minutes. The fluid is than removed. A few weeks ago I was helping to teach a course in Campinas, Brazil with my good friend Dr. Lana. I hold Dr. Lana in the highest esteem for his knowledge of musculoskeletal regenerative medicine. Before I left Brazil I gave Dr. Lana some of the mixture to perform the Artho-Lavage. Dr. Lana than did some interesting work. He looked at patients before the lavage and after the lavage. He studied these patients with a technique called thermograms. Thermograms look for changes in the heat pattern of the body. Typically the more inflamed the area the more intense the color. Reds and oranges will represent areas of intense inflammation. It is very similar to looking at thunder storms on weather radar. The more intense the red or yellow color the stronger the storm or in this case inflammation is.
The above picture, we see a thermogram of a knees. We can tell from these pictures that knees are very inflamed do to the preponderance of yellows and reds. This would typically be a patient who is symptomatic do to the arthritis of his knees. What was done was an Artho-Lavage. The following pictures are post lavage.
The two above pictures represent thermograms that were performed in the same knees post lavage. We have replaced the reds and yellows (representing inflammation) with blues and greens. The inflammation has been dramatically reduce. With the reduction in inflammation there is a dramatic reduction in pain. This is fairly good evidence of the effectiveness of Artho-Lavage.
By significantly reducing the inflammation we have achieved a few goals. We have made the stem cell environment (niche) much more friendly to the stem cells and hopefully have dramatically increased their survival. So far our results are extremely positive. Time will tell but we have made this part of our standard protocol. Our next goal is to achieve the same results with tendons. That seems to be just around the corner. Thanks Dr. P
Cytokine Therapy Is New Alternative to Knee Surgery
BOCA RATON, FL--(Marketwired - June 21, 2016) - Long-term member of the Boca Raton Resort and Club, Mitch Gould, CEO of Nutritional Products International (NPI) and InHealth Media, is a tennis enthusiast and competitor in many sports. He injured his knee/meniscus last November in a friendly hitting session with tennis legend Jimmy Connors, winner of 109 singles titles, at the resort. During the session Gould injured his meniscus.
Gould who is familiar with sports injuries has lifted with Mr. Olympia Ronnie Coleman, a partner with Gould in their online venture Ronniecolemannutrition.com, suffered an umbilical hernia during a workout session prior to the session. Gould underwent surgery to correct the tear and after months of rehabilitation got back on the courts.
"I know that a tear in the knee/meniscus to a tennis player can be detrimental because it disables your ability to move around the court and I was worried I might not be able to play again," Gould said about the injury. "After the match my knee began hurting worse, deteriorating so I went to see my good friend and NPI and InHealth Media Board Member Dr. Joseph Purita."
Dr. Purita has treated several famous athletes including MLB Pitcher Bartolo Colón. His interests beyond traditional practice led him to acquire a degree in anti-aging medicine. He is a pioneer in the use of Stem Cell, Cytokine and PRP therapy for orthopedic conditions and a world-renowned authority on anti-aging medicine and the use of nutritional supplements. He has lectured world wide on the use of supplementation in wellness, anti-aging and orthopedic capacities. Most recently Dr. Purita gave Mr. Gould's injured knee a treatment of Cytokine Therapy.
"After a series of shots, a lot of yelling and six weeks of healing I truly feel like a new man," said Gould. "The procedure is incredible. I never thought I would feel this good. Another month of physical therapy and it's time to hit the courts again."
Cytokines is a technical term for growth factors. Cytokines -- from the Greek cyto- ("cell") and kinos ("movement") -- are tiny cell-signaling protein molecules secreted by various cells. Growth factors are signaling molecules that are typically secreted at the site of repair by many different cell types including platelets, stem cells and fibroblasts. These growth factors bind to the cell membrane and start the cascade of DNA synthesis, mitosis and cell repair, essentially repairing the injury without surgery.
There are some marriages that are made in heaven and this may be one of them. Iontophoresis is a technique of introducing ionic medical compounds into the body through the skin by applying a local electrical current. The above picture is a model of how Iontophoresis works. Essentially, Iontophoresis makes like charges repeal each other and opposites attract. The patches have both a positive and negative electrode. The negative drug ions are repelled from the negatively charged electrode. The direct current moves ions from the drug electrode down deep into the area of injury. Iontophoresis has been around for some time but Regenerative Medicine may be giving it a rebirth. Typically, it has been used in sports injuries to give cortisone to an area of injury. We know all too well that cortisone (steroid) does not heal anything. However, it does occasionally have its place. The intriguing aspects of Iontophoresis is the fact that it has the ability to deliver needed substances to "where the action is".
We have done some testing and have demonstrated that the materials do indeed penetrate to the depths of the joint. This can be seen by the following X-ray pictures. The picture on the left shows an arrow pointing to an X-ray dye that has just been added to the patch. We see left photo the dye is at the skin line. In the picture on the right the dye has penetrated down to the bone after several hour hours.
So far nothing is that revolutionary. But now comes the intriguing part. We can now utilize cytokines in a method which was available to only a handful of physicians. We can deliver them right to the joint, ligament or tendon where they are needed.
Cytokines are signaling molecules that mediate a cellular response. My dear friend and colleague, Dr. JO Serrentino, founder of Cytokine Therapy, puts it nicely: "Cytokines tell cells where to go and what to do. Often in a disease state there is an imbalance at the cellular level. Cytokines can help promote healing and repair, addressing the root cause". This technology is now available and it is called CT BIONICS PATCH SYSTEMS. The CT stands for Cytokine Therapy. We need to realize that stem cell therapy is essentially cytokine therapy. In scientific circles we know that stem cells are biochemical factories which produce many different growth factors of which cytokines are one very important type.
Most of the conditions in the musculoskeletal field and for that matter most everything in medicine deal with an imbalance of cytokines. Imagine if we were able to add cytokines to the patches and then deliver these cytokines to the areas that they are needed in. These areas include arthritic joints, areas of tendonitis, bursitis, muscle injuries and the list goes on and on. This is where the magic starts happening. We are now able to deliver the cytokines exactly to where they are needed. We have had the privilege of actually doing this via an injectable route for some time.
I suspect that the Iontophoresis will deliver the cytokines in a more uniform fashion than a painful needle injection. We have proprietary formulas for the cytokines mixtures. These formulas will be specific to specific conditions. For instance we have protocols designed for tennis elbow, osteoarthritis of shoulders, hips, knees, and the lumbar spine. We are aware that certain bad cytokines are present in the joints and at the same time they cause swelling, pain and inflammation. These are called the master inflammatory cytokines. The main inflammatory cytokines are called Interleukin-1, interleukin-6, and Tumor Necrosis Factor (TNF). Various combinations of the "good" cytokines will be used in the patches. They will essentially disable these master inflammatory cytokines. Some of these good cytokines are called Interleukin-1 antagonist, Interleukin-10, and a number of others. The combinations and ratios of the cytokines are all important! They vary from one condition to the other. They are very specific in composition and ratios.
The other important aspect of CT Bionics Patch Therapy is the proper placement of the patches. I myself was surprised by the placement of some of the patches. Their placement seems to follow the lines of the science of Kinesiology. Kinesiology is the scientific study of human or non-human body movement. Kinesiology addresses physiological, biomechanical, and psychological mechanisms. Applications of kinesiology to human health include biomechanics and orthopedics; strength and conditioning; sport psychology; methods of rehabilitation, such as physical and occupational therapy, and sport and exercise.
Studies of human and animal motion include measures from motion tracking systems, electrophysiology of muscle and brain activity, various methods for monitoring physiological function, and other behavioral and cognitive research techniques. Kinesiology as described above should not be confused with applied kinesiology, a controversial medical diagnostic method. Using Dr. Jo's expertise she has given us ideas based on Kinesiology where to position the patches.
As we can see the use of the patches involves a number of factors. The type of disease process determines the composition and ratio of the cytokine growth factors. The condition also determines position and the type of patch used. Some patches will be used for 4 hours while other will be used overnight. Like many things in the Regenerative Medicine Field, a marriage of technologies many times produce some remarkable results. I feel certain the CT Bionics Patch System will fill this niche. We are now able to precisely deliver factors where they are needed when they are needed. Eventually we will allow certain physicians and other health professionals the ability to use these patches. This is a technology that is too important to keep under wraps.