Ask the Experts
Stem Cell Therapy
How does Institute of Regenerative Medicine differ from other facilities performing stem cell and PRP injections?
The Institute of Regenerative Medicine is very different from most all of the entities out there that are performing Regenerative Medicine treatments. We are taking a multifaceted approach in our treatment of the patient. Our differences start from the very beginning.
We are one of the few stem cell facilities in the world that is staffed by seasoned board certified orthopedic surgeons. Who can better handle orthopedic problems than a surgeon who is specifically trained to handle these problems from many different approaches? Seeing the anatomy first hand in an operating room setting is invaluable in knowing the anatomy and how to provide Regenerative Medicine treatments. If you have a Regenerative Medicine doctor who states he is an orthopedist ask him if he is board certified in Orthopedic Surgery. There are times when we can wear two hats and combine aspects of Orthopedics and Regenerative Medicine. Obviously, what sets us apart from other orthopedic practices is the fact that we also offer the use of Stem Cells and Platelet Rich Plasma (PRP) therapy as an alternative to formal surgery. We have strived to combine the latest technology to achieve the best result for our patients. We are constantly looking for ways to improve our outcomes rather than sitting on our past accomplishments.
In addition to having orthopedic surgeons on staff, we also utilize the latest techniques for imaging a problem such as fluoroscopy or ultrasound imaging. We are also one of only a few Regenerative Medicine practices nationwide that utilizes a flow cytometer to analyze the Stem Cells.
Our Methods are Simple but at the Same Time is Cutting Edge
One of the main tenants of Regenerative Medicine is the following:
At the Institute of Regenerative Medicine we will utilize two major types of stem cells in addition to other regenerative cells. These are called mesenchymal (MSCs) and hematopoietic stem cells (HSCs). These cells are used in combination with other regenerative cells. We need to remember that the cells work like a symphony orchestra. Just as all the instruments in the symphony are important the various regenerative cells are important.
Many facilities outside the United States make use of embryonic stem cells, which outside of the United States are easy to procure. The problem with the embryonic stem cells are the many complications associated with them. Besides the ethical considerations, from a practical point of view, we are still a long way from being able to utilize these cells in a safe and consistent manner. When using embryonic stem cells, you are inheriting any potential diseases that the baby may have. For instance, the baby may have a gene that when past age 50 may cause a tumor. The embryonic cells themselves may act as a tumor since there is no natural check on these cells. Furthermore, these cells are foreign materials to the body, and the body will attack these cells in an immune response. This can sometimes result in a serious medical condition called graft versus host disease. For this reason, the patient may have to be placed on immunosuppressant drugs—much like any organ transplant patient. With our present technology, embryonic stem cells are not the answer to the orthopedic problems that we deal with. The FDA has also put significant restrictions on the use of this type of cell in humans.
There are some centers, which recommend taking the stem cells from the bone marrow and growing them in a laboratory and then injecting them back into a patient. This process may not be the best way to achieve repair of problems. There are studies, which suggest that once the stem cells are manipulated outside the body they lose their effectiveness. Furthermore, there is a suggestion that by reproducing these cells outside the body the genetic makeup of the cells may be altered leading to any number of significant problems. Among other factors, it is believed that the telomeres, or ends of the DNA strands, may be significantly altered. The FDA has ruled that cultured cells by and large can not be used in the United States. We further know that larger numbers of mesenchymal stem cells do not translate into greater success. In 2012, a biologics company called Osiris presented evidence at the American Academy of Orthopedic Surgery that when 50 million cultured stem cells were injected into patients 20% of the patients reported less pain while when 100 million were injected 0% of the patients had less pain.
Also, what sets the Institute of Regenerative Medicine apart from other facilities is the fact that we at one time were utilizing human growth hormone (HGH). We used HGH because the evidence is overwhelming that it can contribute to cartilage and tendon repair. We no longer use HGH. We are now using a variety of growth factors that are measured in nano doses. Some of these growth factors include IGF-1 (Insulin Growth Factor) which is the active form of HGH. IGF-1 is known as a substance, which directly stimulates cartilage formation and tissue repair. Other growth factors utilized include FGF (Fibroblast Growth Factor), Interleukin-10, Interleukin-1 antagonist, Interleukin 3 and 4 amongst other ones. These growth factors are utilized in a number of ways including an iontophoresis patches. An iontophoresis patch is like a band aid with a built in battery. The following diagram shows what the patches look liked.
The small electrical current drives the growth factors deep into the joint or tendon area. We are not able to use any these cytokines on our athletes including high school, college and the professional levels. The leagues would consider this performance enhancement even though the dose is only a portion of one day’s dose and actually only works on a molecular level in the micro environment. We do not make the rules, we follow them! Certain medical conditions will cause us to defer the use of IGF-1 and the other cytokines. You will need to check with our physicians. We feel that we have made a quantum leap in our regenerative practice by utilizing additional growth factors as part of the overall treatment for our patients. More can be read about this in our section concerning growth factors which are also called cytokines.
Our Orthopedists Recommend Supplements to Turn on Telomerase. Any clinic that is involved with stem cells, PRP and regenerative medicine needs to consider the Telomeres or the ends of the DNA strand. Below, we see a diagram of the Telomere or end of the DNA strand. On the left we see an embryonic (young) cell with a long telomere while on the right we see an adult (old) stem cell with a much shorter telomere.