Stem Cells Therapy for Arthritis (Part 2)
On our previous post, we showed you the analysis Naples orthopedic surgeon, Leon Mead made about Stem Cells Therapy for Arthritis. On this second part, we continue talking about Microfracture during a knee replacement, amnion and what happens after surgery.
‘The microfracture is a procedure that has been done for decades and has been well studied. Unfortunately, without the additional stem cells, this has historically only allowed regeneration of scar tissue which it only lasts a few years. No normal joint surface was ever regenerated. During a microfracture any unstable tissue, less than 30% of the normal joint thickness, is removed down the bone. In my experience, this damaged surface won’t regenerate and continuous to degenerate if it is not removed. All additional exposed bone is scrapped and a perforation in the marrow cavity is made with a 1mm drill bit and specially designed awls. This allows the marrow to coat the end of the exposed bone. At the end of the procedure, your constraint stem cells are combined with a product called amnion and injected into the joint.
As we age, our stem cells become less active. By adding grow factors to stem cells injections, old stem cells will behave more like juvenile stem cells and will remain active for longer periods of time. Grow factors are obtained from specific areas in human placentas. This product is called amnion because is obtained from the amniotic tissue on a child’s side of placenta. The placentas are obtained from live healthy births from twelve hospitals in the Dallas area. There are no ethical concerns with this as this placenta tissue is routinely discarded after the birth.
All tissue is tested for diseases and sterile processed. The FDA has approved this process. This tissue comes fresh frozen on dry ice and has to be used within fifteen minutes after external exposure to preserve the function grow factors. Within seven minutes of exposure to this growth factors, adult non-active stem cells will change their cellular characteristics and resemble the spinal shape of the juvenile more active stem cells form.
This stem cells then remain biologically active for up to eight months. Much longer than non-exposed cells. Another huge benefit from the amnion is that inhibits scar tissue formation along your body promoting minimal scarring. We use amnion to improve the biologic activity of our relatively inactive adult stem cells. Amnion basically turbo charges the adult stem cells causing them to actually change their cell appearance and activity. It also increases life spam stem cells relative to non-exposed stem cells.
After the Surgery
After the surgery you will need to be non-bearing weights for three weeks. We also recommend the use of CPM or continuos passive motion machine for two to three hours daily for six weeks. CPM has been shown in prior studies to have a huge impact on the quantity and quality of the regenerated joint surface. Even though CPM was designed for this, and all successful protocol say six weeks, insurance companies in all their wisdom have decided to pay for only three weeks.
At the three weeks time, you can progressively place more weight in the leg achieving full weight bearing at six weeks. Then we will give you a prescription for an unloading brace to be worn at the three week time to help you protect the joint surface. This period is the hardest part of the operation. Being non-weight bearing and using the arms to assist in walking is difficult at any age but particularly so the older we get. Our arms are just not used to that kind of workout. Some people will use a wheel chair during this three week period of time. An aspect that is far more difficult than any replacement.
During this phase you also need to be off anti-inflammatory medications like Advil or Alleve. This mediations significantly inhibit stem cells function. I also do not recommend the use of tobacco products. At the six weeks time we recommend a second injection of the amnion. All successful protocols today have used a second injection of cells. It is a simple office injection. The procedure is not mandatory but highly recommended. At this time we also recommend a gel injection as it helps with joint regeneration. Most insurance companies will cover the gel injection. At this time, it would be ok to do some stationary bike several days a week. At the three month time we will begin formal therapy. I delay the process to let cells regenerate. During this period it is completely normal to have pain and feel uncomfortable. It takes four to six months for patients to appreciate a significative improvement.’
Orthopedic Corner | Leon Mead MD Orthopedic Doctor | 730 Goodlette Road North, Suite 201 Naples Florida 34102 | Phone: (239) 262-1119