Adipose Tissue and Mesenchymal Stem Cells: State of the Art and Lipogems® Technology Development

Abstract

In the past few years, interest in adipose tissue as an ideal source of mesenchymal stem cells (MSCs) has increased.  These cells are multipotent and may differentiate in vitro into several cellular lineages, such as adipocytes, chondrocytes, osteoblasts, and myoblasts.

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New Regenerative Medicine for Spine Services Now Available

April Spring Break and Easter 005 (2)Dr. Bright McConnell of Charleston Sports Medicine welcomes Dr. Russell Daniel to their Daniel Island location. Dr. Daniel brings decades of clinical experience in pain management including interventional pain procedures such as kyphoplasty and percutaneous spinal decompression. He is a board-certified anesthesiologist. Dr. Daniel will partner his services with Dr. Bright McConnell to provide comprehensive regenerative medicine treatments, such as platelet rich plasma (PRP) for the spine. The spine regenerative medicine service fulfills the continuum of orthobiologic and stem cell based therapies offered at Charleston Sports Medicine.

Dr. Daniel is a graduate of University of Georgia, suma cum laude, bachelor of science in biochemistry. He received his medical degree, completed his internship in surgery and residency in anesthesiology from the Medical College of Georgia. Dr. Russell Daniel will share his time between caring for his long standing Southcoast Spine and Pain patients in Aiken and developing his practice on Daniel Island. Dr. Daniel has extensive related training in the field of spine care.

 

 

Speed healing with regenerative medicine treatments that continue to be the greatest “game changer” in orthopedic medicine

Game_LEAD_RoadSignXrays_WEBRegenerative Medicine Speeds Healing for Orthopedic Injuries

Regenerative medicine continues to keep its promise as the greatest “game changer” in orthopedic medicine. For both chronic and acute pain patients, the scope of minimally invasive orthopedic treatments available is widening. Charleston Sports and Orthopaedic Regenerative Medicine has kept pace with the regenerative medicine advancements over the past decade. While surgeries, such a total knee replacement, produce excellent outcomes and may be the best choice for some patients, the world of regenerative medicine is a game changer for athletes and active “boomers” seeking functional improvement without surgery. Techniques and technology advancements such as stem cell therapy, platelet rich plasma therapy, gene transfer and tissue engineering, are moving the field of orthopedics into a new era.

 

An orthopedic surgeon’s quality outcomes for invasive and minimally invasive treatments are highly contingent on the patient’s ability to heal. Injured tissues including muscle, tendon, ligament or cartilage are a catalyst for the body to try and heal the injury through its own repair mechanisms.  Blood flow is a critical element to the body’s own healing power. Inside and around joints, the blood flow is typically lacking. Thus, the body may be unable to heal the injury adequately or even at all. The amount of degeneration or damage and the age of the patient may further challenge the body’s own efforts at healing the injury.

 

When the body is unable to recover, or heal, the result for the patient manifests itself as pain, weakness, joint locking, disability, and swelling. The solution to this problem is to augment the natural healing process to heal or even “grow back” the damaged tissue.

 

As surgeons continue to face challenges regarding the healing of diseased or injured musculoskeletal tissues, regenerative medicine aims to develop novel therapies that will replace, repair, or promote tissue regeneration. Our practice remains at the forefront of this growing application of regenerative medicine in orthopedics. All orthobiologic procedures are performed under local anesthesia in the office. Regenerative medicine services that incorporate orthobiologic options, include:

 

Platelet Rich Plasma (PRP)

Charleston Sports Medicine specializes in an orthobiologic treatment known as “platelet rich plasma” or PRP. Used to treat such injuries as tennis elbow, Achilles tendonitis, patellar tendonitis, and plantar fasciitis, PRP is blood plasma derived from patient’s own blood with concentrated platelets. These bioactive proteins initiate connective tissue healing: bone, tendon and ligament regeneration and repair, promote development of new blood vessels, and stimulate the wound healing process.

 

Amniotic Allograft

Amniotic Allografts (amniotic tissue) is a promising regenerative treatment option, due to its rich source of growth factors, hyaluronic acid, proteins, essential nutrients, and a low risk of immune response.  Amniotic Allografts are a tissue graft derived from placenta and are great options for use in osteoarthritis and tendinopathy including plantar fasciitis.

 

Adipose Derived Mesenchymal Stem Cells (ADMSC)

ADMSC is a minimally invasive procedure where stems cells are collected from fat cells found in the patient’s abdomen. This procedure treats progressive osteoarthritis and is an excellent non-surgical treatment option.

 

Bone Marrow Aspiration Concentrate Therapy (BMAC)

BMAC is a minimally invasive procedure where stems cells are collected by aspirating the bone marrow from the back of the patient’s pelvis using a small needle. Performed in an office setting with local anesthesia and with little or no discomfort, a concentration of stem cells, called bone marrow aspiration concentrate (BMAC), is then injected close to the injured or diseased tissue using diagnostic image guidance. This procedure, sometimes combined with ADMSC, is a more advanced form of regenerative therapy for patients with significant tissue damage.

 

–         Bright McConnell, III, MD

The Role of PRP in the Treatment of Early Knee Osteoarthritis

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Lipogems: The Next Generation Way to Heal

Lipogems is a cutting-edge technology that harnesses the powerful healing capacity of your own adipose tissue to support your body’s natural regenerative process. Dr. Bright McConnell is among the first in the area to provide Lipogems Adipose Tissue Technology for the treatment of orthopaedic pathologies. Lipogems is a promising addition to the suite of regenerative medicine options available at Charleston Sports Medicine. This novel procedure may provide a natural alternative or addition to surgical intervention to support your body in the reconstruction and repair of damaged or injured tissue.

You may not realize, but every tissue in your body is constantly repairing itself. Adipose tissue (fat) has been widely studied in literature and is known to have an innate healing potential. The use of fat was documented during World War I to aid in the healing of soldiers’ battle wounds. Since then, a large body of research has demonstrated a variety of promising applications for adipose tissue in healing and regenerating damaged tissues. Patients seeking a minimally invasive alternative to a major surgical intervention, and patients who have not responded to steroid injections and physician therapy may be good candidates for the Lipogems treatment.

To find out more, call us to schedule an evaluation or request an evaluation online.

Back Pack Pain & Tension Reducing Tips

Back to school shouldn’t mean back to tension in the neck, back and shoulders related to book bags. Backpacks stuffed full of books, binders and supplies are hardly ergonomically correct. Enter middle school or high school, and gone are the days of properly wearing the backpack on both shoulders. Tweens and teens don’t always have maintaining musculo-skeletal health top of mind.

Adults wearing a heavy computer bag on one side of the body share the same risks as their younger book bags on “one shoulder” wearing counterparts. The fact is, at least 14,000 children are treated for backpack-related injuries every year according to the U.S. Consumer Product Safety Commission. Parents often think of bone and muscle health during sports. However, the daily, repetitive damage of heavily weighted items worn on one side of the body cause the spine to contract to compensate for the uneven distribution of weight. The spine automatically leans to the other side, increasing pressure. During critical growth development of a child improper weight distribution can also impact posture. Risks include the following:
– Tension of the neck, back, and shoulder muscles
– Scoliosis of the Spine (curvature of the Spine)
– Lower and mid-back pain
– Pelvic tilt
– Asymmetric Gait
– Sore hips
– Knee pain

Some tips for better backpack/computer bag health:

  1. Purchase back backs or computer bags with multiple compartments to more effectively distribute weight equally of items being carried.
  2. Use both straps.
  3. For younger children, consider a backpack with a waist strap to further distribute the weight.
  4. Pack heavier items closest to the back.
  5. Choose shoulder bags or backpacks with optimal shoulder and/or back padding.
  6. Check regularly with your child to make sure they are only bringing home what is necessary and not carrying around unnecessary (lingering) items.
  7. If possible, keep larger reference books or textbooks at home.
  8. Make sure your child has enough time between classes to store books not needed in their locker.

Talk to your doctor if you experience any of the above symptoms.

backpack blog visual

Are You A Candidate for Minimally Invasive Knee Procedure, Subchondroplasty®

Subchondroplasty BlogSubchondroplasty is a minimally-invasive surgery that targets and treats subchondral defects associated with chronic Bone Marrow Lesions (BML), an often-painful defect of the spongy cancellous bone that underlies and supports the cartilage of your joint.

Some quick facts about Subchondroplasty include:
— Utilizes a minimally invasive technique
— Performed in a outpatient setting
— Requires a short rehabilitation period
— Future treatment options, such as total knee replacement, remain open

Despite negative x-rays and physical examination, when Bone Marrow Lesions (BMLs) are the cause of pain, the minimally invasive Subchondroplasty Procedure may relieve the pain.

You may be a candidate for the procedure if you have:
— Symptomatic knee pain for 3+ months
— Discomfort when walking or standing
— Limited benefits from NSAIDs, bracing, injections or physical therapy
— Symptoms that returned after an arthroscopy

How are BMLs diagnosed?

BMLs can only be seen on certain MRI sequences, where they are marked by edmatous or “inflamed” areas that have been shown to represent a healing response surrounding a microscopic insufficiency fracture within the subchondral bone. The bright white areas on an MRI show stress in the bone that is a result of micro-cracks.  These cracks can be the result of early arthritis.

mri of chronic bone marrow edema

How is Subchondroplasty performed?

The procedure is usually performed along with arthroscopy (image guided) of the affected joint, allowing your surgeon to see and treat lesions inside the joint that may also be causing pain. Subchondroplasty is a mini-open procedure that provides patients a treatment option between conservative therapies and surgical intervention, such as joint replacement.

Below is a picture outlining the procedure. The subchondroplasty is a same-day procedure done with minimally invasive techniques.

SCP Surgical Procedure

How do I get started?

Call Charleston Sports Medicine for a consultation to see if you are a candidate for the Subchondroplasty procedure for joint pain relief. Dr. McConnell will do a complete assessment of possible risks before deciding if this procedure is a good fit for you. Conservative care options such as bone grafting may need to be explored as an alternative prior to recommending surgery.

Will The SCP® Procedure keep me from having total joint surgery?

Many patients delay or avoid progressing to more-invasive procedures such as total joint replacement. However, results of any surgical procedure vary from patient to patient. Should it become necessary, total joint replacement is still an option for you after SCP®.

How do I Know if SCP® is Right for Me?

Do some or all of these statements describe you?

  • I have experienced ongoing joint or bone pain for 3 months or more
  • I have increasing discomfort when walking, running, or standing
  • I have had limited or no relief from NSAIDs, bracing, injections or physical therapy
  • I had little benefit from arthroscopy, or my symptoms returned after the procedure

You may be a candidate.

Will I be anesthetized during the procedure?

Anesthesia is a way to control pain during a procedure. Some surgeons use a local and/or regional anesthetic that numbs the operative area, which allows you to remain awake but pain-free during surgery. Other surgeons prefer general anesthesia. With general anesthesia, you will be unconscious and not feel pain during the procedure.

What are the precautions and risks for this treatment?

Only your health care team can determine if you are healthy enough for surgery. Consult your doctor for a complete assessment of possible risks before deciding to have surgery.  If you and your doctor determine that total joint replacement is necessary, a prior Subchondroplasty® Procedure does not prevent this as an option. Should it become necessary, total joint replacement is still an option for you.

Concentrated Bone Marrow Aspirate for the Treatment of Chondral Injuries and Osteoarthritis of the Knee

A Systematic Review of Outcomes

Jorge Chahla,* MD, Chase S. Dean,* MD, Gilbert Moatshe,*† MD, Cecilia Pascual-Garrido,‡ MD,
Raphael Serra Cruz,*§ MD, and Robert F. LaPrade,* MD, PhD

Investigation performed at Steadman Philippon Research Institute, Vail, Colorado, USA

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Platelet-Rich Plasma: Pain Relief for Knee OA

In the past, anecdotes lauding the benefits of platelet-rich plasma (PRP) in the treatment of knee osteoarthritis (OA) amassed faster than we could produce empirical data. As the desire increases to use minimally invasive, cost-effective treatments prior to surgical intervention, published data is finally gaining ground. PRP has now emerged in the literature as a way to reduce OA-associated pain and morbidity in the active aging population. READ MORE

Your Regenerative Medicine Solutions

Dr. McConnell’s Regenerative Medicine techniques are changing how patients heal. Stem cells act as natural healers. Recent advancements in stem cell therapy have allowed the use of stem cells for orthopedic treatment. At Charleston Sports Medicine, Dr. McConnell harnesses the healing power of stem cells using the following therapies:

  • Adipose Derived Mesenchymal Stem Cells (ADMSC) – A minimally invasive procedure where stem cells are collected from fat cells found in the abdomen
  • Bone Marrow Aspiration Cocentrate Therapy (BMAC) – A minimally invasive procedure where stem cells are collected by aspirating the bone marrow from the back of the patient’s pelvis using a small needle.
  • Stem Cell Therapies and Platelet Rich Plasma (PRP) – stem cells are capable of repairing the damage to an orthopedic injury in an accelerated time with pain relief resulting within 2-3 weeks.
  • Prevecare Supplements- Supplements can greatly improve the body’s ability to heal following stem cell therapy. The use of pharmaceutical grade nutritional supplements is recommeneded. Charleston Sports Medicine offers a customized program of Prevecare Supplements for patients.

Charleston Sports Medicine is harnessing the unique biologic properties of the placental tissues to improve clinical outcomes for our patients. Regenerative treatments, such as Amniotic Allografts, have been shown to substantially shorten the time it takes for patients to make a healthy recovery from joint replacement, join reconstruction and spine surgery, returning them to normal activities quicker. Learn more about Amniotic Allografts:

  • What are amniotic stem cells? Amniotic tissue is derived from the amniotic sac and has the potential to become (regenerate) any one of a number of different cells, such as skin, blood, or bone cells. It provides a promising alternative to surgery by promoting safe and natural healing.
  • Is Amniotic Regenerative Medicine safe? Amniotic Tissue Allografts are both safe and effective. The injections have been used over 10,000 times in the United States with no reported adverse side effects and have 100% safety record in Europe with 100,000’s of patients. Amniotic Tissue Allografts should not be confused with stem cells from embryos. This type of stem cell comes from the amniotic sac-not an embryo.
  • What conditions can amniotic stem cell injections treat? Amniotic stem cell therapy may be useful in treating pain associated with the following:
    • Knee osteoarthritis
    • Rotator cuff tendonitis
    • Degenerative arthritis
    • Achilles tendonitis
  • What benefits are included in amniotic injection therapy? Amniotic injections are steroid-free, naturally occurring anti-inflammatory agents. The injections contain hyaluronic acid (for lubricating cartilage and stimulating cartilage growth).

 

The Charleston Sports Medicine Team strives to become your partner in your total health. Our affiliated practice, FitMed Partners, also offers scientifically proven preventive age management, bio-identical hormone therapy and medically based fitness and nutrition programs. The FitMed Elite Athlete Program provides a menu of advanced sports performance testing, not typically covered under insurance, for affordable prices.