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Regenerative Medicine2022-05-26T11:26:33+00:00

Regenerative Medicine

What is Regenerative Medicine?

Regenerative medicine therapies, also sometimes called orthobiologics, use biological tissues found in the human body, such as blood, fat, or bone marrow. In most cases, this type of biologic treatment is created using the patient’s own tissue to treat an injury. This is called “autologous” regenerative medicine. These therapies are generally safe for patients, since they are derived from the patient’s own cells, and carry no risk of rejection or acquired infections from other donors.

What is it used for?

Regenerative orthopedics may improve pain and discomfort of the musculoskeletal system and enhance the healing of orthopedic conditions, such as injuries of a tendon, ligament, bone, muscle, spinal disc, meniscus of the knee, cartilage, or other musculoskeletal tissue. Most of these parts of the body have a relatively poor ability to heal on their own. The idea behind regenerative medicine is to help these tissues heal better.

Orthobiologics can be used to treat degenerative conditions such as certain forms of arthritis, as well as sports injuries and traumas. Regenerative medicine may help some patients avoid orthopedic surgery completely.

Conditions Commonly Treated with Regenerative Medicine include:

  • Osteoarthritis and joint pain

  • Tendonitis and tendinosis

  • Degenerative disc disease in the spine

  • Fractures (broken bones) that are not healing correctly

  • Intervertebral disc tears

  • Cartilage injuries

  • Meniscus tears

  • Muscle strain injuries in athletes

  • Labral tears (torn hip labrum or torn shoulder labrum)

  • Partial tendon tears

  • Nerve inflammation

  • Plantar fasciitis

  • Ligament sprains or tears (such as ACL tears or MCL tears of the knee)

Regenerative Medicine FAQs

How are the “injectables” in regenerative medicine prepared?2022-05-24T18:52:52+00:00

The tissue sample (of blood, fat, or bone marrow) will be “spun down” in a centrifuge and concentrated. This concentrate contains certain cells and molecules that help injuries heal.

How does regenerative medicine work?2022-05-24T18:52:24+00:00

Samples of a person’s own body tissue (blood, fat, or bone marrow) are collected and concentrated via centrifugation to produce a solution (concentration of certain cells) that is then regrafted into the patient.

Some evidence suggests that these prepared concentrates contain not only cells that signal or “call” other cells to gather at the site of injury to assist with healing, but also many proteins and molecules that alleviate the inflammation process and pain symptoms.

What is Platelet-rich plasma (PRP) treatment?2022-05-24T18:51:38+00:00

PRP is produced from a small sample of a person’s own blood. The blood is centrifuged (spun down) to isolate and concentrate platelets and growth factors, which are the blood cells that assist in natural tissue healing processes.

These platelets and growth factors, along with a fluid portion of blood called plasma, are then injected back into the person at the site of their injury. The injection contains a number of proteins that can potentially decrease inflammation, reduce pain and improve tissue healing. PRP has been used for many soft-tissue injuries, including those in ligaments, tendons, knee menisci, cartilage and muscle. As with all autologous regenerative medicine, PRP is generally safe, since it is a therapy derived from the patient’s own blood.

What Does Recovery Look Like After the iO-Core™ Procedure?2022-05-24T18:50:31+00:00

iO-Core™ is an outpatient procedure performed in a surgical procedure room, surgical center, or hospital setting. From start to finish, the whole procedure takes about 60 minutes. You will be under general sedation during the treatment process.

After treatment, patients are often released within a few hours. Upon discharge for recovery, you may be given pain medications and instructions to rest. Within a few days after the iO-Core™ procedure, many patients report significantly reduced pain and restoration in joint mobility at the treatment site. Many patients report pain relief within weeks following surgery.

How Does the iO-Core™ Procedure Work?2022-05-24T18:50:00+00:00

During the iO-Core™ procedure, a board-certified surgeon will perform the following steps to treat damaged, unhealthy bone that’s causing joint pain.

  • A percutaneous intact bone graft is completed. A small needle extracts a healthy piece of bone, which is later placed into the area of dying, unhealthy bone (bone marrow lesion). The patient’s healthy bone graft and bone allograft assists in structural support, along with re-growing and healing the damaged bone.
  • Continuous X-ray imaging (fluoroscopic imaging) is used to identify the exact location of the bone marrow lesion. Then a core decompression is performed by advancing an instrument into the damaged bone around the affected joint. Decompression relieves built-up pressure caused by bone marrow lesions.
  • Bone marrow aspirate is injected into the damaged bone and within the joint space. The aspirate is rich in growth factors, stem cells and progenitor cells that provide additional healing factors to damaged areas of the joint. A bone marrow injection helps with revascularization and it sends a signal to the body to begin repairing the damaged bone and cartilage.
What Is the Science Behind of the iO-Core™ Procedure?2022-05-24T18:48:48+00:00

Traditionally, arthritis is considered to be a “surface problem” because it causes progressive degeneration of the surface layer of cartilage that protects joints. But new research* and studies have revealed that arthritis is a systemic degenerative process that likely follows this path:

Bone pathologies like bone marrow lesions and osteonecrosis may develop as a result of acute or chronic injury to a joint. Swelling and reduced blood flow reaching the bone may cause progressive damage, severe pain and disability.

These pathologic conditions tend to progress rapidly for the majority of patients who develop bone marrow lesions and osteonecrosis. Over time, cartilage degradation and loss occurs.

Left untreated, bone pathologies like bone marrow lesions and osteonecrosis leave patients with limited options, such as undergoing invasive joint replacement surgery to help reduce pain and restore joint mobility.

Arthritis involves degeneration of surface cartilage along with degeneration of the underlying bone and connective tissue. Therefore, methods that only treat the surface loss of cartilage will not likely stop the progression of disease as the underlying bone continues to weaken and degenerate. Patients will likely continue to suffer from severe pain and declining movement and mobility.

However, a treatment method like iO-Core™ that addresses both the surface loss of cartilage and underlying bone damage may help patients reduce pain, regain mobility and may prevent further progression without the need to undergo a potential invasive surgery.

What is the iO-Core™ Procedure?2022-05-24T18:46:58+00:00

A COMPREHENSIVE NEW APPROACH TO JOINT PAIN

iO-Core™ Procedure takes a modern approach to the treatment of joint pain. Our goal is to regenerate, preserve, and restore function to your existing joint without major surgery or joint replacement surgery. The iO-Core™ procedure is a patented and Trade-Marked procedure developed by Dr. William Baumgartl, to address the most severe degenerative joint diseases, and as an option for patients who wish to avoid an orthopedic joint replacement procedure. The procedure is based on the concept that joint degeneration is both a surface problem of the cartilage, and also the sub-cartilage bone degeneration. Most physicians are only treating the surface cartilage inside the joint. The iO-Core™ technique was developed to not only address the surface cartilage but to take it a step further by identifying and treating the vital boney structure that supports and provides key nutrients to the cartilage in your joint.

New and an ever-increasing number of research papers indicates that joint pain can be attributed to underlying bone marrow lesions and insufficiency fractures. Bone marrow lesions lie just beneath cartilage in your joint causing severe swelling and pain. Just like any other lesion, swelling from these bone marrow lesions irritate the surrounding nerves of the joint and impairs the circulation supporting the cartilage. Remember, cartilage has no nerves; the joint pain you feel is from the nerves in the surrounding tissue.

iO-Core™ trained physicians identify these lesions using MRI imaging. A specialized instrument decompresses the swelling in the lesion. Fresh healthy tissue is grafted to fill the space left by the lesion. Once the tissue graft is in place, your own bone marrow derived stem cells are placed in and around where the lesion had been. These same bone marrow stem cells are also place inside the joint itself onto the surface cartilage to boost the healing both inside the joint and the supporting bone.
Unlike traditional treatments for arthritis that focus on reducing symptoms, the iO-Core™ procedure takes a comprehensive approach to joint restoration and pain relief by targeting the root cause of joint pain, damage and degeneration. The outpatient procedure harnesses the body’s own healing capabilities to treat cartilage defects and bone marrow lesions that damage the underlying bone and cause significant pain in patients with moderate to advanced arthritis.
A procedure that addresses both the surface loss of cartilage and underlying bone damage may help patients reduce pain, regain mobility and prevent or delay further progression without the need to undergo invasive surgery. According to the journal of Bone and Joint, “approximately 1 in 5 patients still experience chronic pain”* after the invasive knee replacement surgery.

How long does it take to see any results?2022-05-24T18:45:54+00:00

BMC injections may begin relieving pain as early as several weeks after the injection but typically it may take up to eight to twelve weeks before there is a noticeable effect. A decrease in pain does not necessarily mean the injury is completely healed as BMC has a strong anti-inflammatory effect. It is recommended that you adhere to the rehabilitation protocol and follow-up appointments as prescribed.

What can I expect after my bone marrow procedure?2022-05-24T18:45:00+00:00

BMC can stimulate a healing response and the first phase of healing involves inflammation. As a result, BMC may initially cause stiffness and mild swelling that can typically last about one week. Anti-inflammatory medications are discouraged for up to two weeks after the procedure to allow for an adequate natural inflammatory response. Ice, acetaminophen (Tylenol), and pain medications can be used if necessary. Motion Activity involving the injured body without strengthening is encouraged. Physical therapy is encouraged following the treatment, depending on the nature of the injury. The bone marrow aspiration site may feel like a bruise for several days and will need approximately one week for complete healing. A waterproof dressing will be provided but still avoid pools, hot tubs and baths during this time period. Showers are allowed.

What can I expect on the day of the bone marrow procedure?2022-05-24T17:53:04+00:00

Expect to be in clinic for around two hours. Paperwork will need to be completed prior to your injection. The procedure will take place in the clinic in a procedure room. A local anesthetic will be administered at the site to numb the area and after the bone marrow aspiration is performed, a bandage will be applied. The bone marrow will be processed immediately afterwards. The BMC will be administered the same day via injection to the affected area using ultrasound and xray guidance in the clinic. Depending on your injury, an orthosis may be administered followed by any prescriptions including physical therapy. A follow-up appointment will be made at this time as well.

How is bone marrow concentrate (BMC) used to help repair or heal tissue?2022-05-24T17:52:25+00:00

Experts are still learning about how BMC will work within the body (mechanism of action), as well as how well it will work (clinical efficacy). However, experts do believe that BMC decreases (modulates) inflammation and it can potentially help new tissue form.

Bone Marrow Concentrate may:

  • Treat bone fractures that have not grown back together
  • Improve wound healing
  • Improve cartilage function
  • Treat bone death (osteonecrosis)
  • Improve tendon function
  • Treat osteoarthritis in joints
  • Delay disease progression (as in arthritis)
How is bone marrow concentrate (BMC) obtained?2022-05-24T17:51:37+00:00

The first step in producing BMC is to collect bone marrow aspirate through a minimally invasive method that uses a needle to remove bone marrow from a large bone, such as the pelvic bone. The procedure is generally done under local anesthesia, sedation or with general anesthesia. The aspirate is then put through processing that uses a centrifuge. Bone marrow processing methods vary widely and can affect the number and quality of cells, especially in terms of useful stem and progenitor cells.

What is Bone Marrow Concentrate (BMC)?2022-05-24T17:50:46+00:00

Bone marrow is the soft, spongy substance that fills the inner cavities of bones where blood is produced. Tiny spaces in the bone marrow hold blood and stem cells, the primitive cells that are able to grow into various types of blood cells. Under certain conditions, some of these stem cells can also create new tissue like bone, cartilage, fat and blood vessels.

Bone marrow concentrate (BMC) is made by first collecting bone marrow aspirate from a large bone such as the pelvic bone.

What are cell-based therapies?2022-05-24T17:48:38+00:00

Other cell-based therapies work very similarly to platelet-rich plasma injections, but involve other types of human cells.

  • Bone marrow concentrate (BMC, and also known as “bone marrow therapy”) is a cell-based treatment produced from bone marrow cells. The bone marrow is usually collected from a person’s hip bones.
What can I expect after my PRP joint treatment?2022-05-24T17:47:55+00:00

PRP can initiate a healing response and the first phase of healing involves inflammation. As a result, PRP may initially cause stiffness and mild swelling that can potentially last for up to one week. Anti-inflammatory medications are discouraged for up to two weeks after the procedure to allow for an adequate natural inflammatory response. Ice, acetaminophen (Tylenol), and prescribed pain medications can be used if necessary. Motion Activity involving the injured body without strengthening is encouraged. Physical therapy is encouraged following the treatment, depending on the nature of the injury.

What can I expect on the day of the procedure?2022-05-24T17:46:46+00:00

Expect to be in clinic for about one hour. Paperwork will need to be completed prior to your injection. A blood draw from your arm will be performed and this blood will be processed immediately afterwards. The PRP will be administered the same day via injection to the affected area using ultrasound guidance in the clinic. Depending on your injury, an orthosis may be administered followed by any prescriptions including physical therapy. A follow-up appointment will be made at this time as well.

What are the potential benefits of Platelet Rich Plasma injections?2022-05-24T17:43:10+00:00
  • May make aggressive treatments unnecessary, such as a dependence upon medications or the need for surgery.
  • May considerably accelerate healing when measured against results of traditional therapies.
  • Pain and swelling reduced naturally.
  • Return of function more complete with shorter recovery time.
  • Minimal side effects, as PRP stimulates and directs the body’s own natural healing functions.
  • Non-invasive except for blood draw and injection.
  • Therapy can be safely repeated, but one treatment may be all that is needed.
  • Injections can be placed directly into the injury, even tendons and ligaments, without weakening them.
  • Platelet rich plasma injections can heal and strengthen tendons and ligaments, thickening them so they are less accident prone. Both tendons and ligaments are known to develop weaker areas where blood flow is diminished due to stressful activity and shock. PRP therapy can ward off repeated injury in these areas.
What is a Platelet?2022-05-24T17:41:44+00:00

Platelets, also referred to as thrombocytes, are the smallest blood cells and travel with our blood through the circulatory system. One of their chief purposes is to bind together in the presence of damaged blood vessels and form clots to stop bleeding.

However, platelets that have been activated by the presence of an injury can stimulate an entire healing cascade, including bringing in stem cells to rebuild the damaged tissue while plasma nutrients work to regenerate tissue.

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