TeleMedicine visits available now - Get remote care from the safety of your home. Click to schedule an appointment.
TeleMedicine visits available now - Get remote care from the safety of your home. Click to schedule an appointment.

How to treat Chronic Injuries- Regenerative Medicine approach

chronic injuries
img

How to treat Chronic Injuries- Regenerative Medicine approach
We all have chronic injuries. Even after recovering from an acute injury the involved area is more prone to long term degeneration, instability, and pain. In this video I discuss a healthier approach to managing chronic injuries that includes a regenerative medicine perspective. Key concepts include treating stability and inflammation. I also discuss a patient with chronic knee issues who with regenerative medicine has been able to continue his career as a active duty military professional.


***For evaluation and treatment at Chicago Arthritis and Regenerative Medicine:
https://www.chicagoarthritis.com/schedule-a-telemedicine-appointment/


Hello this is Siddharth Tambar, from Chicago Arthritis and Regenerative Medicine. It’s October 14th, 2020. Welcome to our weekly live broadcast. So today I want to talk about how to address chronic injuries in a regenerative medicine style. So I’m a big football fan and it’s football season right now and there’s injuries happening left and right as the sport is expected to do. And when you see injuries you start to realize that there’s the acute nature of injuries in terms of what needs to be handled at that moment. But then, these people have chronic issues as well. And how should they be thinking about their issues and how can we better actually treat them. And reality is that for most of us, a lot of our musculoskeletal issues chronically will be from some mild chronic soft tissue injuries when we were younger at some stage of life. And so having an understanding of how to think about chronic injuries and chronic issues is key because it’ll make a big difference in terms of how you actually get a better outcome longterm. So number one, goals from treatment have to be pain relief, functional improvement, and keeping you active and exercising. And I think that’s across the board what goals should be for musculoskeletal issues but definitely for chronic injuries. And it’s important to understand that address this earlier rather than later, if you have chronic instability in an area that’s been previously injured, it’s going to make you more prone to osteoarthritis, tendonitis, longterm as well. And so you’re better off trying to address that at an earlier stage before it gets more advanced. You can still treat something when it’s become more chronic or more advanced but understand that it’s always better to treat it earlier. So if you, there’s a couple of key things that I would recommend. Number one, is stabilizing an area. So if you have an injury that is still relatively early acute or subacute, obviously the ways that you’re going to treat that are going to begin with bracing, physical therapy, if it’s severely traumatic or severely problematic or unstable then even surgery at that time. Obviously the classic example right now is Dak Prescott of the Dallas Cowboys who had a really severe ankle fracture injury or dislocation and obviously they’re going to treat that acutely in the proper way, surgically and bracing and resting and all that, longterm though because he’s got now chronic instability that will develop in that area because of injury to the soft tissue ligaments and all that, that he should be thinking about longterm, meaning five, 10 years down the line how does he prevent that from getting worse. That may not be on his mind right now, but it should be some point. I recommend that people should be thinking about regenerative medicine at an earlier stage of their recovery from a early injury, because there’s a lot of benefit to that. Whether that is taking injury that is not a surgical case and treating it at that stage or taking an injury that is actually a surgical case and when it’s actually been settled down to then actually apply either your own platelets or bone marrow drive stem cells makes a lot of sense at that stage as well. Chronically stability is really important because that what’s driving that chronic arthritic or chronic tendinopathy. And again, maybe some kind of bracing intermittently while you’re physically active can be helpful. I think it’s super important to do the corrective exercises either physical therapy or on your own longterm as well, because you need that kind of stability and strength around that area that’s been injured. In addition I think regenerative medicine utilizing your own platelets or bone marrow stem cells makes so much sense in a chronic injury because that’s what going to actually prevent that from getting worse. I think as much as possible if you have a chronic injury and instability, you want to try to avoid surgery. The issues with surgery are that most of the typical minimally invasive surgeries are about cutting out tissue that’ll actually leave that area more unstable longterm and actually potentially accelerate that degenerative process. And then the other component to that is, regenerative medicine is really made for those kind of cases in terms of helping to improve stability, helping to improve inflammation that’s where it really shines. So number two, kind of key concept is inflammation. So certainly if an area is inflamed, either acutely or chronically, rest, activity modification makes a lot of sense temporarily. I would strongly recommend avoiding using anti-inflammatory medications in large part because while they may be helpful short term, they just have too many side effects longterm. In addition, when you look at some of the supplements like curcumin, turmeric as well omega-3 we know that those kinds of issues can actually help in terms of inflammation and can actually help with wear and tear arthritis as well. And so strongly recommend that as well. You can use ice in a limited fashion. If you’re relying on it too often, I think you really need to make sure you’re seeing a physician expert in musculoskeletal medicine to make sure that you’re actually making that, you’re actually addressing the issue properly and that you’re not just masking the pain. A great example of this, is actually a patient of mine who had a PCL, posterior cruciate ligament injury in his knee several years ago. He’s active military still. He’s more on the training side now. But I essentially see him roughly every six months or so for PRP treatment. At which time we’re treating a number of different ligaments in the knee his PCL, his ACL as well as his medial collateral ligament and some of his patellofemoral ligaments and also treating the patellofemoral joint. What’s helpful in that case is we’ve been able to give him better stability, which has enabled him to continue to function and train at a very high level that he’s required to do as part of his work and in the military. In addition, it’s also helped in terms of just a day to day activities and pain relief as well. Taking a treatment that is relatively very limited in risk and invasiveness, right. And just injecting his own platelets to help keep him going at that kind of level, taking a chronic injury and helping him to stay that physically active is incredibly key. And again, it’s important to understand that most chronic degenerative issues, chronic arthritis or chronic tendinopathy patients are typically they’ve had a milder injury at some point and if you can treat some of those milder injuries at an earlier stage, you give yourself a better chance of preventing this from progressing. Wonderful, so that’s what I want to talk about with chronic injuries today. I see there’s a question that I have regarding chronic pain and also having MS. Is regenerative medicine a treatment option. Yeah, so from a chronic pain standpoint it depends on why you have it right. Is it chronic pain because, let’s say an area has been chronically weakened or unstable and has progressively become degenerative. If it’s at the level of the joint or tendon or ligaments, then that can be treated. If it’s higher up, let’s say at the level of spinal cord, I don’t think there’s enough evidence that’s really a proper treatment for multiple sclerosis at this time. There may be experts in neurology or neurosurgery that have a different opinion but at least from my perspective, I’m still possibly a candidate if the issue is at the level of the joint or the tendon, but probably not a candidate if it’s at the level of the spine. Great. Well, thank you very much for everyone’s time. As a reminder, we do this on Mondays and Wednesdays answering your questions, discussing concepts that are relevant to what we do here at Chicago Arthritis and Regenerative Medicine, focusing on nonsurgical, management and treatment of arthritis, tendonitis, injuries and back pain. In addition, I’m also doing a webinar today four o’clock central standard time. You’ll see a link for that below on whichever platform you’re watching where I’m discussing regenerative medicine treatments for lower back pain. Until next time, until we talk again, have a good day and live well. Bye bye


MEDICAL ADVICE DISCLAIMER: All content in this message/video/audio broadcast and description including: infor­ma­tion, opinions, con­tent, ref­er­ences and links is for infor­ma­tional pur­poses only. The Author does not pro­vide any med­ical advice on the Site. Access­ing, viewing, read­ing or oth­er­wise using this content does NOT cre­ate a physician-patient rela­tion­ship between you and it’s author. Pro­vid­ing per­sonal or med­ical infor­ma­tion to the Principal author does not cre­ate a physician-patient rela­tion­ship between you and the Principal author or authors. Noth­ing con­tained in this video or it’s description is intended to estab­lish a physician-patient rela­tion­ship, to replace the ser­vices of a trained physi­cian or health care pro­fes­sional, or oth­er­wise to be a sub­sti­tute for pro­fes­sional med­ical advice, diag­no­sis, or treatment. You should con­sult a licensed physi­cian or appropriately-credentialed health care worker in your com­munity in all mat­ters relat­ing to your health.

Questions and Answers re your Musculoskeletal Health

img

Questions and Answers re your Musculoskeletal Health:

-How to diagnose a joint infection.
-How to evaluate and treat bursitis.
-Can you inject stem cells into an infected joint?
-When would you retreat a joint or tendon if it’s already been treated with a regenerative medicine treatment.

***For evaluation and treatment at Chicago Arthritis and Regenerative Medicine:
https://www.chicagoarthritis.com/schedule-a-telemedicine-appointment/


– Hello. This is Siddharth Tambar from Chicago Arthritis and Regenerative medicine. It’s October 5th, 2020, and welcome to our weekly live educational broadcast. So last couple of weeks, I’ve been doing this on my own, but I have a team here today asking me questions, which is the way we’re supposed to be doing it, where I answer questions that they have, or that patients have about what we do here in clinic. As a reminder, we are focused on nonsurgical treatment and management of arthritis, tendinitis injuries, and back pain. So great to be doing this with questions again. Jackie, you have questions go for it.

– [Jackie] Yeah, so the first one would be how to rule out the infection of the joint?

– Okay. So first question was from a patient who was asking, how do you know if you have infection in a joint? So a couple things, number one, if you have an infection, there’s certain classic things you would expect to have. Fevers, for sure, swelling in the joint as well, but the gold standard way to really rule that out would be to take fluid out of the joint and to send that off to the lab, let that incubate and grow for several days and rule out any bacteria, fungus, or any other kind of infectious organisms. So for most people, it should be that simple. There are some cases where someone may have a chronic infection or a chronic reaction if they’ve got hardware in the joint, but for the most part, ruling out infection is generally pretty straightforward in that manner. Next question.

– [Jackie] What can you do for patients that have bursitis?

– Great. So what can we do for patients that have bursitis? So bursitis essentially means over different parts of the body, let’s say the shoulder, the knee, the hip, you have the small little fluid sacks called a bursa, which basically helps to protect the bone and that part of the region from any kind of stress, it’s just another sort of small buffer. And in some patients you can have an irritation of that sack, which then leads to bursitis, pain and swelling. So what’s interesting is that number one, does a person really have bursitis? So something that I frequently see, whether it’s for hip bursitis or shoulder bursitis, is that what gets called clinically bursitis is not actually truly bursitis. When you actually look under ultrasound, which you find is more tendonitis and you don’t actually find fluid in the bursa. So number one is, do you really have that proper diagnosis? And so if somebody truly has tendonitis and it’s not actually bursitis, you’d want to make that diagnosis first. And then the treatment for that would be as we do that, as we do this every single day, which is physical therapy, activity modification, and then if needed using either your own platelets for platelet rich plasma or your own bone marrow derived STEM cells, inject that into the injured tissue, whether that is the tendon, the ligaments that support the support that area as well. And sometimes if there is a chronically irritated bursa, even injecting into that as well. On the other end, if somebody really does have fluid in the bursa, then number one, just draining the fluid out of the bursa, making sure that it’s not infected, making sure that there’s no crystals or other inflammation in it. And then treating not only the bursa with those same cells, but then also treating those other soft tissue components around that as well to help basically protect that area, make it stronger, and then prevent that recurrence of bursitis. What other questions?

– [Jackie] My very last one. Patient wanted to know, how would that procedure work for him, the regenerative procedures, if he does in fact have infection in the joint?

– Okay, great question. So last question that Jackie asked is I guess the question is, can you utilize these kinds of cell based treatments if you have an infection in the joint? And really the simple answer is no. I mean, if you truly have an infection in the joint, you’d want to get that cleared. Firstly with antibiotics, you may need to actually get that surgically cleared as well, drained out more thoroughly. I would not recommend injecting cells or really anything for that matter into an actively inflamed joint. A better option would be to treat the infection first and then treat any sort of residual issues that may be there. For people that have had chronically injured joint after a prior infection, after the infection is cleared and you’re kind of fully away from that, then you can actually inject your own cells, whether it’s bone marrow or platelets into the joint, to actually treat that injured joint to that point. But when it’s actually infected, you definitely want to avoid that.

– [Jackie] Thank you.

– Devi or Susan, questions?

– [Susan] Nope, none for me.

– Wow, I must be doing a great job answering questions at works then.

– [Jackie] I do have a question. I know I said last one.

– Yes, please.

– [Devi] So we oftentimes have patients who are repeat customers to either treat the same joint a few years later, or the complimentary joint. So, you know, first we did right hip and then coming back to the left. So is it normal for patients to have a few years go by and have the same area treated again and why?

– Okay, great question. So the question is, is it normal to retreat an area after it’s been treated once? Partly it depends on what the problem is, right? So if somebody has, let’s say a recent onset injury, the expectation is if you can treat that early on, you can actually prevent that from progressing in the future. They probably would not need repeat treatments. On the other end, if somebody has, let’s say a chronically arthritic knee or lower back, it’s likely that they will need repeat treatments sometime in the future. The evidence shows that not only do people get long lasting results, but that if they do need a second treatment, they’ll actually get a improvement to a higher level after that second treatment as well. So a couple examples of that. Number one is my own mother-in-law, I’ve treated one or the other knee, basically every six months. So treating, let’s say, her left knee once per year, her right knee once per year. It’s been about a year since we last treated either one of her knees. And she’s someone that has had really significant damage in the knees in the past. Because we’ve repeat treated her over time, she’s actually done well without any treatment for either one of those needs for the last year. So she’s had sort of a persistent longer lasting result because she’s had repeat exposure to cells. Another example would be a patient who I saw in the past that had what I would consider a very challenging hip case. And he actually got treated every six months, three times with his own bone marrow STEM cells. And he’s done phenomenally well, like much better than I would have expected. And so even in cases that would be considered chronic or poor candidates repeating treatment can make a big difference longterm as well. So absolutely for chronic issues, you should expect somewhere down the line, repeat treatment. Note that the best way to maintain effectiveness longterm is to maintain ideal body weight, strength around that joint as well, and alignment, neuromuscular health, metabolic health, all the basics that we talk about nowadays. So yes.

– [Devi] Is that expectation set during the evaluation with you?

– It’s discussed, for sure. Yeah, absolutely. I mean the data and the evidence and the numbers that we generally kind of quote about effectiveness of treatment are based on a one time treatment. What I tell patients is expect somewhere down the line, if you have a chronic issue, you’ll likely need a repeat treatment again at some point. What else? Devi, Jackie.

– [Jackie] I think those were my main ones for this topic.

– Susan, are you inspired with any questions?

– [Susan] No, none. Okay, great. Well, thank you very, very much everyone. This is a relatively short one, but sometimes that’s all the questions that there are. And as a reminder, we do this live two times per week, Monday and Wednesday. As another reminder, I’m doing a webinar this Wednesday 5:00 PM central standard time on regenerative medicine treatments for knee pain. So if you have knee arthritis and are interested in STEM cell treatment, we’ll talk about that. If you’re someone that’s had a recent onset knee injury, we’ll talk about how platelet rich plasma or your own bone marrow cells can help out. If you have an ACL injury, MCL injury, a tendon related injury or tendonitis. Or if you’re just interested in regenerative medicine, learning more about treatment in general and how you can discern and figure out which physician or clinic to see based on best practices, I’ll be discussing that as well. So until next time, have a good day and live well. Bye bye.

– [Woman] Thanks, Dr. T.

– You’re welcome.


Content- Weekly Education
Live Weekly educational meeting for the team at Chicago Arthritis and Regenerative Medicine where we discuss the basics of what we do for arthritis, tendinitis, injuries, and back pain.
Watch live on FB/IG/Youtube every Monday.
https://www.Instagram.com/ChicagoArthritis
https://www.Facebook.com/ChicagoArthritis
https://www.youtube.com/c/chicagoarthritis

***For more educational content:
Sign up for our email newsletter:
https://www.chicagoarthritis.com/newsletter/

See our blog:
https://www.chicagoarthritis.com/blog/

Listen to the Regenerative Medicine Report podcast:
https://www.chicagoarthritis.com/regenerative-medicine-report/


 

MEDICAL ADVICE DISCLAIMER: All content in this message/video/audio broadcast and description including: infor­ma­tion, opinions, con­tent, ref­er­ences and links is for infor­ma­tional pur­poses only. The Author does not pro­vide any med­ical advice on the Site. Access­ing, viewing, read­ing or oth­er­wise using this content does NOT cre­ate a physician-patient rela­tion­ship between you and it’s author. Pro­vid­ing per­sonal or med­ical infor­ma­tion to the Principal author does not cre­ate a physician-patient rela­tion­ship between you and the Principal author or authors. Noth­ing con­tained in this video or it’s description is intended to estab­lish a physician-patient rela­tion­ship, to replace the ser­vices of a trained physi­cian or health care pro­fes­sional, or oth­er­wise to be a sub­sti­tute for pro­fes­sional med­ical advice, diag­no­sis, or treatment. You should con­sult a licensed physi­cian or appropriately-credentialed health care worker in your com­munity in all mat­ters relat­ing to your health.

PRP Treatment- Right versus Wrong

the right way to do prp treatment
img
Weekly Live broadcast- Right vs Wrong ways to get PRP Treatment
How do you know whether your physician is an expert in regenerative medicine?
In this video we discuss right and wrong ways when it comes to PRP treatment.

Hello, this is Siddharth Tambar from Chicago Arthritis and Regenerative Medicine. Welcome to our weekly live broadcast. It’s September 16th, 2020. I hope everyone’s doing well. Hope everyone is healthy and staying happy and healthy. So on this weekly broadcast, I discuss topics relevant to what we do here in the clinic at Chicago Arthritis and Regenerative Medicine, where we focus on nonsurgical treatment and evaluation of arthritis, tendonitis injuries, and back pain. Key concepts, key understandings that explain what we’re doing, how we’re doing things, our approach to things, and even try to answer a lot of your questions that you may have as well.

So today I wanted to discuss something that came up because a patient of mine had some questions. So a patient of mine who had come to me asking about his right knee pain, right knee osteoarthritis. He’d been treated by a couple other physicians in the past, and he’d had umbilical cord fluid injected at one point, he’d had PRP treatments injected about a month ago, and he had questions about what to do next, because he wasn’t really responding. And it occurred to me that the manner that he had been treated from a regenerative medicine standpoint, they were missing certain key principles. And one of those key principles is understanding how to use platelets in a correct way.

So a key understanding when it comes to regenerative medicine is how to utilize the orthobiologics. How to utilize the cells and the products that you’re using to treat people for their musculoskeletal conditions. And in his case, the way that he was treated was not optimal. There was a lot of things that were missing. There were technique issues, target issues in terms of what tissues they were treating, imaging, no imaging and what kind of cells that they were using. From the platelets standpoint, there were some definite problems.

So the way that he got treated was, he got a succession of treatments split apart by two weeks. And immediately I could tell he didn’t get the right kind of treatment for his condition. And it’s because they didn’t have a really correct understanding for how platelet-rich plasma works and how to get the best e6ffects from platelet-rich plasma. The reality is that there are best practices in this sort of field, there are ways to do it right and optimal, and there are ways that you can do it that maybe are not optimal and that may belie a lack of experience or expertise in the field. And I think that’s unfortunately what this patient of mine had dealt with from another provider.

So key concepts behind platelet-rich plasma, number one, we know that concentration of platelets makes a difference. So platelet-rich plasma is essentially a process where we take a sample of your own blood, concentrate that over multiple centrifugations until you have a very high concentration of your own platelets, and then inject that under ultrasound guidance into tissue that’s been damaged. That’s the basics.
So there’s a couple of things that we know about platelet-rich plasma. Number one, we know that if you have osteoarthritis, that the correct way to treat your condition is by utilizing a high concentration of your own platelets. If you utilize a low concentration of platelets, the problem is that you’re not going to get the right kind of response. So utilizing a high concentration of platelets, 14 to 20 times a normal concentration of platelets, will give you a better response to osteoarthritis treatment.

So what does that mean, exactly? the way that platelets work is a couple of ways. Number one, the growth factor from the platelets help to stimulate your own local mesenchymal stem cells. Those stem cells are basically your body’s normal and natural way of trying to recover from injuries and keeping the joint healthy. An unhealthy joint, what you see are the wrong kind of proteins and enzymes, basically a chronically inflamed and unhealthy joint. So on a biochemical level, by stimulating those mesenchymal stem cells, you can get a better, healthier joint because those cells start pumping out the right kind of enzymes and proteins. A healthier biologic joint. So we know that a higher concentration of platelets will give you a better response to mesenchymal stem cells in terms of stimulating them, in terms of getting them to start functioning better as well.

I know that this patient didn’t get a high concentration injection because when you do that, you have more inflammation upfront and you have that inflammation for the first few weeks after, or for the first few days and stiffness for the first couple of weeks after treatment. So for a physician recommending to him that he should get repeat treatment automatically at every two weeks for the next two to three cycles, he was very likely utilizing a very low concentration of platelets because most people couldn’t tolerate that level of inflammation on a repetitive scale that frequently, if they’re doing it correctly.

The second thing is how much blood do they actually take from him? If you want to concentrate platelets to a very high concentration level for one joint, you’re going to have to take a couple hundred CCs of blood. That is at least six to nine ounces of blood. In his case, they took out 10 to 20 CC, one to two vials. I know they’re not doing it correctly because that’s not enough blood to get a high concentration. Unfortunately, when you ask that clinic that question, they didn’t understand what he was asking. And so it just belies their inexperience and lack of expertise in the field.

Second thing is there is, you can utilize platelets in different ways. So injecting a joint is one thing, but from a regenerate medicine standpoint, you need to be treating ligaments, tendons, other soft tissue structures, even nerves. You don’t use the same platelet concentration for each one of those areas. If I want to treat a tendon, I’ll use a slightly lower concentration of platelets. If I want to treat a nerve, I’ll end up treating that with platelet lysate, which is just the growth factor from the platelets. And if I want to treat the ligaments, I’m going to end up using either platelet lysate or platelet-poor plasma. And if I’m treating muscles, I’m using platelet-poor plasma. So there’s different types of platelets. There’s a higher concentration of platelets, a greater amount of blood.
There’s just much more subtlety to doing this the correct way. And unfortunately, this individual did not get this the correct way. Then the last thing is timing of prp treatment. So in this individual’s case, he’s being recommended getting multiple treatments in quick succession. If you’re doing this correctly, that elevated level of inflammation, you have to give it time for the body to properly heal and respond to that. So the optimal response, I tell patients, expect to be feeling better at the four to six week mark. Let’s reassess at the two month mark to see how much better you are. And if you’re still getting better, let’s give it more time just to let you continue to get better on your own. On the other end, if you start plateauing and you’re not at your goal, then let’s repeat treatment at that point.

So in this patient’s case, it was a wrong platelet preparation. It was a wrong frequency of treatment as well. The other thing is knowing when to treat more aggressively and when to treat a little bit more mildly. So in this individual’s case, he wanted to get back to some level of activity, exercise activity at a faster level than what I would normally recommend after PRP treatment. He wanted to get to more high-impact activity within the first month after treatment. I said, that might be possible. However, if you’re looking to get back into something much faster, you may want to give it a little bit more time from the platelet standpoint. If you want to get back into something faster, let’s say in season during a competitive sports season, you may be better off getting dextrose prolotherapy, which is less inflammatory, that can kind of help out short-term, and then when you have a little bit more time, maybe two months, then maybe let’s do platelet-rich plasma at that time.

The keys to platelet-rich plasma, getting the right concentration, the right lab prep to do it properly, the right platelet types to do it as well. Your physician, if they’re doing this correctly, should be able to answer those questions. Meaning what’s the concentration of platelet-rich plasma that’s been using, how much blood are they drawing. Are they using different types of platelet preparations for different tissues that are being treated at the same time. And what’s the progression of this. It shouldn’t be over two weeks. It really should be over that couple month period.

I hope that’s helpful. I hope that gives you some sense of how platelet-rich plasma should be utilized to give you some sense for how physicians should be utilizing this correctly. As a reminder, I’m doing a webinar later on today at 5:00 PM central standard time. You’ll see a link for that below, where I’ll be talking more about regenerative medicine in a more expansive way. The truth about regenerative medicine. Also, as a reminder, I do a live broadcast live stream twice per week, Mondays and Wednesdays. Any questions, concerns, or thoughts, email, leave them down below and until next time, have a good day and live well. Bye bye.


Chicago Arthritis and Regenerative Medicine Weekly Live broadcast.
Check us out live on Instagram, Facebook, or Youtube every Wednesday at 12:15pm cst.
Discussing relevant issues regarding state of the care for arthritis, tendinitis, injuries, and back pain.
https://www.Instagram.com/ChicagoArthritis
https://www.Facebook.com/ChicagoArthritis
https://www.Youtube.com/c/chicagoarthritis
***For more educational content:
Sign up for our email newsletter:
https://www.chicagoarthritis.com/newsletter/
See our blog:
https://www.chicagoarthritis.com/blog/
Listen to the Regenerative Medicine Report podcast:
https://www.chicagoarthritis.com/regenerative-medicine-report/

***For evaluation and treatment at Chicago Arthritis and Regenerative Medicine:
Determine if you are a Regenerative Medicine treatment candidate:
https://www.chicagoarthritis.com/regenexx-candidate-form/
Contact us for more information or to schedule an appointment:
https://www.chicagoarthritis.com/contact-us/

MEDICAL ADVICE DISCLAIMER: All content in this message/video/audio broadcast and description including: infor­ma­tion, opinions, con­tent, ref­er­ences and links is for infor­ma­tional pur­poses only. The Author does not pro­vide any med­ical advice on the Site. Access­ing, viewing, read­ing or oth­er­wise using this content does NOT cre­ate a physician-patient rela­tion­ship between you and it’s author. Pro­vid­ing per­sonal or med­ical infor­ma­tion to the Principal author does not cre­ate a physician-patient rela­tion­ship between you and the Principal author or authors. Noth­ing con­tained in this video or it’s description is intended to estab­lish a physician-patient rela­tion­ship, to replace the ser­vices of a trained physi­cian or health care pro­fes­sional, or oth­er­wise to be a sub­sti­tute for pro­fes­sional med­ical advice, diag­no­sis, or treatment. You should con­sult a licensed physi­cian or appropriately-credentialed health care worker in your com­munity in all mat­ters relat­ing to your health.

Personalized Care in Regenerative Medicine

https://youtu.be/CVtTyvHtWYc

Personalized Care in Regenerative Medicine
A major strength of regenerative medicine care for musculoskeletal conditions is the ability to personalize treatment based on your condition, severity of pathology, and other medical comorbidities. In this video you’ll learn more about how we personalize care using regenerative medicine techniques.


Hello everyone, this is Siddharth Tambar from Chicago Arthritis and Regenerative Medicine. Welcome to our weekly live broadcast. It’s September 9th, 2020, I hope everyone had a great labor day weekend, and I hope everyone is healthy and doing well. So we’re back at it here in the office and today I want to talk about personalization in regenerative medicine care. So this comes up from time to time and I’ll give a couple of examples of where this is super relevant. But one of the main strengths and benefits of regenerative medicine is its ability to personalize and tailor treatment to the individual that you’re treating. As opposed to medication where you have relative limitation in terms of how personalized you can make treatment. Regenerative medicine really gives you a really wide latitude for personalization and individualization of treatment. So I’ll give you a couple different examples to that.

So number one, one size does not fit all is always a good strategy when it comes to musculoskeletal health. Namely, if you have a knee issue or shoulder issue, you may not be the same sort of problem or the same type of person who respond to treatment as let’s say your neighbor who may also have a knee and a shoulder issue. And as much as you can have a personalized approach to care, that will make a big difference in terms of the outcome, because number one, it requires your physician to really understand what your issues are.

Number two, it really requires a detailed understanding of how to treat a musculoskeletal pathology in a way that will get you a better result. In addition different tissues are not treated the same, they’re treated differently. The way you treat a joint or cartilage injury, the way you treat bone swelling or bone marrow edema, the way you treat tendon injury or tear, or the way you treat a chronically lax ligament, or chronically weak, or atrophic muscle or chronically irritated nerve these are all very different in nuance. And if you utilize the same platelet preparation for each one for example, for platelet rich plasma, then you’re not really treating the tissue appropriately, you’re really treating it too, in too much of a uniform manner. You really should be utilizing subtlety and difference with how you treat these different types of tissues. So as an example, different platelet preparations will give, will help different types of tissue. So when it comes to joints for example, arthritis, you want to use as high a concentration of platelet rich plasma as you want to. You want to use a 14 to 20 times, concentration of platelet rich plasma, that’s very hard to get. There’s no commercial over the counter system or kit based system that physicians use that’ll do that. You can do that in a lab based system by taking more blood and by concentrating it over serial centrifugations, but you re you really require that kind of flexibility and personalization. With tendons while there is some lab based evidence that higher concentrations of platelets get better results. Clinically, we know that a moderate level of platelet rich plasma will do better than a low dose platelet rich plasma. In joints clinically we know a higher dose platelet rich plasma will do better than a low dose platelet rich plasma. When it comes to ligaments, either utilizing a low concentration of platelet rich plasma, or platelet lysate, which are just a growth factors from the platelets is how as a physician, I want to treat that. You don’t need that to be super hyper inflammatory, you just want to have a mild amount of inflammation When it comes to nerves, utilizing platelet lysate, the growth factors from the platelets is healthier and less inflammatory and less irritating to the nerves than normal platelet rich plasma, which tends to be more inflammatory. And lastly, when it comes to using muscles or treating muscles you want to use, what’s called platelet poor plasma, where you don’t have a lot of platelets. That’s actually been shown to be better for muscles and platelet rich plasma. So having both a different set of concentrations, as well as different types of platelet preps is what’s going to make a difference when it comes to deciding what sort of preparation you want to use based on the tissue that you’re treating.

In addition, there are other factors that can make a difference; age can make a difference. If you’re older and you’re treating a joint injury, you want to utilize a higher dose of platelet rich plasma, rather than if you’re somebody very young. Person, who’s 80 plus years old may be very healthy, but you want to to use a higher dose of platelet rich plasma than let’s say someone who is 18 years old and has a milder injury and is just a healthier and has a more robust response to treatment. In addition, if you have other types of medical comorbidities, let’s say chronic diabetes, chronic metabolic syndrome, you likely are someone would require a stronger treatment rather than someone who’s otherwise healthier. So understanding not only musculoskeletal pathology, but understanding how these treatments work, as well as the different types of orthobiologic treatments or platelets or bone marrow stem cells, or other types of treatments that we utilize in this regenerative medicine field makes a big difference and realizing that the individual person’s own variables and factors makes a difference as well, makes a big difference.

So I’m going to give two examples. First is a 57 year old man who I treated recently, who has some mild arthritis in his shoulder AC joint, the joint on top of the shoulder. And he also has a mild to moderate degree of rotator cuff tendonitis, not a really bad tear, but it does have some irritation to the tendon. And the way that we treated his case was I utilized a 14 times concentration platelet rich plasma for the AC joint because it is a joint and will do better with a higher dose platelet rich plasma. And then I utilized seven times concentration, platelet rich plasma for the tendon. I did not want to go overly inflammatory. And I also used platelet lysate for the ligaments around the shoulder as well, understanding that that prolotherapy concept of strengthening ligaments and improving stability will go a long ways to improving both the AC joint arthritis, as well as the rotator cuff tendonitis. But really utilizing in that one patient three different platelet preps is really key.

One way that, you know if you’re dealing with a regenerative medicine expert is do they have that level of dexterity, subtlety and personalization. The way that you know you’re not dealing with an expert is if they are really utilizing a one size fits all platelet rich plasma for your entire condition. That’s not the right way to do it.

Second case would be a individual that has, a patient of mine that I’ve treated for knee and shoulder issues. He was treated by a colleague of mine Dr. Landrum for some arthritic issues in his neck and his thoracic spine. So he ended up having a high dose platelet rich plasma injection into his facet joints. That is 14 times normal concentration he also had platelet lysate, the growth factors from the platelets injected into the epidural space. So again, two different types of platelet preps based on what tissue is being treated. And in addition, in order to draw enough platelets, we had to do a very large volume blood draw, about 450 CCs. That’s a pretty large blood draw, that’s about how much you would actually give during if you’re actually donating blood. So pretty large blood draw we required a blood bag, extra ACD, which is the anticoagulant you put into the blood bag to make sure it doesn’t clot. And then it actually required some additional steps by my own staff to actually properly prep the blood so that you can get the proper product. So it really required multiple steps and really more than just a quick blood draw and five minute preparation, which you do hear some clinics doing, which is not the right way to do this. But in this gentleman’s case because we took the extra effort to properly do this, take the extra blood draw properly, prepare two different types of platelet preps he’ll likely get a much better result than if we’d done this in a you know, really not properly professional manner. So I’m very hopeful that he’ll have a great response like he has for his other areas because we’ve taken the time and the effort to do this properly.

So personalization in regenerative medicine, personalization in terms of tissue that we treat in a comprehensive manner, personalization in terms of choosing the right orthobiologics or cell based treatments based on your condition, and personalization utilizing the right sort of concentrations of your platelet, rich plasma products based on your actual conditions and your underlining medical issues as well. It makes a huge difference, we’ll get you a better result and it’s the right way to do this as opposed to maybe some other ways of doing this.

Thank you for your time. As a reminder we’re doing a live stream talking about topics related to musculoskeletal health and wellness twice per week Monday and Wednesday. This week didn’t do one on Monday just because it was labor day, so I’m glad to get back to this on Wednesday. But we’ll be back at this on Monday as well. In addition, doing a live webinar, which we’ll get more information within the body of this, wherever this is posted on social media, where discussing issues related to regenerative medicine, name of the webinar is the Truth about regenerative medicine. You’ll learn a lot more about details of what is, what is not regenerative medicine, realistic results, what can be treated, what can’t be treated, what are ways to know that you’re going to get a good treatment by a legitimate physician, legitimate clinic and ways to avoid poor quality treatments and clinics as well. Until next time, have a good day and live well. Thank you very much. Bye bye.


Chicago Arthritis and Regenerative Medicine Weekly Live broadcast.Check us out live on Instagram, Facebook, or Youtube every Wednesday at 12:15pm cst.Discussing relevant issues regarding state of the care for arthritis, tendinitis, injuries, and back pain.https://www.Instagram.com/ChicagoArthritishttps://www.Facebook.com/ChicagoArthritishttps://www.Youtube.com/c/chicagoarthritis
***For more educational content:Sign up for our email newsletter: https://www.chicagoarthritis.com/newsletter/
See our blog:https://www.chicagoarthritis.com/blog/
Listen to the Regenerative Medicine Report podcast: https://www.chicagoarthritis.com/regenerative-medicine-report/


***For evaluation and treatment at Chicago Arthritis and Regenerative Medicine:Determine if you are a Regenerative Medicine treatment candidate: https://www.chicagoarthritis.com/regenexx-candidate-form/
Contact us for more information or to schedule an appointment: https://www.chicagoarthritis.com/contact-us/


MEDICAL ADVICE DISCLAIMER: All content in this message/video/audio broadcast and description including: infor­ma­tion, opinions, con­tent, ref­er­ences and links is for infor­ma­tional pur­poses only. The Author does not pro­vide any med­ical advice on the Site. Access­ing, viewing, read­ing or oth­er­wise using this content does NOT cre­ate a physician-patient rela­tion­ship between you and it’s author. Pro­vid­ing per­sonal or med­ical infor­ma­tion to the Principal author does not cre­ate a physician-patient rela­tion­ship between you and the Principal author or authors. Noth­ing con­tained in this video or it’s description is intended to estab­lish a physician-patient rela­tion­ship, to replace the ser­vices of a trained physi­cian or health care pro­fes­sional, or oth­er­wise to be a sub­sti­tute for pro­fes­sional med­ical advice, diag­no­sis, or treatment. You should con­sult a licensed physi­cian or appropriately-credentialed health care worker in your com­munity in all mat­ters relat­ing to your health.

The Truth about Regenerative Medicine

The Truth about Regenerative Medicine

Webinar- 20200902

What you’ll learn from this webinar:
-What are the best available treatments for arthritis/tendinitis that do not require surgery- for example stem cell, blood/platelet treatments.
-What is legit and not legit in the field of Regenerative Medicine.
-How to choose the best physicians/clinics for regenerative medicine. How to avoid the snake oil sellers.