Restore-Me.Com also helps patients find Biologic Centers of Excellence, Cellular Therapy, and Ortho-Biologic Specialists closest to them for evaluation and possible treatment. These providers are trained and board certified medical professionals.
Biologic Modalities for Joint Preservation and Pain
The biologic treatment of Musculoskeletal injuries and diseases is a relatively new and exciting area of orthopedics.
Musculoskeletal injuries and diseases are affected and regulated by your body’s natural healing processes. There is
a complex “dance” of cellular and chemical activity that occurs in your body to promote healing and repair of damaged
tissues, including muscles, tendons, ligaments, bone, and cartilage. When tissues are damaged or become aged, their
reparative mechanisms are often no longer as effective.
There are naturally occurring cells in the body that have the capability to differentiate and promote the repair and
regeneration of a variety of damaged tissues. These cells produce a variety of chemicals (growth factors and cytokines)
that signal other cells to repair, decrease inflammation, and inhibit the breakdown of tissues. These cells are in high
concentration in certain parts of your body including adipose (fat) tissue and bone marrow.
Alternative Treatment Options
Most diseases and injuries can be treated by a variety of methods depending on the individual circumstances of the patient. For example, arthritis of the knee might be treated first with modification of activities, weight loss, over the counter anti-inflammatory medications, physical therapy, bracing, corticosteroid injections, and hyalouronic (lubricant) injections.
In some cases, knee arthroscopy may be helpful and in the most advanced stage of knee arthritis, total knee replacement is the most reliable method for decreasing pain and improving function. It’s important to weigh the pros and cons of your various treatment options before deciding which approach is best for you.
Precautions and Risks
The risks related to restorative therapy as practiced by most specialists are very low. There
may be some mild discomfort associated with any procedure. However, there is a very small risk of infection whenever aspirations and injections are performed. Nerve damage, vessel damage, and injury to other important structures are exceedingly rare. Orthopedic, pain management, and other sub-specialists, use their detailed knowledge of normal anatomy as well as imaging
techniques to assure your procedure is done as safely and effectively as possible. Patients are given some important pre-procedure and post-procedure instructions that help reduce the risk of complications. Patients with a history of bone
marrow disease, cancers of the blood system (leukemia, lymphoma, etc.), and active infections are may not be candidates
for this type of cellular therapy. Patients with bleeding disorders and other chronic medical problems may not be suitable candidates as well.
Goals and Success Rate
The goal of restorative therapy is to reduce pain and improve function without the need for surgery. In some cases, the
condition being treated is too severe to achieve these goals and other treatments may be necessary. Studies in humans
have indicated that the treatments are very safe and low risk. Studies regarding the effectiveness therapy compared to
"no treatment" or other accepted treatments are still in the early phases and are complicated by the fact that it is difficult
to design good controlled and randomized studies in humans. Furthermore, different investigators often use different
techniques and have different definitions of success. Nevertheless, many independent investigators have shown evidence
of effectiveness in treating orthopedic injuries and diseases by reducing pain and improving quality of life. Some studies
have shown MRI evidence of healing and even regeneration of tissue (including cartilage) that would not have been expected
without the treatment. Reported success rates are as high as 70- 90% in some studies. When treatment is successful, pain
relief and improvement in function typically begin to occur about 5-6 weeks after treatment. The exact mechanism by
which restorative cellular therapy may decrease pain and improve function is still in the process of being understood. Restorative medicine specialists are committed to following the results of their patients using an "outcomes" system that monitors the success
rate of the treatments.
PRP - Learn more here...
A commonly used “orthobiologic” is Platelet Rich Plasma (PRP). This material is usually isolated after a routine blood draw. A
centrifuge is used to isolate the portion of your blood that contains a variety of chemicals (growth factors, enzyme inhibitors,
and cytokines) that assist the healing processes. It can be used alone, or along with other restorative treatment procedures,
to supplement and stimulate healing of damaged or diseased tissues. PRP preparation systems have been designed to produce
a plasma solution rich in platelets and proteins. Processes used to concentrate platelets may result in different recovery level
of platelets from whole blood, depletion levels of red blood cells, amounts of leukocytes (white blood cells), and different
viability and potency platelets.
Platelets (Thrombocytes) are the main component of PRPs and play a central role in hemostasis and tissue healing. Platelets
are the architects of tissue healing as their presence to an injury site initiates and guides the healing process. When activated,
platelets change shape and exhibit stickiness, while increasing their surface area to attach and spread over the injury site. Clot
formation then occurs, providing a fibrin-based bioscaffold which sustains a healing environment. During the clot formation
process, platelets degranulate and release growth factors which participate in and enhance the healing process. In addition
to releasing growth factors, platelet degranulation also produces a multitude of bioadhesive proteins and of bioactive factors,
such as fibrinogen, fibronectin and vitronectin, which are all critical to the healing process and the recruitment of cells.
Plasma contains biological factors and proteins involved in healing, including growth factors. Leukocytes (white blood cells)
are responsible primarily for defending the body against infection, but also serve other functions during tissue healing. These
cells, when present in suitable concentration, are key players during the initial inflammation phase of tissue healing, protect
the body against infection, remove undesired organisms produce antibodies, and/or are involved in allergic response.
Leukocytes are nucleated cells and therefore can release growth factors which in turn may be beneficial to the healing process.
Initial improvement may be seen within a few hours of the PRP injection. However, healing is unique to your
injury and your body’s recovery. The complete reparative process can take up to 12 weeks.
Microfragmented adipose tissue processed by the LIPOGEMS System is used to provide cushion and support to
help the natural healing process by supporting the repair, replacement, reconstruction of damaged or injured
tissue. The LIPOGEMS minimally invasive procedure is performed in a physician’s office or a surgical setting and
can be completed in less than an hour. The fat is first harvested. It’s then gently processed and/or cleaned with
the LIPOGEMS device and then delivered into areas in the body to promote healing.
LIPOGEMS is ideal for patients who would prefer an alternative to a major, invasive surgery; or would like to use it
in addition to your surgery to promote faster healing.
Advantages of Lipogems
• FAT is minimally invasive to harvest
• Most people have a lot of extra FAT
• FAT is the highest quality tissue
• FAT has 100-500 times more reparative cells
than other similar tissue
• FAT provides cushion and support
• For patients that suffer from orthopaedic
conditions in multiple areas of their body,
Fat cells can be delivered to multiple areas
in just one visit
• Research has shown that as a person ages,
their FAT maintains its reparative properties
unlike other similar tissue, such as bone marrow,
which may lose healing capacity with age
• FAT contains many supportive and reparative
cells that help to promote a healing environment
throughout the body