Stem Cell and Biologic Treatments

Biologic Treatments

Biologic therapy includes innovative treatments that enhance the body's natural capacity to heal. It is a type of regenerative medicine that uses various technologies to harvest the natural healing resources of the body such as stem cells, platelets and growth factors and targets their activity towards areas that need healing. These regenerative substances are present in various tissues and are usually obtained from the bone marrow, blood and fat. Biologic therapy is used to treat various medical and orthopedic ailments. It enhances the body's ability to heal injuries including broken bones, and injured muscle, tendon, and ligaments. It can slow down degeneration, reduce pain, improve movement and delay the need for surgery.

Biologic therapy is an emerging field with a tremendous potential for growth and new applications.

Viscosupplementation Injections

Viscosupplementation refers to the injection of a hyaluronan preparation into the joint. Hyaluronan is a natural substance present in the joint fluid that assists in lubrication. It allows smooth movement of the cartilage covered articulating surfaces of the joint.

Synvisc is one of the most commonly used hyaluronan preparations. It is indicated in the management of shoulder, knee, hip or ankle osteoarthritis that has not responded to non-surgical treatment options such as pain medications, physical therapy and corticosteroid injections.

Synvisc provides symptomatic relief and delays the need for surgery. It is injected directly into the joint to replenish the diminished synovial fluid, thereby enhancing its lubricating properties. A single dose or a total of three separate doses of Synvisc, over several weeks, may be required for optimum benefit.

Some patients may experience mild pain, swelling, warmth and redness at the injection site for up to 48 hours following a Synvisc injection. Headache and joint stiffness may also occur in some cases. Ice packs and an analgesic may be used, if required, to ease the discomfort. Any strenuous activity such as jogging, or tennis should be completely avoided for 48 hours to a week after the injection and should be resumed only after consultation with your doctor.

Synvisc injection not only supplements the hyaluronan in the joint but also stimulates the production of hyaluronan in the treated knee. This provides gradual symptomatic relief over the course of the injections. This effect may last for several months.

Please note: Immediately consult your doctor if you develop fever or the pain and swelling fail to resolve after 48 hours following the injection.

PRP Injections

Our blood consists of a liquid component known as plasma. It also consists of three main solid components which include the red blood cells (RBCs), white blood cells (WBCs), and platelets. Platelets play an important role in forming blood clots. They also consist of special proteins, known as growth factors, which help with our body's healing process. Platelet-rich plasma or PRP is a high concentration of platelets and plasma. A normal blood specimen contains only 6% platelets, while platelet-rich plasma contains 94% of platelets and 5 to 10 times the concentration of growth factors found in normal blood, thus greater healing properties.

Indications

PRP is a relatively new method of treatment for several orthopaedic conditions such as muscle, ligament, and tendon injuries; arthritis; and fractures. PRP injections can help alleviate painful symptoms, promote healing and delay joint replacement surgeries.

Procedure

Your doctor will first draw about 10 cc's of blood from the large vein in your elbow. The blood is then spun in a centrifuge machine for about 10 to 15 minutes to separate the platelets from the remaining blood components.

The injured part of your body is then anesthetized with a local anesthetic. The platelet-rich portion of your blood is then injected into your affected area. In some cases, your doctor may use ultrasound guidance for proper needle placement.

Post-Procedural Care

  • It is normal to feel some discomfort at the injection site for a few days after your procedure.
  • You will be prescribed pain medications by your doctor.
  • You may use cold compresses to alleviate your symptoms.
  • We do not recommend the use of NSAIDs (i.e. ibuprofen) for 5 days after the injection, but patients can use acetaminophen. This allows for an inflammatory/healing response to occur.
  • You may resume your normal activities but should avoid any strenuous activities such as heavy lifting or exercises.

Risks and complications

There are very minimal risks associated with PRP injections. Some of the potential risks include

  • Increased pain at the injection site
  • Infection
  • Damage to adjacent nerves or tissues
  • Formation of scar tissue
  • Calcification at the injection site