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Stem cells for hurt knees?

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#31 tepol

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Posted 06 November 2014 - 05:48 PM

If I were you I'd get Prolotherapy on the knees , its far cheaper than PRP , works as well if not better depending on what proliferant is used / doctor  - or you could spend a ton on stem cells and cross your fingers.

 

If you do go stem cells China might be worth a look if your prepared to take risks / be more experimental than what is allowed elsewhere.


Edited by tepol, 06 November 2014 - 05:57 PM.


#32 kaypeeoh

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Posted 09 November 2014 - 11:58 PM

Prolotherapy is the use of PRP.  Prolotherapy used to be done by injecting 50% dextrose.    These days most say PRP works better.  I've had PRP in both Achilles.  One is back to normal and the other is 80%.



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#33 tepol

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Posted 11 November 2014 - 12:13 PM

Prolotherapy is the use of PRP.  Prolotherapy used to be done by injecting 50% dextrose.    These days most say PRP works better.  I've had PRP in both Achilles.  One is back to normal and the other is 80%.

 

Wrong - Prolo does not use your blood so it is far cheaper to do ( I had it for $175.00 per area and up to 12-15 shots )

 

Dextrose is just one option , but takes longer to act - there are others like sodium morruahte far more effective imo

 

There is no evidence PRP works because there is no way to establish what universal solutions are being used by everyone.


Edited by tepol, 11 November 2014 - 12:21 PM.


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#34 sthira

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Posted 11 November 2014 - 02:14 PM

Neither prolotherapy nor PRP have been shown to regrow avascular meniscus cartilage.

#35 kaypeeoh

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Posted 11 November 2014 - 03:30 PM

Prolotherapy is proliferative therapy, a phrase coined by George Hackett, MD.  The idea is to induce proliferation of healing tissue.  Going back 20 years injections of 50% dextrose was often used.  It was also called sclerotherapy.  Later is was found that improved results happened  by injecting plasma, the liquid portion of blood.    Plasma is rich in healing properties.    Ross Hauser, MD as written several books on PRP and stem cell treatments, all written for the laymen.    Dextrose induces inflammation, the first step to healing an injury.   Plasma fills the injured area with proteins that become scar tissue, thickening the injury at the osteo-tendinous junction. 

 

PRP can be used to heal meniscal damage for the same reason. 


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#36 sthira

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Posted 11 November 2014 - 03:55 PM

Thanks for the Google education, but PRP doesn't regrow avascular meniscus tissue. Only one (over-hyped) study published in January 2014 indicates that in some patients stem cell injections post surgery may repair about 15% of lost cartilage one year later. We don't know what kind of tissue was regrown, nor if it was helpful.

PRP and prolotherapy for regrowing avascular meniscus cartilage are expensive placebos sold by liars. I'd love to be proved wrong about that.

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#37 kaypeeoh

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Posted 11 November 2014 - 04:57 PM

A common injury in dogs is a torn ACL--CCL in the veterinary world--which often includes a tear of the medial meniscus.  For 30 years the standard has been to remove the loose flap of meniscus.  The defect fills with fibrocartilage, arguably a weaker tissue but functional.  PRP into the joint should speed up the deposition of fibrocartilage.  I've only done this to a half-dozen dogs but so far they seem to be healing quickly.  



#38 sthira

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Posted 11 November 2014 - 04:58 PM

Adult Human Mesenchymal Stem Cells Delivered via Intra-Articular Injection to the Knee Following Partial Medial Meniscectomy
A Randomized, Double-Blind, Controlled Study
C. Thomas Vangsness Jr., MD; Jack Farr II, MD; Joel Boyd, MD; David T. Dellaero, MD; C. Randal Mills, PhD; Michelle LeRoux-Williams, PhD
J Bone Joint Surg Am, 2014 Jan 15;96(2):90-98. http://dx.doi.org/10.2106/JBJS.M.00058

ABSTRACT
Background: There are limited treatment options for tissue restoration and the prevention of degenerative changes in the knee. Stem cells have been a focus of intense preclinical research into tissue regeneration but limited clinical investigation. In a randomized, double-blind, controlled study, the safety of the intra-articular injection of human mesenchymal stem cells into the knee, the ability of mesenchymal stem cells to promote meniscus regeneration following partial meniscectomy, and the effects of mesenchymal stem cells on osteoarthritic changes in the knee were investigated.

Methods: A total of fifty-five patients at seven institutions underwent a partial medial meniscectomy. A single superolateral knee injection was given within seven to ten days after the meniscectomy. Patients were randomized to one of three treatment groups: Group A, in which patients received an injection of 50 × 106 allogeneic mesenchymal stem cells; Group B, 150 × 106 allogeneic mesenchymal stem cells; and the control group, a sodium hyaluronate (hyaluronic acid/hyaluronan) vehicle control. Patients were followed to evaluate safety, meniscus regeneration, the overall condition of the knee joint, and clinical outcomes at intervals through two years. Evaluations included sequential magnetic resonance imaging (MRI).

Results: No ectopic tissue formation or clinically important safety issues were identified. There was significantly increased meniscal volume (defined a priori as a 15% threshold) determined by quantitative MRI in 24% of patients in Group A and 6% in Group B at twelve months post meniscectomy (p = 0.022). No patients in the control group met the 15% threshold for increased meniscal volume. Patients with osteoarthritic changes who received mesenchymal stem cells experienced a significant reduction in pain compared with those who received the control, on the basis of visual analog scale assessments.

Conclusions: There was evidence of meniscus regeneration and improvement in knee pain following treatment with allogeneic human mesenchymal stem cells. These results support the study of human mesenchymal stem cells for the apparent knee-tissue regeneration and protective effects.

#39 sthira

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Posted 11 November 2014 - 05:12 PM

A common injury in dogs is a torn ACL--CCL in the veterinary world--which often includes a tear of the medial meniscus. For 30 years the standard has been to remove the loose flap of meniscus. The defect fills with fibrocartilage, arguably a weaker tissue but functional. PRP into the joint should speed up the deposition of fibrocartilage. I've only done this to a half-dozen dogs but so far they seem to be healing quickly.


It seems to work in sheep that have been artificially wounded with specifically designed cartilege cuts, too. But not (yet?)in humans. Thousands of people have spent big money trying PRP and prolotherapy for regenerating lost meniscus cartilege (it's uninsurable since it doesn't work). If it worked now in humans, we'd know, since millions have undergone arthroscopic surgery for torn menisci.



I respect that veterinary medicine is often way more advanced and experimental than human medicine, however.

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#40 platypus

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Posted 11 November 2014 - 05:56 PM

Here's some discussion about the HGH-therapy:

 

http://www.kneeguru....p?topic=40093.0



#41 sthira

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Posted 11 November 2014 - 06:18 PM

Morphoangiogenesis in artificially wounded rabbits. Does it translate to people? No one knows. So you gamble at $400 per injection, and need ten injections over time. The thread linked ^^ was posted in 2007. If this consistently worked everyone suffering this awful injury would be shouting HGH injection praises from the rooftops and insurance would likely cover it. It doesn't work.

One problem is this: anecdotal Internet responses to expensive procedures that have little to no science to back their lofty claims sound a lot like Amazon reviews for supplements. Where is the truth?

#42 platypus

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Posted 11 November 2014 - 06:56 PM

Morphoangiogenesis in artificially wounded rabbits. Does it translate to people? No one knows. So you gamble at $400 per injection, and need ten injections over time. The thread linked ^^ was posted in 2007. If this consistently worked everyone suffering this awful injury would be shouting HGH injection praises from the rooftops and insurance would likely cover it. It doesn't work.

One problem is this: anecdotal Internet responses to expensive procedures that have little to no science to back their lofty claims sound a lot like Amazon reviews for supplements. Where is the truth?

What do you mean HGH-injections do not work? Did you contact the now elderly doctor who has pioneered the technique decades ago? Unless everyone is lying it certainly works for some people. 

 

http://osteochondral...x.php?topic=9.0

 

http://www.hgh.tv/hu...egeneration.php

 

BTW, 400$ injections are dirt cheap compared with joint replacement or the cost of stem cell therapies. 


Edited by platypus, 11 November 2014 - 06:59 PM.


#43 sthira

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Posted 11 November 2014 - 07:14 PM


Morphoangiogenesis in artificially wounded rabbits. Does it translate to people? No one knows. So you gamble at $400 per injection, and need ten injections over time. The thread linked ^^ was posted in 2007. If this consistently worked everyone suffering this awful injury would be shouting HGH injection praises from the rooftops and insurance would likely cover it. It doesn't work.

One problem is this: anecdotal Internet responses to expensive procedures that have little to no science to back their lofty claims sound a lot like Amazon reviews for supplements. Where is the truth?

What do you mean HGH-injections do not work? Did you contact the now elderly doctor who has pioneered the technique decades ago? Unless everyone is lying it certainly works for some people.

http://osteochondral...x.php?topic=9.0

http://www.hgh.tv/hu...egeneration.php

BTW, 400$ injections are dirt cheap compared with joint replacement or the cost of stem cell therapies.

From the Dr. Dunn website (which doesn't mention regrowth of avascular menuscus tissue):

"This form of HGH Joint Therapy generally lasts for three to twelve weeks, dependent upon the location and the severity of the joint issue. Sadly, this form of Human Growth Hormone treatment is not taken care of by insurance, so the treatment must be paid for completely by the patient. The average cost of HGH for Joint Rehabilitation Therapy is about ten thousand dollars in total."

If it works, then why won't insurance cover it? The answer from insurance is that it's experimental, and there's not enough human data.

#44 platypus

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Posted 11 November 2014 - 07:25 PM

 

If it works, then why won't insurance cover it? The answer from insurance is that it's experimental, and there's not enough human data.

 

That may well be, since proving it to FDA is so expensive. This does not mean that the therapy does not work, however. I think Dr. Dunn said in his interview that he will instruct other doctors about the therapy and he talks about the right dosage in his interview. This means that if you want to go experimental you just need to procure the HGH yourself and find a person abroad who is qualified and willing to administer the injections. I bet you will spend a lot less than 10000$.



#45 sthira

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Posted 11 November 2014 - 07:36 PM

What a mess. And for a simple cartilege injury. This is why I have so little hope for regenerative medicine, or the longevity movement in general. Whatever you do, please don't damage your white zone avascular meniscus. You'll have trouble walking on your way to immortality.

#46 sthira

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Posted 11 November 2014 - 11:38 PM

A common injury in dogs is a torn ACL--CCL in the veterinary world--which often includes a tear of the medial meniscus. For 30 years the standard has been to remove the loose flap of meniscus. The defect fills with fibrocartilage, arguably a weaker tissue but functional. PRP into the joint should speed up the deposition of fibrocartilage. I've only done this to a half-dozen dogs but so far they seem to be healing quickly.


Do you do MRIs of your dog patients? It'd be interesting if you would do before and after MRIs to see what your PRP injections are actually doing.
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#47 seivtcho

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Posted 12 November 2014 - 10:21 AM

By the way, sthira, did you choose what option to take? Did you have better results?



#48 sthira

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Posted 12 November 2014 - 01:52 PM

By the way, sthira, did you choose what option to take? Did you have better results?


I still haven't decided.

#49 tepol

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Posted 13 November 2014 - 02:07 PM

What a mess. And for a simple cartilege injury. This is why I have so little hope for regenerative medicine, or the longevity movement in general. Whatever you do, please don't damage your white zone avascular meniscus. You'll have trouble walking on your way to immortality.

 

I agree ,because  theres no money in cures only passive temporary " fixes " .that demand more.

 

I also agree about PRP / Prolo not helping your injury - my point was that prolo works just as well for far less for overall joint stability .



#50 kaypeeoh

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Posted 13 November 2014 - 05:46 PM

Just saw a patient for a recheck today.  He had a torn ACL repaired with 80# fishing line inserted extracapsular.   Often that works well enough.  For him it didn't seem to.  At ten days PO there was significant drawer sign, the hallmark for incompetent ACL.  Yet at 20 days (today) there is no drawer sign.  In surgery I wasn't happy with the implant placement so I hedged my bets by filling the joint with PRP.   PRP is platelet-rich plasma.  I thing the platelets grow into the retinaculum, leading to a stable knee.   AKA the  stifle in the animal world. 

 

kpo

 



#51 resveratrol_guy

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Posted 16 November 2014 - 03:30 PM

I greatly value the very few "reasonable" my-stem-cell-experience blogs I find out there. Almost invariably, they're either marketing blather or disengaged skepticism. This one by Marion Odgers deals with rheumatoid arthritis in the context of adipose stem cell therapy by StemGenex. Executive summary: it worked well beyond the placebo threshold, but minor residual problems remain, and the path to healing was painfully oscillatory in quality for months -- all in all, the client is well satisfied with the results. As I've stated in my own thread, adipose scares the crap out of me for several reasons (maybe I'm overly paranoid, but no one has yet rationally refuted my concerns); so I would prefer iliac crest bone marrow stem cell therapy. Which brings me to my second point: a trusted  friend of mine told me that his mother had brilliant results with her knee, and is now doing the same therapy on the other one. She was able to cancel her artificial knee replacement surgery. I can ask him for the name of the center, if need be, which is in California and not connected with my other thread (but yes, they are a BMSC shop).

 


Edited by resveratrol_guy, 16 November 2014 - 03:31 PM.


#52 sthira

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Posted 16 November 2014 - 07:53 PM

Well, RA is different from a cartilage tear, of course. But overall, my takeaway from the whole "stem cell rejuvenation" gig is that the marketing is probably ahead of the science. Classical error made by injured, fragile people looking for healing. Maybe injected stem cells migrate and cause tumors elsewhere? That's FDA's concern, I think. I'm seeing an ortho in a few weeks. See what the (biased) university-connected docs have to pitch with regard to meniscal tear regeneration. I don't expect much. Boo-hoo

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#53 resveratrol_guy

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Posted 16 November 2014 - 09:56 PM

Well, RA is different from a cartilage tear, of course. But overall, my takeaway from the whole "stem cell rejuvenation" gig is that the marketing is probably ahead of the science. Classical error made by injured, fragile people looking for healing. Maybe injected stem cells migrate and cause tumors elsewhere? That's FDA's concern, I think. I'm seeing an ortho in a few weeks. See what the (biased) university-connected docs have to pitch with regard to meniscal tear regeneration. I don't expect much. Boo-hoo

 

There is no hope of stem cell marketing ever being accurate: most therapists are full of exaggerated claims and obtuse testimonials; while overregulated conventional docs say it doesn't work because they don't want to get sued if it fails, but won't get rewarded if it succeeds. But that's OK because stem cells don't care about truth-in-advertising. So I would look at the noisy-but-ample data on all this, and ignore both camps otherwise.

 

I don't think the FDA is concerned about health at all, but I think you're correct that their overriding putative "concern" about stem cell therapy is unregulated tissue growth. But again, if the reproduction of senescent stem cells were the only requirement for cancer, then babies would be loaded with tumors, because they're formed from decades-old stem cells, just like the ones that might fix your cartilage. And statistically, I think we've had enough test cases (tens of thousands) of BMSC and adipose therapies in the good old overregulated USA that if the cancer risk were wildly increased, we would have seen the lawyers partying by now. (Yeah, the theoretical increased risk might for example peak 20 years out, but that would still probably result in a detected increase in short term malignancies, especially because the cancer risk is widely advertised to patients in the popular press.) But this doesn't seem to be happening.

 

What does seem to be happening with respect to mortality risk is a steady stream of incompetent therapists having procedural accidents resulting in injury and death, mainly in dodgy third world clinics. But if the therapy is successfully delivered, then logically, better tissue perfusion due to IV (but not cartilagenous) stem cell injection should actually improve organ function and immune access to deeply buried cells, thereby reducing the probability of cancer, and likely all-cause mortality. Bottom line: I understand that we won't be able to prove the safety and effectiveness of stem cell therapy for several human lifetimes yet, so we're forced to decide on the most logically appealing argument and risk-reward tradeoff, and behave accordingly. Welcome to life with noisy data.

 

So because stem cell therapy can have such global effects, the best method of analysis may be something along the lines of what I'm trying to do along with my friend: if you take a risk, publish as much data as you're willing to share, so that eventually we can achieve a roughly accurate understanding of cause-and-effect. Clinical trials are almost invariably too narrow in their focus (and to be sure, their selection criteria) to see the majority of either risks or benefits, so I suspect that most of our understanding of this field will come from retroactive data mining of published before-and-after measurements, which are inevitably tainted data sources, but are certainly worth more than "we don't know" when taken in the aggregate. I don't want this to turn into a discussion of artificial intelligence, but suffice to say that the most significant missing piece of engineering in stem cell research is probably an IBM-Watson-like machine which can read massive amounts of untrusted data about therapy effects, and come to some statistically supported conclusions using forensic/Bayesian techniques to eliminate the BS.

 

So I for one would be thrilled to have any statistically significant data that emerges from your case, good or bad.

 



#54 NLTCrow

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Posted 16 November 2014 - 11:00 PM

While I have not had any Stem Cell injections, I have spoken extensively with a Dr in my town about having it done.

 

She uses adipose from lipo rather than bone marrow.

She combines the stem cell injections with PRP and recommends following up with additional PRP treatments in the subsequent months as it tends to sustain & bolster the stem cell's effectiveness.

From her experience she threw out that knees show the most improvement, about 80% vs shoulders & hips which are closer to 50%.

 

A buddy of mine had it done on his knees & a shoulder and raves about how great they feel.

 

I'd love to have it done but it would cost close to $20K for both knees, both shoulders & a hip and that's just not gonna happen right now.

 

These kinda treatments are not approved by the FDA and that's why/how insurance refuses to cover it.

 

I have had both Prolozone & PRP treatments in a knee for a fractured patella (kneecap) and noticed no real improvement.

I also had a couple Prolozone treatments in a hip and again noticed no real improvement.

 

Be happy to pass along the doc's name if anyone is interested, shoot me a PM.



#55 ironfistx

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Posted 26 November 2014 - 01:14 PM

I sorted my knee out with Gelatine and Horny Goat Weed.
Horney goat weed provides the same thing as stem cells without the cost and pain.
 

 

Is there any information about this?  How does horny goat weed do the same thing?



#56 tepol

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Posted 30 November 2014 - 01:59 PM

Has any one ever had PRP with that matristem miracle powder ( acell ) ?

 

 

 

 



#57 sthira

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Posted 04 December 2014 - 07:11 PM

Repairing tears in meniscus cartilage made joint trouble more likely than physical therapy did
By Robert Preidt
Wednesday, December 3, 2014

A common type of knee surgery may increase the chances of arthritis, a new study suggests. The procedure repairs tears in the meniscus, a piece of cartilage that acts as a shock absorber. There are two in each knee, and they stabilize the knee joint. Meniscal tears are one of the most common knee injuries, and surgery is often performed to reduce pain and improve joint function, the researchers said.

In their study, the scientists used MRI scans to look at 355 knees with arthritis, and compared them to a similar number of knees without arthritis. The average age of the patients was about 60 and most were overweight.

All 31 knees that were operated on to repair meniscal tears developed arthritis within a year, compared with 59 percent of knees with meniscal damage that did not have surgery.

Cartilage loss occurred in nearly 81 percent of knees that had meniscal surgery, compared with almost 40 percent of knees with meniscal damage that did not have surgery, the study found.

The study was to be presented Wednesday at the Radiological Society of North America annual meeting in Chicago.

Even though surgery to repair meniscal tears is common, "increasing evidence is emerging that suggests meniscal surgery may be detrimental to the knee joint," study author Dr. Frank Roemer, from Boston University School of Medicine and the University of Erlangen-Nuremberg in Germany, said in a society news release.

"The indications for meniscal surgery might need to be discussed more carefully in order to avoid accelerated knee joint degeneration," he suggested.

An alternative to surgery is physical therapy to help maintain and restore knee muscle strength and range of motion. Ice and nonsteroidal anti-inflammatory medications (NSAIDs) are also used to treat pain and symptoms, according to the release.

SOURCE: Radiological Society of North America, news release, Dec. 3, 2014

#58 kaypeeoh

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Posted 08 December 2014 - 11:16 PM

I saw a canine patient today that I'd seen for a torn ACL nine months ago.  He was in today for a routine checkup and shots.  Nine months ago the client said she couldn't afford the $3000 ACL surgery.  She agreed to experimental therapy.   I used a micro-cannulus to suck out 30cc of sq fat from the dog.  Then spun the fat in a centrifuge.  This separated the fat into 3 distinct sections.  The center section contains the stem cells.   Then I mixed that with an equal volume of plasma.   Then injected the mixture into the damaged stifle joint. 

 

As of now the leg is normal.  I can't see anything wrong and the dog runs fine. 

 

Fat has 100X more stem cells than a similar volume of bone marrow.   I think marrow is more popular because it can be injected through a smaller needle.   For the dog I punctured the joint using a scalpel then using a cannulus injected the stem call/plasma mixture into the joint. 

 

The fat extraction is similar to  human liposuction for fat removal.  The main difference is the microcannulus which breaks up the fat a bit while it's being aspirated into a 20cc syringe. 

 

I had bone marrow stem cells injected into my Achilles tendon earlier this year.  It didn't do much and then I had PRP treatment eight weeks ago.  Now the Achilles is pain-free and I'm back to running.   Maybe the stem cell treatment needed the addition of PRP to work. 

 

kevin


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#59 sthira

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Posted 09 December 2014 - 12:44 AM

I saw a canine patient today that I'd seen for a torn ACL nine months ago. He was in today for a routine checkup and shots. Nine months ago the client said she couldn't afford the $3000 ACL surgery. She agreed to experimental therapy. I used a micro-cannulus to suck out 30cc of sq fat from the dog. Then spun the fat in a centrifuge. This separated the fat into 3 distinct sections. The center section contains the stem cells. Then I mixed that with an equal volume of plasma. Then injected the mixture into the damaged stifle joint.

As of now the leg is normal. I can't see anything wrong and the dog runs fine.

Fat has 100X more stem cells than a similar volume of bone marrow. I think marrow is more popular because it can be injected through a smaller needle. For the dog I punctured the joint using a scalpel then using a cannulus injected the stem call/plasma mixture into the joint.

The fat extraction is similar to human liposuction for fat removal. The main difference is the microcannulus which breaks up the fat a bit while it's being aspirated into a 20cc syringe.

I had bone marrow stem cells injected into my Achilles tendon earlier this year. It didn't do much and then I had PRP treatment eight weeks ago. Now the Achilles is pain-free and I'm back to running. Maybe the stem cell treatment needed the addition of PRP to work.

kevin


Thanks for the report, Kevin. Veterinary medicine is definitely more progressive than ours. I wish we were able to safely experiment with techniques that are likely to regenerate torn parts but are still not proven. Your canine patient's ACL injury was vascular? And was your Achilles' tendon injury also vascular? Do you think blood supplies to the injured areas help facilitate the effects of (fat-derived) stem cell and plasma mixtures?

As of now, I've done little to help my torn avascular meniscus beyond strengthening my quads and core. I'm in limbo and don't really know what to do. It seems as though the sensible arthroscopy I had on the knee a few years ago was probably a mistake. Current literature appears to be revealing that post-arthroscopic injuries are more likely to become arthritic.

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#60 kaypeeoh

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Posted 09 December 2014 - 07:57 PM

In animals abnormal stress on the ACL can tear the meniscus as it breaks the ACL;   Commonly the two injuries occur together.   I thought the dog had a torn meniscus because it made a clicking noise as he walked.  At the same time there was drawer sign that meant a torn ACL.   I think the Stem cells AND PRP injected into the joint allowed healing of the meniscus.  At the same time it thickened the retinaculum which stabilized the joint.

 

kpo






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