Bone Marrow Prolotherapy to the Ankle

A thirty-five year old patient came into our office complaining of a 15 year-long ankle injury. He is a boxer and cyclist. The patient first suffered a bad ankle sprain while playing college basketball and the residual pain increased over the years. He had a few cortisone shots that had helped temporarily but the pain always returned with greater intensity. He had constant clicking and grinding. In March of 2010 he had arthroscopic surgery to remove bone spurs. He was told he would need further surgery and an ankle fusion. The patient was not happy with this recommendation and went looking for an alternative therapy.

At the patients first Prolotherapy treatment his ankle injury was assessed. Due to the severity of the injury we estimated that the patient would need 6-12 treatments spaced one month apart. We used a standard dextrose Prolotherapy solution with added human growth hormone (HGH) and administered 52 injections to the patient’s ankle. CM had gradual improvements with the first two treatments and hit a plateau after his third treatment. When he came in for his fifth treatment he expressed his concern over the plateau. we suggested that he try Bone Marrow Prolotherapy or also referred to as Stem Cell Prolotherapy

Bone Marrow Prolotherapy to the Ankle: In this patient’s case, the 10cc of his own bone marrow was injected into his ankle. He also received 22 injections of a dextrose Prolotherapy solution strengthened with HGH. He left with the same instructions as before – use heat twice a day and avoid running and jumping but stay active with swimming and cycling.

He returned three months later and enthusiastically told us about his decrease in pain. He said the difference in the Bone Marrow Prolotherapy was “like night and day.” He had a tremendous improvement in pain – the intensity was far less, his popping and clicking was eliminated, and he had absolutely no pain at rest. He believed that one more treatment would be sufficient to heal his sports injury once and for all. He received another Bone Marrow Prolotherapy treatment along with 52 injections of dextrose Prolotherapy solution. He returned to full activity and no longer had ankle pain plaguing him throughout the day.

This story is the perfect example of how the body knows best. He was seeing gradual improvements with standard Prolotherapy, but his body needed something else to reach complete healing. By providing bone marrow to the injury site, the body was able to take stem cells and grow the specific reparative cells that his ankle needed. No matter the joint injury, Caring Medical uses Prolotherapy to heal – dextrose Prolotherapy, Platelet Rich Plasma (PRP) Prolotherapy and Bone Marrow Prolotherapy provide many options for each patient’s needs. Call us today at 708-848-7789 to find out more.

To learn more about Bone Marrow Prolotherapy

 

Stem cells to relieve degenerative joint disease

Is stem cells harvested from your own bone marrow the answer to chronic degenerative joint disease in the knees? A renowned Prolotherapy doctor and chronic joint pain specialist says yes.

Ross Hauser, M.D., has made a reputation for injection therapies that rebuild damaged joints. He has delivered hundreds of thousands of injections to over 10,000 patients in a treatment called Prolotherapy,

In this treatment a simple sugar (dextrose) is injected into damaged knees, backs, shoulders, and other joints to accelerated the body’s own inflammatory response. This helps the immune system rebuild the soft tissue that hold the joints together.

In the knee, Prolotherapy strengthens the powerful ligaments and repairs partial tears. Studies have shown that Prolotherapy can rebuild cartilage and help patients and athletes avoid surgical repair and/or total knee replacement.

Now Dr. Hauser says, clinical findings and observational studies are showing that accelerated cartilage growth can be obtained in the most degenerated of knees. Those with “bone-on-bone” or osteoarthritis, with the introduction of stem cells into the Prolotherapy treatment.

While traditional Prolotherapy has shown results in the regrowth of articular cartilage, Dr. Hauser says the introduction of stem cells, harvested from the patients own bone marrow, can accelerate Prolotherapy’s ability to rebuild cartilage in the knee.

“The results we see in patients are very encouraging,” says Dr. Hauser. What we do is extract a small amount of bone marrow from the patient. From this bone marrow we extract stem cells. The stem cells are then injected into the knee with the idea that they will ignite a regrowth of the knee’s cartilage.”

“Stem Cell or Bone Marrow Prolotherapy is usually reserved for the most severe cases of joint degeneration,” adds Dr. Hauser. “Traditional Prolotherapy using dextrose Prolotherapy has been shown in many studies to be effective in reduction of pain and strengthening of the knee in up to 90% of cases. Stem cells are used for those patients where knee surgery may not be an option, or for the athlete who wants to rebuild their knee as opposed to the constant removal of cartilage tissue.”

Dr. Hauser is medical director of Caring Medical and Rehabilitation Services in Oak Park, IL. The clinic has prepared an extensive website on stem cell/bone marrow prolotherapy that will help patients learn about this new procedure visit www.bonemarrowprolotherapy.com

New Prolotherapy Video – Prolotherapy injections

Ross Hauser, M.D. explains the different types of Prolotherapy injections.

Ross Hauser, M.D., is recognized as one of the leading experts in Prolotherapy. His Chicago area chronic pain clinic  is located in Oak Park, Illinois

Bone marrow injections for cartilage repair

Direct uncultured bone marrow cells regenerate articular cartilage in animal study

The question still remains, “Is Bone Marrow Prolotherapy the very best type of stem cell therapy?” Let’s put it another way, “Is direct bone marrow injection the best way to introduce stem cell therapy into a joint?” Let’s take a look at why these researchers give a resounding “yes” answer to that question.

Researchers from the Graduate School of Human Comprehensive Sciences, at the University of Tsukuba Japan have successfully regenerated articular hyaline cartilage by using uncultured bone-marrow-derived cells.1  The researchers wanted to determine if autologous (cells from the same animals) bone marrow cells could regenerate articular cartilage. To determine this they generated large full-thickness articular cartilage defects in the knees of 48 Japanese white rabbits. The animals were divided into four groups: the uncultured bone marrow cell group; the peripheral blood cell group; a fibrin group (gel used in the study);  or a control group, where nothing was done.  The knees of the rabbits were studied 3 months after the treatments were given. The articular cartilage underwent histological and histochemical investigation (under the microscope). So what did placing bone marrow cells do to the articular cartilage in this study?

According to the authors, “In the bone marrow cell group, regeneration of cartilage could be detected in almost all of the sections…the percentages of Safranin-O-stained areas (stains for cartilage granules) with respect to the regenerated soft tissue area were significantly higher in the bone marrow cell group than in the other groups.’1  They also noted “…our group has reported that autologous bone marrow-derived culture-expanded cartilage repair.  Comparing these latter results with those of the bone marrow cell group (direct bone marrow injection) there was no significant difference in any criteria….In conclusion, the transplantation of autologous uncultured bone marrow-derived mononuclear cells contributes to articular cartilage repair.  The easy and safe method used in this study is potentially viable for clinical application.”

The question still remains does bone marrow have to be cultured to get more stem cells to make it effective?  Our experience at Caring Medical is no, just like these researchers found. They found, as we surmise, that the stem cells in human bone marrow are smart enough to find the injured area and start proliferating, differentiating and proliferating the necessary cells to make the tissue that is degenerated or torn.  In other words, the body knows best.  Direct bone marrow injection for the regeneration of tissue such as articular cartilage and meniscus works in humans and there is no reason it won’t work in people.  We hope to be one of the centers to prove it!

1Chang F, Ishii T, Yania T. Repair of large full-thickness articular cartilage defects by transplantation of autologous uncultured bone-marrow-derived mononuclear cells.  Journal of Orthopaedic Research. 2008;26:18-26.

Ross A. Hauser, M.D.
Dr. Hauser the Medical Director of the comprehensive Prolotherapy, PRP, and Bone Marrow Prolotherapy clinic, Caring Medical & Rehabilitation Services in Oak Park, Illinois. Dr. Hauser is one of the leading experts in the treatment of chronic pain and sports injuries with Prolotherapy.

PRP (platelet rich plasma) and bone marrow to grow cartilage

PRP (platelet rich plasma) and bone marrow to grow cartilage

What is the role of platelet rich plasma in bone marrow prolotherapy for articular cartilage regeneration?

It is already well established that bone marrow contains mesenchymal stem cells, also called connective tissue progenitor cells. The question is “How can we get these stem or progenitor cells to repopulate an area the quickest?”  How can we get stem cells to proliferate and differentiate the way we want them?

Recently researchers at Stanford University Medical Center asked these questions.1 Specifically they tested, whether platelet rich plasma (PRP) may be useful for cartilage regeneration by seeing mesenchymal stem cells grew more quickly when grown in a medium with PRP.1

PRP can be defined as plasma with enriched levels of platelets relative to whole blood. Within platelets are alpha granules that contain powerful growth factors that are proposed to substantially aid the healing of soft tissue structures such as tendons.  PRP is one of the available proliferants used at Caring Medical for Prolotherapy, thus we call it appropriately PRPP or Platelet Rich Plasma Prolotherapy.

The Stanford researchers found a 10% PRP solution caused a fivefold increase in mesenchymal stem cell proliferation after 7 days.  The PRP treatment also caused an increase in expression of markers of both chondrogenic and osteogenic differentiation by human mesenchymal stem cells.  They noted, “Adding PRP to mesenchymal stem cells and then using the combination to treat bone, ligament, tendon, or cartilage may be valuable….this suggests that PRP may selectively encourage mesenchymal stem cell differentiation along a chondrogenic line.”

This article provides some of the scientific research that supports the use of PRP in Bone Marrow Prolotherapy. While direct bone marrow aspiration injection (direct Bone Marrow Prolotherapy) involves the injection of only bone marrow into the injured tissues and joints; concentrated bone marrow aspiration can include just bone marrow or bone marrow combined with PRP. Either of these solutions is then concentrated to make whatever volume is needed.  An example of would be someone coming for advanced osteoarthritis and a total of 12cc of solution is desired (6cc for each knee). If PRP is used, 20cc of PRP could be combined with 30 cc of bone marrow and then the solution concentrated down (to concentrate the cells and growth factors) to 12cc.

The reason to use the PRP would be the same as the article shows, to enhance the growth of the mesenchymal stem cells, only the stimulation would occur in situ or in its natural environment. Where would that be?  The injections are given at the site of the knee arthritis. The mesenchymal stem cells (bone marrow concentrate) and PRP (concentrate) would be injected right into the person’s arthritic knees!

In our office, this is typically done every six to eight weeks and normally takes four to six visits to achieve pain resolution.  Before and after x-rays or MRIs are encouraged to better quantify the articular cartilage and/or meniscus regeneration. The most important result, however, is the decrease in the pain level, improved joint range of motion, and increased walking and exercise ability.

Ross A. Hauser, M.D.
Dr. Hauser the Medical Director of the comprehensive Prolotherapy, PRP, and Bone Marrow Prolotherapy clinic, Caring Medical & Rehabilitation Services in Oak Park, Illinois. Dr. Hauser is one of the leading experts in the treatment of chronic pain and sports injuries with Prolotherapy.

Prolotherapy Newsletter 1/12/2011

● Bone Marrow Prolotherapy – Hip
One of our first patients to receive Bone Marrow Prolotherapy to his hip has reported great results thus far (it’s only been a week and a half) but he says he can feel a difference. MG is a 46 year old contractor who does a lot of physical work. He received regular Hackett-Hemwall Prolotherapy with HGH to his severely arthritic hip from late 2007 to early 2009. He was much improved from this Prolotherapy but had not been able to return to full athletics because the increased activity would aggravate his hip. He was interested in trying out Bone Marrow Prolotherapy.

● Is it Loose Ligaments Causing Your Low Back Pain?
Read about some typical pain patterns experienced with ligament injury to the lower back.

● Knee Arthroscopy
The Patient thought her arthroscopy was for meniscal repair, but she received a resection – the case of Brenda from Boston – Prolotherapy would have been a much better option! Brenda from Boston came to Caring Medical with the desire to avoid getting bilateral knee replacements. She was already told by a surgeon that she was a great candidate for knee replacement surgery. Brenda is 70 years old.

Prolotherapy newsletter January 5, 2011

Prolotherapy newsletter January 5, 2011
We have a new video – bone marrow Prolotherapy What are growth factors? Why are growth factors important? Thank you for your interest in Bone Marrow Prolotherapy and how Prolotherapy is used at Caring Medical to help in the repair of ligaments, tendons, and cartilage. In this video, Ross Hauser, MD reviews what growth factors are and their role in treating pain and soft tissue injuries. Watch the video

Prolotherapy while undergoing chemotherapy Recently a potential new patient contacted Caring Medical about the possibility of getting Prolotherapy for some knee arthritis, while she underwent chemotherapy. She had been on Taxol (chemotherapy drug) for breast cancer.

Prolotherapy after back surgery Patients often have chronic low back pain persisting after surgery and are put into the category of people with “failed back surgery syndrome.” It is easy to find reasons why a back surgery patient would still have pain after the surgery. During surgery, for example, a discectomy (removal of the disc), the surgeon must spread some muscles and cut some of the ligaments in order to perform the surgery. The surgery itself can cause ligamentous laxity and instability of the spine.

When should the Prolotherapy start working? The anesthetic in the solution used during Prolotherapy sessions often provides immediate pain relief. The pain relief may continue after the effect of the anesthetic subsides due to the stabilizing of the treated joints because of the inflammation caused by the Prolotherapy injections.

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