Liza Maniquis-Smigel, MD use of Orthobiologic Therapy in the treatment of joint and spine degeneration.
Orthobiologic Therapy is exploding in the medical field, and for good reason.. It is a very exciting time for medicine, especially in the field of reparative medicine.
In Orthobiologic Therapy we use a person’s own healing cells from fat, and blood (alone or in various combinations) and inject them straight to the area which has a cellular deficiency.
The goal is to stimulate the repair of injured tissues.. Our fat cells contain medicinal signal cells and progenitor cells, among other names. These cells, growth factors and signal proteins have the ability to heal tissues like cartilage, bone, and ligaments.
Consequently, researchers and clinicians are focusing on alternative methods for cartilage preservation and repair. Recently, cell-based therapy has become a key focus of tissue engineering research to achieve functional replacement of articular cartilage.
- "Regenerative medicine offers the exciting potential of developing alternatives to total joint replacement for treating osteoarthritis.”
- Orthobiologic Therapy shown to reverse joint disease in selected patients.
Orthobiologic Cell Therapy or Prolotherapy?
For many patients the success rate with traditional Prolotherapy in this office is in the 90%+ range for all patients. However, for those cases of advanced arthritis, meniscus tears, labral tears, bone-on-bone, or aggressive injuries, our Prolotherapy practitioners may choose to use orthobiologic injections to enhance the healing, in combination with dextrose Prolotherapy to strengthen and stabilize the surrounding support structures for meniscus repair.
Typically the tissue that we are trying to stimulate to repair with Orthobiologic Therapy or Prolotherapy is articular cartilage, but we can also proliferate soft tissues structures such as ligament and tendons. This is new technology so we are studying it as we use it to treat patients.
Improvement in technique Platelet Rich Plasma Therapy combined with Orthobiologic Therapy
We agree that orthobiologic therapy has benefits but may not provide a full cure. This is why we recommend the use of Platelet Rich Plasma Therapy in conjunction with adipose cell therapy. Platelets aid the adipose cells in their various jobs including differentiation and then aid in the differentiated cells making the extracellular matrix to repair the injured tissue.
Platelet Rich Plasma contains a myriad of substances that stimulate healing:
- Platelet-Derived Growth Factor (PDGF) Attracts immune system cells to the area and stimulates them to proliferate. Has been shown to enhance ligament and tendon healing.
- Transforming Growth Factor-8 (TGF-8) Secreted by and affects all major cell types involved in healing. Similar affects as PDGF.
- Vascular Endothelial Growth Factor (VEGF) Helps new blood vessel formation, thereby increasing vascularity in injured areas.
- Fibroblast Growth Factor (FGF) promotes the growth of the cells involved in collagen and cartilage formation.
The goal of Orthobiologic Therapy
Our ultimate goal with all forms of Prolotherapy is to get the patients back to doing the things that they want to do without pain. It is our hope that the Orthobiologic treatments will form functionally, structurally, and mechanically equal to, if not better than, tissue which has been designed to replace (or work alongside of) damaged tissue. It is hard to prove the above statement because we cannot sacrifice human beings after Prolotherapy to see if the tissue looks and acts normally. We can, however, report that the majority of our patients who receive Orthobiologic Therapy along with traditional Hackett-Hemwall Prolotherapy get back to activities and have dramatically decreased pain levels using this comprehensive approach.
Adipose Cell Procedure
The adipose cell therapy is an outpatient procedure performed by board certified physicians . The total procedure time is approximately 2 hours.
- Harvest: Using a liposuction procedure, 100-200cc of adipose tissue is harvested from the patient.
- The fat is isolated, washed and then micronized in sterile conditions.
- The advantages of adipose cell therapy are:
- Patients receive their own cells so there is no risk of immune rejection.
- Autologous cell therapy is a minimally invasive procedure with little to no down time.
- The adipose cells are injected into localized tissues.
- The growth factors and cytokines attract stem the areas of inflammation and damage.
- Distressed signals trigger cells to differentiate.
- Differentiating cells begin to integrate with target tissues or organs.