Stem Cell Treatment

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What is Regenerative or Stem Cell therapy?

As we age, we are in a continuous battle between activity-induced stress on our musculoskeletal system and our ability to recover. During this cycle of tissue breakdown and repair, our body uses specialized cells to make new tissue to help in the recovery process. These specialized cells called Mesenchymal Stem Cells (MSC) simply respond to repetitive stress (injury) by helping you to make new tissue.

During our lifetime we use up millions of these cells that are held in reserve throughout our body. Although we have an abundant supply of these special Stem Cells, the aging process seems to reduce their ability to “turn on” and repair damaged tissue. With continued stress we develop chronic pain and loss of function. Stem Cell therapy is the process of injecting high concentrations of these special cells into tendons, ligaments, joints, nerves and muscle to help “you repair you”.

What are the potential benefits of Regenerative or Stem Cell therapy using MSC?

The major benefits are the repair and regeneration of injured or damaged tissue. MSC can regenerate tissues such as torn meniscus, ligaments, rotator cuff, tennis elbow and also degenerative diseases like arthritis and osteoarthritis. Therapy using MSC decreases pain and improves function. The procedure is done in our office, under local anesthesia. This eliminates the risks associated with surgery or general anesthesia.

What are the risks and side effects to Stem Cell therapy?

These procedures are considered very safe. Most patients will experience mild pain and soreness during and after the procedure.  Because your own blood, bone marrow and fat is used, there is no chance of ‘rejection” by your body.  This procedure is done under sterile conditions and risk of infection is low.

While the treatment is typically mildly painful we use oral medications and local anesthetics to help reduce your pain during the procedure.  You may notice some pain and discomfort after the procedure. This is more frequent after bone marrow aspiration. Most patients find over the counter medications, ice and rest sufficient to help with the pain.

What is the difference between Stem Cells from fat and from bone marrow?

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Adipose Derived Stem Cells (ADSC) are collected from fat via a Lipo-aspiration technique (NOT Liposuction) and bone marrow cells are collected from your hip crest bone. Bone Marrow Aspirated Cells (BMAC) have a superior ability help those patients that need enhanced oxygen and nutrient delivery to damaged tissues.

ADSC have more regenerative properties to form new ligaments, cartilage and bone.  This technique is best utilized to help fill tissue that has larger defects and/or torn tissue. 

Are there any ethical issues with Adult Stem Cells?

No, adult stem cells are from you!  They reside in your bone marrow and fat and they exist in large quantities. We use your own Stem Cells and do NOT store or alter them in any way.

What is PRP and why is it used with Stem Cell Therapy?

Platelet Rich Plasma (PRP) is found in your own blood. Once we collect your blood and concentrate these platelets, we inject into your injured area to enhance the healing process at the site.  Platelet cells release growth factors and other proteins as well as stopping bleeding to the area.  Injecting PRP releases a powerful dose of growth factors to accelerate and enhance tissue repair and healing properties of the Stem Cells.  By using PRP with Stem Cell therapy, we increase the wound healing and reparative potential to your damaged tissue.

How is PRP obtained?

PRP is obtained with a simple and safe blood draw. Special collection tubes are used and about 30 to 50cc or roughly 2-3 tablespoons of blood is obtained. The blood is spun down with special FDA approved equipment until the PRP mixture separates. The PRP is ready for injection or to be mixed with bone marrow or fat stem cells for treatment to relieve your pain and heal arthritis and injuries.

Is Stem Cell Therapy Approved by FDA?

The FDA does not regulate medical procedures performed by qualified and licensed doctors. Currently, there are no clear protocols to treat any disease with adult stem cells in the U.S.  As we ONLY use your adult stem cells and we do not alter, manipulate or store your stem cells, FDA approval isn’t necessary.  Our procedure is to re-inject your stem cells during the same day in same procedure.

How long has PICSM been doing these types of procedures?

At Performance Injury Care and Sports Medicine (PICSM) we are a leader in using regenerative therapy.  We have years of experience in using ultrasound guided injections to help repair chronic & acute injuries.  Dr. Steele has been using Platelet Rich Plasma (PRP) therapy since 2008 and we are continually updating our techniques to better help you get back on track with a healthy lifestyle. 

What sets PICSM apart from other Stem Cell clinics?

Many Stem Cell clinics are popping up all over the U.S. and are advertising here in Montana.  Many of them are using marketing and very little science or expertise in using Stem Cell therapy.   Here at PICSM, we evaluate you to determine why you have pain.  We utilize x-ray, MRI and diagnostic ultrasound to determine what led to the tissue breakdown in the first place.

We do all of our injections with ultrasound guidance to insure proper needle placement inside your body.  We pride ourselves in the advanced imaging that we offer here in Helena.  We will not just inject your injured area and wave goodbye with a sheet of instructions.  We typically see you back for 4 follow up visits to discuss range of motion, strengthening and other exercises along with checking your progress.  During your follow up visits we may use low light laser therapy over the treatment site to enhance your recovery. 

We believe that the newly formed tissue is very fragile and needs to be protected with bracing and/or crutches to allow for complete regeneration and healing.  By coordinating your care with an accurate diagnosis, ultrasound guidance for correct placement of the stem cells, protection of the newly formed tissue with proper bracing and follow-up visits to help with strengthening and motion of the tissue we have superior outcomes.  If you do not try and restore normal movement, function and balance to the injured area, you will have recurrence of pain. 

How do I know if I’m a Stem Cell therapy candidate?

Consult with Dr. Steele to see if you have any type of joint or tendon pain that hasn’t resolved with conservative therapy. After a complete medical evaluation, Dr. Steele will determine which one of the biological regenerative procedures will best help you recover.  Stem Cell therapy works best with moderate arthritis, joint pain or degenerative tendon or ligament disease. Stem Cell Therapy helps YOU fix you.

How do I know if the Stem Cells are injected in the correct place?

At our clinic we know that the success of any treatment relies on having the correct diagnosis and an accurate delivery system to the diseased tissue.  By using ultrasound imaging, we can see exactly where the needle is being placed.  By visualizing the correct site of injury, we can provide an accurate and effective treatment helping you to get back to work, sport or play.

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All of our regenerative procedures are done with advanced Musculoskeletal Ultrasound Imaging.  We not only utilize the best ultrasound imaging equipment in Montana, we are also the most highly trained diagnostic musculoskeletal clinic in Montana.  Dr. Phillip M. Steele and Abbey M. Barnhart, PA-C are both Registered Musculoskeletal Ultrasound certified (RMSK). 

Dr. Steele is recognized regionally as well as nationally through his many lectures and faculty positions in advanced ultrasound courses.  He works as an advisor to RMSK helping to write the training exam and works with other leaders in the field of diagnostic ultrasound imaging to promote diagnosis and treatment of nerve entrapment injuries. 

What do I need to do to prepare for my Stem Cell or PRP treatment?

We recommend that you take no ibuprofen type medications for 2-3 weeks before the procedure and 4-6 weeks afterwards.  Patients should stop all tobacco products 2 weeks before the treatment date and for 6 weeks after.

When we are treating a joint for osteoarthritis we will ask you to come to the clinic about one week before the procedure to receive a joint injection with 5% dextrose.  This “primes the pump” before your procedure acting to rev up your immune system’s response to the stem cell procedure.  In some cases we will fit you with a brace and/or crutches before your procedure date.  It is important to not damage newly formed tissue so we typically fit you for these items prior to your procedure.

When can I go back to my regular activities or should I take time off work?

The procedure is a same-day office procedure. Patients are usually sore during the first couple days after the injection. Depending on the work you do, you may be able to  return to work the next day, but we recommend taking at least one day from work to allow you to take it easy.  Depending upon your lifestyle and the type of procedure, you may return to work with some bracing to prevent re-injury.

How soon will I notice improvement?

Stem Cell treatments stimulate the growth and repair of connective tissues but require time to complete the healing process.  Typically, patients notice improvement after 2 weeks and continue to notice improvement for months after the procedure.  One study on ankles showed continued improvement up to 22 months.

I hate needles and am nervous about having any procedures!

We can prescribe an oral anti-anxiety medicine and pain medicines that you take prior to the procedure. During the procedure, we use local anesthetic. Most of our patients feel minimal discomfort. Feel free to bring your favorite music device and ear buds!

Does insurance cover these procedures?

PRP and Stem Cell treatments are considered an experimental procedure by most commercial insurance plans.  While workman’s compensation may authorize these procedures in Montana, most insurance companies will not pay for PRP or Stem Cell treatments.  You may use your health savings account for payment.

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