Regenerative Non-Surgical Procedures

A PRP procedure involves injection of patients own growth factors into a specific area, causing a healing cascade to repair any damage or tissue degeneration by promoting growth of new cells and rebuilding new tissue in the damaged area. PRP has been shown to cause new cell growth in ligaments and tendons, without significant inflammation. The Clinical data has shown that multiple growth and healing factors present in platelet-rich plasma may enhance and accelerate the body’s healing process and tissue regeneration.

PRP has been used clinically for nearly two decades to facilitate both bone and soft tissue healing. Growth factors begin tissue repair and regeneration at the wound site. They derive from platelets and initiate connective tissue healing, bone regeneration and repair, promote development of new blood vessels and stimulate the wound healing process. Potential benefits of this procedure are: Reduction of pain, increase in functional ability, and decrease in arthritis progression.

Bioactive proteins and growth factors in PRP include: PDGF-AB, TGF-b1, VEGF, fibroblasts growth factors and many others. By concentrating the platelets from freshly drawn peripheral blood, it is possible to create a solution of autologous growth factors to help up regulate the normal healing by actively recruiting natural body repair cells to participate in the regenerative process.

Most recently, PRP is being used in Regenerative Injection Therapy where it is injected into:

• Spinal facet joints
• Spinal discs, or around spinal nerves

To Treat:

• Neck and back pain due to arthritis of spinal joints
• Painful spinal disc tear
• Some disc herninations

Treatments are performed in the office-based setting, utilizing ultrasound guidance or in an ambulatory surgery center to allow accurate injections PRP to the exact site of an injury or pathology.

Autologous Fat Grafting (also known as Adipose Derived Stromal Vascular Cell Grafting) is used primarily for additional cushioning and scaffolding in a treatment of advanced structural injuries. In addition, it provides a more condensed source of autologous progenitor type reparative cells (form one’s own body) and acts as a rich matrix for cellular tissue and growth factors to gradually heal a defect.

Adipose stem cells are one of the richest source of stem cells in the body. They have the ability to differentiate into chondrocytes, fibroblasts, and other musculoskeletal tissue. The adipose stem cells have very similar properties to bone marrow mesenchymal stem cells, and have a wide range of therapeutic applications, based on its ability to self-renew and its ability to differentiate along multiple lineage pathways. AFG injections are used in cases of either more significant tears, defects, necrotic or avascular tissue, which may need new cellular material to be viable.

The abundance of stem cells in adipose tissue and the ability to easily collect large amounts of adipose tissue via mini-liposuction presents as an advantage, and eliminates the need for tissue culturing. Depending on the literature reviewed, there is anywhere between 500 and 2500-times the number of stem cells in adipose tissue as compared to bone marrow. The main components of the AFG fraction include adipose derived mesenchymal stem/stromal cells, hematopoetic stem cells, adipocytes and attached progenitor cells, T regulatory cells and activated monocytes and perivascular cellular components.

The AFG is obtained usually from the lateral hip, buttocks or abdominal area using a low suction system, as to keep the cells viable and undamaged. It is done under a local anesthetic. Usually no sedation is needed. The fat is obtained and the tissue is prepared, and mixed with platelet-rich plasma (PRP). The PRP is prepared by taking a tube of whole blood and processing it using one of the platelet harvesting systems. The fat is prepared and the platelet-rich plasma is added in appropriate quantities.

During the procedure the area of injury is examined and marked where the grafting will take place. Then this area is sterily prepped and locally anesthetized. Once the area is numb, the graft tissue is placed into the damaged area, until all the defects are filled with new tissue. Once this is accomplished, a sterile dressing is applied.

Usually there is some pain and discomfort for approximately 2-7 days. This tends to resolve with each day. Ice for 20 minutes, every 2 hours for the first day or so, is helpful. Appropriate pain medication might be used after the procedure, including Tylenol. Usually the patient receiving the graft would need to avoid NSAIDS for 5 days prior to the procedure and 5 days after the procedure. The patient should then follow-up in 4-6 weeks. Some patients may require physical therapy, depending on their situations. The graft grows and stays viable for 3 months, but may take up to 6-9 months to totally incorporate into the surrounding tissue.

Most recently AFG is being used in Regenerative Injection Therapy where it is injected into:

• Spinal joints and ligaments

To treat:

• Spinal joints arthritis
• Other spinal problems

Bone Marrow Concentrate (BMC) is a promising regenerative therapy to help accelerate healing in moderate to severe osteoarthritis or tendon injuries. Similar to Platelet Rich Plasma (PRP), or autologous fat grafting (AFG), BMC harnesses the body’s natural ability to heal itself by using regenerative cells found in a patient’s own bone marrow. Bone marrow is the soft tissue found in the hollow interior of bones. In adults, marrow contains a rich reservoir that produces new blood cells, including regenerative cells. These cells can be extracted from a patient’s pelvis and used for BMC injection therapy.

The process of obtaining and preparing these powerful regenerative cells is relatively simple.Stem cells are gathered by aspirating (removing through suction) bone marrow from the back of a patient’s pelvis with a tiny needle. Since the patient is given a local anesthetic, only minimal discomfort results from the procedure. The bone marrow is then placed in a centrifuge, which separates the regenerative cells and platelets from the rest of the blood products. The result is a concentrate that is 5-11 times richer in regenerative cells and growth factors, and includes platelets, mesenchymal stem cells, and other kinds of stem cells used in adult stem cell therapy. This concentrated bone marrow product is reintroduced via injection into the injured area during stem cell therapy.  Generally, the repair process takes two to three months to complete, but in most cases improvement can be noticed before then. About four to six weeks after the stem cell injection, the patient receives a platelet-rich plasma injection on the afflicted area; this is followed by another injection four to six weeks afterward. These injections enable the stem cells to continue growth and multiply to support cartilage or surrounding soft tissue.

With new techniques and technological improvements, regenerative cells can easily be obtained and concentrated in a simple office procedure. This point of care treatment allows for minimal manipulation of cells which are injected into the injured area on the same day.

Most recently BMC is being used in Regenerative Injection Therapy where it is injected into:

• Spinal facet joints
• Spinal intervertebral discs
• Around spinal nerves

To Treat:

• Neck and back pain due to arthritis of spinal joints
• Painful spinal disc tear
• Some disc herninations

Prolotherapy is a non-surgical injection procedure used to relieve back pain by treating connective tissue injuries (ligaments and tendons) of the musculoskeletal system that have not healed by either rest or conservative therapy in order to relieve pain and to improve structural stability. Treatments are performed in the office-based setting, utilizing ultrasound guidance or in an ambulatory surgery center to allow accurate injections to the exact site of an injury or pathology.

To treat:

• Arthritis of spinal joints
• Spinal disc tear
• Disc herniations
• Back sprain

A PRP procedure involves injection of patients own growth factors into a specific area, causing a healing cascade to repair any damage or tissue degeneration by promoting growth of new cells and rebuilding new tissue in the damaged area. PRP has been shown to cause new cell growth in ligaments and tendons, without significant inflammation. The Clinical data has shown that multiple growth and healing factors present in platelet-rich plasma may enhance and accelerate the body’s healing process and tissue regeneration. PRP has been used clinically for nearly two decades to facilitate both bone and soft tissue healing. Growth factors begin tissue repair and regeneration at the wound site. They derive from platelets and initiate connective tissue healing, bone regeneration and repair, promote development of new blood vessels and stimulate the wound healing process.

Potential benefits of this procedure are:

• Reduction of pain
• Increase in functional ability
• Decrease in arthritis progression

Bioactive proteins and growth factors in PRP include: PDGF-AB, TGF-b1, VEGF, fibroblasts growth factors and many others. By concentrating the platelets from freshly drawn peripheral blood, it is possible to create a solution of autologous growth factors to help up regulate the normal healing by actively recruiting natural body repair cells to participate in the regenerative process.

Most recently, PRP is being used in Regenerative Injection Therapy where it is injected into joints and cartilage tissue to treat a number of musculoskeltal problems including:

• Joint arthritis
• Cartilage defects
• Meniscal injury and tear
• Labral tear and many others

Treatments are performed in the office-based setting, utilizing ultrasound guidance or in an ambulatory surgery center to allow accurate injection PRP to the exact site of an injury or pathology.

Autologous Fat Grafting (also known as Adipose Derived Stromal Vascular Stem cells Grafting) is used primarily for few reasons, one, when treating more advanced tendon, ligament or cartilage injury. Another reasons is that it provides more condense source of autologous stem cells (Adult stem cells from your own body), and also it acts as a matrix for cellular tissue and growth factors to slowly heal a defect. Adipose stem cells are one of the richest source of stem cells in the body. They have the ability to differentiate into chondrocytes, fibroblasts, and other musculoskeletal tissue. The adipose stem cells have very similar properties to bone marrow mesenchymal stem cells, and have a wide range of therapeutic applications, based on its ability to self-renew and its ability to differentiate along multiple lineage pathways. AFG injections are used in cases of either more significant tears, defects, necrotic or avascular tissue, which may need new cellular material to be viable.

The abundance of stem cells in adipose tissue and the ability to easily collect large amounts of adipose tissue via mini-liposuction presents as an advantage, and eliminates the need for tissue culturing. Depending on the literature reviewed, there is anywhere between 500 and 2500-times the number of stem cells in adipose tissue as compared to bone marrow. The main components of the AFG fraction include adipose derived mesenchymal stem/stromal cells, hematopoetic stem cells, adipocytes and attached progenitor cells, T regulatory cells and activated monocytes and perivascular cellular components.

The AFG is obtained usually from the lateral hip, buttocks or abdominal area using a low suction system, as to keep the cells viable and undamaged. It is done under a local anesthetic. Usually no sedation is needed. The fat is obtained and the tissue is prepared, and mixed with platelet-rich plasma (PRP). The PRP is prepared by taking a tube of whole blood and processing it using one of the platelet harvesting systems. The fat is prepared and the platelet-rich plasma is added in appropriate quantities.

During the procedure the area of injury is examined and marked where the grafting will take place. Then this area is sterily prepped and locally anesthetized. Once the area is numb, the graft tissue is placed into the damaged area, until all the defects are filled with new tissue. Once this is accomplished, a sterile dressing is applied.

Usually there is some pain and discomfort for approximately 2-7 days. This tends to resolve with each day. Ice for 20 minutes, every 2 hours for the first day or so, is helpful. Appropriate pain medication might be used after the procedure, including Tylenol. Usually the patient receiving the graft would need to avoid NSAIDS for 5 days prior to the procedure and 5 days after the procedure. The patient should then follow-up in 4-6 weeks. Some patients may require physical therapy, depending on their situations. The graft grows and stays viable for 3 months, but may take up to 6-9 months to totally incorporate into the surrounding tissue.

Most recently AFG is being used in Regenerative Injection Therapy where it is injected into
joints and cartilage tissue to treat a number of musculoskeltal problems including:

• Joint arthritis
• Cartilage defects
• Meniscal injury and tear
• Labral tear and many others

To treat:

• Spinal joints arthritis
• Other spinal problems

Amniotic fluid and amniotic tissue based products are rich in growth factors and embryonic cells which can assist in tissue healing and remodeling.

Amniotic products are typically extracted from the amniotic fluid or/and amniotic membranes after a pregnant woman has delivered her baby. The amniotic fluid surrounds the fetus during development in the uterus and it is contained by the amniotic membrane. Research has demonstrated the regenerative potential of amniotic tissue in wound healing. Tissue banks handle the amniotic tissue storage, testing and delivery, to assure its safety and efficacy.

Amniotic products can provide reduction in pain, inflammation and improve symptoms of arthritis or ligaments, tendons, meniscal injuries and many others with not many known negative reactions. This experimental injection treatment can be combined with lubricating hyaluronic acid to increase the efficacy and to improve tissue healing, lubrication, cushioning and protection. Some of the big advantages using these products are: easy recovery and prevention of patients’ own tissue extraction need.

Bone Marrow Concentrate (BMC) is a promising regenerative therapy to help accelerate healing in moderate to severe osteoarthritis or tendon injuries. Similar to Platelet Rich Plasma (PRP), or autologous fat grafting (AFG), BMC harnesses the body’s natural ability to heal itself by using regenerative cells found in a patient’s own bone marrow. Bone marrow is the soft tissue found in the hollow interior of bones. In adults, marrow contains a rich reservoir that produces new blood cells, including regenerative cells. These cells can be extracted from a patient’s pelvis and used for BMC injection therapy.

The process of obtaining and preparing these powerful regenerative cells is relatively simple.Stem cells are gathered by aspirating (removing through suction) bone marrow from the back of a patient’s pelvis with a tiny needle. Since the patient is given a local anesthetic, only minimal discomfort results from the procedure. The bone marrow is then placed in a centrifuge, which separates the regenerative cells and platelets from the rest of the blood products. The result is a concentrate that is 5-11 times richer in regenerative cells and growth factors, and includes platelets, mesenchymal stem cells, and other kinds of stem cells used in adult stem cell therapy. This concentrated bone marrow product is reintroduced via injection into the injured area during stem cell therapy.  Generally, the repair process takes two to three months to complete, but in most cases improvement can be noticed before then. About four to six weeks after the stem cell injection, the patient receives a platelet-rich plasma injection on the afflicted area; this is followed by another injection four to six weeks afterward. These injections enable the stem cells to continue growth and multiply to support cartilage or surrounding soft tissue.

With new techniques and technological improvements, regenerative cells can easily be obtained and concentrated in a simple office procedure. This point of care treatment allows for minimal manipulation of cells which are injected into the injured area on the same day.

Most recently BMC is being used in Regenerative Injection Therapy where it is injected into joints and cartilage tissue to treat a number of musculoskeltal problems including:

• Joint arthritis
• Cartilage defects
• Meniscal injury and tear
• Labral tear and many others

Prolotherapy is a non-surgical injection procedure used to relieve joint pain by treating connective tissue injuries (ligaments and tendons) of the musculoskeletal system that have not healed by either rest or conservative therapy in order to relieve pain and to improve structural stability. Treatments are performed in the office-based setting, utilizing ultrasound guidance or in an ambulatory surgery center to allow accurate injections to the exact site of an injury or pathology.

To treat:

• Degenerative Arthritis
• Meniscal Tears
• Patellar Tendonitis/Tendinosis
• Quadriceps Strain
• Rheumatoid Arthritis
• Chondromalacia Patella
• Enthesopathy
• Partially Torn Major Ligaments ACL/LCL/MCL
• Tennis Elbow (Lateral Epicondylitis)
• Golfer’s Elbow (Medial Epicondylitis)
• Arthritis
• Carpal Tunnel Syndrome
• DeQuervaine’s Tenosynovitis
• Trigger Finger
• Wrist or Finger Tendinitis
• Wrist or Finger Arthritis
• Achilles Tendinitis
• Ankle Sprains
• Patellar Tendonitis/Tendinosis
• Foot or Ankle Arthritis
• Foot or Ankle Tendinitis

A PRP procedure involves injection of patients own growth factors into a specific area, causing a healing cascade to repair any damage or tissue degeneration by promoting growth of new cells and rebuilding new tissue in the damaged area. PRP has been shown to cause new cell growth in ligaments and tendons, without significant inflammation. The Clinical data has shown that multiple growth and healing factors present in platelet-rich plasma may enhance and accelerate the body’s healing process and tissue regeneration.

PRP has been used clinically for nearly two decades to facilitate both bone and soft tissue healing. Growth factors begin tissue repair and regeneration at the wound site. They derive from platelets and initiate connective tissue healing, bone regeneration and repair, promote development of new blood vessels and stimulate the wound healing process. Potential benefits of this procedure are: Reduction of pain, increase in functional ability, and decrease in arthritis progression.

Bioactive proteins and growth factors in PRP include: PDGF-AB, TGF-b1, VEGF, fibroblasts growth factors and many others. By concentrating the platelets from freshly drawn peripheral blood, it is possible to create a solution of autologous growth factors to help up regulate the normal healing by actively recruiting natural body repair cells to participate in the regenerative process.

Most recently, PRP is being used in Regenerative Injection Therapy where it is injected into soft tissue, and back to treat a number of musculoskeltal problems, including:

• Inflammation of tendons and soft tissue
• Ligaments and tendons tear
• Sprains and strains
• Muscle tissue tears and contusions
• Bursitis
• Cartilage defects
• Meniscal injury and tear
• Plantar fascilitis

Treatments are performed in the office-based setting, utilizing ultrasound guidance or in an ambulatory surgery center to allow accurate injections PRP to the exact site of an injury or pathology.

Autologous Fat Grafting (also known as Adipose Derived Stromal Vascular Stem cells Grafting) is used primarily for few reasons, one, when treating more advanced tendon, ligament or cartilage injury. Another reasons is that it provides more condense source of autologous stem cells (Adult stem cells from your own body), and also it acts as a matrix for cellular tissue and growth factors to slowly heal a defect. Adipose stem cells are one of the richest source of stem cells in the body. They have the ability to differentiate into chondrocytes, fibroblasts, and other musculoskeletal tissue. The adipose stem cells have very similar properties to bone marrow mesenchymal stem cells, and have a wide range of therapeutic applications, based on its ability to self-renew and its ability to differentiate along multiple lineage pathways. AFG injections are used in cases of either more significant tears, defects, necrotic or avascular tissue, which may need new cellular material to be viable.

The abundance of stem cells in adipose tissue and the ability to easily collect large amounts of adipose tissue via mini-liposuction presents as an advantage, and eliminates the need for tissue culturing. Depending on the literature reviewed, there is anywhere between 500 and 2500-times the number of stem cells in adipose tissue as compared to bone marrow. The main components of the AFG fraction include adipose derived mesenchymal stem/stromal cells, hematopoetic stem cells, adipocytes and attached progenitor cells, T regulatory cells and activated monocytes and perivascular cellular components.

The AFG is obtained usually from the lateral hip, buttocks or abdominal area using a low suction system, as to keep the cells viable and undamaged. It is done under a local anesthetic. Usually no sedation is needed. The fat is obtained and the tissue is prepared, and mixed with platelet-rich plasma (PRP). The PRP is prepared by taking a tube of whole blood and processing it using one of the platelet harvesting systems. The fat is prepared and the platelet-rich plasma is added in appropriate quantities.

During the procedure the area of injury is examined and marked where the grafting will take place. Then this area is sterily prepped and locally anesthetized. Once the area is numb, the graft tissue is placed into the damaged area, until all the defects are filled with new tissue. Once this is accomplished, a sterile dressing is applied.

Usually there is some pain and discomfort for approximately 2-7 days. This tends to resolve with each day. Ice for 20 minutes, every 2 hours for the first day or so, is helpful. Appropriate pain medication might be used after the procedure, including Tylenol. Usually the patient receiving the graft would need to avoid NSAIDS for 5 days prior to the procedure and 5 days after the procedure. The patient should then follow-up in 4-6 weeks. Some patients may require physical therapy, depending on their situations. The graft grows and stays viable for 3 months, but may take up to 6-9 months to totally incorporate into the surrounding tissue.

Most recently AFG is being used in Regenerative Injection Therapy where it is injected into soft tissue and back to treat a number of musculoskeltal problems, including:

• Inflammation of tendons and soft tissue
• Ligaments and tendons tear
• Sprains and strains
• Muscle tissue tears and contusions
• Bursitis
• Cartilage defects
• Meniscal injury and tear
• Plantar fascilitis

Treatments are performed in the office-based setting, utilizing ultrasound guidance or in an ambulatory surgery center to allow accurate injections PRP to the exact site of an injury or pathology.

Amniotic fluid and amniotic tissue based products are rich in growth factors and embryonic cells which can assist in tissue healing and remodeling.

Amniotic products are typically extracted from the amniotic fluid or/and amniotic membranes after a pregnant woman has delivered her baby. The amniotic fluid surrounds the fetus during development in the uterus and it is contained by the amniotic membrane. Research has demonstrated the regenerative potential of amniotic tissue in wound healing. Tissue banks handle the amniotic tissue storage, testing and delivery, to assure its safety and efficacy.

Amniotic products can provide reduction in pain, inflammation and improve symptoms of arthritis or ligaments, tendons, meniscal injuries and many others with not many known negative reactions. This experimental injection treatment can be combined with lubricating hyaluronic acid to increase the efficacy and to improve tissue healing, lubrication, cushioning and protection. Some of the big advantages using these products are: easy recovery and prevention of patients’ own tissue extraction need.

Bone Marrow Concentrate (BMC) is a promising regenerative therapy to help accelerate healing in moderate to severe osteoarthritis or tendon injuries. Similar to Platelet Rich Plasma (PRP), or autologous fat grafting (AFG), BMC harnesses the body’s natural ability to heal itself by using regenerative cells found in a patient’s own bone marrow. Bone marrow is the soft tissue found in the hollow interior of bones. In adults, marrow contains a rich reservoir that produces new blood cells, including regenerative cells. These cells can be extracted from a patient’s pelvis and used for BMC injection therapy.

The process of obtaining and preparing these powerful regenerative cells is relatively simple. Stem cells are gathered by aspirating (removing through suction) bone marrow from the back of a patient’s pelvis with a tiny needle. Since the patient is given a local anesthetic, only minimal discomfort results from the procedure. The bone marrow is then placed in a centrifuge, which separates the regenerative cells and platelets from the rest of the blood products. The result is a concentrate that is 5-11 times richer in regenerative cells and growth factors, and includes platelets, mesenchymal stem cells, and other kinds of stem cells used in adult stem cell therapy. This concentrated bone marrow product is reintroduced via injection into the injured area during stem cell therapy.  Generally, the repair process takes two to three months to complete, but in most cases improvement can be noticed before then. About four to six weeks after the stem cell injection, the patient receives a platelet-rich plasma injection on the afflicted area; this is followed by another injection four to six weeks afterward. These injections enable the stem cells to continue growth and multiply to support cartilage or surrounding soft tissue.

With new techniques and technological improvements, regenerative cells can easily be obtained and concentrated in a simple office procedure. This point of care treatment allows for minimal manipulation of cells which are injected into the injured area on the same day.

Most recently BMC is being used in Regenerative Injection Therapy where it is injected into soft tissue and back to treat a number of musculoskeltal problems, including:

• Inflammation of tendons and soft tissue
• Ligaments and tendons tear
• Sprains and strains
• Muscle tissue tears and contusions
• Bursitis
• Cartilage defects
• Meniscal injury and tear
• Plantar fascilitis

Treatments are performed in the office-based setting, utilizing ultrasound guidance or in an ambulatory surgery center to allow accurate injections PRP to the exact site of an injury or pathology.

Prolotherapy is a non-surgical injection procedure used to relieve pain by treating connective tissue injuries (ligaments and tendons) of the musculoskeletal system that have not healed by either rest or conservative therapy in order to relieve pain and to improve structural stability. Treatments are performed in the office-based setting, utilizing ultrasound guidance if needed, or in an ambulatory surgery center to allow accurate injections to the exact site of an injury or pathology.

To treat:

• Tendonitis
• Ligament Sprain and Strain
• Bursitis
• Muscle pathology
• Labral tear
• Rotator Cuff tear