What can I expect coming to Sunstone Regenerative Medicine?
One of the things that is different about Sunstone is that we have surgeons and practitioners who are part of the community and plan to practice here for many years to come. So, you can expect to work with a group of doctors and staff who want to be part of your team to address your pain issues, but who also will give you an honest opinion about whether or not you can be helped by a regenerative medicine treatment. We are not here to sell you a treatment. Bottom line, if we do not think that you would benefit from these treatments, we will give you our honest opinion.
The Sunstone orthopedic surgeons and practitioners are specialists who are fellowship trained orthopaedic surgeons who have pursued additional knowledge and training in orthopaedic applications of regenerative medicine. Subsequently, they have the expertise to apply these treatments that most in this industry do not possess.
In keeping with that philosophy, we will insist that each patient have a comprehensive work up in order to determine if you are a candidate for one of the orthobiologic treaments. Prior to your procedure, we may ask you to get current x-rays performed to our specifications. Additionally, every spine procedure that we do will require a current MRI. Some patients we will refer to the NOSI MRI, which is a new software based MRI that will allow us to target your pain areas very specifically. Colorado Springs Orthopedic Group is the only practice in the state with access to this innovative technology that allows us to predict which spine discs are symptomatic.
On the day of your procedure, we want you to wear comfortable clothing that allows us access to the injection site. If we are doing PRP, we will also need to be able to access your arm to draw the blood.
Every injection we do at Sunstone is done under image guidance. If we are doing your injection at our clinic, the practitioners will use the ultrasound machine to make sure that the treatment is targeted to the specific area that is causing your pain. For spine procedures performed at the surgery center, a flouroscopy (XRAY) machine is used to direct treatment. This level of expertise and safety is unmatched in the area.
After the procedure, the area we injected will feel numb because a local anesthetic is used along with the treatment. Normal activities of daily living are allowed, but do not put extreme stress on the area and avoid activities such as high-impact sports or running for 4 to 6 weeks after your injection. You can expect to feel tightness as we are injecting additional fluid volume into the treatment area. With this extra fluid in the joint, strenuous activity will definitely increase your pain following the injections. You can perform normal activities such as walking or driving. If you have had a knee or hip injection, you may experience numbness or weakness in the leg and if you place significant weight on that extremity, you may fall, so please be aware of this potential for weakness which should wear off in 6-8 hours after the injection.
It is normal to feel slightly weak, sore or full in the area injected. Avoid using over the counter anti-inflammatories for pain relief for at least a week. The idea behind these regenerative injections is to begin a cellular healing cascade which will stimulate growth and encourage your own stem cells to move to the area.
What else does this injection contain?
In addition to stem cells, these also contain many other vital substances for the healing process, such as growth factors, fibrocytes, epidermal cells and amino acids. These “other substances” are likely responsible for much of the beneficial effects of these injections.
What are your “results”?
This is a challenging question to answer because of the many different factors that come into play with a regenerative medicine treatment. First, each patient has varying levels of pain, disease progression, structural differences, etc., and then there are also such variances in tolerance to pain, age and overall health.
Additionally, we work with each person to set realistic goals for their treatment based on their individual condition. Some people want to be able to compete at a high level in extreme sports and others want to have their pain reduced so that they can do day-to-day activities. Others understand that they need a joint replacement, but hope to put that off for a few years. Because of all of these factors, our providers tend to be very particular with respect to patient candidacy. We don’t want to just take your money and do an injection and hope for the best. We want to make sure that we give you the best chance for success. Overall, in the right patient with the correct treatment applied properly our patients have excellent results.
Regenerative therapy procedures are very different then say a pain procedure such as a steroid shot. With a steroid shot you can expect an immediate anti-inflammatory effect that may bring you some relief. With the regenerative medicine procedure, there is a chance that you may notice some pain relief after a few weeks but typically you will not notice significant impact until at least 6-8 weeks with the full effect becoming clear over six months or longer. The cells in the area treated need the chance to regenerate, stimulate collagen deposits and build the scaffolding of the tissues through the healing response of your body.
How do I know which procedure is right for me?
Platelet Rich Plasma (PRP) is the essential part of your blood that is responsible for prevention of bleeding and blood clotting. PRP consists of a concentrated number of platelets and many growth factors that, when concentrated in an affected area, can enhance healing at the site of the disease. We will use blood drawn from you and then spin that blood in a centrifuge to concentrate and isolate the plasma which is rich in platelets and growth factors.
PRP therapy can help with orthopedic diseases such as osteoarthritis of many joints, tendonitis, partial rotator cuff tears, plantar fasciitis, tennis and golfer’s elbow, ankle sprains, ligament injuries, skin rejuvenation, alopecia, and many other conditions.
Cord Blood/Wharton’s Jelly/Amnion and other donated tissues: Birth tissues donated after a live birth via caesarian section are harvested and screened for use in regenerative medicine treatments using protocols established by the FDA and other regulatory agencies such as the Center for Disease Control (CDC) and the American Association of Tissue Banks (AATB). Any chorion in the birth tissue components is removed so that these tissues do not express antigens to remove the risk that your body might reject these tissues. Liquid amnion fluid, which comes from the placenta, is one such birth tissue that has use in regenerative medicine because of the many growth factors, amino acids, cytokines, hyaluronic acid, etc. that it contains. Amnion is known to have anti-inflammatory properties. Wharton’s Jelly comes from the umbilical cord and is known to have many times more growth factors than other tissues. Cord blood remains in the placenta and umbilical cord and has been harvested for years for use in hematopoietic stem cell reconstruction. The product that Sunstone uses is harvested through the Utah Cord Bank in a process that isolates all of these tissues in one. The Utah Cord Bank has never had a regulatory complaint or reaction to their product after 60,000+ uses. Sunstone uses these tissues at patient request or for patients who may not be candidates for BMAC. The doctors will discuss at length the options to help you determine what is best for you.
BMAC or Bone Marrow Aspiration Concentrate: Bone marrow is the spongy tissue in the center of your bone that is contains stem cells. Our bone marrow is the power house for producing plasma, red blood cells, immature cells (stem cells) and white blood cells. Bone marrow aspiration concentrate (BMAC) is thought to be helpful for advanced healing in conditions such as osteoarthritis, tendon and ligament injuries, Achilles Tendinitis, Sacroiliac (SI) Joint Dysfunction, Iliotibial Band (ITB) Syndrome, spinal pathologies, and many other conditions.
The collection site from which our doctors will harvest the BMAC is the iliac crest (top ridge) of the back of the hip bone. If the extraction is done in the clinic, you will be asked to lie down on your stomach or side or back for the collection, and your lower body will be draped with cloths so that only the area surrounding the site is exposed. The doctor will then clean the site with an antiseptic and inject a local anesthetic to numb the area. When the site is no longer sensitive, the practitioner will make a very small incision and insert a specially designed needle through the skin and into the bone. For an aspiration, a syringe is attached to the needle to collect a small amount of marrow.
Even though your skin has been numbed, you may feel pulling and/or pushing pressure sensations during the procedure. Most people tolerate the procedure well and most of the pain is with the initial injection of numbing solution. After the needle has been withdrawn, a sterile bandage is placed over the site and pressure is applied. The entire harvest procedure typically lasts only minutes. Once the concentrate is extracted from the bone marrow it can be injected into the problem area effectively. Once site of injury has been concentrated with bone marrow aspiration, growth factors and stem cells begin to regenerate as needed for the particular injured area. This process takes about 2 hours and you are able to go home as soon as procedure is completed.
When the BMAC is used during surgery, the surgeon will typically do the Bone Marrow Aspiration immediately at the beginning of the surgery once the patient has been anesthetized. The aspiration process is similar to what is described above except the patient will not feel anything at the time as they are under anesthesia. The BMAC is processed in a centrifuge to isolate and concentrate the bone marrow and after the surgery is complete, the BMAC is injected into the area that needs treatment.