What was previously referred to as a stem cell treatment we now know as orthobiologics, or substances used in treatments to speed up injury recovery. Orthobiologics such as bone marrow and adipose (fat) tissue are rich in mesenchymal stem cells (MSCs), cytokines, and growth factors, which act as messengers to repair injuries and prolong the life of osteoarthritic joints.
Dr. Robert uses a combination of bone marrow, fat, platelet rich plasma, and exosomes to treat different conditions like osteoarthritis of the knees, hips, shoulders, and ankles; as well as osteochondritis dissecans (OCD), avascular necrosis (AVN), nonunion fractures, meniscus tears, and tendon or ligament tears. All of the orthobiologic substances used in the treatment are autologous, meaning they are derived from the patient’s own body
The procedure is only part of the recovery from musculoskeletal injuries and conditions. Supplements, body composition measurements, physical therapy, and correction of gait, alignment, and leg height discrepancy are all important pieces of Dr. Robert’s orthobiologics treatment protocol.
- Murphy JM, Fink DJ, Hunziker EB, Barry FP, et al. Stem cell therapy in a caprine model of osteoarthritis. Arthritis & Rheumatism, 48 (12): 3464-3474, December 2003.
- Rose NB and Dellon AL: Epicondylitis and Denervation Surgery. Current Orthopaedic Practice, 25 (5): 446-452, September/October 2014.
- Mishra AK, Skrepnik NV, Edwards SG, et al. Efficacy of platelet-rich plasma for chronic tennis elbow: a double-blind study, prospective, multicenter, randomized controlled trial of 230 patients. Am J Sports Med, 42: 463-471, 2014.
- Mascarenhas R, Salzman BM, Fortier LA, et al. Role of platelet-rich plasma in articular cartilage injury and disease. J Knee Surg, 28(1): 3-10. February 2015.
- Gosens T, Peerbooms JC, van Laar W, et al. Ongoing positive effect of platelet-rich plasma versus corticosteroid injection in lateral epicondylitis: a double-blind ramdomized controlled trial with 2- year follow up. Am J Sports Med, 39:1200-1208, 2014.
- Anz AW, Hackel JG, Nilssen EC, Andrews JR: Application of biologics in the treatment of rotator cuff, meniscus, cartilage, and osteoarthtis, J AM Acad Orthop Surg. 22(2): 68.-79, February 2014.
- Pham PV, Bui KH, Ngo DQ, et al. Activated platelet-rich plasma improves adipose-derived stem cell transplantation efficiency in injured articular cartilage. Stem Cell Res Ther, 4(4):91, August 2013.
- Orth P, Rey-Rico A, Venkatsesan JK, et al. Current perspectives in stem cell research for knee cartilage repair. Stem Cells Clon, 7:1-17, January 2014.
- Michalck J, Moster R, Lukac L, et al. Autologous adipose tissue-derived stromal vascular fraction cells application in patients with osteoarthritis. Cell Transplant, January 2015.
- Xia P, Wang X, Lin Q, et al. Efficacy of mesenchymal stem cells injections for the management of knee osteoarthritis: a systematic review and meta-analysis. Int Orthop, May 2015.
- Centeno CJ, Schultz JR, Cheever M, et al. Safety and complications reporting update on the re- implantation of cultre-expanded mesenchymal stem cells using autologous platelet lysate technique. Curr Stem Cell Res Ther, 2011; 6:368-378.
- Davatchi F, Abdollahi BS, Mohyeddin M, et al. Mesenchymal stem cell therapy for knee osteoarthritis. Preliminary report of four patients. Int J Rheum Dis, 20411; 14:211-215.
- Emadedin M, Aghdami N, Taghiyar L, et al. Intra-articular injection of autologous mesenchymal stem cells in six patients with knee osteoarthritis. Arch Iran Med, 2012; 15:422-428.
- Lee KB, Wang VT, Chan YH, et al. A novel, minimally-invasive technique of cartilage repair in the human knee using arthroscopic micro-fracture and injections of mesenchymal stem cells and hyaluronic acid-a prospective comparative study on safety and short-term efficacy. Ann Acad Med Singapore, 2012; 41:511-517.
- Wakitani S, Okabe T, Horibe S, et al. Safety of autologous bone marrow-derived mesenchymal stem cell transplantation for cartilage repair in 41 patients with 45 joints followed up for 11 years and 5 months. J Tissue Eng Regen Med, 2011; 5: 146-150.
- Teo BJ, Buhary K, Tai BC, et al. Cell-based therapy improves function in adolescents and young adults with patellar osteochondritis dissecans. Clin Orthop Relat Res, 2013; 471: 1152-1158.
- Kasemkijwattana C, Hongeng S, Kesprayura S, et al. Autologous bone marrow mesen-chymal stem cells implantation for cartilage defects: two cases report. J Med Assoc Thai, 2011; 94:395-400.
- Vangsness CT Jr, Farr J II, Boyd J, et al. Adult human mesenchymal stem cells delivered via –intra- articular injection to the knee following partial medial meniscectomy: a randomized, double-blind, controlled study. J Bone Joint Surg Am, 2014; 96:90-98.
- Pak J, Lee JH, Lee SH. A novel biological approach to treat chondromalacia patellae. PLoS One, 2013; 8e64569.
- Orozco L, Munar A, Soler R, et al. Treatment of knee osteoarthritis with autologous mesenchymal stem cells: a pilot study. Transplantation, 213; 95:1535-1541.
- Jo CH, Lee YG, Shin WH, et al. Intra-articular injection of mesenchymal stem cells for the treatment of osteoarthritis of the knee: a proof-of-concept clinical trial. Stem Cells, 2014;32:1254-1266.
- Saw KY, Anz A, Merican S, et al. Articular cartilage regeneration with autologous peripheral blood progenitor cells and hyaluronic acid after arthroscopic subchondral drilling: a report of 5 cases with histology. Arthroscopy, 2011;27:493-506.
- Orozco L, Munar A, Soler R, et al. Treatment of knee osteoarthritis with autologous mesenchymal stem cells: two-year follow-up results. Transplantation, 2014; 97:e66-68.
- Centeno CJ, Schultz JR, Cheever M, et al. Safety and complications reporting on the re-implantation of culture-expanded mesenchymal stem cells using autologous platelet lysate technique. Curr Stem Cell Res Ther, 2010;5:81-93.
- Centeno CJ, Freeman MD. Percutaneous injection of autologous, culture-expanded mesenchymal stem cells into carpometacarpal hand joints: a case series with an untreated comparison group. Wien Med Wochenschr, 2014;164:83-87.
- Koh YG, Jo SB, Kwon OR, et al. Mesenchymal stem cell injections improve symptoms of knee osteoarthritis. Arthroscopy, 2013; 29:748-755.
- Koh YG, Choi YJ, Kwon SK, et al. Clinical results and second-look arthroscopic findings after treatment with adipose-derived stem cells for knee osteoarthritis. Knee Surg sports Traumatol Arthrosc, 2015; 23:1308-1316.
- Randelli et al (2014) Regenerative medicine in rotator cuff injuries. Biomed Res Int. 2014:129515 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4145545/pdf/BMRI2014-129515.pdf
- Centeno et al. (2015) A prospective multi-site registry study of a specific protocol of autologous bone marrow concentrate for the treatment of shoulder rotator cuff tears and osteoarthritis. J Pain Res. 2015 Jun 5:8:269-76. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4463777/pdf/jpr-8- 269.pdf
- Hernigou et al (2014) Biologic augmentation of rotator cuff repair with mesenchymal stem cells during arthroscopy improves healing and prevents further tears: a case-controlled study. Int Orthop. 2014 Sep:38(9):1811-8 http://www.ncbi.nlm.nih.gov/pubmed/24913770 http://link.springer.com/article/10.1007%2Fs00264-014-2391-1#page-1
- Ajibade et al.(2014) Emerging Applications of Stem Cell and Regenerative Medicine to Sports Injuries. Orthop J Sports Med.2014 Feb 6;2(2):2325967113519935 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4555618/pdf/10.1177_2325967113519935.pdf
- Hak et al. (2015) A Double Blinded Placebo Randomized Controlled Trial Evaluation Short-term efficacy of Platelet-Rich Plasma in Reducing Postoperative Pain After Arthroscopic Rotator Cuff Repair: A Pilot Study. Sports Health. 2015 Jan;7(1)58-66 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4272693/pdf/10.1177_1941738114548413.pdf
- Scapone et al. (2013) Effectiveness of Platelet-rich Plasma Injection for Rotator Cuff Tendinopathy: A Prospective Open-label Study. Glob Ady Health Med. 2013 Mar:2(2):26-31 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3833522/pdf/gahmj.2012.054.pdf
- Saltzman, Bryan M., MD, Benjamin D. Kuhns, MD, Alexander E. Weber, MD, Adam Yanke, MD, and Shayne J. Nho, MD, MS. “Stem Cells in Orthopedics: A Comprehensive Guide for the General Orthopedist.” The American Journal of Orthopedics. N.p., 27 June 2016. Web.
- J Exp Orthop. 2018 Dec 19;5(1):52. “Autologous micro-fragmented adipose tissue for the treatment of diffuse degenerative kneeosteoarthritis: an update at 3 year follow-up”
- Biomed Pharmacother. 2019 Jan;109:2318-2326. doi: 10.1016/j.biopha.2018.11.099. Epub 2018 Nov 29. “Mesenchymal stem cell-based therapy of osteoarthritis: Current knowledge and future perspectives.”
- Genes (Basel). 2017 Oct 13;8(10). pii: E270. doi: 10.3390/genes8100270. “The Effect of Intra-articular Injection of Autologous Microfragmented Fat Tissue on Proteoglycan Synthesis in Patients with Knee Osteoarthritis.”
Journal of Translational Medicine. 2018 Dec 13; 16 (1) : 355. “A specific protocol of autologous bone marrow concentrate and platelet products versus exercise therapy for symptomatic knee osteoarthritis: a randomized controlled trial with 2 year follow-up.” Christopher Centeno, Mitchell Sheinkop, Ehren Dodson, Ian Stemper, Christopher Williams, Matthew Hyzy, Thomas Ichim, Michael Freeman
- Alberto J. Panero, DO*, Alan M. Hirahara, MD, FRCSC, Wyatt J. Andersen, ATC, Joshua Rothenberg, DO, Fernando Fierro, PhD First Published March 7, 2019 “Are Amniotic Fluid Products Stem Cell Therapies? A Study of Amniotic Fluid Preparations for Mesenchymal Stem Cells With Bone Marrow Comparison”
- International Journal of Molecular Sciences. 2019 Mar 5; 20 (5). “Development of Autologous Platelet-Rich Plasma Mixed-Microfat as an Advanced Therapy Medicinal Product for Intra-Articular Injection of Radio-Carpal Osteoarthritis: From Validation Data to Preliminary Clinical Results.” Alice Mayoly, Aurélie Iniesta, Caroline Curvale, Najib Kachouh, Charlotte Jaloux, Julia Eraud, Marie Vogtensperger, Julie Veran, Fanny Grimaud, Elisabeth Jouve, Dominique Casanova, Florence Sabatier, Régis Legré, Jérémy Magalon
- International Journal of Molecular Sciences. 2019 Mar 5; 20 (5). “Bone Marrow Aspirate Concentrate for the Treatment of Avascular Meniscus Tears in a One-Step Procedure-Evaluation of an In Vivo Model.” Matthias Koch, Selma Hammer, Julian Fuellerer, Siegmund Lang, Christian G Pfeifer, Girish Pattappa, Johannes Weber, Markus Loibl, Michael Nerlich, Peter Angele, Johannes Zellner