Hip Procedure Outcomes Archives « Regenexx™ Regenexx™

Hip Procedure Outcomes

Helping a Dancer with Hip Pain Avoid Hip Labrum Surgery

Tuesday, November 6th, 2012

Can a platelet shot act as a hip labrum surgery alternative? I’ve blogged before about what I call “Hip Labrum Mania“. By this I mean the sudden increase in popularity of hip labrum surgery based on tears or impingement (FAI or CAM) seen on MRI. In our experience, few hip labrum tears or impingements are the cause of the patients pain, while many get operated. We firmly believe that once this runs it’s course, the medical community will categorize hip labral tears much the same way that we now should categorize meniscus tears. In the last several years, research has shown that physicians must be very careful about concluding that a meniscus tear is the cause of the patient’s pain, as many patients without knee pain have meniscus tears on MRI. The same will hold true for tears in the hip labrum and most cases of MRI defined impingement. So if we shouldn’t operate on most of these, what should we do? First, look for another source of the patient’s pain-usually in the low back. However, if there is an issue that can definitely be tied to the hip, we’ve had good success with injection based therapies under both fluoroscopy and ultrasound, targeting the tear and the rest of the hip. We have used Super Concentrated Platelets (SCP is our version of super concentrated PRP), or if the tear is more severe, the patient’s own stem cells. Below is an e-mail from a ballet dancer first seen by Dr. Hanson in May of last year. At that point she had noticed a pop in her hip while dancing about a month prior and still had a painful hip. A good hands on exam including looking at the labrum under ultrasound showed a defect in the labrum that did correlate with her exam as a cause of pain. Dr. Hanson injected her with SCP and here’s her 1.5 year report (that’s her above dancing Swan Lake in Germany after joining the Stadttheater Bremerhaven company):

“Dear Dr. Hanson,

I’m not sure if you remember me, but I had two Regenexx prodedures in May and June of last year (2011). I had a labral tear in my right hip. I remembered you said to email you with an update, and I never did!

I am a contemporary ballet dancer who was dancing professionally in Colorado, and I had a contract to dance in Germany when I found out about my labral tear. I took about 6 weeks off completely dancing after my second injection before starting here in Germany. I began the season dancing and am still dancing strong here in Germany today! I do not feel pain anymore. I do not have as much range of motion in that hip anymore–of course as a dancer we deal with extreme range. Every once in a while I get the very very beginning sensation of what it used to feel like when my hip would “catch”, but it never catches.

Overall, I am extremely happy with my hip and the procedures I had done at your clinic. I would not have been able to take this job in Germany if I had to get surgery and be out of dancing for a year or more. Thank you, and I hope you and the other doctors are doing well with helping other patients and getting more exposure. I tell all my dancer friends who have injuries about your clinic.

Elizabeth Towles”

NOTE: Regenexx SCP is a medical procedure and like all medical prodcedures has a success and failure rate. Not every Regenexx SCP Hip Labral Tear patient can expect these same results

Note: Any case reports or patient results presented on this web-site are not indicative of all patient results. Like any medical procedure, all Regenexx procedures have a success and failure rate.

Tags: hip labrum surgery alternative
Posted in Hip, Hip Procedure Outcomes, Latest News, Regenexx-SD, Sports Injury | Comments Off

Helping Hip Arthritis with Stem cells

Monday, October 29th, 2012

TB was a 53 year old woman who was first seen by our clinic by Dr. Hanson in October of 2011. She had worsening right greater than left hip and groin pain due to arthritis that had further progressed the last year. She had trouble sitting and moving her leg outwards and was told that for a cultured stem cell procedure (Regenexx-C in the Caymans), the more severe right hip was a FAIR candidate and the opposite with less severe arthritis was a GOOD candidate. Her MRIs did show loss of cartilage as well as bone cysts and swelling, which are common in more severe hip arthritis. She had her own cultured stem cells injected back into both hips at the end of January 2012. Dr. Hanson used exacting placement of the cells using both ultrasound and fluoroscopy. She just wrote Dr. Hanson about her 10 month results, reporting 80% improvement. Since she still has some pain with hip abduction, she’s asked if she should consider another injection of the cells she has saved in the Caymans from the first procedure. This is a great feature of the Cayman’s site, as it allows patients who are prolific cell growers to “bank” cells for future use. This not only saves time, but money as well. The upshot? The Cayman Islands are traditionally known for another type of banking, but “stem cell banking” is allowing this patient to get additional treatments without having to go through another stem cell harvest procedure!

NOTE: RegenexxCayman is an independently owned and operated medical services provider operating exclusively in the Cayman Islands and is not part of or affiliated with the Centeno-Schultz Clinic or any U.S. Regenexx Network provider. The Regenexx-C procedure licensed by RegenexxCayman is not approved by the U.S. FDA for use in the United States. 80% improvement can not be expected for all Regenexx-C patients.

Tags: hip arthritis stem cells
Posted in Hip, Hip Procedure Outcomes, Latest News, Regenexx-C | Comments Off

Regenexx Stem Cell Procedure in Chicago helps Hip Arthritis Patient

Saturday, September 29th, 2012

Just to make sure you don’t think that all of the good stem cell work happens just in Colorado, this is an e-mail from the hip arthritis patient of a Regenexx network provider who is in Chicago (Dr. Sheinkop). The e-mail and picture says it all!

“Subject: Feeling Fantastic

Doctor,

So I rode about 85 miles with about 8,500 vertical feet of climbing around Lake Tahoe on Friday, and then another 50 or so miles with 4,000 feet on Saturday, and the hip didn’t bother me once. I’m still doing big stretches in the mornings. Even as I type this, I’m shaking my head, since it doesn’t seem possible and I have to pinch myself. Thank you a million times over. I feel so lucky to know you and to be blessed with your help and care.”

NOTE: All Regenexx procedures are medical procedures and therefore have a success and failure rate. All Regenexx Hip patients will have the same results.

Tags: hip arthritis stem cells
Posted in Hip, Hip Procedure Outcomes, Latest News, Regenexx-SD | Comments Off

Regenexx-C Hip Treatment Failure

Tuesday, September 18th, 2012

As I have blogged before, hips are harder to treat with stem cells than knees. Since we’ve had a run of “rah rah” posts on positive outcomes, it’s time for a post to balance the picture. VK was a 53 year old man with hip problems since childhood. By adulthood these quieted down and he was better until 2006 when he injured his hip during martial arts. At that point an x-ray showed moderate to severe hip arthritis. He was first seen in 8/09 with a recent MRI also showing a hip bursitis and a gluteal muscle tear. His pain was between low level 1-2/10 and moderate level 5-6/10. He was placed in the POOR-FAIR candidacy grade, but wanted to avoid a hip replacement and try the Regenexx-C procedure instead. In October of 2009 he underwent a single Regenex-C treatment into the hip. His result? He reported no improvement and eventually did get a hip replacement. The upshot? Hips generally don’t respond as well as knees or other joints and other authors have commented on why. While we’ve seen some great successes with hips, we’ve also seen our share of treatment failures like VK. Stem cells aren’t magic, but tools that can fail like any other tools.

NOTE: The Regenexx-C procedure licensed by RegenexxCayman is not approved by the U.S. FDA for use in the United States. RegenexxCayman is an independently owned and operated medical services provider operating exclusively in the Cayman Islands and is not part of or affiliated with the Centeno-Schultz Clinic or any U.S. Regenexx Network provider.

Posted in Hip, Hip Procedure Outcomes, Regenexx-C | Comments Off

Managing an Arthritic Hip with Stem Cells over the Long Haul

Wednesday, May 23rd, 2012

Can we manage severe hip arthritis with stem cell injections?

CM is a 52 year old woman who presented to our clinic in 2008 with fairly severe hip arthritis (most of the hip cartilage gone, but not “bone on bone”). She was very active and noted a significant decrease in hip range of motion and new onset hip pain after trying to get back in shape with yoga. She was seen by our clinic in 2008. While she had clear hip arthritis, like many of our hip arthritis patients, she also had irritated nerves in her back that went undiagnosed, so these were treated as well. In 2008 she received a Regenexx-C procedure where we injected her own cultured stem cells. She came back last year for an update treatment where we again treated her low back and injected same day stem cells into her hip. This year she’s back for another update injection of same day cells as she’s very active and wants to continue to work out at a high level. So where is she at at this point? She reports about 70% overall improvement and is much more active. However, an important point is that she has not regained her lost hip range of motion (ROM). As I have blogged before, this lost hip ROM likely comes from the early and destructive phase of hip arthritis and even patients treated with stem cells rarely recover this function. So how did she do structurally over the past 4 years? I’ve placed her films above. Note that while the 2008 MRI is a slightly different front-back angle, the arthrograms (radiographic contrast in the joint) are remarkable for what they don’t show over the past 4 years. They don’t show any significant advancement in joint space collapse. Since they’re not 100% perfect matched images for angle of the x-ray beam, it’s tough to call any increase in joint space using these films. The upshot? This woman has regained much lost physical activity and has maintained significant reductions in pain over the past 4 years. Her hip arthritis (which usually progresses rapidly) is stable, but her hip range of motion hasn’t returned. It’s likely that she will continue to get update treatments once every year or two.

NOTE: Regenexx-C is a medical procedure and like all medical procedures has a success and a failure rate. Not all Regenexx-C patients will have the same result. The Regenexx-C procedure licensed by RegenexxCayman is not approved by the U.S. FDA for use in the United States. RegenexxCayman is an independently owned and operated medical services provider operating exclusively in the Cayman Islands and is not part of or affiliated with the Centeno-Schultz Clinic or any U.S. Regenexx Network provider.

Tags: hip stem cell injection
Posted in Avascular Necrosis Procedure Outcomes, Hip, Hip Procedure Outcomes, Latest News, Recent Results, Regenexx-C, Regenexx-SD | Comments Off

Using Stem Cells in an Elite Track Athlete: Regenexx Patient Cydonie Mothersill wins Cayman Invitational

Sunday, May 20th, 2012

$running stress fracture treatment$

Can stem cells be used as a running stress fracture treatment in an elite track athlete? Cydonie Mothersill is an elite track athlete and gold medalist at the 2010 Commonwealth games, 2010 Mayaguez, and CARIFTA games. After her great performance at the Commonwealth Games in 2010, she was within striking range of a medal in the 200M at the London Olympics. When our stem cell lab opened in the Cayman Islands last year, we were told that the Cayman government wanted us to see Cydonie to keep her running. She initially presented to us with a non-healing tibial stress fracture, Achilles tendonitis, and a hip labrum tear. Any of these injuries could have been career ending for an elite runner. The difficulties in treating Cydonie were the same as with any elite athlete; all of her non-invasive treatment had to be fit in and around her high level running and training. However, had Cydonie gone the traditional orthopedic surgery route, her surgical hip labrum repair and bone grafting, or fixation for the stress fracture (or being off training for 6 months) would have taken her out of an entire season. While for a younger runner, losing a season to heal multiple injuries might have been chalked up to experience; at 32 with her last Olympics looming, this wasn’t an option for Cydonie. Instead, Dr. Hanson went to work using a Regenexx-SD stem cell injection treatment for her hip and tibial stress fracture and followed that up with Regenexx-C treatments. Can a running stress fracture be treated with stem cells? We’ve demonstrated proof of concept by publishing a case series of non-healing fractures that we treated successfully only with an injection of stem cells. We’ve also posted many cases showing that we can help the hip labrum heal through a very precise injection of the patient’s own stem cells into the labral tear. Within a few weeks, the pain and swelling from the tibial stress began to subside and the hip pain was gone. I then saw her again in the Cayman Islands in March. By that time her biggest ongoing issue was the Achilles area, which was reinjected along with her back (Regenexx-PL-Disc). By the March visit, the only thing that made the tibial stress fracture hurt was decelerating after a race. Since all of this had been accomplished with injections instead of surgery, she was still able to train hard. As a testament to her perseverance and this unique medical treatment plan, she recently won the 200M in the recent Cayman Invitational! We’re proud to have helped Cydonie avoid career ending surgery by using her own stem cells and hope that she continues to use her unique drive and spirit to run her race. Next stop-London Olympics!

NOTE: Regenexx-C and Regenexx-SD are medical treatments and like all medical treatments have a success and failure rate. Not all Regenexx-C and Regenexx-SD patients can expect the same result.

Tags: running stress fracture treatment
Posted in Ankle, Ankle, Foot and Toe Procedure Outcomes, Back and Disc Procedure Outcomes, Back/lumbar, Foot, Fracture Non-Union, Hip, Hip Procedure Outcomes, Latest News, Non-Union Fracture Procedure Outcomes, Recent Results, Regenexx-C, Regenexx-PL, Regenexx-SD | Comments Off

Stem Cells for Hip Osteonecrosis-Mexican Style: Ole?

Thursday, March 8th, 2012

Why are we so finicky about candidacy grading? As you may know, we insist on giving every patient an honest assessment of their candidacy grading-Good, Fair, or Poor. Being a good candidate doesn’t guarantee the procedure will work just like being a poor candidate doesn’t guarantee it will fail. However, given all the patients we’ve treated through the years, the patient has a rough assessment of where they stand. They also know the possible headwinds they may experience. Recently my partner John Schultz performed an evaluation on a patient with ARCO grade 3-4 hip AVN with collapse of the bone. She was a poor candidate for hip stem cell treatment of any type because she had a “square peg in a round hole”. This is based not only on our clinical experience going back 6 years and treating more than a hundred severe hip patients, but also based on the published works by Gangji and Hernigou. Dr. Schultz told her she was a poor candidate for our treatment. Believing stem cells were magic (they are not), she called a Mexican outfit with little experience treating hip AVN and was told that their stem cells would likely work. She went to Mexico and had a very painful bone marrow aspiration from her tibia (not a great place to take a marrow aspirate because the bone is very thick and it’s painful). The cells were spun down in the same way that she could have gotten at many clinics in the United States using a bedside centrifuge. They then re-injected the cells into the hip joint without any guidance (blind), so we have no idea where they went. In addition, for AVN, since the main issue is in the bone, injecting cells into the hip joint after the bone has collapsed will do little good – like trying to fix the roof on a house where the structure of the roof has collapsed. However, this was done this way because the technical expertise needed to place cells into the bone is very high. She had intense pain, so the next day they carried her back from her resort hotel to the clinic for a second injection. After paying $8,500, she’s now signed up for a hip replacement after Dr. Schultz again refused to treat her with stem cells because it wouldn’t help her hip. The upshot? Buyer beware. There’s a good reason we’re brutally honest with patients about their prospects, as we’ve usually treated many patients just like them and know what works and what doesn’t. Again, while this doesn’t mean all good candidates get amazing results or all poor candidates get no results, it does mean that we try hard to not take money from patients we have little hope of helping. When we do agree to treat poor candidates, we continually emphasize that we are not optimistic about their prospects. In addition, the basis for the treatment needs to make sense, even if it ultimately fails. For example, not placing cells in the bone to treat a bone disease is a bad idea.

NOTE: All Regenexx procedures are medical procedures and like all medical procedures they have a success and failure rate.

Tags: hip avn stem cells
Posted in Avascular Necrosis Procedure Outcomes, AVN/Osteonecrosis, Hip, Hip Procedure Outcomes, Latest News, Recent Results | Comments Off