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Stem Cell Treatments

Joint Arthritis is a personal and painful subject to me.  Athletics, Military Service, sports, Martial arts and Surgical occupation created a perfect scenario for progressive arthritis in my back, neck, knees, hands and fingers. 

I have tried it all - steroids injections, NSAIDs, herbal supplements, magic formulas, fish and krill oils, turmeric, MSM, AOA acids, Chondroitin, Chiropractic treatments, physical therapy, hot showers, specialty mattresses and pillows, muscle relaxants, CBD oils, and even opiods.  They work to an extent but then fail within a few days or months.

That is why after researching Regenerative options for over 3 years, I finally gave in and I am glad I did.  Now I am better and I am a believer.

I specialize in small joint arthritis - wrists, hands, fingers, TMJ and toes.  Most orthopedists treat knees, shoulders and spine - I limit myself to what I understand the best - small joints that commonly create big pains.

Our joints are highly underappreciated structures. They provide not only motion but also act as shock absorbers.  Trauma, age, overweight, excessive stress on joints and overuse eventually wear off the cartilage cushion inside our joints, joint lining gets inflamed producing

                pains,
                redness,
                swelling,
                morning stiffness, or stiffness after resting,
                grating sounds,
                joint deformities,
                bone spurs and more. 

Joints get swollen, even harder to move and eventually we experience difficulty walking, squatting, climbing stairs, bending over, lifting, gripping, dressing, combing hair, tying shoes, buttoning our cloth, difficulty pinching and gripping and more.

In patients with rheumatoid arthritis our own immune system attacks the joints leading to inflammation and eventual joint destruction.  We do not know what is causing Rheumatoid Arthritis but we believe that Tumor Necrosis Factor (TNF) and Interleukin 1 and 6 promote inflammation and trigger the immune system.  That is why medications and treatments that reduce TNF and IL-6 may be effective in reducing the joint damage.

Psoriatic Arthritis is another autoimmune condition causing joint inflammation and destruction.

Lupus is another autoimmune disease that can affect the joints with inflammation and destruction of cartilage.

There are 29 bones in wrist, hand and fingers.  Arthritis can affect any of them.

X-ray is the primary way to diagnose arthritis.  Changes in the joint surfaces and narrowing of the joint spaces are the first signs of arthritis.  Eventually bone spurs can be seen also.           

Hand and small joint arthritis is surprisingly common.  Arthritis is the most common condition affecting hands.  Hand and wrist arthritis are thought to be second most common arthritis after knees.  Millions of patients suffer from hand arthritis. About 14% of US population report wrist arthritis. 

Rheumatoid arthritis affects the wrist in 2.5 million people.  In RA patients wrist arthritis is present in 75% of patients, and in 95% it will eventually become bilateral (involve both sides).   About 25% of women and about 5-15% of men after 50 develop thumb arthritis. 

Most common non-surgical treatment options for hand and other small joint arthritis are

                Oral Non-Steroid anti-inflammatory medications,
                                  like Motrin, Tylenol, Aspirin, Naproxen, etc
                Physical and Occupational therapy -  Splinting, Hot and Cold Therapy,
                                  Hand Exercises
                Local Capsaicin Creams
                Oral Steroids
                Steroid Injections
                Immunosuppressants
                Narcotic (opioid) Pain Medications
                CBD oil compounds
                Oral supplements , such as Turmeric, Glucosamine, Chondroitin and others

Surgery is traditionally considered when medical treatments are not successful.   I usually tell my patients that they have to choose between using a hammer and crocheting but not both.  Most common procedures performed are

                Joint fusions.  Joint is removed and adjacent bones are fused together.  Pain is improved as the joint is not moving but the patient permanently loses mobility of the joint. (HAMMER) This surgery is usually reserved for younger more active patients.

                Joint replacement.  Joints are removed and replaced with metal, plastic or silicone joints o rolled tendon.  Pain is improved but surgery is usually reserved for elderly patients who are not anticipated to perform strenuous activities and these joints wear off easily. (CROCHETING)

REGENERATIVE THERAPIES for SMALL  JOINT ARTHRITIS.

One of the most fascinating areas of current research and clinical practice to me is treatment of wrist, hand and finger joint arthritis with stem cells and other regenerative therapies. As a long term skeptic myself, I and most traditional academic hand surgeons used to frown upon stem cells and PRP treatment of small joints.

However, the tide is turning.  Unfortunately, as the conservative therapies commonly fail and surgeries do not produce desired results, use of your own stem cells appears to be very promising.  We believe that stem cells and other regenerative therapies effectively reduce inflammation by decreasing concentrations of Tumor Necrosis Factor and Interleukin-6.

Based on our internal data from over 100 centers across the country, using our protocols, the patients report 73-79 percent improvement in their symptoms as early as within the first 3 weeks after treatment.  Depending on the degree of arthritis and joint destruction, patients may require one or more treatment.

As we use our own cells, there is no rejection reaction.  Complication rates are under 2 percent and mostly limited to pain at donor site, or infections (consistent with any surgical procedure).

Usually the patient returns to activities and therapy immediately after the procedure.

The procedure usually performed under local anesthesia, however, in some patients with multiple joint injections, sedation can be used for comfort.  Injections are performed under x-ray or ultrasonic guidance.

Many patients with joint arthritis also have chronic inflammation of surrounding tendons and ligaments (tendonitis), which can be addressed at the same time.

Regenerative therapies will not cure arthritis but they have demonstrated a great degree of effectiveness in improving pains , reducing inflammation and improving motion in small joints with minimal complications and side effects.

Stem cells and other regenerative therapies for small joint arthritis are considered investigational and experimental and not covered under most insurance plans, however, associated procedures may be.

If you are frustrated with your current arthritis treatment, like me, if you would like to postpone or possibly avoid the need for surgery,  or possibly stop getting steroid injection, please call our office and see if Stem cell treatment or other regenerative modality is right for you.

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Dr. Volshteyn is a board certified Plastic Surgeon, who is specialized in reconstructive and plastic surgery.

ABOUT DR. VOLSHTEYN PATIENT REVIEWS

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