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Stem Cell Therapy for Arthritis and Sports Injuries

Dr. Alon Antebi discusses a new approach to treating ligament and joint pain by using stem cell therapy, who would be a great candidate for stem cell therapy and the recovery period needed.
Stem Cell Therapy for Arthritis and Sports Injuries
Featured Speaker:
Alon Antebi, DO
Dr. Alon Antebi is Chief of the Orthopaedic Department at Antelope Valley Hospital in Lancaster, California, and Chief of the Joint Program at Ridgecrest Regional Hospital in Ridgecrest, California. He is also a member of the medical staff at Palmdale Regional Medical Center in Palmdale, California; Henry Mayo Newhall Memorial Hospital in Valencia, California; Providence Holy Cross Medical Center in Mission Hills, California; and Antelope Valley Surgical Institute (AVSI) in Lancaster, California.

Learn more about Alon Antebi, DO
Transcription:

Melanie Cole (Host): If you’ve ever had a sports injury, you know how debilitating they can be and how they can keep you from enjoying even your normal everyday activities, much less any exercise or sports that you like to do. Well doctors are now using stem cell therapy to treat those sports injuries. We’re going to learn about them today. My guest today is Dr. Alon Antebi. He’s a board certified Orthopedic Trauma and Joint Reconstructive Surgeon and a member of the medical staff at Palmdale Regional Medical Center. Dr. Antebi, I’m so glad to have you with us today. Tell us what types of sports injuries can be treated with stem cells?

Dr. Alon Antebi (Guest): Different types of sports injuries include ligament sprains, muscles injuries, in addition to articular injuries as well meaning injuries to the cartilage in the joints in addition to treating arthritis as well.

Host: So then what are stem cells? Let’s talk about what they are and give us some of the theories behind stem cell therapy.

Dr. Antebi: Sure, so stem cell is kind of like the latest buzz word in orthopedic medicine. There’s a lot of studies out there that show that there’s definitely some potential benefit to the treatment with the use of stem cells. What is a stem cell? That is a great question. So a stem cell is basically a cell, which a cell is a living, breathing organism. It obviously comes from a human and the cell itself is what we call undifferentiated, meaning it’s a baby cell that just kind of hatched if you will and it doesn’t really know what it wants to be yet, and depending on the environment that it’s put it, it can differentiate into a different cell. So if you put it, for example, onto a muscle tissue, it can differentiate to muscle. If you insert it where there’s damage, it can differentiate into cartilage, or a ligament, or a muscle, or a tendon, whatever it may be. There’s different ways of extracting or obtaining stem cells and we can talk about that as well.

Host: Yeah, let’s do that, let’s talk about that because isn’t that amazing how they can differentiate and change and adapt? So how are they retrieved because I think that’s what people wonder about and if there’s controversy over any of that.

Dr. Antebi: Yeah lots of controversy and there’s different studies to kind of discuss the different options in various different ways. There’s definitely a lot of hocus pocus out there. There are lots of clinics outside of the United States that offer stem cell therapy for various different conditions and I’m not really here to comment about those, but some of the conditions that they treat are Parkinson’s disease, multiple sclerosis, people with cancer, antiaging, and these clinics are based out of somewhere in the Caribbean, overseas, where people are paying a lot of money for these treatments that really don’t have a lot of validity to their claims in my opinion, but specifically dealing, as an orthopedic surgeon, I’m dealing with musculoskeletal issues and that’s what I’ll comment on. So stem cells can be retrieved a few different ways. One is – the first one is what we call autologous – I’m sorry allograft tissue. Allograft tissue can be obtained from mesenchymal placenta. So what happens is when a women gives birth, her placenta has a lot of stem cells in it. So what happens is there’s various clinics that obtain this tissue and they extract the stem cells from the placenta and they process it because anytime you obtain tissue from another person, you have to make sure that there’s no disease transmission. You don’t want to – first rule of medicine is do no harm. So you don’t want to give stem cells from a donor to a recipient and then God forbid give them some kind of disease like HIV or hepatitis so it has to be treated, and usually in that treatment process which usually involves temperature like cold and also sometimes radiation therapy to the stem cells, a lot of times a lot of the stem cells are damaged. I tend not to use those type of stem cells. Other types of stem cells come from autograft, meaning coming from the person themselves. One way to get it is from fat. So almost like getting a little minor liposuction, a surgeon would insert a device into an area of fat, suck some fat from a person, which kind of sounds enticing, almost like getting a little liposuction at the same time, but it’s not that much fat that we get. It’s maybe about 10, 15, 20 cc of fat, and then that fat is processed to get the stem cells from the fat themselves. The third way of getting stem cells is the most common way, I do it, is obtaining it from bone marrow. So what I do is I bring a patient to surgery, do a little minor procedure where they go through some sedation under the care of an anesthesiologist, and then what happens is I insert what’s called a specialized Jamshidi needle into the iliac crest, which is their pelvis and through that needle, I extract a bunch of bone marrow, usually again about 20 to 30 cc of bone marrow concentrate, and that bone marrow is then processed in a machine to spin that bone marrow blood down. All of our cells in our body have a certain weight to them. Each thing weighs something in our blood, and by spinning it down in a fast centrifuge, the heavier cells get pushed toward the bottom and the lighter cells are at the top of the tube after it’s spun down, so we know by the weight of the stem cells which layer we want and we extract that from the tube after the bone marrow is spun down, and that’s what we inject into the particular area.

Host: Wow, what an explanation Dr. Antebi, who can get stem cell therapy and tell us a little bit about your experience doing it? What have you seen as far as outcomes?

Dr. Antebi: Sure, so you have to kind of be careful when we talk about stem cell therapy. First of all the stem cell therapy is more often than not, not covered by most insurance companies. So patients who come in for stem cell therapy are patients who are essentially candidates for a knee replacement or a hip replacement where they want to try something alternative outside of getting a big operation to replace their joint. I’ve also done stem cell therapy on patients – younger patients that come in for example with a knee injury, with a torn meniscus, or a patient that comes in with a torn ligament injury in their wrist or their elbow where conservative treatment has been attempted with bracing or physical therapy or medication and they’re still having issues. Rather than go in and do a forma surgical repair on that ligament or torn tissue, we inject the area with the bone marrow concentrate and within 6, 8, sometimes 12 weeks, patients are doing marvelous and they’re healed without any big formal operation.

Host: So what results have you seen Dr. Antebi?

Dr. Antebi: A lot of the results that I’ve seen with most patients have been very favorable. I would probably say stem cell therapy is not 100%. It’s not a panacea. I’d say about 70% to 85% of my patients are seeing positive results where their pain and their symptoms are abated with stem cell therapy and avoiding big surgery.

Host: That’s great. You know people are always looking for an alternative to surgery to at least try first. So are some doctors using stem cell therapy in combination with another regenerative type of medicine like PRP, platelet rich plasma? Tell us about that.

Dr. Antebi: Sure, yeah PRP is – a lot of lay people know that it’s a process where we take the blood from the vein, not the bone, and we spin it down to just get the plasma and the platelet layer. Some researchers have found that the use of PRP in conjunction with stem cells works in addition to the use of the stem cells. I find it that I’ve tried PRP in my patients for these various conditions and what I’ve found is that PRP works great for soft tissue problems but not necessarily with cartilage problems. So if somebody has tendonitis of the elbow, tendonitis of the knee, of the ankle, we can inject PRP in conjunction with stem cells into soft tissue but not into joints where people are suffering from arthritis.

Host: So as we wrap up, what would you like listeners to know because there’s a lot of information on the internet and they’re not quite sure what to believe or whether this is something they should investigate and try. What would you like them to know Dr. Antebi about stem cell therapy for sport related injuries?

Dr. Antebi: Sure, so stem cell therapy as you mentioned is a great up and coming new modality for treatment of pain and sport related injuries in addition to arthritis; however, buyer beware. You have to make sure that you have to go to a credible institution in addition to know what you’re getting. Are you getting mesenchymal from placenta, are you getting fat, are you getting bone marrow, and if you are getting the mesenchymal, is it frozen, is it freeze dried, people need to know exactly what they’re getting into before they start undergoing these procedures because the jury is still out with a lot of these procedures.

Host: Well that’s really a good point and it’s great advice for people to hear. Thank you so much Dr. Antebi. You are a great guest as always and we really appreciate you coming on today and telling us about that. What an interesting topic. Thank you again. That wraps up another episode of Palmdale Regional Radio with Palmdale Regional Medical Center. You can head on over to our website at palmdaleregional.com to get more information or to get connected with one of our providers and if you found this podcast as cool as I did, learning about stem cells and how they can be used for orthopedic conditions and sports injuries, share it on your social media, share it with your friends and family. You’ve got to know somebody with knee issues, so share it with them and they can look into this as well. Physicians are independent practitioners who are not employees or agents of Palmdale Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians. Until next time, I’m Melanie Cole.