Alpha 2 Macroglobulin (A2M)

One of the newest methods now offered by Dr. Anden involves A2M, a naturally occurring chemical in our blood that has been shown to slow arthritis progression in animals. A2M protein is made in your liver. Using special binding sites, it will bind and trap bad enzymes that are destroying your cartilage. Once trapped, the A2M and the disabled enzymes are removed by your body naturally.

An A2M injection contains a concentrated dose 6X more than what already occurs in your blood naturally. When this level of A2M is injected into your joint or disc space, it can provide the necessary amount of A2M to bind and remove destructive proteases associated with degeneration within the joint or disc space.

How is an A2M Injection done?

Just like the PRP, the A2M procedure begins with drawing your blood. The amount of blood drawn will depend on the area that we are treating. Once drawn, we will spin and concentrate your blood in to PRP an PPP (platelet poop plasma). Once the plasma is separate out it goes through and additional filtration process to be able to isolate the yellow plasma. This yellow plasma, will be used to inject a concentrated does of A2M back into the problem joint.

Are A2M injections painful?

No, the injection is not painful. The A2M solution is soothing to the joint space as it immediately starts to remove the harmful proteins.

Can I go back to work or daily activities?

Typically, you’ll be able to return to work the same day. Your physician will instruct you on any restrictions based on your specific injury.}

Our office is eager to answer your questions. Please contact us today for scheduling and pricing!

 

Stem Cells from Bone Marrow Concentrate (BMC)

What Is Bone Marrow?

Bone marrow is the soft spongy tissue that is found in the center of your bones. Bone marrow aspirate concentrate (BMAC) is made from fluid taken from the marrow. Since this is the location of production, immature forms of cells, called stem cells, will be found here.

What are Stem Cells?

Stem cells are the body’s main cells for repairing damaged tissue and reducing inflammation. They can divide and replenish cells that have been damaged by disease, injury or normal wear and tear. BMC/Stem Cell injections are used to treat various orthopedic injuries, tendon injuries and osteoarthritis.

How does BMC therapy work?

While similar to Platelet Rich Plasma and using your body’s growth factors; BMC also utilizes stem cells that are contained within your own bone marrow. The marrow contains a rich pool of pluripotent stem cells that can be withdrawn from your hip bone.

How is the Bone Marrow Concentrate Collected?

This procedure will be done under x-ray guidance in order to guarantee a successful aspiration.

You will arrive into a sterile procedure room and be prompted to lay down on your stomach. The area will be cleaned and prepped. Dr. Anden will use a local anesthetic to numb the area, which will be at the top ridge of the rear of the hipbone.

Dr. Anden will insert a hollow needle through your skin and into the bone. The center portion of the needle is removed, and a syringe is attached to draw fluid out of the marrow. You should only feel pressure and possible dull ache at this time.

After the procedure, you will be bandaged and rest while Dr. Anden processes and collects the stem cells. Your injection will be done 20 minutes after the aspiration.

Post injection soreness at the injection site (shoulder, hip, knee, etc.….) can be expected because of the inflammatory response, just like Plate Rich Plasma. This pressure and soreness usually resolves within a few days after the injection. It is acceptable to use pain medication after this procedure. A prescription may be provided to control discomfort as needed.

IT IS CRITICAL TO AVOID ANTI-INFLAMMATORY MEDICATION and ICE before and after the procedure. We want to create an “inflammatory” response, which is going to stimulate your body into healing the injured area. If you are using ice or anti-inflammatories this will counteract the treatment. Avoid medications such as: Aleve, Motrin, Celebrex and Naproxen/Naprosyn.

BMC / Stem Cell Injection Treatment Protocol

The recovery process and minor risks are similar to Platelet Rich Plasma Injections.

On average, most patients see signs of improvement within 6-8 weeks. During this time frame you will want to avoid over loading the injected area and generally “take it easy” while the body is healing itself. It takes time to heal and regenerate, so you can expect a slow progression over 3-6 months.

The most important part of any stem cell therapy is adhering to your post-procedure restrictions, which are covered before your procedure. For the procedure to have the best chance to yield lasting benefit, our physician strongly recommends:

  • No anti-inflammatory medications for a minimum (preferred) 6 weeks
  • Rest for the first 24–48 hours, but do not lie sedentary
  • Start Physical Therapy within 4-6 days.
  • *Get your recovery packet here!

 

PRP – Platelet Rich Plasma

What is Platelet Rich Plasma Injection Therapy?

Although blood is mainly a liquid (called plasma), it also contains small solid components (red cells, white cells, and platelets.) The platelets are best known for their importance in clotting blood. However, platelets also contain hundreds of proteins called growth factors which are very important in the healing of injuries.

PRP is plasma with many more platelets than what is typically found in blood. The concentration of platelets — and, thereby, the concentration of growth factors — can be 5 to 10 times greater than usual.

How do you extract PRP?

Creation of PRP is simple, painless, and conveniently done at an office visit.

The process of creating PRP begins with drawing your blood. The amount of blood drawn will depend on the area that we are treating. We typically take 30-60 ml’s of whole blood. Once the blood has been drawn, Dr. Anden will place the blood into a centrifuge to spin and concentrate the blood. This process takes about 20 minutes. Once the blood has been spun, we will separate the Platelet RICH Plasma from the Platelet POOR Plasma. Dr. Anden will then injection the PRP into the problem area using ultrasound OR x-ray guidance.

Similar to Prolotherapy, the risks of PRP are low and the most common side effects are temporary increases in pain, stiffness and swelling, as well as bleeding/bruising in the area.

Does the injection hurt?

Generally speaking, all injections come with some discomfort. The level of discomfort depends on the part of the body being treated, as well as, the tolerance of the patient.

There is typically an increase in pain after the injection, as we injected a very concentrated solution. You will feel a significant amount of pressure during the injection and for a few hours following. Dr. Anden will give you pain medication following the procedure, but you may take Tylenol on your own.

IT IS CRITICAL TO AVOID ANTI-INFLAMMATORY MEDICATION and ICE before and after the procedure. We want to create an “inflammatory” response, which is going to stimulate your body into healing the injured area. If you are using ice or anti-inflammatories this will counteract the treatment. Avoid medications such as: Aleve, Motrin, Celebrex, Naprosyn, and Mobic.

What can PRP Treat?

PRP can treat all chronic and acute joint, ligament and tendon injuries including: tennis elbow, plantar fasciitis, Achilles tendonitis, rotator cuff tears, shoulder dislocations, meniscal tears, osteoarthritis and chronic low back pain, neck pain and any other areas of injured connective tissue, joints, tendons or ligaments.

PRP Treatment Protocol

The benefit to PRP therapy is that this can be a permanent fix, unlike other treatments, such as cortisone, which is temporary. On average, most patients see signs of improvement within 6-8 weeks. During this time frame you will want to avoid over loading the injected area and generally “take it easy” while the body is healing itself. It takes time to heal and regenerate, so you can expect a slow progression over 3-6 months.

The most important part of any stem cell therapy is adhering to your post-procedure restrictions, which are covered before your procedure. For the procedure to have the best chance to yield lasting benefit, our physician strongly recommends:

  • No anti-inflammatory medications for a minimum (preferred) 6 weeks
  • Rest for the first 24–48 hours, but do not lie sedentary
  • Start Physical Therapy within 4-6 days

 

What is Prolotherapy?

Prolotherapy is an injection used to repair injured tendons, ligaments and joints. Tendons and ligaments can be strained as they connect muscle, tissue and bone and involve joint stability and movement. These structures generally have a limited blood supply, meaning incomplete healing is common after injury. The incomplete healing results in a relaxed tendon/ ligament that can become a source of weakness and pain. Prolotherapy stimulates healing and can be used effectively to treat musculoskeletal conditions.

How does Prolotherapy work?

Prolotherapy is based on the principle of injecting a proliferant solution (mild irritant solution, usually 15-25% dextrose) directly into weak or damaged soft tissue where tendons and ligaments attach to the bone. This initiates an inflammatory response which promotes the body’s own wound healing mechanism by increasing the blood and nutrient supply to that area.

What can Prolotherapy treat?

Clinically, Prolotherapy has an 85% success rate for most types of musculoskeletal pain. It has been shown effective on areas of the body such as: neck, back, shoulder, elbow, hip, knee, ankle, foot or anywhere that a tendon or ligament may become strained, sprained, or overstretched.

Prolotherapy Treatment Protocol

Many patients report experiencing relief after only one session, however the average person requires 2-3 treatment sessions given at 4-6-week intervals.

Prolotherapy is an extremely safe procedure. The most common side effects experienced by patients are temporary increases in pain, stiffness, and swelling (1-2 days after due to the inflammatory response), as well as bleeding/bruising in the area.