Connecting with Medicinal Signaling Cells

What if you could solve joint pain naturally and without surgery by using the exact same mechanisms your own body uses? What if there was a cell based treatment (CBT) that was scientifically proven to relieve joint pain and required little to no downtime? What if you could return to work the same day as your treatment, and very quickly return to or achieve the lifestyle you long for?

That’s the power of Medicinal Signaling Cells, molecular biologics and scaffold engineering that is Regenerative Medicine and Regenerative Orthopedics.

Regenerative Medicine uses the body’s own cells to repair damaged or injured areas, allowing for natural healing, thus delaying or avoiding the need for surgery.

I was fortunate to work with some of the world’s leading experts in this area, both as a researcher and as a practicing orthopedic surgeon in the best training and treatment facilities in the world.

But how did I come to Regenerative Medicine and how did I establish Wilmington’s first clinic based on biologics and cell based treatments?

It all started at UNC Chapel Hill as an undergrad, when I became interested in cellular healing through molecular biological pathways. I wanted to figure out better ways to treat patients that would facilitate a quicker recovery with the least amount of scarring. I completed two years of research in the field following my surgical internship, while my interest continued to build. During my residency, I realized there were French and other European surgeons and thought leaders already using cellular based techniques for clinical treatment. It all made sense chemically. I was already familiar with using bone morphogenic proteins and other commercially available biologics to achieve better clinical results in the setting of trauma and fusion surgery. I wanted to be a shoulder and elbow expert, and that’s the path I stayed on.

During my surgical sports medicine fellowship at the Steadman-Hawkins clinic in Vail, Colorado, I focused on the need for a better solution in patients with large rotator cuff tears and poor or deficient tissue, many of which go on to fail because the biology has failed. The problem was, many repairs failed due to the loss of collagen and tissue degeneration that comes with tissue senescence and age. The tissue just couldn’t hold a suture.

Looking for a better way, my colleagues and I began weaving biologics (medical products made from natural sources and harvested from the same patient being treated) into shoulder rotator cuff repairs. In 2007, after observing better results than we had seen without the biologic techniques in patients with poor tissue, we began contemplating a completely new procedure that would be a solution for patients with what were named and coded “irreparable rotator cuff tears.” These large to massive tears had lost tissue substance (tendon turns to fat when not under tension). We replaced the tissue defect by suturing in an acellular dermis allograft (patch of reversed collagen scaffolding) and impregnating it with the patient’s stem cells that we harvested and used the same way we do in our clinic today.

We were the first in the nation to perform these cases, although the techniques had been used in Europe for decades. Interestingly, we also noticed that patients with shoulder arthritis also responded extremely well to CBT, but it wasn’t until later that we began to use biologics for arthritis pain.

This therapeutic combination was so successful in our hands and gave so many patients durable relief that we knew we were looking at the next generation in orthopedic and joint pain care. We expanded the treatment to cartilage defects of the knee, and success there led us into other indications.

Many of our patients had no other choice but joint replacement and that was probably the group that gave us the most incentive to progress the field. Treatment of knee arthritis soon followed. Today, thanks to the initial patients who trusted our dedication to them, to science and to medicine, we can use CBT in almost every joint in the body that meets treatment protocol standards. Our success rate is very high, but we are very careful whom we select as appropriate for the procedure. In some cases, surgery is the best option. When that’s the case, we support any decision our patients make and ensure that they get the very best surgeon for their particular clinical issue.

I have accumulated a massive knowledge base on stem cell biology and related molecular chemistry, and I love it. After family, cells have become my hobby and life. In the eyes of the indoctrinated, I may seem to have made a big translational leap from bench to clinic using stem cell preparations for people with chronic joint pain and/or arthritis. I did that because I saw too many surgeons indicating too many people for joint replacement far sooner than I thought was necessary or appropriate. It’s amazing to think that just 10 years after my formal decision to pursue biologics and stem cell therapies as the best available treatment for patients that word has spread, and tens of thousands of joint care patients around the world are finding profound, long-lasting relief without surgery.

I’m honored to have been the first to bring these technologies to the area and introduce them into the mainstream. We use this technology right here in southeastern North Carolina every day at the Regenerative Medicine Clinic. Without a doubt, Biologics are the future of medicine and surgery in every specialty.