Is it possible to avoid Osteonecrosis surgery? Osteonecrosis is a bad disease where the bone begins to die off. It often means certain surgery, either to ream out the dead bone or to replace the joint. However, can this dreaded disease be treated simply by using a specialized injection of your own stem cells?
My partner, John Schultz, came into my office the other day and enthused, “Do you know that we’re pretty much the only place on earth where work like this is being done?” while showing me the two fluoroscopy images above. So what do they show?
First, Osteonecrosis is a disease where the cells that maintain bone can no longer keep up with it’s maintenance and the bone begins to die off. Sometimes it can be due to lost blood supply to the bone (hence it’s sister term of “avascular” necrosis), but most of the time we either don’t know what causes it, or the cause is medications or chemicals. One example of a chronic cause is anti-inflammatory steroid use. In fact the hip on the right that Dr. Schultz was treating belongs to a patient who got Osteonecrosis in both hips because of many years of being on a steroid inhaler for chronic sinusitis (Pulmicort).
The treatment for this bad disease is almost always surgical. In one surgery called a CORE decompression, the surgeon takes a ball point pen sized drill and creates a tunnel through the bad bone. Sometimes they will also insert a bone plug or hard dowel. If that doesn’t work, the joint has to be replaced. What’s so interesting about the above pictures that got my partner excited was that the ankle bone on the left and the hip bone on the right are being treated with a truly minimally invasive injection procedure. A needle called a trocar is inserted under x-ray guidance, without surgery, to inject stem cells. There’s solid research all the way back to the 90s that this injection procedure works well in the early stages of Osteonecrosis. We’ve been performing it for about a decade. What’s unique is the there are few places on earth where the expertise exists to do these procedures. In the U.S., outside of our network, you would be hard pressed to find a doctor who would have experience in performing this precise bone injection. More importantly, when you do less damage getting stem cells to the area through injection versus surgery, patients benefit by fewer complications and shorter recovery.
The upshot? Regenexx isn’t magic stem cells, it’s Interventional Orthopedics – the concept that precise image guided injections of our advanced platelet or stem cell preparations can replace the need for much more invasive surgery. The pictures above are an example of the sophistication level of that new approach!