Orthopaedic Stem Cell Treatment

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1 Orthopaedic Stem Cell Treatment Stem Cell Injections Surgically Implanted Stem Cells Learn about the treatment option that is best for you.

2 Emory Healthcare patients can benefit from surgical implantation or injections of their own stem cells to treat chronic orthopaedic conditions. This treatment can reduce pain and provide long lasting relief from chronic tendinitis, early arthritis and cartilage damage in the joint. It uses your own body s repair mechanisms and natural growth factors to promote healing. Why do I have chronic pain in my joints and tendons? As we age, our bodies undergo wear and tear from previous injuries, exercising and playing sports. We do not repair these injuries as well as we do when we are young. We produce less of our repair cells (called mesenchymal stem cells) as we get older so it takes longer to recover. In some cases, the joint damage is so significant that the body cannot repair itself at all. Where do Stem Cells reside in the body? The two places in the body with an abundance of Stem Cells are your bone marrow and your adipose tissue (fat cells). These are the two places your doctor may choose to take cells from to help treat your chronic tendon or joint pain. How can Orthopaedic Stem Cell treatment help me? Stem Cells harness the healing power of your own blood and work to actually repair your damaged tissue. We isoloate stem cells from a small sample of your bone marrow or fat cells and inject or implant them directly into the damaged area. Stem cells can differentiate into specific types of cells depending on the environment they are placed, providing possible regeneration of cartilage, bone, and tendon. What are the benefits of Stem Cell injections? Stem Cell injections provide a non-surgical treatment option to reduce pain while still providing long lasting relief from chronic tendinitis, ligament and joint pain. The injections are performed under Ultrasound guidance to ensure proper placement of the stem cells.

3 What are the benefits of surgically implanted Stem Cells? Surgical implantation of stem cells is used to treat early arthritis and/or significant cartilage damage in the knee. Implanting the stem cells allows the surgeon to use a higher concentration of stem cells that can be delivered to a smaller, more focused area. The stem cells can be glued down to ensure they stay in the proper place. Other benefits include the ability to add a microfracture during the implantation to further enhance the effectiveness. Surgical implantation can also be combined with other arthroscopic procedures in the area such as meniscal tears or debridement. What are the risks? Orthopaedic stem cell treatment uses your own stem cells. Since the cells come from your own blood, there is no chance of your body rejecting it it is just boosting your body s ability to heal. There is a small risk of infection as with any injection or surgical procedure. You can expect the site where we collected the stem cells to be sore for a few days after the procedure. How to prepare for an injection or surgery Injection Seven days before your injection, do not take any anti-inflammatory medicine. Do not take medicines like Aspirin, Motrin, Advil, Aleve and Naprosyn. Tell your doctor if you are on any blood thinning medications. The day of your injection, drink as much water as you can. Surgery Seven days before your surgery, do not take any antiinflammatory medicine. Do not take medicines like Aspirin, Motrin, Advil, Aleve and Naprosyn. Tell your doctor if you are on any blood thinning medications. Do not drink or eat after midnight the night before your surgery. This is an outpatient procedure so you will go home the same day. Please arrange to have someone drive you home after surgery.

4 What to expect during the procedure Step 1: Injection: Your doctor applies a numbing medicine to your hip or stomach area depending on where the cells come from. Step 1: Surgical Implantation: Under anesthesia, we prepare the hip area, from where the stem cells are going to be aspirated. Step 2: We then use a needle to collect 1-2 ounces (30-60cc) of bone marrow stem cells or less than 1 ounce (about 20cc) of adipose-derived stem cells. Step 3: We separate the stem cells and platelets from the rest of your blood with a centrifuge machine. Step 4: Injection: We then inject the healthy stem cells and growth factors into the injured area. Step 4: Surgical Implantation: A very small camera is inserted through a small incision, or portal, in the joint. The camera projects onto a television monitor, allowing the surgeon to accurately implant the stem cells. Several other small portals are used to allow the surgeon to place various small instruments into the joint to help implant the stem cells and use a special glue to hold the cells in place. Remember, we only use your own stem cells and blood during this procedure.

5 After your procedure: Your hip may be sore at the aspiration site for a few days. Do not take any anti-inflammatory medicine for at least two weeks after the procedure. For pain, take acetaminophen (Tylenol) or medicine prescribed by your doctor. For the first 24 hours, ice only if needed, minutes every 2-3 hours. After one week, you can resume physical therapy. Your doctor may ask you to remain non weight bearing for some period of time depending on the site and extent of cartilage damage. Call your doctor immediately if you experience unbearable pain, bleeding, or signs of infection, such as streaking, fever or chills. Emory Orthopaedics & Spine Center 59 Executive Park South Atlanta, Georgia emoryhealthcare.org/ortho

6 What should I do if I think I am a candidate for Stem Cell treatment? If you live near Atlanta, we recommend scheduling an appointment for a consultation so that we can look at your radiology films (X-rays) and examine you to determine whether or not you are a good candidate. Please call to schedule a consultation. If you live more than 2-3 hours away, feel free to send us your images (X-rays and/or MRI) and records to review. Please remember to include your name, phone number and/or address, and we will contact you with our recommendation within 7-10 business days. Please work with your local health care professional to send us the following: 1. Recent X-ray and/or MRI (no more than a few months old) 2. Medical records (pertaining to your injury) Send your documents and images to: Emory Orthopaedics & Spine Center Attn: Ortho Stem Cells 59 Executive Park South, Suite 1000 Atlanta, GA You can find more information on our website including a list of Frequently Asked Questions. emoryhealthcare.org/orthostemcells Emory Healthcare, Inc. ORS /13

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