Stem Cell Orthopedics: 

The Sports Medicine of the Future!

- M. Walter M.D.

The field of Regenerative Orthopedics is extremely useful for sports injuries of all kinds. Almost all of these injuries involve connective tissue structures i.e. ligaments, tendons and joint capsules. Sometimes there is a history of sudden trauma although, in many cases, there may be a repetitive strain “overuse” pattern, where the structure has been weakening over a period of time. Since these connective tissue structures have very little blood flow, healing can often be problematic. If the problem is chronic or fails to heal itself in about 3 to 4 weeks, the fastest and indeed the best way to fix the damage is to target the damaged structure(s) with injections of stem cells, PRP or other regenerative solution. 

Some of the more common areas we can treat with stem cell therapy and regenerative injections are the knee, shoulder, elbow, wrist and low back, but we can pretty well inject and help the healing in almost any joint in the body, from the bottom of your foot (plantar fasciitis) to the neck and sub-occipital area. With a skilled and experienced doctor our success rate is better than 80% for long-term resolution. If done properly, this therapy is very safe and has very little chance of adverse effect. Patients have almost no downtime and can return to activities of daily living almost immediately. For athletes this is by far the most effective treatment to allow the quickest possible return to the sport they love.  

There are several keys to optimize a stem cell therapy. The first key is make the right diagnosis of what specific structure(s) are the root cause of the problem. In many cases there may be multiple structures that are contributing to the pain and loss of function so it is important to identify and prioritize the pain generators. As useful as imaging techniques such as MRI and ultrasound are, it is a mistake to rely on them too heavily. Results can be misleading and only give part of the picture. Not every structural abnormality is a pain generator. Also, they often miss the micro-tears in connective tissue structures that are so often the root cause of the pain. 

In order to get a clear picture of the problem and properly identify pain generators it is crucial that patients have a thorough palpation exam of the areas in question from a skilled regenerative orthopedic doctor. Stem Cell Orthopedics is a “hands-on” specialty and a palpation methodology is the only reliable way to properly identify and 

prioritize the specific structures that are causing the problem. If direct palpation of a certain structure produces the “jump sign” and reproduces the pain, it is virtually diagnostic that you have identified the root-cause(s) of pain. In medicine it is said that half of solving a problem is correctly diagnosing what’s causing it. Once identified and prioritized accordingly, we can inject stem cells and regenerative solutions with specificity and have an excellent chance of solving the root cause(s) of the issue. 

The second key is the typeof regenerative solution we select for a given patient and the particular problem. Stem cells freshly prepared on the spot from your own fat combined with PRP (growth factors from your blood) is the most powerful and safest regenerative solution we have – I call it the Mercedes-Benz of injection solutions. It has about 10 times the regenerative power of PRP alone. Stem cells with your own DNA and genetic code are intelligent and as long as you deliver them to within a dime of the damage, they have an amazing ability to detect tissue disruptions at a cellular level, become the right type of cell and regenerate the damaged tissue. 

The two sources of autologous stem cells (from your own body) are your fat and bone marrow. The stem cells from fat are more powerful to rebuild orthopedic structures and it is far easier and more pleasant to collect a little fat with a gentle liposculpting procedure than to do a bone marrow aspiration.  

Particularly if there is severe degeneration in a region, I generally prefer to use a stem cell/PRP combo over PRP by itself. One reason is I usually can fix a problem with a single treatment whereas with PRP or other regenerative solutions such as dextrose (Prolotherapy) we may need 3-6 sessions. I like to say that I only have one time to make a first impression; my intention is to try and have the biggest impact and resolve orthopedic problems as quickly and directly as possible.  

Third, the right rehab is important to a great outcome. We need to get movement in the affected joint(s) as soon as possible. This helps get more circulation in the area and is necessary for the correct regeneration of tissues. As patients feel stronger they can incrementally add load to the healing areas. If the activity produces pain, they need to back away and allow more healing time. In addition, If the problem involves feet, ankles, knees, hips or low back I want to make sure that patients have optimal orthotics. If a patient’s wheel alignment is not perfect when they walk they will continue to break down the area in question. Once we inject an area, it is important that we try and optimize the biomechanics. Finally, since stem cells are really part of the body’s healing process, I recommend to all my patients to boost their healing power by eating a low inflammation diet and getting plenty of sleep.

Let’s review the pros and cons of the stem cell option¾80-85% success rate, minimally invasive, no downtime, effectiveness in addressing micro tears in the connective tissues, very safe if done correctly. The only real potential downside to a stem cell procedure is you have to pay for it and it may not work. 

Your stem cells have an innate intelligence and if applied correctly, can be an immensely powerful healing force. Stem cells are the power that built you in the first place, they certainly have the ability to heal and rebuild a small part of you. Modern medicine is only beginning to understand the full potential of stem cells and in many cases the results may be far superior than what you might get with surgery ¾and far safer! This is the sports medicine of the future!

About Dr. Walter:Mark Walter MD, CM, CCFP has pioneered the field of Regenerative Orthopedics for the last 20 years and is considered one of the top Stem Cell Orthopedic specialists in Florida. Dr. Walter received his M.D. degree from McGill (1980) and completed his residency in Family Practice and Sports Medicine in 1982. He went on to do five years of post-doc fellowship work in Regenerative Orthopedics with the world-renowned Hackett-Hemwall foundation, in association with the University of Wisconsin. During that period Dr. Walter was mentored by and worked with some of the top regenerative orthopedic teachers in the world. Dr. Walter is a leading expert in myofascial pain generators and ligament and tendon regeneration. 

For more information, to schedule a personal consultation with Dr. Walter (by phone or in-person) or to sign up for a free seminar, please call Stem Cell Orthopedics in Sarasota, FL at (941) 955-4325

or email us at stemcellortho@gmail.com.

Also, please visit us at StemCellOrthopedics.com

Stem Cell Orthopedics:

Healing Knee Problems

M. Walter M.D.

The most common condition that I treat as a stem cell orthopedic specialist is arthritis or degeneration of the knee. The knee is the largest joint in the body and arguably the most prone to degeneration. We see the whole gamut from mild degeneration to full blown bone-on-bone osteoarthritis. Our goal is to help patients avoid knee arthroscopy /replacement. Even with severe cases we have about an 80% success rate. Our intention is not to just postpone surgery but to heal the knee so that patient will be able to avoid surgery for the long term. To me, surgery should always be the last resort and my intention is to do everything possible to find a nonsurgical way to return the patient to full and active life (and use of the affected joint or structures).

Knee arthritis is not just a loss of cartilage but also involves loosening of the capsule and damage to the surrounding ligaments and tendons. This loosening and instabilityof the joint is very important. If the femur is not held firm on the tibial plateau the joint can shift or subluxate. This displacement is a serious problem. First, it pulls on the highly innervated capsule, a mechanism that may actually produce much more pain than the commonly referred to “bone-on-bone” mechanism. Secondly, nothing will accelerate damage and degeneration of the joint faster than repeated subluxation. The articular cartilage is grooved to hold the joint in place, sliding out of place will cause tearing etc. of the cartilage.

In stem cells orthopedics, one of our first goals when we inject stem cells in and around the knee is to tighten and stabilize the joint. This initiative in itself may greatly lessen the pain from the joint. Further improvements can occur over time as the stem cells regrow cartilage.

The safest and the most effective stem cells to use are those from your own fat, mixed in with PRP (growth factors from your own blood). It is very important to not only inject in the joint but also to pepper the surrounding ligamentous capsule. I also highly recommend that you check your wheel alignment and make sure you have optimal orthotics to minimize the strain and keep everything in alignment.

Prior to the procedure patients are weaned off anti-inflammatories as they interfere with the body’s healing systems. Following the procedure patients are encouraged to return to activities of daily living and start walking immediately (with corrective orthotics please!). The knee needs movement to heal optimally. Things like cycling etc. can be introduced as tolerated. Sporting activities such as golf or tennis may take a little longer depending on how severe the problem was to start with. It can take up to 4-6 weeks before the joint is strong again.

About Dr. Walter:Mark Walter MD, CM, CCFP has pioneered the field of Regenerative Orthopedics for the last 20 years and is considered one of the top Stem Cell Orthopedic specialists in Florida. Dr. Walter received his M.D. degree from McGill (1980) and completed his residency in Family Practice and Sports Medicine in 1982. He went on to do five years of post-doc fellowship work in Regenerative Orthopedics with the world-renowned Hackett-Hemwall foundation, in association with the University of Wisconsin. During that period Dr. Walter was mentored by and worked with some of the top regenerative orthopedic teachers in the world. Dr. Walter is a leading expert in Myofascial pain generators and ligament and tendon regeneration. 

For more information, to schedule a personal consultation with Dr. Walter (by phone or in-person) or to sign up for a free seminar, please call Stem Cell Orthopedics in Sarasota, FL at (941) 955-4325

or email us at stemcellortho@gmail.com.

Also, please visit us at StemCellOrthopedics.com

Stem Cell Orthopedics: 

Doctor, what kind of stem cells work best?

M. Walter M.D.

As an MD specializing in stem cell orthopedics I often get asked what stem cells are best to help heal orthopedic problems like knee/hip arthritis, shoulder problems, back pain and other common problems.

This is part of a larger question which is what regenerative solution is best and where and how do we place it to best help the body repair the particular damaged structures that are causing pain and disability. Stem cells are only one type of regenerative solution and are generally used with PRP (platelet rick plasma) from your blood. The type of stem cells or solutions we use and how we use them have a huge impact on the success of the procedure. 

The field of Regenerative Orthopedics has been around a long time and includes many different kinds of solutions. For many years doctors used a dextrose solution to help heal joints (Prolotherapy). About a decade ago we started to use PRP (platelet rich plasma) which was the first biologic regenerative solution and greatly enhanced our regenerative power. In the last 6 years or so we have added stem cells to the choices available. Stem cells are the cells that built us in the first place- they are immensely powerful and can rebuild virtually any tissue in the body.

For orthopedic applications the most common types of stem cells used are either umbilical (from newborn umbilical cords) or autologous from your own body, either bone marrow or from your fat. For most cases I do not recommend umbilical. Although the idea of  using the stem cells of a newborn is compelling, it actuality doesn’t work that well. Recent studies have found that the cells are mostly dead and there is always the risk of contamination. Also, I don’t like the idea of using foreign genetic material. Lastly, to properly treat most orthopedic conditions you need much more volume than is commonly provided by umbilical stem cell companies. 

Autologous stem cells (from your own body) on the other hand, are freshly prepared and have much greater amounts of growth factors. Also, since the cells are from your own body, you can harvest however many stem cells you need for a given application. In addition, cells from your own body contain your own DNA and genetic blueprint of how best to rebuild you.  When choosing between bone marrow and fat, such factors as how much body fat the patient has available for harvesting is important. For orthopedic applications fat cells have more potency than bone marrow and are easier (and more pleasant!) to harvest. 

Ideally for any given patient, a doctor might use a combination of dextrose, PRP and autologous stem cells, properly apportioned and injected on a priority basis at the root cause of problems. In addition, since many pain generators are contained in the myofascia, it is important that the doctor has proper palpation skills in order to properly identify and prioritize the primary pain generators (with the jump sign) and to ensure that the patient gets all his pain generators attended to. 

Properly used, stem cells are very powerful healing agents that have the potential to heal most common orthopedic problems in a very efficient and elegant manner. The procedure is minimally invasive and done in 3-4 hours in the office setting with only local anesthesia. Patients walk in and walk out a few hours later, returning to activities of daily living almost immediately. If properly done there is a better than 80% success rate, very little downtime and it’s very safe. 

If you have a significant orthopedic concern, I would highly recommend that you fully explore the stem cell option prior to considering surgery. In many cases there may be a simple and safe solution that obviates the need for surgery. This is the Medicine of the Future!

About Dr. Walter: Mark Walter MD, CM, CCFP has pioneered the field of Regenerative Orthopedics for the last 20 years and is considered one of the top Stem Cell Orthopedic specialists in Florida. Dr. Walter received his M.D. degree from McGill (1980) and completed his residency in Family Practice and Sports Medicine in 1982. He went on to do five years of post-doc fellowship work in Regenerative Orthopedics with the world-renowned Hackett-Hemwall foundation, in association with the University of Wisconsin. During that period Dr. Walter was mentored by and worked with some of the top regenerative orthopedic teachers in the world. Dr. Walter is a leading expert in Myofascial pain generators and ligament and tendon regeneration. 

For more information, to schedule a personal consultation with Dr. Walter (by phone or in-person) or, if you live in the Tampa-Sarasota region, to join us for a free seminar, please call Stem Cell Orthopedics in Sarasota, FL at (941) 955-4325

or email us at stemcellortho@gmail.com.

Also, please visit us at StemCellOrthopedics.com

Stem Cell Orthopedics: 

Unleash the Healing Power Within!

M. Walter M.D.

Welcome to an exciting new field in Orthopedics! We now have the technology to use your very own stem cells to help the body heal and regeneratemany common orthopedic problems such as cartilage tears, bone-on-bone arthritis, rotator cuff, hip arthritis, lumbar disc issues and many other conditions. In skilled hands we have a better than 80% success rate for most of these issues (and many more) ¾without the risks and downtime of surgery.

As a physician I have specialized in the field of Regenerative Orthopedics for the last 20 years. In the early years we injected dextrose solutions (Prolotherapy) to help rebuild and tighten ligaments and tendons. Over a decade ago we began to use Platelet rich plasma (PRP) which was the first biologic regenerative solution. This amped up the regenerative power of our solutions so we could now heal larger tears etc. However, in the last 6 years or so, the ability to isolate and concentrate a person’s own stem cells in an office based lab setting has been a game changer. Stem cells, when combined with PRP growth factors, multiplies by many fold the regenerative power of PRP alone. In the right conditions and if injected optimally, your own stem cells can rebuild almost any tissue in your body, in ways that modern medicine is only beginning to understand and with results that may be far superior to current surgical technology.

Stem cells have an innate intelligence and can be a powerful healing force. They are the power that built you in the first place, they certainly have the power to heal you! The real trick is to use the right kind of stem cells, prepare them properly and inject them with precision at the root cause of the problem so they can do their job. 

Make no mistake, Regenerative Orthopedics has a much different approach than surgical orthopedics. Surgical orthopedics has a verymacroapproach to problems and looks at things in terms of surgically repairing (or replacing) anatomic disruptions that you can seein joints, cartilage, discs, nerves and bigger tears in larger ligaments and tendons (macro tears). Stem Cell Orthopedics also considers these macro structures and stem cell / PRP combinations certainly have the power to rebuild these structures. However, with the stem cell approach, we go further to address microscopic tears (microtears) in the myofascia, the miracle connective tissue fabric that holds the whole body together and gives it strength while allowing flexibility and movement. Instead of repairing and replacing at the macro level we inject and seek to repair and regenerate all the tissue disruptions (macro and micro) at the cellularlevel. Surgical Orthopedics is really good at fixing broken bones and large disruptions of the anatomy where there is significant deformity but for many chronicconditions, Stem Cell Orthopedics may have just as good and, in some cases, a far superior outcome to surgical approaches. With far less risk, I might add. 

Of particular interest to Stem Cell Orthopedics are the attachment points where the myofascia connects bone to bone (ligaments and joint capsules) and muscle to bone (tendons). These highly innervated attachments give joint feedback and the proprioception that allows coordinated movement. If damaged with tears or microtears these attachments can become huge pain generators, so much so that in many cases they are often the primepain generator(s). Here’s a crucial point ¾as useful as MRI and ultrasound are for imaging macrotype problems, they are not sensitive enough to pick up the smaller microtears in the myofascia (which are very common!). Hence the diagnosis of the true root-cause of the pain may often be missed if a doctor relies too heavily on standard imaging techniques and does not have the regenerative orthopedic know-how to complement his evaluation with a thorough palpation exam (interrogation) of the myofascia. 

Stem Cell Orthopedics is a “hands-on” specialty as a palpation methodology is the only reliable way to properly diagnose these stretchedattachments (micro tears) as pain generators and to prioritizetheir relative importance in a given patient. If direct palpation of certain structures produces the “jump sign” and reproduces the pain, it is virtually diagnostic that you have found the root-cause(s) of pain. It is said that half of solving a problem is correctly diagnosing what’s causing it. Once identified and prioritized accordingly, we can inject stem cells with specificity and have a really good chance of solving the root cause(s) of the issue. 

Let’s review the pros and cons ¾80-85% success rate, minimally invasive, no downtime, effectiveness in addressing micro tears in the myofascia, if done correctly the procedure is extremely safe; the only real potential downside to a stem cell procedure is you have to pay for it and it may not work. Given this favorable risk-reward ratio, I would highly recommend that if you have a significant orthopedic problem, you find the best stem cell orthopedic specialist you can and fully explore the stem cell option priorto opting for surgical options. If done properly it may solve your problem in an amazing and elegantfashion. This is the medicine of the future!

About Dr. Walter:Mark Walter MD, CM, CCFP has pioneered the field of Regenerative Orthopedics for the last 20 years and is considered one of the top Stem Cell Orthopedic specialists in Florida. Dr. Walter received his M.D. degree from McGill (1980) and completed his residency in Family Practice and Sports Medicine in 1982. He went on to do five years of post-doc fellowship work in Regenerative Orthopedics with the world-renowned Hackett-Hemwall foundation, in association with the University of Wisconsin. During that period Dr. Walter was mentored by and worked with some of the top regenerative orthopedic teachers in the world. Dr. Walter is a leading expert in myofascial pain generators and ligament and tendon regeneration. 

For more information, to schedule a personal consultation with Dr. Walter (by phone or in-person) or to sign up for a free seminar, please call Stem Cell Orthopedics in Sarasota, FL at (941) 955-4325

or email us at stemcellortho@gmail.com.

Also, please visit us at StemCellOrthopedics.com