4. Regenerative Medicine
• The Theory
– The process of creating living, functional
tissues to repair or replace tissue or organ
function lost due to age, disease, damage,
or congenital defects
• The Practice
– The application of scientific principles and
medical technology to support, augment
or induce tissue healing or growth.
6. Diet, Nutrition, Lifestyle
Avoid “toxins…”
• Tobacco and nicotine
• Illicit drugs
• Too much alcohol
• Too much coffee
• Too much red meat
• High sugar/processed food
• Fried food/poly-unsaturated
fats
• Certain medications
– NSAIDS, statins, ACE-inhibitors,
others
Be “friends” with…
• …other people
• Daily activity and exercise
• Adequate sleep
• Meditation/contemplation
• Vegetables, fiber, whole foods
• Garlic, ginger, natural B-
vitamin sources, anti-oxidants
• Certain supplements
– Fish oils, Curcumin,
glucosamine, Vitamin D, others
7. Exercise
Exercise is medicine…
• PROVEN effects
– Tissue health, healing, and
viability
– Longevity
– Reduced disease burden
– Reduced disability
– Improved emotional and
psychological functioning
“Motion is lotion!” A cornerstone of both Rehabilitation and Regenerative
Medicine is coaching and encouraging our patients to be active, flexible,
strong, and coordinated; prescribing and monitoring their progress toward
better overall fitness.
8. Prolotherapy
• Dry needling (debridement)
• Injection of irritative
substance to “proliferate”
tissue healing.
– Dextrose 12.5%
– Glycerin
– Sodium Morrhuate
• Target of therapy is the
“enthesis”
– Soft tissue attachment site to
bone
The ENTHESIS
9.
10. Platelets?
• Platelets contain granules that store
large numbers of “growth factors”
• Alpha granules released (activated)
when platelets aggregate and
adhere to a site of injury or
inflammation
• These growth factors include:
interleukin-1, tumor necrosis factor,
transforming growth factor, insulin
growth factor and more
• It is the activation of platelets and
release of the various growth
factors that makes them special
and is the key to enhancing tissue
repair and healing!
14. • Platelet Plasma Plasma
(PRP)
– PRP is simply whole
blood that is centrifuged
to create an increased
concentration of platelets
with or without WBC’s
• Mechanically or manually
– Manual processing
allows for better
concentration
Platelet Rich Plasma
21. Stem Cell Basics
• Undifferentiated cells capable of turning into
different kinds of tissue
• Three types:
– Embryonic—pluripotent (can be anything)
– Adult/constituent—multipotent (can be become some
things); differentiated by tissue milieu
– iPSC—lab cultured cells “forced” by genetic tinkering
into becoming a particular tissue
• Autologous-from the same person
• Allogenic-from different people
22. Adult Stem Cells
• Present in bone marrow
and adipose tissue
• Three types
– hematopoetic stem cells
form red and white blood
cells
– Stromal or mesenchymal
form skeletal tissue
– Neural stem cells form
neural elements
• They respond to tissue
damage signals and
initiate repair
23. Bone Marrow Aspiration
• Bone marrow is
harvested from the
patient’s illiac crest
• Manually processed to
isolated the stem cell
enriched fraction
• Re-injected into the
patient under image
guidance
27. Summary
• Regenerative Medicine is an approach to
tissue healing that focuses on host factors
first.
• Many of the techniques of Regenerative
Medicine emulate things we already do.
• Biologics (PRP, PL, SC) are not covered by
insurance
• Patient education and selection are critical to
the success of Regenerative Medicine
procedures
