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Regenerative Medicine

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Regenerative Medicine is a growing area of medicine with the potential to heal and regenerate damaged tissues offering improved quality. These solutions address the root cause of many painful musculoskeletal conditions which is a reduction in tissue quality leading to mechanical failure of the joint.

Hyaluronate Injections (HA) are typically offered as treatment for knee pain related to symptoms of osteoarthritis and/or cartilage damage from injury. Hyaluronate is a naturally occurring material that normally exists in our joints and functions to lubricate the joint and reduce mechanical stress in the joint. It also works through other biochemical pathways to reduce inflammation. By reducing mechanical stress in the joint and reducing inflammation HA works to alleviate the typical symptoms of pain and stiffness associated with arthritis. HA is delivered in the office setting by injection. It is a series of injections (avg 3-5) performed weekly/bi-weekly and can be used for the treatment of shoulders, hips, knees and ankles.

In addition to plasma and red and white blood cells, your blood contains specialized cells called platelets that are critical to blood clotting and preventing hemorrhage. Platelets are also rich in protein growth factors that are vital to healing a variety of injuries to the body.

What is Platelet Rich Plasma Injection Treatment?

Made using a patient’s own blood, platelet-rich plasma (PRP) is a preparation offering rich amounts of platelets separated from red and white blood cells during centrifugation. Growth factor concentration delivered by PRP is between five and 10 times greater than what is normally found in drawn blood.

PRP preparations stimulate and accelerate the repair and healing of damaged soft tissue and bone by introducing a concentrated solution of cytokines and other growth factors into injured areas. Growth factor proteins secreted by platelets encourage tissue repair by increasing the production of collagen and promoting stem cell proliferation within muscles, cartilage and ligaments.

In addition, PRP injections stimulate blood flow to injured areas, causing cartilage to become even more resilient against stress or disease.

What is Platelet-Rich Plasma Injections Used to Treat?

  • Chronic tendon injuries, such as tennis elbow, patellar tendon inflammation (runner’s knee) and recurring Achilles tendonitis
  • Acute muscle and ligament injuries (pulled hamstrings, knee sprains and other sports-related injuries)
  • Surgical repair of torn rotator cuff tendons, ACL and MCL tears in the knee and torn knee ligaments
  • Knee, shoulder or hip osteoarthritis
  • In addition to these injuries, PRP injections may also be used to treat other bone, muscle and tissue conditions.

Experience the benefits of natural vitamins, minerals, and amino acids. iOrtho now offers Vitamin Infusion Therapy to raise energy, improve the immune system, provide your body with necessary nutrients and help you with recovery.

Intravenous Vitamin cocktails are tailored to meet specific goals (i.e. Recovery, Athletic Performance, Mood Support, Hydration, Anti-Inflammatory)

What is the benefit of Intravenous vitamin therapy vs oral administration?

There are different ways to infuse micronutrients, using intravenous IV or intramuscular IM routes may be the most effective ways of correcting the essential vitamin and mineral intracellular deficits in certain people. As the name suggests, intravenous administration provides direct delivery to the bloodstream; bypassing any obstacles in the digestive system that may hinder absorption. This results in 100% bioavailability. For example, the level attainable by oral administration of vitamin C is much lower than that of IV administration due to saturation of gastrointestinal absorption abilities and an increase in renal clearance as oral doses increase. It has been shown that the maximum concentration of vitamin C level after oral administration was 9.3mg/dL compared to the peak level of 80 mg/dL when given intravenously.

This is important because some benefits from nutrients are present only when certain concentrations are reached. For instance, the antiviral effect of vitamin C has been demonstrated at a concentration of 10-15 mg/dL; a level not attainable by oral administration.

Oral absorption of a nutrient is often affected by food or impaired by other nutrients and minerals. For example, the absorption of zinc that is given orally is impaired by iron. Additionally, IV administration can prevent gastrointestinal side effects such as upset stomach, nausea, and vomiting which can be limiting for proper dosing and adherence. Improved absorption with reduced GI adverse effects may make IV administration a more suitable option for many people.

AFT or Amniotic Fluid Therapy is regenerative treatment geared toward healing and improving tissue quality through a variety of mechanisms.

The growth factors in AFT work to stimulate existing cells. This stimulation activates existing cells and promotes more robust cellular function and production of vital materials required for maintaining healthy tissue repair and healing. In addition mesenchymal stem cells (MSCs) are able to independently support healthy tissue growth in the area of injury.  Also, factors that reduce inflammation help to reduce pain associated with damaged tissue. This treatment is convenient to receive as an in office procedure. There is no tissue harvesting from the patient since the amniotic fluid comes from healthy donors. The amniotic fluid is subject to standard testing for safety and is approved by the FDA for the proposed use. The treatment is delivered by injection using ultrasound guidance to the area of injury. This treatment can also be coupled with other regenerative treatments to achieve optimal results. It can also help promote healing during and after surgery and can be often used in this setting to promote better surgical recovery.

Answers to some commonly asked questions:

What conditions are treated with orthobiologic therapy?

  • Degenerative joint disorders such as:
    • Sports Injuries
    • Osteoarthritis
    • Joint pain
  • Inflammatory conditions such as:
    • Bursitis
    • Tendonitis
    • Fasciitis
  • Soft tissue injuries such as:
    • Ligament & Tendon sprains
    • Muscle & Meniscus tears

How Do Amniotic Injections Work?

To appreciate how truly innovative this aspect of regenerative medicine is, a person must first understand what amniotic tissue and how AFT works.

The amniotic membrane is a thick basement membrane and an avascular stromal matrix that together make up the inner layer of the placenta. Amniotic fluid is the fluid that surrounds a baby in the womb before birth. Amniotic fluid protects a fetus and facilitates the exchange of water, nutrients, and biochemical products between the mother and the child she’s carrying.The amniotic membrane and amniotic fluid are sources of allograft tissue.  Allograft is a word meaning that tissue is taken from one individual and given to another. The process is safe for both the donor and the recipient. Potential donors submit their medical and social histories, and the medical team undertakes a thorough risk assessment. This ensures that only healthy mothers donate at the time of their scheduled C-sections.

The FDA has certified that amniotic injections are safe for the recipient as long as the product is minimally manipulated, (as BioLab’s Fluid Flow™) is, and as long as it’s homologous. Homologous means that after the amniotic injections, the product performs essentially the same role in the recipient’s body that it did in the donor’s body.Patients can derive additional peace of mind from knowing that although doctors have only recently found exciting new uses for amniotic injections, amniotic tissue-based products have been in use for over a century.

Amniotic injections contain abundant substances that promote healthy tissue regeneration. These components include cytokines, growth factors, fibrinogen, collagen, hyaluronic acid and messenger RNA.

This stem cell recruitment process is of particular value when a patient receives amniotic injections of BioLab’s Fluid Flow™ to help the body heal.

Generally speaking, amniotic injections can be described as consisting of a multipotent tissue matrix.  As such, they function to fill, cover, and protect a defect or void in human tissue.

What Conditions Do Amniotic Injections Help?

Essentially, amniotic injections help with wound care, controlling pain, and orthopedic uses like facilitating repair of tendons, fascia, capsules, and ligaments. They can help chronic tendinopathies, synovial surfaces, tendonitis, and chronic fasciitis (an inflammation of the fascia, which is the connective tissue surrounding muscles, blood vessels and nerves).

To break it down still further, amniotic injections can help patients deal with issues like ACL and MCL tears, biceps and triceps tendonitis, tendinosis, epicondylitis, knee scopes, rotator cuff surgery, facet osteoarthritis, foot and ankle arthroplasty, acromioclavicular joint inflammation, ACL revisions, herniated discs, AVN of the hip and other problems with the knees and hips, plantar fasciitis, post-operative pain resulting from orthopedic and spinal surgery, and the need for tendon and cartilage repair.

Is There a Risk of Rejection with Amniotic Injections?

Amniotic injections carry no risk of rejection. That’s because they don’t contain HLA-A, -B, or –DR antigens, and these are the substances in the chorion (a membrane that contributes to the formation of the placenta) that can trigger an antigen response. They are extracted during processing.

Do Amniotic Injections Carry Other Risks?

You may have heard that some patients who received a product called Infuse experienced difficulty with bone growing where it didn’t belong. This can’t happen with BioLab’s Fluid Flow™  amniotic injections because the cells inside them are self-signaling. That means they’ll grow bone, but only if and where it’s needed.

How Do AFT Injections Compare to Products Offered to Treat Similar Conditions?

Platelet Rich Plasma (otherwise known as PRP) is extracted from venous blood via centrifuging. It contains some growth factors, but the number of mesenchymal cells present is limited by the donor’s age, his or her medical history, and mechanical degradation in the centrifuge. Amniotic injections don’t come with these limitations. Generally speaking, the younger the tissue being processed, the more MSC’s it’s likely to contain, and of course amniotic tissue is quite young indeed.

Cortisone is used because of its supposed anti-inflammatory properties. But it has not yet been the subject of randomized controlled studies, and it has over 100 potential side effects including muscle and tissue atrophy, heightened glucose levels, and tendon rupture. In an effort to prevent these complications, doctors will often limit the number of cortisone injections in any one anatomic area. In contrast amniotic injections have no side effects, so patients can take them as often as necessary, and there’s no maximum dose.

Does Medical Insurance Reimburse for Amniotic Injections?

Insurance companies sometimes reimburse for amniotic injections. The first step is to send your insurance information and your diagnosis for VOBs (Verification of Benefits). Contact the office and a determination can be made if your insurance plan will cover the cost of treatment and what if any out of pocket cost exists.

Please contact us through our secure portal by clicking the blue Message Us button on the bottom right of the iOrtho website. For immediate need, please call us at 833-Go-iOrtho (833-464-6784).

To learn more about this service, please contact iOrtho through the Message Us button or call 833-Go-iOrtho (833-464-6784)
Regenerative Medicine - iOrtho - Staten Island and NYC