Regenerative Medicine

Regenerative Medicine – what is it?

Regenerative medicine is a field of medicine at the intersection of molecular biology and tissue engineering and is a viable non-surgical option for many patients.  Its goal is to heal or replace tissues that were possibly previously determined beyond repair through trauma, disease, or congenital issues.  Certain cells (such as stem cells) in the body rejuvenate, or possess a natural ability to heal.  They have the ability to become other types of cells, such as fat cells (adipocytes), cartilage cells (chondrocytes), bone cells (osteoblasts), and muscle cells (myocytes).  By regenerating these cells or their growth factors, we are able to encourage healing in damaged areas that otherwise have lost these characteristics. These cells can be used for issues such as tendonitis and arthritis.  Stem cell therapies and tissue engineering/biomaterials are just two exciting areas of regenerative medicine that the surgeons at the North Carolina Orthopaedic Clinic (NCOC) utilizes.

Stem cells – how are they harvested?

Stem cells are harvested from your own bone marrow or fat and are a natural, safe option to accelerate healing and repair damage.  The harvested stem cells are then processed in the operating room or in-office to remove unnecessary products in preparation to be reinjected into the patient.  The overall procedures take about 45-60 minutes, but the portion of active time involving the patient (harvesting and re-injecting) is much shorter, about 15 minutes.  The rest of the time is spent processing the cells.

What to expect during/after the procedure for in-office procedures

There is typically minimal pain associated with these procedures as sites are numbed in office before harvesting begins.  After the procedure, the healing process begins.  Some patients notice that initially the pain is the same as before the procedure, or perhaps a little worse for a few days following the procedure due to being sore, with improvement starting 2-4 weeks after the procedure and continuing from there.  Depending on the location of the injection, you may be placed in a boot for a few days to allow the injection site to calm down.  Physical therapy is often used in conjunction with stem cell therapies for the best results. 

How is NCOC using stem cell therapies?

Regenerative medicine is an important aspect of managing both acute and chronic orthopaedic problems.  NCOC is on the forefront of innovation in using both traditional and regenerative medicine to treat numerous knee, shoulder, elbow, hand, and foot and ankle concerns.  NCOC offers both in-office procedures to help prevent or delay surgery and intra-operative techniques to help expedite and reinforce healing.

In the office, NCOC performs Lipogems to help stimulate healing in chronically painful areas.   This procedure utilizes a patient’s own harvested abdominal adipose (fat) tissue that is then spun down into stem cells and injected back into the patient to stimulate healing.  This procedure is done as a same-day, sterile, in-office environment without need for sedation.  Lipogems is similar to PRP injections, but different in that PRP uses plasma (blood products) while Lipogems uses a patient’s own stem cells.  Dr. Parekh has used this technique to successfully treat problems ranging from knee arthritis, to plantar fasciitis to osteoarthritis, delaying or eliminating the need for surgery. You can watch such a procedure being performed at:

In the operating room, NCOC has multiple techniques to promote successful healing post-operatively.  One such technique is bone marrow harvest concentrate (BMAC), where a patient’s bone marrow is aspirated from the calcaneus (heel), tibia (shin), or iliac crest (pelvis) bone, and then spun down into a stem cell concentrate.  Again, as this is the patient’s own tissue, this is considered an autograft.  This concentrate is often mixed with other materials and then reinjected into the body to promote healing in procedures such as spine fusions, midfoot and ankle fusions and enhance fracture healing.  

Finally, at times, the surgeons at NCOC may use engineered tissues in the operating room to close a difficult wound, thereby eliminating or lessening the chance of a skin graft or infection. 

The goal of regenerative medicine as a technique in orthopedics is to promote tissue regeneration resulting in quality patient outcomes.  NCOC is committed to using every technique available to us to successfully alleviate patients’ concerns.  Contact our office at 919-471-9622 to schedule an appointment to discuss your options.