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|New Jersey Stem Cell Therapy
|Dr. Silberman trained under one of the pioneers in the field of regenerative medicine, Dr.
Brian Shiple, while a fellow at the Crozer Chester Medical Center Sports Medicine
Dr. Silberman uses a patent pending bone marrow needle to obtain stem cells and
progenitor cells that requires:
Only a single puncture
10cc or less of bone marrow aspirate
No manipulation, centrifugation, or addition of any substances
No processing off the sterile field, reducing the risk of infection
No discarding or filtering of any stem and progenitor cells
Eliminating peripheral blood contamination with
Other systems are contaminated with peripheral blood from your marrow, require
multiple puncture sites, sometimes drilling of bone, excessive removal of more than 60cc
of marrow aspirate, which then has to be manipulated, filtered, and spun with additives,
ultimate discarding of most of the fluid and hence, discarding of stem cells and progenitor
Figure 1. Traditional Method Causes Peripheral Blood Contamination
For example, Regenexx, which can cost $6000, uses pretreatment with prolotherapy
injections the week of the procedure, six to ten puncture sites in your iliac crest, 60 to
150cc of bone marrow aspirate which hurts, and then manual separation with additives
and centrifugation or spinning of the marrow aspirate, plus the need for PRP therapy to
be performed with the procedure.
Dr. Silberman's method means less cost, less time, less pain, less risk of infection, less
risk of allergic reaction, less waste, better numbers.
Figure 2. Dr. Silberman's novel Marrow Cellution method, delivers pure bone
marrow aspirate direct from your body back into your body with no need for any
processing, additives, or spinning.
What are mesenchymal stem cells or multipotent stromal cells (MSCs)?
Mesenchymal stem cells, or MSCs, are multipotent stromal cells that can 1. differentiate
into a variety of cell types including: osteoblasts (bone cells), chondrocytes (cartilage
cells), myocytes (muscle cells) and adipocytes (fat cells), 2. modulate oxidative stress,
3. have immunomodulatory, anti-inflammatory, and anti-aptoptic effects.
(Strioga et al. Stem Cells Dev. 2012 Sep 20;21(14):2724-52).
Osteoarthritis is a mesenchymal disease in which the activity of MSCs are altered leading
to an absence of repair and increased degeneration of cartilage.
(Jo et al. Stem Cells 2014; 32:1254-1266).
MSCs are known to stimulate chondrocytes to proliferate and synthesize extracellular
matrix, to induce anti-inflammatory cytokine production, and to possess
immunumodulatory properties, resulting in anti-inflammatory activity, regeneration, and
Bone Marrow Derived stem cells are obtained in the office via bone marrow aspiration
with a needle inserted in the iliac crest of the pelvis. Adipose derived mesenchymal stem
cells (AD MSCs) are obtained in the office via lipoaspiration of fat from your abdomen
Postulated mechanisms of MSCs for the treatment of arthritis are:
1. Direct differentiation into chondrocytes (articular cartilage) or more likely,
2. Paracrine effects of secreted bioactive materials, modulating inflammation and
providing an environment for tissue regeneration, by controlling cytokine and growth
factor production from endogenous cells or through secretion of bioactive materials.
Conditions that Bone Marrow Aspirate Stem Cells may be used for at New
Jersey Sports Medicine:
Osteoarthritis or degenerative arthritis or rheumatoid arthritis and similar arthropathies
Osetochondral cartilage defects, degeneration, injury or wear, OCDs
Meniscus Tears, Labral Tears, Ligament Sprains, Tendon Tears, Muscle Tears,
Tendonosis and Tendonopathy
What to expect?
For Bone Marrow Aspirate Derived Stem Cells at New Jersey Sports Medicine:
A patent pending, FDA approved bone marrow harvesting needle is used by Dr.
Silberman, which is a minimally invasive, high yield, low volume aspiration, with NO
manipulation, centrifugation, or addition of any substances. Your skin overlying your iliac
crest (pelvis) and the lining of your pelvic bone will be anesthetized with a small injection.
An access needle is then inserted through the cortex of your ilium into the medullary
cavity and with a syringe up to 10ml of marrow will be aspirated. The bone marrow
aspirate is then injected into your joint, tendon, or ligament. This system is much less
painful then what you might have heard about 'bone marrow biopsies' and some patients
do not feel any pain. A typical patient visit is less than one hour.
For Adipose Derived Mesenchymal Stem Cells:
First the skin on your abdomen or buttock is anesthetized with a small lidocaine
injection. Next a blunt tip cannula is inserted into the fat layer and a mixture of 250cc of
sterile saline and lidocaine and epinephrine is infiltrated. When adequate anesthesia is
achieved typically after 10 minutes, a harvesting cannula is inserted and your fat is
aspirated. Depending on the site to be treated, about 60cc of fat is removed, not enough
to give you a look of 'liposuction'. The lipoaspirate then has to be manually processed
and manipulated and is then injected into the arthritic joint or diseased ligament or
tendon. This type of visit may take 2 hours.
Read more on bone marrow aspirate derived stem cells versus adipose derived stem
cells from liposuction or lipoaspiration.
Is bone marrow aspirate or adipose tissue stem cell injection for everyone?
No. I have seen many athletes and patients come from other locations treated with stem
cell therapy, prolotherapy, ozone, prolozone, and/or PRP when they should not have
been treated with these often expensive out of pocket treatments. Be wary of
testimonials as they do not constitute science.
Intra-articular Injection of Mesenchymal Stem Cells for the Treatment of Osteoarthritis of the Knee.
Stem Cells 2014; 32:1254-1266.
Adult Human Mesenchymal Stem Cells Delivered via Intra-Articular Injection to the Knee Following
Partial Medial Meniscectomy
A Randomized, Double-Blind, Controlled Study.
J Bone Joint Surg Am, 2014 Jan 15; 96 (2): 90 -98.
Mesenchymal Stem Cell Injections Improve Symptoms of Knee Osteoarthritis.
Arthroscopy April 2013Volume 29, Issue 4, Pages 748–755
A multi-center analysis of adverse events among two thousand, three hundred and seventy two adult
patients undergoing adult autologous stem cell therapy for orthopaedic conditions.
International Orthopaedics August 2016, Volume 40, Issue 8, pp 1755–1765
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