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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
Trained in lipoaspiration by Dr. Paul Tortland, another leader in the field of regenerative
medicine, Dr. Silberman currently performs stem cell injections using bone marrow
aspiration, as he has found bone marrow to be superior to adipose tissue in efficacy and
Dr. Silberman uses an FDA approved, patent pending bone marrow needle to obtain
stem 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), and no discarding or filtering of any of your stem
cells and progenitor cells.
Other stem cell bone marrow systems produce aspirates contaminated with peripheral
blood, require multiple puncture sites (or drilling of bone), excessive removal of more
than 60cc of marrow aspirate (which has to be manipulated, filtered, and spun with
additives), and ultimately, the discarding of most of the aspirate, and hence with it the
discarding of your stem cells and progenitor cells.
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 stem cell method yields an average of 37 million nucleated cells.
Adipose tissue (lipoaspirate) processed mechanically yields 10,000 to 240,000
nucleated cells. This is the process used by other regional regenerative institutes.
While you may have read that adipose tissue hosts more stem cells than bone marrow,
this only holds true in regenerative medicine in the manner in which your fat tissue is
processed. To obtain a high stem cell yield, your fat must be enzymatically broken down
and expanded and cultured outside the body, and this process is illegal in the U.S. The
addition of chemicals makes your fat a drug which have to be rigorously studied for
human use prior to market. These toxic chemicals used in the process have not been
studied in humans. To bypass the FDA, companies have come with ways to
mechanically process your fat without chemicals, such as shaking them in a bag of
marbles, but these methods yield contaminated, low, variable stem cell counts. These are
the methods used by other New York and New Jersey regenerative institutes.
Dr. Silberman's method means less cost, less time, less pain, less risk of infection, less
risk of allergic reaction, less waste, better numbers.
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 30 to 45 minutes.
For Adipose Derived Mesenchymal Stem Cells:
The skin on your abdomen or buttock is anesthetized with a lidocaine injection. Using
your thigh yields low numbers of cells. A blunt tip cannula is inserted into the fat layer and
a mixture of 250cc of sterile saline and lidocaine and epinephrine is infiltrated, which can
be dangerous. When adequate anesthesia is achieved, a harvesting cannula is inserted
and your fat is sliced, diced, and aspirated. If done incorrectly, "dimpling" may result.
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, either mechanically
which yield low cell counts and a high blood mononuclear cell count, which you do not
want, or enzymatically, with the addition of proteolytic chemicals, which you do not want.
This type of visit may take 3 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. Dr. Silberman has
treated failures from the "Kobe" Clinic in Germany where stem cells are cultured outside
of the body, patients seen at the Hospital for Special Surgery (HSS), and patients from
the Cleveland Clinic. Nobody is bigger than medicine so don't be fooled by regenerative
institutes and stem cell centers. 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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