Posts Tagged ‘doctor chat’

Takeaways from Dr. Oskouei’s Stem Cell Treatment Chat

Stem Cell TreatmentThank you for attending the live chat on Stem Cell Treatment for Osteoarthritis on Tuesday, Aug. 12. We had a great discussion, so thank you to all who participated and asked questions. We were thrilled with the number of people who were able to register and participate in the chat. Check out the chat transcript for a full list of questions and answers!

The response was so great that we had a several questions we were not able to answer during the chat, so we will answer them below for your reference. The questions have been broken into sections based on topic:

Surgical vs. Non-Surgical Stem Cell Treatment

  • How exactly do both stem cell treatments work?

Shervin Oskouei, MDDr. Oskouei:

When implanted surgically, they recruit surrounding cartilage cellsand begin differentiation into mature cartilage.

  • Can you explain the differences in “stem cell implantation surgery” and “stem cell injections?

Shervin Oskouei, MDDr. Oskouei:

Injections alleviate pain and symptoms; whereas,  surgical implantation surgery is a way to actually grow cartilage in areas where the cartilage is lacking.

  • What determines whether you get the surgical or nonsurgical procedure?

Shervin Oskouei, MDDr. Oskouei:

It depends on patient preference, but also on the amount of damage. If the damage is severe, the patient may not be a candidate for surgical implantation. An MRI is useful in determining who is a good candidate.

  • Is the surgical procedure preferable to the injection for a knee?

Shervin Oskouei, MDDr. Oskouei:

It depends on patient preference, but also on the amount of damage.

  • For the surgical solution, are a patient’s own stem cells used?

Shervin Oskouei, MDDr. Oskouei:

Yes, we use the patient’s own stem cells.

 

Recovery

  • How long does it take to notice a difference/improvement in symptoms and pain?

Shervin Oskouei, MDDr. Oskouei:

It typically takes about six weeks to notice a difference in pain.

  • Do you recommend PT after the procedure?

Shervin Oskouei, MDDr. Oskouei:

Yes, I recommend physical therapy, but it should not be very aggressive.

  • Will the stem cells migrate to other parts of the body, helping more than just the targeted joint?

Shervin Oskouei, MDDr. Oskouei:

No, the stem cells stay in the targeted joint.

  • Do you have any statistics on how long a time period patients typically experience pain relief after receiving the injections treatment?

Shervin Oskouei, MDDr. Oskouei:

Patients typically experience pain relief for about four to six months.

  • Does the osteoarthritis then stop progressing in that area or will it eventually take over again?

Shervin Oskouei, MDDr. Oskouei:

In the case of surgical implantation, osteoarthritis is stopped and often reversed.

  • After the injection, how long before someone could resume walking 1-2 miles per day if they had been doing so before the treatment?

Shervin Oskouei, MDDr. Oskouei:

I would suggest waiting about six weeks.

 

Candidacy

  • Is stem cell therapy an option for people whose osteoarthritis is advanced? If not, what is the alternative?

Shervin Oskouei, MDDr. Oskouei:

It depends on the severity and grade of cartilage damage. Alternatives include joint replacement surgery.

  • Do you expect the procedure to improve in the future so those of us with late osteoarthritis might avoid surgery?

Shervin Oskouei, MDDr. Oskouei:

That is possible now!

  • If the knee is bone on bone, would this still be a candidate?

Shervin Oskouei, MDDr. Oskouei:

It depends on the amount of cartilage loss, not just the depth of cartilage loss. In other words, if the patient has a subtotal area of cartilage loss, even if its bone on bone, then they would be a candidate. If the whole joint surface is devoid of cartilage, then they are likely not the best surgical candidate.

  • In cases where the condition is severe with pronounced bowing of the leg is this procedure recommended? Also will the bowing be corrected?

Shervin Oskouei, MDDr. Oskouei:

No, with severe deformity, reconstructive surgery is generally recommended.  However, some slight varus (bowing) deformity is acceptable for stem cell treatment.

  • How does one begin the process for determining if the procedure is recommended?  Do you see patients for assessment or is that done by someone else?

Shervin Oskouei, MDDr. Oskouei:

I see them. I would love to see an X-ray and MRI of your affected joint. We can order it or you can order it and send it in for us to evaluate it.

  • How do you get evaluated for this procedure?

Shervin Oskouei, MDDr. Oskouei:

Call 404-778-6363 to schedule an appointment.

  • I am 70, and have had both knees and my right hip replaced. Am I too old to have the procedure done on my left hip?

Shervin Oskouei, MDDr. Oskouei:

No, not at all. We would love to see your MRI to see if you’re a candidate.

  • Is this something a 60 year old man should be looking into?

Shervin Oskouei, MDDr. Oskouei:

Absolutely!


Shervin Oskouei, MDDr. Oskouei:

Age isn’t as much of a factor as the amount of cartilage loss and deformity. 80 year old patients have benefited from this procedure in the past.

 

Traveling for Treatment

  • For out of town patients, how long should we plan to be in Atlanta for the procedure? 

Shervin Oskouei, MDDr. Oskouei:

Two days.

  • For patients from overseas can the PRP injection be administered on same day as stem cell injection? 

Shervin Oskouei, MDDr. Oskouei:

Yes.

  • If we do not live close, can we mail a copy of the MRI i to see if we are a candidate? 

Shervin Oskouei, MDDr. Oskouei:

Yes! That’s ideal.

About Dr. Oskouei

Shervin Oskouei, MDShervin V. Oskouei, MD, assistant professor of Orthopaedic Surgery at Emory University, is an expert in the treatment of musculoskeletal (extremity) tumors, total hip and total knee replacements and revisions. Dr. Oskouei started practicing at Emory in 2004. Dr. Oskouei is board-certified and fellowship trained in orthopaedic surgery. Combining his experience and interests with the state-of-the-art facilities of Emory University and the Winship Cancer Institute of Emory University allows Dr. Oskouei to treat patients with the latest modalities using a multi-disciplinary approach.

Related Resources

Takeaways from Dr. Bradbury’s Hip and Knee Replacements Chat

Thank you for participating in the online chat on Hip and Knee Replacements.  We had a lot of really great questions.  We received a few questions a couple times so we will highlight the answers to those questions here!

What is the longevity of knee replacements?

The lifespan of a knee replacement is related to the body weight and activity level of the individual who receives the replacement.  Individuals who are very active often reduce the longevity of their knee replacement because high activity can put extra stress on the implant leading to loosening of the implants from the bone or “wearing” of the parts used to replace the joint.  Being overweight increases the forces on implant and can also lead to early failure.  In general, 15 year survivorship of modern knee replacement designs used in  good candidate is around 90 percent.

Typically for younger patients,  if x-rays do not show complete loss of cartilage, “bone on bone”, I recommend waiting as long as possible to have the knee replacement surgery.  However, if there is “bone on bone” arthritis, knee replacement is the most effective treatment, but the risks of early failure are increased.

What exercises can I do for a total knee replacement?

Low impact aerobic conditioning 4-5 times per week for 4-6 weeks prior to surgery is best.  Low impact activities include swimming, elliptical, or stationary  bike.

“Prehabilitation” is rehabilitation to get your body ready for the surgery so you can recovery as quickly as possible after surgery.  Instruction during this period should be focused on strengthening the muscles around the joint.  The prehabilitation period should last for several weeks before surgery.

How long is recovery after hip/knee replacement?

It is best to think of how long it takes to reach recovery milestones –

• For hip replacement, pain is typically better than what it was prior to surgery in 2-3 weeks, normal walking typically occurs by 6-8 weeks and full recovery typically occurs within 3-4 months.

• For knee replacement, pain is typically better than what it was prior to surgery by 4-6 weeks, normal walking typically occurs by 8-10 weeks and full recovery typically occurs within 4-5 months.

Thank you again for attending the chat. I hope you found the information useful!  If you have questions or would like to schedule an appointment with an Emory Orthopedic Surgeon about hip or knee replacements please call 404-778-7777.

>>Read the full transcript from the online chat here!<<

About Dr. Bradbury

Dr. Bradbury is an Assistant Professor of Orthopaedic Surgery at Emory. He specializes in hip and knee arthroplasty. He really enjoys this area of orthopaedic surgery because of the consistency of success in the properly selected patient. Dr. Bradbury’s professional goal is the improvement in quality of life for patients with pain secondary to hip and knee problems.

His research interests center around infections involving hip and knee replacements which are rare, but difficult problems. Dr. Bradbury is researching the success rate of current treatment methods for hip and knee replacement infections caused by resistant bacteria (MRSA). Through his research, he hopes to find better way to both prevent and treat periprosthetic hip and knee infections.

Related Links

Debunk the Myths of Running

Peachtree Road RaceIf you are a runner, you have probably heard someone you know say something about running and your health like “You can die of a heart attack if you run too much” or my favorite “If you run too much, you will need your knees replaced later in life”.  Running can be a very safe and healthy sport.  There are so many advantages of running – It makes you feel better, keeps you mentally and physically in shape and can even improve your social life.   Let’s debunk the myths others may have told you so you can feel confident you are enjoying the sport you love.

Your heart and running

Consistent running reduces your risk of heart disease.

o Your increased heart rate from running for an extended period makes your heart stronger!

o Running can help lower blood pressure by helping to maintain the elasticity of your arteries.  When you run, your arteries expand and contract more than normal so this keeps the arteries elastic and your blood pressure low.  Most elite and very serious runners have very low blood pressure.

o Running can help reduce or maintain your weight.  Running burns more calories than most other exercise and it can be done relatively inexpensively.  A 150 pound man will burn over 100 calories for every mile running at moderate pace.    With a lower body weight you also have less chance of developing type II diabetes.  Type II diabetes is typically associated with obesity.

o Running often can help improve cholesterol numbers.  Bad cholesterol (LDLs) typically go down and good cholesterol (HDL) can go up.

I recommend consulting with your physician before starting to run if you are not a runner to get a full physical to ensure your heart is in tip top shape to start a running schedule.

Your bones and joints and running

Your body was built to run!  Evolution has developed our bodies so that we have the necessary tools to move and stay physically active.  To prove this, a recent study by the American Journal of Preventive Medicine revealed that long distance-runners did not have accelerated rates of osteoarthritis.  In fact, weight-bearing exercises like running can help maintain or build bone mineral density by helping you avoid osteoporosis. Therefore, experts tend to agree that running can help you fight against arthritis and other bone and joint problems.  Injuries that runners usually suffer are typically from doing too much too soon or at a quicker than natural pace for your body.  Runners will also see injuries due to wearing incorrect shoes, shoes that are too old or running with incorrect form.  Eliminate bad running habits and you will run injury free!

One myth that is true and you should take careful note of is the dangers of developing skin cancer as a runner.   The more miles you put in, the more time you are probably spending in the sun.  I recommend wearing sunscreen on every run, regardless of the time of day you run and wearing a hat and/or sunglasses.  I also recommend  running in the very early morning or in the evening instead of running when the sun is the hottest.  If you suspect any abnormal lesion or marking, see your dermatologist right away!
So get out there and run!  You will be happy you did!

Upcoming Live Chat with Emory Sports Medicine Specialist

UPDATE: CHAT TRANSCRIPT

Are you training for the AJC Peachtree Road Race or another running race this summer or fall? If so, join Emory Sports Medicine physician, Dr. Amadeus Mason for a live online web chat on Tuesday, May 14 to learn how to run injury free.  Dr. Mason will be available to answer questions on training, stretching, how to prevent common running injuries and treating injuries when they occur.

Emory Healthcare is a proud sponsor of the AJC Peachtree Road Race.

Emory Healthcare is the largest, most comprehensive health system in Georgia and includes Emory University Hospital, Emory University Hospital Midtown, Emory University Orthopaedics & Spine Hospital, Wesley Woods Center, Saint Joseph’s Hospital, Emory Johns Creek Hospital, Emory Adventist Hospital, The Emory Clinic, Emory Specialty Associates, and the Emory Clinically Integrated Network.

Come visit us at the AJC Peachtree Road Race expo in booth 527 to get your blood pressure checked and learn more about how Emory Healthcare can help you and your family stay healthy!

Related Resources

About Dr. Brandon Mines

Brandon Mines, MDBrandon Mines, MD, is an assistant professor of orthopaedics. Dr. Mines started practicing at Emory in 2005 after completing his Sports Medicine Fellowship at University of California – Los Angeles. Dr. Mines is board certified in both family practice and sports medicine. He has focused his clinical interest on sports injuries and conditions of the shoulder, elbow, wrist/hand, knee, foot and ankle. He is head team physician for the Women’s National Basketball Association’s (WNBA) Atlanta Dream and Decatur High School. He is also one of the team physicians for the Atlanta Falcons.  His areas of interest are diagnosis and non-operative management of acute sports injuries, basketball injuries, tennis injuries, golf injuries and joint injections.

Does Your Child Have Hip or Spine Problems? Chat Live with Dr. Fletcher!

Pediatric Orthopedic ChatDid you know that children can be affected by a wide array of orthopaedic hip and spine issues? Scoliosis, kyphosis, hip dysplasia, leg length differences and femoroacetabular impingement are just a few of the conditions our team sees most commonly from pediatric patients. These conditions can lead to time away from school and chronic pain and disability later in life.

Join Emory Pediatric Orthopaedic surgeon, Dr. Nicholas Fletcher, for a live interactive web chat on Tuesday, February 5 at noon to get all your questions about symptoms, causes and the newest treatment options for pediatric orthopedic hip and spine conditions answered! See you there!


Sign Up for the Chat


About Dr. Fletcher
Dr. Nicholas FletcherDr. Fletcher takes care of all pediatric orthopaedic trauma, neuromuscular disorders, leg length differences, foot conditions, and angular deformities of the lower limbs. In addition, the management of pediatric spinal and hip conditions are particular areas of expertise. Dr. Fletcher also specializes in pediatric and young adult hip conditions including hip dysplasia, femoroacetabular impingement (FAI), perthes disease, avascular necrosis, and slipped capital femoral epiphysis. He is one of only a handful of surgeons in the southeast with expertise in the Ganz or periacetabular osteotomy (PAO) for hip dysplasia and the modified Dunn osteotomy for slipped capital femoral epiphysis. He takes care of children of all ages with hip conditions in addition to young adults with hip dysplasia and impingement.