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"Stem cells a lso relea se cy tokines [ proteins that help reg ulate immune response] that attract and activate more stem cells and repair cells," he continues. "Additionally, stem cells deactivate the macrophages, which are the cells that chew up cartilage. A ll of those actions of repa ir natura l ly ta ke place in the body, but as people age, they have fewer and fewer active stem cells available to perform the function they 're designed for. W hat we're doing with stem cell therapy is helping the body do what it is designed to do." THE POWER OF PLATELETS Platelet rich pla sma therapy dif fers from stem cell therapy in severa l ways, including the method of ex traction. A ll that is needed is a blood sa mple, which is obta ined from the patient 's arm with a norma l blood draw. While a centrifuge separates the red blood cells from the platelets, creating a solution that contains five to 10 times the body's natura l concentration of platelets, a nurse prepares the patient for injection in the procedure suite. The physician uses loca l anesthetic to numb the sur- face of the skin, and the injection takes place under fluoroscopic, ultrasound or CT guidance to ensure precise delivery to t he i ntended tissue. The process ta kes 60 to 90 minutes from collection to injection. "I prefer to use PRP therapy instead of stem cell therapy to treat sof t tis- sues, such as tendons and ligaments," Dr. Johnson says. " There is no need to inject stem cells into those tissues because the PRP attracts the body's stem cells to the site. That's one of the func- tions of platelets: to attract stem cells, as well as to stop bleeding and release more than 100 factors that promote the hea ling cascade." RELIEF, WORTH THE WAIT T he s t a rke s t d i f fer enc e s b e t we en regenerative medicine therapies a nd traditiona l nonsurgica l pain manage- ment techniques lie in t he timeline and nature of pain relief. An injectable steroid, for exa mple, ma sks pa in by mitigating inflammation, Dr. Johnson says. A s a resu lt , it 's relatively fa st acting — patients often notice the relief that comes with the anti-inflammatory eect within two days. Stem cell a nd PRP therapies work dierently. " Wit h regenerative medicine, t he substances we introduce into the body initiate a hea ling process that ta kes time," Dr. Johnson says. "Patients may experience light discomfort and inflam- mation immediately, but after severa l weeks, they begin to experience long- lasting relief. That 's because they 've started to regain tissue hea lth." Add i n g st ress t o a joi nt or t issue that©has undergone a regenerative medi- cine procedure may disrupt and©delay healing, so Dr. Johnson advises patients to rest for two days to give the repair pro- cess time to take hold and then gradually increase their activit y level over the course of a month. Typica lly, stem cell therapy and PRP therapy are one-time treatments, but patients who©experience relief followed by relapse of symptoms may be candidates for additiona l injec- tions. Patience is cr ucia l to success. Comprehensive care, including physical therapy, is a lso important. " T h e b o d y 's c a p a c it y t o h e a l i s e x t r a or d i n a r y, but it t a k e s t i m e ," Dr. Johnson says. " We facilitate that natura l process, and it's important for patients to remember that it doesn't happen overnight." AN EXPANSIVE FUTURE CDI ha s been tracking t he prog ress of©regenerative medicine patients since the service began last year, and©the data revea l over whelmingly positive out- comes. Regenerative medicine will©soon expand to CDI locations in other states. Dr. Johnson expects the field's clinica l applications to grow, as well, to include treatment of neurodegenerative a nd cardiovascular conditions, from mul- tiple sclerosis and Parkinson's disease to heart attack and stroke. " We' l l c ont i nue t o see re sea rch- er s a nd© cl i n ici a n s e x plore t he u s e of©regenerative medicine in many are- nas," Dr. Johnson says. "I think using the©body 's natura l repair mechanisms r a t her t h a n c hem ic a l s w i l l b e t he pa r t of© medicine's future that devel- ops fastest." CDI pla ns to continue using regen- erative medici ne pr i ma r i ly to treat musculoskeletal pain and may add new biolog ic therapies that ca n en ha nce t hos e t her a pie s . I n t he mea nt i me , Dr. Johnson urges prima r y ca re a nd ot her physicia n s t o remember t hat regenerat ive med ici ne is a n opt ion to help patients overcome acute a nd chronic pain. "Regenerative medicine is a conserva- tive therapy," Dr. Johnson says. "It 's worth considering as an a lternative to multiple exposures to medications, espe- cia lly opiates, or surgery. Regenerative medicine doesn't replace surgery, but it may be a n option for individua ls who have exhausted traditiona l nonopera- tive treatment." F o r m o r e i n f o r m a t i o n a b o u t rege n e rative m edic in e at CDI , v i s it mycdi.com/regenerativemedicine. ■ " Using regenerative medicine, we can interrupt the degenerative cascade that takes place in a joint or tissue due to injury or disease by restoring a healthier environment for cells — slowing down, and in some cases, reversing, the process of deterioration." BLAKE A. JOHNSON, MD, FACR, TWIN CITIES MEDICAL DIRECTOR AND DIRECTOR OF NEUROIMAGING AT CDI AND DIRECTOR OF REGENERATIVE MEDICINE AT CDI 0 9 M D N E W S . C O M /// M D N E W S M I N N E S O TA ■ 2 017

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