Marc Darrow MD, JD., and Brent Shaw at the Darrow Stem Cell Institute in Los Angeles
Brent is an aspiring physician who recently graduated with a degree in Biochemistry-Molecular Biology from University of California, Santa Barbara.
At UCSB, he worked alongside sports medicine physicians for the baseball and basketball programs. During this sports-medicine internship he saw the extensive and painful rehabilitation process for collegiate athletes recovering from surgery.
Brent has worked in our office for two years and has been researching how our stem cell procedures heal different musculoskeletal conditions. Working as the full-time director of research, he has completed three publications and plans to submit at least five more studies before starting medical school. Brent created an outreach program that gives high school and undergraduate students the opportunity to intern as clinical research volunteers. In addition to working with Clinical research Brent, these students are able to shadow Dr. Darrow to observe procedures.
Brent presented an hour-long lecture on our stem cell and PRP studies to the doctors and administration of UCLA’s Physical Medicine and Rehabilitation residency program. Brent has a passion for teaching and plans to continue educating patients, students, and physicians on the prospects of regenerative medicine in his future medical endeavors.
In his spare time, Brent enjoys hitting 350-yard drives with Dr. Darrow on the golf course. If you would like to apply to be a clinical research volunteer, you can email Brent at firstname.lastname@example.org
Short-Term Outcomes in Treatment of Knee Osteoarthritis with Four Bone Marrow Concentrate Injections
Citation: Short-Term Outcomes in Treatment of Knee Osteoarthritis With 4 Bone Marrow Concentrate Injections
Brent Shaw, Marc Darrow, MD JD : Darrow Stem Cell Institute, Los Angeles, CA, USA
Armen Derian : Mayo Clinic, Phoenix, AZ, USA
Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders June 18, 2018 Link to study
Preliminary research suggests that bone marrow concentrate (BMC), which contains mesenchymal stem cells and platelets, is a promising treatment for knee osteoarthritis. The aim of this study was to build upon this preliminary research by reporting the short-term progress of fifteen patients (twenty knees) with knee osteoarthritis through four BMC treatments.
Patients were advised to receive BMC injections approximately two weeks apart. The last follow-up was conducted a mean 86 days after the first treatment. Baseline and post-treatment outcomes of resting pain, active pain, lower functionality scale, and overall improvement percentage were compared after each treatment.
On average, patients experienced a 2.1 decrease in resting pain, a 3.5 decrease in active pain, and a 9.8 increase in functionality score at the final follow-up. Additionally, patients reported a mean 67% total overall improvement at study conclusion. Outcomes at the final follow-up after the fourth treatment were statistically significant compared to outcomes at baseline, after first treatment, after second treatment, and after third treatment.
These results are promising, and additional research with a larger sample size and longer follow up is needed to further examine the treatment effectiveness of multiple BMC injections for knee osteoarthritis.
Preliminary Data: The table below illustrates 20 osteoarthritic knees that were tracked through four stem cell treatments.
Short-Term Outcomes in Treatment of Hip Osteoarthritis with Four Bone Marrow Concentrate Injections: A Case Series
Darrow M, Shaw B, Darrow B, Wisz S. Short-Term Outcomes of Treatment of Hip Osteoarthritis With 4 Bone Marrow Concentrate Injections: A Case Series. Clinical Medicine Insights: Case Reports. 2018 Aug;11:1179547618791574. http://journals.sagepub.com/doi/full/10.1177/1179547618791574
The use of mesenchymal stem cells from bone marrow concentrate (BMC) has become an increasingly popular option as an alternative to total joint replacement. Although there is evidence to support the use of BMC injections to improve quality of life for patients with knee osteoarthritis (OA), there is limited evidence to support its use in patients with hip OA. This case series provides the short-term outcomes of four patients who each underwent four BMC injections. On average, the last follow up was administered three and half months after the first injection. The results show that patients experienced decreased resting and active pain compared to baseline and mean 72.4% total overall improvement. Patients also reported less difficulty in performing daily activities following the procedure. These encouraging results warrant further research to better understand the effects of BMC injections on hip OA.
Preliminary Results: The table below illustrates the baseline and post-treatment outcomes of four osteoarthritic hips that underwent four stem cell treatments
Treatment of Lower Back Pain with Bone Marrow Concentrate
Lower back pain can be a debilitating condition that is often caused by ligament and fascial sprains, and muscle strains. Even though the diagnosis may be a herniated disc, facet arthropathy, degenerative disc disease, spinal stenosis, scoliosis, spondylosis, spondylolisthesis, or other pathology, we have found for the past twenty years, with thousands of successfully treated patients, that the actual pain generator may not even be noted in the diagnosis. With the risk of adverse complications of surgery and ineffectiveness of epidural injections, bone marrow concentrate (BMC) offers a promising treatment to treat lower back pain. BMC contains mesenchymal stem cells that have the ability to differentiate into muscle, cartilage, and bone, in addition to releasing trophic factors that enhance tissue regeneration. The four patients included in this study underwent at least one BMC injection to the entheses of muscles, fascia, and ligaments surrounding the lumbar spine. At one-year follow-up all four patients experienced a decrease in resting and active pain. Patients also reported a mean 80% total overall improvement and were able to perform daily activities with less difficulty. These encouraging results warrant further investigation of the full potential of BMC injections for lower back pain.
Preliminary Data: The table below illustrates the baseline and post-treatment outcomes of four lower back pain patients that underwent stem cell procedures
Platelet Rich Plasma Therapy on unresolved chronic wrist pain
Orthopedic & Muscular System: Current Research (March 2019).
The objective of our study, was to share with the medical community our observations on pain and function in 6 patients who had their wrists (one patient had both wrists treated), who underwent PRP injections to the ligaments and joints of the wrist. We hypothesize that by strengthening the ligaments and regrowing tissue within the wrist joints, we may provide patients improved quality of life and pain relief.
These findings have been summarized here:
- Platelet-Rich Plasma (PRP) is a minimally invasive surgical alternative that uses components from a patient’s own blood to regrow tissue and relieve pain. This study investigated the clinical effect of PRP on unresolved wrist pain.
- Six patients and seven wrists underwent a series of two to four PRP injections for unresolved wrist pain.
- Outcomes of resting pain, active pain, upper functionality scale, and overall improvement percentage were measured and compared to baseline.
- The final follow-up was performed an average of 6.57 months after injection.
- All patients included in the study experienced decreases in pain and improvement in functionality score at final follow-up.
Studies submitted for Publication Section
Treatment of Unresolved Lower Back Pain with Platelet-Rich Plasma Injections
Background: Platelet-Rich Plasma (PRP) is a non-invasive modality that has been used to treat musculoskeletal conditions for the past two decades. Based on our research, there were no publications that studied the effect of PRP on unresloved lower back pain. The aim of this study was to report the clinical outcomes of patients who received PRP injections to treat unresolved lower back pain.
Methods: 67 patients underwent a series one, two, or three PRP injections into the ligaments, muscle, and fascia surrounding the lumbar spine. Patients who received two treatments received injections a mean 24 days apart and patients who received three treatments received injections a mean 20.50 days apart. Baseline and posttreatment outcomes of resting pain, active pain, lower functionality scale, and overall improvement percentage were compared to baseline and between groups.
Results: Patients who received one PRP injection reported 36.33% overall improvement and experienced significant improvements in active pain relief. These same patients experienced improvements in resting pain and functionality score, yet these results were not statistically significant. Patients who received a series of two and three treatments experienced significant decreases in resting pain and active pain and reported 46.17% and 54.91% total overall improvement respectively. In addition, they were able to perform daily activities with less difficulty than prior to treatment.
These results demonstrate that PRP injections may be a viable conservative approach to treat lower back pain. Additional research is needed to confirm these findings.
Studies Awaiting Publication
1. Treatment of Shoulder Osteoarthritis and Rotator Cuff Tears with Spun and Whole Bone Marrow Concentrate Injections
2. Comparing Outcomes of Spun and Whole Bone Marrow Concentrate injections in Hip and Shoulder Pain Patients
3. Treatment of Chronic Low Back Pain with Platelet-Rich Plasma Injections
4. Treatment of Hand and Wrist Osteoarthritis with Bone Marrow Concentrate: A Case Series
5. Treatment of Ankle Osteoarthritis with Bone Marrow Concentrate Injections
6. Treatment of Chronic Knee Pain with Platelet-Rich Plasma Injections
7. Treatment of Chronic Hip Pain with Platelet-Rich Plasma Injections.