Orthokine Therapy: Modern Day Fountain of Youth?

Written by admin on October 1, 2012 – 9:52 am -

Orthokine therapy is a new sports medicine treatment recently receiving widespread interest and acclaim. It was developed primarily for the treatment of osteoarthritis (OA) by German doctors, Dr. Peter Wheling and Julio Reinecke, PhD., of Dusseldorf, Germany. Little is known about this experimental technique, and there is scant data to support its efficacy, but anecdotal reports have been, high-profile and promising. Much like the mythical fountain of youth, the technique, its clinical mechanism, and its results are shrouded in mystery. Similar to Platelet Rich Plasma Therapy (PRP therapy), whose mechanism and effect has been discussed at great length, and is now widely-recognized in the public consciousness as the standard musculoskeletal rejuvenation therapy, Orthokine therapy is also an autologous treatment provided as an injection of the patient’s own blood. There are no foreign materials or substances used, so risk of adverse side effects is minimal, and the injections are well-tolerated.

In theory, proteins commonly found in patient’s blood –such as Interleukin – 1- Receptor – Antagonist (IL -1Ra) – possess inherent anti-inflammatory and analgesic properties that serve to protect and to preserve the cartilage in an arthritic joint against degradation by osteoarthritis.

During the Orthokine procedure, blood is obtained from the patient using a syringe containing beads that will enhance and/or release the production of these cartilage-protective proteins. The blood is stored at body temperature for up to 9hours, during which time, the concentration of the joint preserving proteins, have increased up to 100 times greater than normal. After the incubation period, the sample is centrifuged to isolate the enriched serum of proteins from the other elements of blood. It is then divided into numerous vials that may be used immediately or frozen for future treatments. The serum is then injected into the affected joint to decrease pain, increase range of motion, and decelerate the progression of degenerative joint disease, and (hopefully) improve the joints longevity. The practitioners report almost immediate improvement and symptom resolution for 2-4 years.

Orthokine therapy is being used throughout Europe but is not yet FDA approved for use in the United States. Professional athletes such as Kobe Bryant and Alex Rodriguez are among those who have traveled to Europe to receive the Orthokine therapy with the hopes of alleviating pain, enhancing their performance and extending their athletic careers.

It is unclear whether Othokine is the long-sought OA treatment (minimally invasive, long-lasting, relatively inexpensive to provide), the next innovation, or just the latest “snake oil” cure-all. It is certain, however, that despite the lack of clinical data, many more modern day Conquistadors will travel to Europe to imbibe this latter day fountain of youth, following the examples of the superstar “Ponce de Leon” that preceded them.–at least until it is “discovered” again somewhere else.

Dr. Mark Galland is a Board Certified Orthopaedic Surgeon specializing in sports medicine, practicing in Wake Forest and North Raleigh. He serves as team physician and Orthopaedic consultant to the Carolina Mudcats, High-A Affiliate of the Cleveland Indians of Major League Baseball, as well as several area high schools and colleges. Dr. Galland can be reached at (919) 562-9410 or by visiting www.orthonc.com or www.drmarkgalland.com.

Caitlin Davis, ATC/LAT is a post graduate fellow at GOSM… For more information, visit us at www.atcfellowship.com

References
Wehling, P. D. P. (2012). Molecular orthopaedics. Retrieved from http://www.wehling-hartmann.de/en/wir-ueber-uns/
Wheling, P. D. P. (2007). Osteoarthritis: The individual osteoarthritis therapy. Retrieved from http://alfa-arthro.com/dokumenti/BookletOA_Pat_05062007.pdf


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See What You Hit

Written by admin on September 24, 2012 – 9:41 am -

Football is one of the most dangerous and violent sports. Though it has been considered the classic “contact sport,” it is more accurate to say it is the ultimate “collision sport.” While concussions currently garner the media spotlight, injuries to the neck and spine are ignored– until disaster strikes. Recently, defensive backs at Catawba and Tulane Universities both suffered severe cervical spine injuries. Last season, at Rutgers University, Eric LeGrand was injured while making a tackle, and he remains paralyzed from the neck down.

The cervical spine is comprised of the first 7 spinal vertebrae. The nerves that exit the cervical spine are vital to both basic and sophisticated body functions including respiration and movement. Cervical spine injuries typically result from an axial load, which is a force that originates at the top of the head and continues longitudinally down the spine. “Spearing” is the term used for a tackle in which the player leads with the head, and the top of the head makes initial contact with the opponent. This type of tackle has been banned in the NFL to ensure the safety of NFL athletes as well as the young players that emulate them. Roger Goodell, commissioner of the NFL, has said that football needs a “culture change” in order to become a safer sport at all levels. Rules changes are welcome, but to decrease the prevalence of these injuries, It is perhaps more important that coaches, parents, and players be educated in proper tackling technique. The NFL has joined with USA Football, the governing body of youth football, to form the “Heads Up Football” initiative to teach proper tackling technique and increase awareness of head and neck injuries. According to Heads Up “The right way of tackling begins with ‘the breakdown’: feet set, hands sunken, the arc of the back straight and the knees bent. The head is up at all times.” A player must always be able to “see what you hit.” If you can’t, your technique is incorrect.

Given the inherent danger of participation in football, it is important to have a well-coordinated medical team present at every game. These medical professionals include the athletic trainers, first responders, team doctors and EMS. Fortunately, these teams were present on the sidelines at Catawba, Tulane, and Rutgers, their skilled, rapid, and coordinated efforts were essential in achieving the best outcomes.

Dr. Mark Galland is a Board Certified Orthopaedic Surgeon specializing in sports medicine, practicing in Wake Forest and North Raleigh. He serves as team physician and Orthopaedic consultant to the Carolina Mudcats, High-A Affiliate of the Cleveland Indians of Major League Baseball, as well as several area high schools and colleges. Dr. Galland can be reached at (919) 562-9410 or by visiting www.orthonc.com or www.drmarkgalland.com or you can follow him on twitter: @drmarkgalland.

Kate Anderson, ATC/LAT is a post-graduate fellow at GOSM, Galland Orthopaedic and Sports Medicine. Follow her on twitter @kattethegreatt.


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