Over the last five years, R. Wade McKenna, DO, founder of North Central Texas Orthopedics and Sports Medicine of Decatur, Texas and McKenna Orthopedics of Trophy Club, Texas, has treated over 3,000 patients with point-of-care Autologous Biologic Therapy (ABT). ABT is the use of a patient’s own regenerative cells and other growth factors to promote and accelerate the body’s natural healing cascade. With the recent news of high profile athletes such as Alex Rodriguez, Kobe Bryant, Tiger Woods and Peyton Manning traveling overseas for similar treatment, we asked Dr. McKenna if this technology is unavailable or unapproved in the United States.
Dr. McKenna replies with a chuckle, “Neither of those assumptions is true. In fact, I began using point-of-care Autologous Biologic Therapy to aid in the healing of rotator cuff surgeries more than five years ago. My initial use of ABT was directed toward improving surgical results only in rotator cuff surgery. However, the positive effect the addition of this biologic therapy had on rotator cuff surgical outcomes was so impressive I began to expand the use of this novel treatment to other difficult-to-treat injuries and conditions. The only reason I can think of as to why these athletes went overseas is because they’ve never heard of my practice in Decatur, Texas.”
The use of a patient’s own growth factors derived from platelet-rich plasma (PRP) has been a popular treatment for sports related ligament and tendon injuries. McKenna adds, “Initially the focus centered on the wound care market where PRP showed promising results. We began to understand the healing powers found in whole blood, and early adaptors such as myself incorporated the therapy into our patient care protocols. For Kobe Bryant and Alex Rodriguez, their treatments contained stem cells not found in whole blood. Most of the physicians in the U.S. don’t have experience in point-of-care Autologous Biologic Therapy so high-profile athletes such as these seek treatment with cultured stem cells in Europe.”
Both Bryant and Rodriguez were seeking a clinical culturing process of their own stem cells to achieve a desired number of these regenerative cells that would produce a positive outcome. In the U.S., the FDA has yet to approve stem cell culturing for the purpose of treating these injuries, causing most Americans to seeking this treatment to travel overseas.
In Decatur, Texas, Dr. McKenna uses a centrifuge to achieve similar large numbers of regenerative cells and administers them to his patients in an FDA approved point-of-care procedure. The processing is done while the patient is undergoing treatment for his/her injury and takes less than 25 minutes. In Europe the cells are cultured in a laboratory and administered to the patient two to three days later, which is a procedure that is not FDA approved.
The method Dr. McKenna uses to acquire a patient’s regenerative cells from his/her bone marrow does not require culturing. “I began utilizing regenerative cells in point-of-care treatments for orthopedic related complications over five years ago. Back then I was limited to surgical applications due to the archaic method of bone marrow harvest and the lack of a sophisticated processing device. The new Bio-MAC bone marrow aspiration cannula from Biologic Therapies changes all that,” says McKenna.
Previous to recent advances in technology by Biologic Therapies, Inc. (BTI), obtaining bone marrow aspirate was a difficult and painful process using a hammer-driven cannula (needle). “I was fortunate to have a business contact that was focused on bringing marrow harvesting and processing out of the dark ages. Together, we collaborated on designing a state-of-the-art harvesting device, the Bio-MAC Bone Marrow Aspiration Cannula, as well as developing a centrifuge system capable of concentrating millions of regenerative cells from the blood products in the harvested marrow. I’m very proud of our development and feel BTI’s Bio-MAC will revolutionize the emerging point-of-care Autologous Biologic Therapy market,” said McKenna.
Dr. McKenna has joined forces with Biologic Therapies of Ocala, Florida. “Biologic Therapies is our medical think tank,” explains McKenna. “We are now able to further the advancement of Autologous Biologic Therapy while promoting the business of point-of-care regenerative medicine. No other company I’m aware of combines the two.” Point-of-care refers to the process of harvesting regenerative cells from bone marrow and reintroducing those cells back into the patient is one, quick procedure without any culturing of the cells.
With the use of technology he developed with Biologic Therapies, Dr. McKenna has successfully drawn regenerative cells from the bone marrow of his patients in an in-office setting. These new advancements have made obtaining bone marrow aspirate and the use of regenerative cells a much easier and cost efficient point-of-care process.
One of the most innovative uses of bone marrow aspirate concentrate, which was pioneered by Dr. McKenna, involves treating arthritic knees. “Arthritis is technically just the absence of articular cartilage covering the joint surfaces. Many times small arthritic lesions develop which are called osteochondral defects. These defects often progress to severe changes involving the entire joint,” explains McKenna.
Currently, the standard of care for these osteochondral defects or arthritic lesions is a surgery called microfracture. In microfracture surgery an arthroscopic procedure is performed to create small fractures through the underlining cancellous bone to treat the defect. These small holes help promote healing by the liberation of small amounts of bone marrow within the joint.
“My initial thought involving this process was that if small drops of liberated bone marrow aided in healing of these lesions, what would the addition of active regenerative cells from concentrated bone marrow aspirate be capable of doing?” states McKenna. This thinking led to the development of a protocol to treat patients with not only isolated osteochondral lesions, but also to treat patients with more severe osteoarthritis.
Dr. McKenna adds, “The growth of articular cartilage is common in children as they develop into adults and cartilage volume increases. Unfortunately, the growth of articular cartilage in adults is rare and treatment for the loss of cartilage has been focused on replacing or fusing these arthritic joints.”
The use of Autologous Biologic Therapy in a solution of concentrated growth factors has brought new hope to patients suffering from worn out arthritic joints. “The procedures we are developing are very similar to the stem cell therapy procedure Kobe Bryant, Tiger Woods and Alex Rodriguez received in Europe. Our clinical results are showing a rejuvenation of the knee’s overall function. MRI and standing x-rays confirm the space between the bones (cartilage area) is increasing. It’s early in the development stage, but if my use of regenerative cells continues to produce such positive outcomes, it’s quite possible we will have developed a new standard of care for millions suffering from arthritis,” says McKenna.
I also wanted to know if high-profile athletes, or those dreaming of being one (weekend warriors), were the only people who will benefit from this emerging point-of-care regenerative medicine?
McKenna answers, “I believe that almost any patient undergoing surgery can expect improved surgical results with this technology. This is evidenced by the fact that the most frequent application of regenerative cells is found in spine surgery. Surgeons utilize the phenomenal healing characteristics of regenerative cells to increase the formation of bone and aid in the formation of the fusion mass. The results of spinal fusions have been dramatically improved with the use of regenerative cells derived from bone marrow aspirate concentrate.”
McKenna goes on to explain, “Fractures that fail to heal are called non-union fractures and this is one of the most challenging issues in orthopedic surgery. The use of regenerative cells to heal these fracture non-unions continues to evolve. I have used mesenchymal stem cells with great success to aid in the healing of non-union fractures involving the clavicle, tibia and metatarsal bones of the foot.”
As a trained Trauma specialist, Dr. McKenna takes Emergency Room calls and sees many broken hips. Most of these fractures occur in elderly women who suffer from osteoporosis. “The introduction of bone marrow aspirate concentrate to augment the fixation of hip fractures has, in my clinical experience, increased the viability of the femoral head. I have seen 80-year-old patients walk into my office following hip fracture surgery with a femoral head that, on x-ray, looks unaffected by their previous fracture. Prior to the use of bone marrow aspirate concentrate this result would be uncommon,” states McKenna.
As we concluded the interview Dr. McKenna added with a great voice of confidence, “Certainly the future of orthopedics and all the surgical subspecialties will involve the use of regenerative biologics like stem cells. Unlocking the body’s ability to heal itself is the real future of patient care. I am proud to be involved as an innovator in this emerging technology.”