Nord Regenerative Sports Medicine
Dedicated to providing cutting edge technology for the care of our patients, whether it involves surgery or the latest in office treatments.
In addition to Dr. Nord’s extensive surgical and sports medicine experience, this clinic tries to provide the latest techniques that have science and research behind them.
We don’t try to make outrageous claims. We will provide you with the latest research to support treatments we decide on together.
What is Regenerative Medicine?
Regenerative Medicine is the use of Biologic agents to improve the quality of life. This includes the use of blood products, bone marrow, or adipose tissue. Blood products include PRP (Platelet Rich Plasma) and PPP(Platelet Poor Plasma). There are numerous sources of stem cells and growth factors that include bone marrow aspirate, adipose derived stroma, fetal or amniotic tissue.
This clinic does not use any fetal tissue, nor do
we clone or grow cells.
Much of our processes involve harvesting your own cells and growth factors and then concentrating them and injecting them into injured or damaged tissue with the hope of improved healing. This is not a miracle cure but can help regenerate or heal some tissues. It will not make you 20 years old again.
What are Orthobiologics?
Orthobiologics are a treatment that uses the body’s own tissue and cells to help heal and
regenerate. Commonly used orthobiologic treatments are platelet-rich plasma (PRP), bone
marrow concentrate (BMC), and donated amniotic injectable. These are explained below.
Platelet-Rich Plasma (PRP)
What is PRP?
PRP stands for Platelet-Rich Plasma. Platelets contain growth factors that help the body's own healing
process. Your own blood is drawn just like you have it drawn at a lab. The blood is
then placed in a special machine that spins it down and separates it to get the platelets. The platelets are
then injected back into you at the place where your problem is, sometimes under ultrasound or X-ray guidance . Though many people find it very tolerable , we do offer sedation choices.
Bone Marrow Concentrate (BMC)
What is BMC?
Bone marrow is a rich source of stem cells. Stem cells can be harvested from many areas and tissue types,
but bone marrow is an excellent choice Stem cells are known to have the ability to differentiate into many
types of tissue like muscle, tendon, ligament, bone, blood cells, and others. This gives the potential for a
self-renewal process that could improve and heal degenerative and damaged tissue.
PRP vs. BMC
PRP contains platelets and growth factors thought to improve the body’s own healing
process. BMC contains stem cells that are thought to provide more of a self-renewal
process. The BMC also does contain a percent of platelets as well – almost like a
“PRP Plus” injection. Think of BMC like seeds in the garden, while PRP is like the
fertilizer for the garden.
Choosing which injection is right for you will be a decision between you and your doctor
based on your individual case. There are many factors to consider including the condition
being treated, medical history, current literature and experience that will help determine
which treatment might provide the best outcome
Bone Marrow As Source of Stem Cells and Growth Factors
What is Bone1What is Bone Marrowbones are the producing center of your
r muscles.
Bone marrow is the soft spongy tissue that is found in the center of your bones. In adults, marrow in the large bones are the producing center of your red blood cell, white blood cells and plasma components. Since this is the location of production, immature forms of these cells called stem cells, will be found here. Bone Marrow extractions have been conducted for
quite some time now and used in fields such as
oncology and hematology. The vital components in
bone marrow were initially used for transplant
purposes in patients with an immune deficiency, such
as caused by blood cancers or disorders. The skill of
extracting has not changed but the Donor is YOU
and the recipient is YOU, preventing any rejection or
allergic reactions.
What are Bone Marrow Stem Cells?
The immature stem cells found inside the bone marrow have the potential to develop into various mature cells such as a muscle cell, the cells of a vessel, cells of a cartilage or even bone cells. Two of the main stems cells found in bone marrow include:
- Hematopoietic Stem Cells – give rise to the three classes of blood cells that are found in the circulation: white blood cells, red blood cells and platelets. These are the cells that actually drive tissue regeneration and create supportive circulation.
- Mesenchymal Stem Cells – also know a Marrow Stromal Cells. These cells have the capacity to form osteoblasts or bone structure, chondrocytes or cartilage, and myocytes or muscles.
Is the process experimental or new?
Bone Marrow extractions have been conducted for
quite some time now and used in fields such as
oncology and hematology. The vital components in
bone marrow were initially used for transplant
purposes in patients with an immune deficiency, such
as caused by blood cancers or disorders. The skill of
extracting has not changed but the Donor is YOU
and the recipient is YOU, preventing any rejection or allergic reactions.
The immature stem cells found inside
Bone marrow stem cells are the regenerative cells
responsible for repair and rebuilding damaged tissue.
The concentrated cells accelerate the healing
process, promotes strength, offer pain relief and
improve overall function. The healing cascade can
be active and take place over a 4-6 week period. A
follow-up PRP procedure may be recommended if
desired relief is not met.
Are There Any Risks?
Bone marrow extractions are relatively safe procedures when conducted by a trained professional in a sterile environment. Complications are rare but can include: Bleeding particularly in patients with a low platelet count or clotting disorder.list the usual blleding pain infection don’t oversimplify
Infection in patients with weakened immune systems. Antibiotics can be given post extraction to decrease risk in this group of patients. Bone marrow aspiration, amniotic or other sources of stem cells should not be given to patients who have had cancer due to the risk of the stem cells becoming cancer cells or reactivating the cancer.
The Healing Process
Bone marrow stem cells are the regenerative cells
responsible for repair and rebuilding damaged tissue.
The concentrated cells accelerate the healing
process, promotes strength, offer pain relief and
improve overall function. The healing cascade can
be active and take place over a 4-6 week period. A
follow-up PRP procedure may be recommended if
desired relief is not met.
How Long is the Procedure?
Treatment is in an outpatient setting. The actual extraction can take up to 10 minutes, but the concentrating process can take up to 30 minutes, during which the patient will be waiting.
What to Expect
The area of extraction is
locally numbed so no pain is
felt. Bone marrow is extracted
from the back of a patient’s
pelvis or hip bone from an
area called the posterior iliac
crest.
A suctioned syringe attached
to a long needle is used to
reach the posterior aspect of
the hip, during which minimal
discomfort is felt due to local anesthetic.
The collected sample is transferred through a filter
then placed into a centrifuge for spinning. Spinning at
a high speed separates the platelets and the stem
cells from the bone
marrow sample. This
concentration of
stem cells and
healing components,
collectively known as
the bone marrow
concentrate, are
reintroduced to the
injured area.
Majority of patients are able to return to usual
activities within 1-2 days but some pain may be felt for up to 1 week.
What should I do or not do?
There are a few recommendation, such as drinking plenty of fluids and eating a good meal. Please consult with you physician about medication or prior history of blood disorder. Pain control, if needed with be given.
Are there W
W
Why BMC?
• Less side effects when
compared to steroid
injections or surgery.
• Reservoir of stem cells
• Regenerative
properties
• Natural & organic;
from your own body
• Speeds up & promotes
healing
• Minimal to no down
time
• Minimally invasive
Start Healing and Get Back to Life
Bone Marrow Concentration (BMC) is
to be used in the clinical laboratory or
intraoperatively at the point of care
for the safe and rapid preparation of
platelet-poor plasma and platelet
concentrate (platelet-rich plasma)
from a small sample of whole blood
or a small mixture of blood and bone
marrow. The platelet-rich plasma can
be mixed with autograft and/or
allograft bone prior to application to
an orthopaedic site.
For more information, please discuss
with your healthcare provider or go
to www.orthoillustrated.com to learn
more about the process.
Amnion Viscous – Amniotic Injectable Treatment
What is Amnion?
Arthrex Amnion™ Viscous is amniotic fluid rich in growth factors that activate the body’s own healing
response. It is derived from donated human birth tissue and fluid. Birth tissue is obtained with consent
from healthy mothers during cesarean section delivery. Arthrex It can be used when patients don’t want to use bone marrow. Since the cells are frozen, most of the activity is due to the growth factors. Amnion Viscous is indicated for surgical
applications associated with soft tissue procedures. It can be applied directly at the site of inflammation
or injury.Found
iAre there adverse reactions?
• Short term adverse reactions – the main adverse reaction is pain and discomfort during and
after injection. This is because we are stimulating an inflammatory and healing response. It
is also possible to develop a low grade fever, body aches, or fatigue.
• Your own cells and tissues are used which reduces risk for contamination or rejection.
• Very low risk of infections, DVT, or neurovascular injury.
• Long term, the only problem that you could encounter is that it is not effective.
Will this just “mask” or “cover up” my symptoms?
• The purpose or theory of biologics treatments is to optimize healing and improve the body’s
own framework. Therefore we are trying to induce a healing process rather than just
covering symptoms up with something like pain medications.
How many treatments/injections will I need?
• Typically the average patient requires one treatment. Sometimes a patient will need 2 or 3
treatments.
• This is normally assessed at least 6 weeks after the first injection. We usually do not consider
a repeat injection if the injection helped completely or did not help at all. A repeat injection
may be beneficial in those that get partial relief after the first treatment or if symptoms
return after a period of time.
How long is the healing process?
• The body starts the healing process over the first 4-6 weeks, but can take up to 9-12 months
to completely heal depending on the problem. Usually symptoms and mobility improve
over the first 4-8 weeks.
Frequently Asked Questions
When can I return to work or school?
• This is patient dependent. It is ok to return the next day if symptoms are controlled.
However, it is acceptable to take a day or two off. A note can be provided if needed.
Does it regrow cartilage?
• Scientific studies are promising, but currently there is nothing definitive that shows this in
human studies. Literature currently shows pain reduction in patients with arthritis and
cartilage defects.
Does insurance cover biologic treatments?
• There are some cases where insurance will cover treatments. However, most insurances do
not cover this procedure and the patient is responsible for out of pocket expenses. If you
have questions about your specific insurance you are encouraged to call your insurance
company.
• HSA and FSA accounts can be used to pay for the procedure. It is your responsibility to call
and check with them ahead of time.
• There may be financing options available for the procedure.
How does Amnion work?
• Arthrex Amnion™ Viscous is rich in growth factors that activate the body’s own healing
response. Amnion is highly anti-inflammatory, improves healing and reduces scar tissue.
Injectable amnion may be a safe and more effective strategy in treating tendonitis, fasciitis
and joint arthrosis.
What is the screening process for Amnion?
• The Arthrex Amnion™ Viscous was recovered from a qualified donor and processed using
aseptic techniques in accordance with federal, state, and/or international regulations and to
the standards of the American Association of Tissue Banks. The donor has been screened and
tested for communicable disease risks and other exclusionary medical conditions. The results
of the donor screening and testing has been reviewed by the Medical Director (or licensed
physician designee) of UMTB Biomedical, Inc. and the donor has been deemed suitable for
transplantation., marrow in the large
bones are the producing center of your
red blood cells, white blood cells and
plasma components. Since this is the
have the capacitcartilage, and myocytes or muscles
Meet Our Doctors
Dr. Keith Nord
Dr. Nord is the founder and CEO of Sports, Orthopedics & Spine in Jackson, TN and
Nord Regenerative Sports Medicine
Dr Nord is Board Certified by the American Board of Orthopaedic Surgery
He has additional qualifications in Sports Medicine and was the Director of the SOS Shoulder Arthroscopy and Sports Medicine Fellowship
He is a Master instructor in Shoulder and Knee arthroscopy
He has developed training programs for Orthopaedic Surgeons at the Masters Course, his presentations are required for all Orthopaedic Residents by The American Board of Orthopaedic Surgery prior to entering the Operating Room and he is currently in charge of the shoulder team for developing a computer simulator for teaching surgery worldwide.
He has extensive experience and knowledge in Biologics including use of PRP, Bone marrow aspirate, Amniotic and Adipose derived Stem Cells. a Description
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