Why Regenokine, Orthokine Injections did not work

Dr. David Woznica ProlotherapistDavid N. Woznica, MD

In this article we will discuss the role of:

  • inflammation in healing;
  • inflammation in the role of joint destruction and
  • RegenokineOrthokine, and autologous conditioned serum injections. Treatments that target the interleukin-1 (IL-1) family’s immune response to inflammation.

If you have questions, you can get help and information from our Caring Medical staff

Inflammation and interleukin-1

The interleukin-1 (IL-1) family are a group of small proteins called cytokines that are released by cells and affect the behavior of other cells through cell messages or in scientific terms, cell signalling. The family is put into action by infection, injury or allergy. Once in the circulating blood, the interleukin-1 family become the “shakers and movers,” of the immune system as they help initiate the inflammatory response. In joint damage, the family signals the start of systematic changes including tissue remodeling of ligaments, tendons and cartilage, where it contributes to both destructive (catabolic) and (anabolic) repair processes.

This is what interleukin-1 does:

  • Stimulation of fibroblast cell growth (cartilage production)
  • Increased collage and procollagenase synthesis (cartilage production)
  • Chemotaxis of T and B lymphocytes (gets immune cells moving so they can better receive the message that the immune system is mobilizing).

Joint fever

When we have an infection, fever is stimulated by Interleukin-1. The fever is part of a “hostile,” “inflammatory” environment created against viral or bacterial agents causing the infection.

However, if the immune response is not sufficient enough, the infection remains and a situation of low-grade fever develops and prolongs the problem. This is why a doctor may recommend to a patient that they do not suppress the fever, and “let it run its course,”  because by taking anti-inflammatories, they are diluting the immune response.

In our practice we apply this thinking to chronic joint inflammation. The continuous suppression of inflammation is causing long-term joint problems in the patient.

Please see my article on Osteoarthritic bone repair for a discussion on managing inflammation in degenerative joint disease.

Please see our articles on the traditional therapies for osteoarthritis include rest, ice, compression, elevation – The Rice Therapy, When NSAIDs nonsteroidal anti-inflammatory medications make pain worse, and cortisone shots.  In these articles we have written and demonstrated research on how these treatments have been shown to accelerate the arthritic process by immune response suppression.

Regenokine and Orthokine

The concept behind Regenokine (what is is called in the United States), Orthokine (what it is called in Germany where its innovator Dr. Peter Wehling first applied treatment), and  autologous conditioned serum injections (the scientific name most applied as a derivative form of Platelet Rich Plasma Therapy) is to attack the  interleukin-1 (IL-1) family.

As joints degenerate into an osteoarthritic state, more interleukin-1 is produced to break down the diseased tissue and make way for remodelling of new tissue. However, as in a runaway fever, runaway inflammation continues to breakdown cartilage in the joint.  In the Regenokine/Orthokine treatment, doctors take blood, spin out various anti-inflammatory proteins and growth factors including the interleukin-1 receptor antagonist (IL-1Ra) and reinject it back into the body. This works as an anti-inflammatory agent with the goal of treatment to stop the cartilage breakdown.

In 2011, Ross Hauser, MD  published the following research in the Journal of Prolotherapy. In it he continued to advise with caution the use of those agents that would reduce, hinder, or inhibit the inflammatory response to healing.

Numerous strategies have been employed over the years attempting to improve ligament healing after injury or surgery. . . although steroid injections and nonsteroidal anti-inflammatory drugs (NSAIDs) have been shown to be effective in decreasing inflammation and pain of ligament injuries for up to six to eight weeks, the properties of ligament healing are inhibited.

For this reason the use of anti-inflammatory elements is cautioned in athletes and patients who have ligament injuries. As such, NSAIDs are no longer recommended for chronic soft tissue (ligament) injuries, and for acute ligament injuries should be used for the shortest period of time, if used at all.

Regenerative medicine techniques, such as Prolotherapy, have been shown in case series and clinical studies, to resolve ligament injuries of the spine and peripheral joints. More Prolotherapy studies in more controlled settings with larger numbers would further prove the effectiveness of this therapy.1

If you have questions, you can get help and information from our Caring Medical staff

1 Hauser RA, Dolan EE. Ligament injury and healing: an overview of current clinical concepts. Journal of Prolotherapy. 2011 Dec;3(4):836-46.

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