Installment 66 - Ask the Doctor with Joseph Purita, M.D.

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Jeannine

Pioneer Founding member
About Joseph Purita, M.D.
Joseph Purita, M.D., a pioneer in many different aspects of orthopaedic surgery, graduated from Georgetown University Medical School and served his surgical internship at the University of Florida Medical Center. Following completion of a residency in orthopaedic surgery at University of Miami-Jackson Memorial Hospital, where he served as chief administrative resident, Dr. Purita joined the Boca Raton Orthopaedic Group in 1981 and has been practicing there ever since.
Dr. Purita is a member of the following professional organizations: Fellow, American Academy of orthopaedic Surgeons, Fellow, American College of Surgeons, American Medical Association, Southern Medical Association, Palm Beach Medical Society, Broward County Medical Society, Palm Beach Orthopaedic Society and Florida Medical Association, Member of the Korean Stem Cell Association, and the American Academy of Regenerative Medicine.

Dr. Purita is Board Certified by the following organizations: American Board of Orthopaedic Surgery and American Academy of Pain Management.

Dr. Purita has been an instructor and proctor of surgeons in the use of lasers in arthroscopic and orthopaedic surgery at a variety of hospitals in the United States. Over the years his interest has centered on Regenerative Medicine. Dr. Purita has lectured internationally on five continents. He has been co chairman at a number of these conferences. The lectures he has given in the field of stem cells and regenerative medicine number well over twenty-five. He has actually been a visiting professor at a number of these meetings actually performing cases with the physicians from that country. He has been instrumental in some countries in helping to design some of their policies concerning the use of stem cells. His motto is not to rest on one's laurels but to always try to be on the cutting edge and improve the status quo.

Stem.MD is a network of doctors. Dr. Purita is Chief Medical Officer http://stem.md/about/our-team/

123 NW 13th Street, Suite 206
Boca Raton, Florida 33432
561-394-5556, M – F 8:30 – 4:30 pm EST
Fax: 561-423-8543

www.stem.md

Questions & Answers

Q: I have "bone rubbing on bone" from L-1 to S-1. Are there any autologous stem cell treatments for my condition?
ANSWER:There have been a number of studies that have shown significant results for the use of PRP and or stem cells to treat disc regeneration. If there is no disc left than I am not so sure that this condition can be helped. However, there is one caveat. The pain may not be from the lack of disc space but from other causes. These need to be evaluated by a proper specialist. There is a possibility that the problem may be from the facet joints which are little joints in your back that allow motion. This problem response very to our regenerative techniques. The bottom line is we need a bit more info concerning your condition.

Q: I have chronic inflammatory demylinating polyneuropathy with secondary axonal degeneration which began in Januray, 2011. I can't stand up without a walker. The foot drops. Have you ever had a case like this before? If so, what is the best protocol?
ANSWER: Chronic inflammatory demyelinating polyneuropathy is thought to be an autoimmune condition where the body is essentially attacking itself. The immune system is this case is going haywire. This is in the same general category as for instance Rheumatoid arthritis. One method of dealing with these types of conditions is to use mesenchymal stem cells. These cells are very plentiful in fat tissue. The mesenchymal stem cells are very important for what we call immune modulation. They will affect the stem cell environment to quell some of the inflammatory process. These cells will not cure the disease but make the symptoms better. This problem will also be helped by cytokine therapy which is fairly unique to our practice.

Q: If I got treated once and felt no improvement whatsoever, is it beneficial to try again? Does it make sense to perhaps try marrow rather than adipose since I got no signs of improvement at all from adipose? I have lung disease. With your orthopedic patients, do you find that some need multiple treatments? Maybe, I was expecting too much from just a treatment.
ANSWER: There are many reasons why the treatment may not have been successful. Many reasons may be related to the treating physician. Sometimes the fat may not have been harvested processed in the proper way. We have a number of tricks which allow us to get better activation of the stem cells. We have very specific supplements that we utilize in these cases. These stimulate stem cell output. Perhaps the stem cell that the patient had may be deficient growth factors in the stem cells (this is one of the main reasons why people get into trouble with diseases). We help this deficiency by our use of oral and injectable cytokines. The use of bone marrow will do nothing but help the situation.

Q: Do you offer autologous stem cell treatments for herniated/bulging/degenerative discs in the cervical region of the spine? I may also have a thoracic degenerative/bulging disc problem.
ANSWER: We do have physicians in our network who offer stem cell treatments for disc problems.

Q: Why is it that one person can seem to have so many improvements after stem cell therapy and another person who gets the exact same treatment responds poorly or not at all even though they have similar conditions and are about the same age?
ANSWER: There are many different reasons why there is a discrepancy in the results of patients. If we assume that the same physician treated the patients than it can come down to the efficiency of the patient’s stem cells. The disease condition of the patient can also determine results.

Q: Can someone who has had cancer in the past be treated with stem cells? If so, is there a certain number of years that the cancer needs to be in remission before one could be safely treated?
ANSWER: Patients who have had cancer in the past can be treated on a case by case basis. It is dependent on the type of cancer, the treatment and a host of other conditions.

Q: Do you do all your treatments in the U.S. or are there some that must be performed outside the country due to FDA regulations in the U.S.?
ANSWER:
Currently I am doing all my cases in the U.S. following FDA guidelines.

Do you provide autologous stem cell treatments for subluxated kneecaps with secondary osteoarthritis? What are the current options for this condition? I have the same question for a torn meniscus and cyst in one knee.
ANSWER:It is difficult for me to give an adequate answer to this question without seeing an x-ray. I suspect the subluxation may not be a big problem but the arthritis might be. The treatment for the arthritis would be a combination of stem cells. If the kneecaps are significantly subluxated than arthroscopy may be necessary. A torn meniscus can be treated with regenerative techniques.

Q: Do you foresee insurance companies covering stem cell treatment anywhere in the near future? Is it dependent on FDA approval?
ANSWER:
I suspect with time these procedures will be covered by insurance companies. Realize there is no one currently lobbying the insurance industry to cover these procedures. There is no company that stands to make billions by insurance companies paying for these procedures. Time and economics will change the mind of the insurance industry. As far as the FDA approving these procedures remember one important fact the FDA approves drugs and not procedures.

Q: Is there something you or other doctors do to guide the stem cells to the area where they are needed? I don't understand how the whole process really works to be frank. Is there a simple way to get it through my thick head as to how it works?
ANSWER: Stem cells have ability to home to an area. They are attracted to an area of injury. They are attracted by the cytokines which are released in the area. These cytokine growth factors are what drive tissue repair and attract stem cells to the area. The cytokines are like the body’s cell phone system. This is how the cells communicate with each other. All disease processes are dependent on an imbalance in cytokines. When the cytokines come into balance the disease is eliminated or modified.
 
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