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WHAT TO EXPECT

PATIENT’S INFO

OVERVIEW OF STEM CELL THERAPY TREATMENT

  • Step 1: Consult with Dr Mubark to determine if you are a candidate for stem cell therapy.
  • Step 2: abdominal (tummy) Fat Harvesting process by the plastic surgeon under local anaesthesia at Ormiston Specialist Centre (125 Ormiston Rd/Flat Bush/Auckland).
  • Step 3: Culture/Expansion of your stem cells to many millions at our specialized lab in Auckland, an average time of 6-10 weeks (depending on how fast your cells grow).
  • Step 4: Implantation of the expanded stem cells in combination with your platelet-rich plasma (PRP) under ultrasound guidance by Dr. Mubark.
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Preparing For The FAT Harvest

  • We routinely email the surgical team to book you for the FAT HARVESTING (mini- liposuction) from the abdominal fat under local anaesthesia at Ormiston Specialist Centre
  • Medication –discuss with the plastic surgeon if they need you to stop any medicine; usually blood thinners, to avoid bleeding with the fat harvest.

STEM CELL INJECTION(S)-RECOVERY 2 WEEKS

  • On the day of stem cell injections, we take blood from you and then centrifuge it to extract the platelet-rich plasma (PRP), and then we mix it with the stem cells to implant them together for a better outcome.
  • We use special local anaesthetic in low concentration but much less toxic to the stem cells and the cartilage with prolonged action to help both at the time of and post injections pain, you might still get discomfort for a couple of days after the procedure because of the inflammatory healing response but we can use regular analgesics to help that.
  • Take 2 Panadol tablets one hour before any stem cell injection (s) whether you will take sedation tablets or not as this will help reduce injections pain.
  • Please stop anti-inflammatory medicine like Celebrex, Brufen, Voltaren & others for 1 week before and 2 weeks after stem cell therapy as they reduce the effect of stem cell therapy.
  • Take regular panadol for 3 days regularly 2 tablets up to 4 times daily (maximum 8 tablets a day) then as needed and ask us to provide a script of strong painkillers like codeine or tramadol to keep with you as needed.
  • Continue your regular medicine including aspirin except blood thinners (warfarin, dabigatran and rivaruxaban) should be discussed with me (drhassanmubark@gmail.com).
  • Start on Blackmores Turmeric once daily or similar over the counter 1 week before and 1 week after the injections.
  • If you want to have oral sedation, ask Dr. Mubark to provide a script from our local Ormiston hospital pharmacy to take 1 hour before the procedure.
  • We advise you not to drive on the day of the procedure as there will be pain and pressure in the injected area (s) and for lower limbs we suggest a few days to avoid driving, particularly hip injections for a better outcome.
  • Please avoid alcohol 1 day before and 5 days after the procedure, if difficult to stop then drink a minimum amount.
  • Good water hydration before and after the stem cell injections.
  • We recommend to avoiding driving on the day of the procedure even if you are not sedated.

POST INJECTION

Braces

  • If you have your knees injected, we favor seeing your local physiotherapist do rehab, simply simulating post-keyhole orthopaedic surgery rehab for recovery.
  • We advise rest and bedside stretches for 2 weeks after the injections for recovery then start physio (anywhere handy you choose and you pay for it).

knees: no need for crutches; only braces, preferably used for 6 weeks; please buy a good brace with hinges (pharmacy, sports shop, or online) is more effective; good example; McDavid

Hinged Knee Brace or similar, you can buy from Rebel sports or online https://mcdavid.co.nz/products/mcdavid-429-psii-hinged-knee-brace/

Hips: walking crutches for 2 weeks (please buy or rent them from the chemist) & compression pants for 2 weeks (buy from a sports shop).

Ankles/Feet: 2 weeks of walking crutches (please buy or rent them) & a simple brace or moon boot (you buy or rent it).

Shoulders: no need for a brace. A simple arm sling might be used for a few days to reduce the injection’s pain.

Hands: need some exercises, please follow the link (copy/paste it): https://www.webmd.com/osteoarthritis/ss/slideshow-hand-finger-exercises.

First 2 Weeks after the injections (RECOVERY PHASE)

  • Rest, elevation of the affected area, joint support, turmeric capsules, & analgesic tablets.
  • Avoid anti-inflammatory medicine like Celebrex, Brufen, Voltaren, and Others for at least 2 weeks after the injections to allow the inflammatory healing response of regenerative therapy.
  • Continue all regular medicine including aspirin and blood thinners (For any query email drhassanmubark@gmail.com).
  • Take it as easy as possible with normal daily activities. No physiotherapy is required but simple bedside stretches and a range of joint movement exercises.
  • Walking is okay with braces (knee) or crutches (hip & ankle), depending on which area you have had injected.
  • Normal daily activities and returning to work (if not hard physical work) are all okay but follow the same rules.
  • Avoid, if possible, going upstairs and hills.
  • Avoid heat or cold on the injected site for one week after the injection as this can damage the cells; avoid saunas and swimming in hot water.
  • Exercycle is okay but has no resistance- this is good for the range of movement and reduces stiffness.
  • Avoid running and jumping for at least three months after injections of hip/knee/ankle/feet/toes.

After 2 Weeks

  • Please do physiotherapy with your local physio (if you don’t have one then see our contact us page for a physio, please make the booking with them) and gradual increase of non-impact activities. Ask your physio for rehab, simply simulating post-keyhole orthopaedic surgery rehab for recovery.
  • Swimming okay.
  • Walking activity is okay with the brace. No crutches are needed.
  • Cycling/exercycle is okay, gradually increase the resistance.
  • Cross-trainer is okay.
  • Try graduated strengthening exercises.
  • Avoid, if possible, going upstairs and hills.
  • Avoid running and jumping for 3 months after hip/knee/ankle/feet/toes injections.

After 3 Months

  • All normal activities can be resumed, including running & jumping.