MSK (Musculosketal) • Sports Medicine • Pain Management (Prolotherapy)

As early as 1996 Tulip was pioneering the potential of properly harvested fat cells. Through ground-breaking research we funded at the University of PIttsburgh, we proved that adipose tissue indeed contains undifferentiated cells that can be differentiated into cartilage, bone and connective tissue. How the list of potentialities from ADSC has grown since those early years!

CellFriendly Instruments Make Tulip Number One
Our commitment to fat as a viable resource for regenerative therapy led to the development of our CellFriendly technology. The Tulip Cell Friendly instrumentation is truly Fat-Friendly. It is designed to harvest and reimplant adipose cells in a more friendly manner than traditional stainless steel. Cell Friendly not only makes for a more viable harvest and predictable implant, it is also more friendly to the patient. Some Tulip users report seeing up to 60% less tissue trauma in their patients compared to the trauma caused by stainless steel fat transfer instruments.

As seen in the August 2011 issue of the Journal of Prolotherapy

Autologous Fat Grafts As Mesenchymal Stromal Stem
Cell Source For Use In Prolotherapy: A Simple
Technique To Acquire Lipoaspirantsy
Submitted by: Robert W. Alexander. M.D., D.M.D., F.I.C.S

Introduction & Background

For many years, cosmetic-plastic surgeons have recognized the value of low pressure lipoaspiration for successful transplantation of adipose tissue for structural augmentation. In the introductory years (1980-1990) of liposuction techniques, autologous fat grafting (AFG) was considered unpredictable. Once bioengineers discovered the mechanisms by which lipoaspiration worked, the closed syringe system for gentle harvesting and transplantation was developed and patented. Early belief that effective lipoaspiration was directly related to force of vacuum was replaced by understanding, that, introduction of fluid into the fat layers permitted the fat cells and stroma to enter into a suspension. This suspension was easily extracted through use of closed syringes, and provided adipose tissues with reduced damage and improved grafting results.

As the importance of tumescent fluid distribution was appreciated, more value was placed in extensive pre-tunneling (moving cannula without applying vacuum). This better distributed local solution and enhanced the ability to mobilize the adipose tissues into a suspension, which yielded more successful and predictable AFG. During the late 1990s, surgeons began to include utilization of platelet-rich plasma (PRP) to further enhance the successes and acceptance of the graft tissues, in both large and small volume transfers.
(See the full paper in PDF format)

As seen in the August 2011 issue of the Journal of Prolotherapy

Stem Cell Prolotherapy in Regenerative Medicine
Background, Theory and Protocols
Donna D. Alderman, DO, Robert W. Alexander, MD, DMD, FICS,
Gerald R. Harris, DO, Patrick C. Astourian, MS, PA-C

Introduction

Prolotherapists have known since the 1930’s that a solution as innocent as dextrose, used as an irritant and properly placed, stimulates injured musculoskeletal connective tissue to heal, often dramatically. In the 1990’s platelet rich plasma (PRP) gained acceptance in many surgical circles, and in the 2000’s, Prolotherapists and other physicians in the orthopedic and sports medicine field, began using high-density PRP concentrates (HD-PRP), defined as minimum of 4 times patient baseline platelet levels, to stimulate musculoskeletal connective tissue repair. Recently, Prolotherapists have begun to utilize the potential of autologous adipose (fat)-derived stem/stromal cells (AD-SC) within non-manipulated fat graft scaffolding, combined with high-density PRP concentrates (HD-PRP) to provide a potent biological therapeutic combination. With high levels of platelet-derived growth factors and cytokines, this combination provides both a living bioscaffold and a multipotent cell replenishment source useful for enhanced muscoloskeletal healing. In veterinary medicine, AD-SC's have been utilized effectively for over ten years in the treatment of osteoarthritic joints and connective tissue injuries, showing an over 80% success rate in blinded placebo controlled canine clinical trials. Cosmetic-plastic surgeons have studied autologous fat grafting for structural augmentation via transplantation of lipoaspirants for many years. In the past decade, better understanding of the cellular mechanisms responsible for successful soft tissue augmentation has been reported focusing on the plentiful undifferentiated stromal elements rather than the survival adipocytes.
(See the full paper in PDF format)

Musculoskeletal disorders and open wounds are common in veterinary medicine.

Peer-Reviewed
Advancements in Stem Cell Therapy:
Application to Veterinary Medicine
Donna D. Alderman, DO, Robert W. Alexander, MD, DMD, FICS

Article Overview

• In veterinary medicine, there are options available for both small and large animal practitioners to utilize autologous adipose-derived stem/stromal cells (AD-SCs) to promote healing for injuries and degenerative joint disease.
• By provision of a living bioscaffolding to encourage stem cell adherence-proliferation, the additional cell availability can be further enhanced with addition of high-density platelet-rich plasma (HDPRP).
• The potential of stem/stromal cells, coupled with important inflammatory promotion (HDDPRP). is recognized as safe and efficacious in both open wound surgical care and guided placement.
• The ability to prepare a site for skin graft placement of AD-SCs in recalcitrant full-thickness wounds speeds the healing and recuperation of small and large defects in animals.
• AD-SCs are of significant value in musculoskeletal tissue injury or disease because sites gradually deplete ready access to native stem/stromal cells in chronic injury or degenerative states.
• Multiple studies support the effectiveness of AD-SCs of the use in connective tissue and joint repair, among other potential uses.
• Controlled veterinary clinical trials are continuing, which will provide statistical documentation of the safety and efficacy of AD-SCs, as well as comparisons of different protocols for administration.
• Utilization of AD-SCs with of without HDDPRP concentrates have proven very effective in several thousand injection in preclinical and clinical use by both human and veterinary physicians in the U.S. and elsewhere.
(See the full paper in PDF format)

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