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EPAT Shockwave Therapy Combined With Biologics – Interview With Dr. Saadiq El-Amin, Regenerative Medicine Specialist, Orthopedic Surgeon

EPAT Shockwave and Biologics Like Wharton's Jelly

Biologics, such as Wharton’s Jelly or Platelet-Rich Plasma (PRP), are quickly gaining momentum with the sports medicine community for Regenerative Medicine to treat and heal pain and injuries. The most promising growth area is the use of EPAT Shockwave Therapy combined with Biologics.

We had the honor and pleasure to discuss this new form of treatment therapy with Dr. Saadiq El-Amin, who is a Regenerative Medicine Specialist and Orthopedic Surgeon.

Saadiq El-Amin, MD, PhD, is a board-certified orthopedic surgeon specializing in sports medicine, shoulder and regenerative medicine. He is the CEO and Owner of the Dr. El-Amin Orthopaedic & Sports Medicine Institute, currently on Fox 5 Play to Win as a medical expert, a Professor of Regenerative Medicine at Georgia Gwinnett College and Medical Director at the Concussion Institute at Gwinnett Medical Center.

Tell us a little bit about your practice and what areas of medicine that you specialize in.

Dr. Saadiq El-Amin: I am a board certified orthopedic surgeon, specializing in mainly shoulders, sports medicine and regenerative medicine.

You hold a master’s degree in medical science research and tissue engineering and are an expert in that field. Tell is about that field and what impact it is having in medicine.

My involvement in regenerative medicine goes back to about 1988 when I did a lot of research. I started out at Boston College, and was also doing research at MIT, that is where I was first introduced to regenerative medicine and looking at how cells interact with different surfaces to actually regenerate tissue.

I have been in it a very, very long time and have just seen the growth of it tremendously over the last 5 to 10 years.

It has been evolving not only in orthopedics and sports medicine but it’s also gone into cardiology, neurology, internal medicine, and even skincare. We are really seeing it in all aspects of medicine.

One of the reasons why that is, is because as we age we’re looking for other alternatives to heal and to recover faster and safely so regenerative medicine is becoming a choice and an option for a lot of people who necessarily don’t want treatments where you would actually do surgery.

When regenerative medicine is done correctly, safely, and with pure tissue products it is really making a huge impact in medicine.

Talk about your overall philosophy and your approach to healing and use of regenerative medicine.

I tell my patients it’s a journey we take together and regenerative medicine has been a great option for me on the journey because I’ve been able to offer regenerative medicine to patients. It has prevented them from having to have surgery or it’s helped them with healing their pain to get them back to being healthier and to what they were doing previously before the injury.

I’ve used regenerative medicine on both high level athletes as well as just the general population that come to my clinic. I have patients that have had this and I have been able to avoid performing surgery on them.

Additionally, I have also given it to patients after surgery who may have some wear and tear in their knee and they just want to start the healing process or the recovery process a lot faster, and they have been able to benefit from this as well.

In the scope of the work that you’re doing now, you’ve been utilizing tissue products, specifically something that’s called Wharton’s Jelly. What exactly is that?

Wharton’s Jelly is a tissue product, it is derived from the umbilical cord – it is an umbilical cord component.

The reason why I personally like Wharton’s Jelly is because it contains all the growth factors, all the healing factors, and all the signaling molecules that we basically use to heal. What does that mean?

We know that there are multiple things, such as from the bone marrow that has been shown to heal. You can get it from the abdomen that can also help heal, but Wharton’s Jelly is a kind of a unique process in which you’re getting a huge abundance of growth factors like cellular tissue.

In addition, many of the various growth factors are known to cause healing, regenerative healing, cause an anti-inflammatory process, help with pain, and much more.

What are the applications of Wharton’s Jelly? What type of conditions does it excel in treating?

Common Conditions Wharton’s Jelly Treats Include:

  • Plantar Fasciitis
  • Tennis Elbow
  • Lateral Epicondylitis
  • Small Rotator Cuff Tears
  • Shoulder Pain

It is also being used using it to help with Tendon Injuries associated with Rheumatoid Arthritis or Joint Pain. It has a very wide range, as well as anything that people were using Platelet-Rich Plasma (PRP) for, which is clinically rich plasma.

People are now saying that Wharton’s Jelly or Wharton’s Jelly type products have everything that Platelet-Rich Plasma products have, plus all these other things too, which makes it more powerful.

That is why you’re starting to see the use of Wharton’s Jelly more and more. Personally I have typically used it on a lot of patients who have either failed PRP or didn’t have a good response to it. They had a better response with the Wharton’s jelly type products.

In your practice with regard to patient outcomes, what are you noticing when utilizing the Wharton’s Jelly?

I’m noticing that patients are getting back to their regular activity levels a lot sooner, and their pain is being decreased considerably.

In addition to that, I am also noticing that they are able to avoid having procedures which they wouldn’t have had in the past.

As an example, I had a particular patient that was a high performance gymnast who had a very bad wrist injury that was involving her growth plate. This patient probably was unable to compete at a high level.

She ended up being treated with a Wharton’s Jelly umbilical cord product into her growth plate to help it heal. Within eight weeks it healed the fracture and she’s back to competing.

With regard to sports medicine, I have been able to use it on many professional athletes, some who are even playing now and not having inflammation or pain. I have also used it on collegiate and some high school athletes.

I’ve had patients come in with small meniscus tears who otherwise were looking at a season ending surgery. I have successfully used Wharton’s Jelly on them and they’ve gotten back to playing and continue to play. Many are one to two years out and hadn’t had any more problems. So Wharton’s Jelly is real promising. It’s really exciting to see this happening.

There are a lot of tissue products out there. How does Wharton’s Jelly specifically stack up against other types of products that are out there? What are the differences and the benefits?

That’s the million dollar question because when you’re trying to decide what to use, it’s not just the Wharton’s Jelly that makes a difference, but to me it is also how it is processed and what makes it safe, because at the end of the day, it is human tissue. It is a human tissue product. Where products differ is ultimately in how they are processed, I think that’s very, very important.

I tell any doctor that it doesn’t matter about what’s in the product. What matters is that the product is safe. You could have an amazing product that has all these amazing growth factors and all these great new things that can heal, but if it’s tainted with Hepatitis, CMV, Lyme disease or all these other things, what are you going to tell your patients?

So the most important thing is to do no harm. As physicians, we all take the Hippocratic Oath. So, to me the most important thing when you’re dealing with these type of products, any tissue product, is to make sure you know the safety and efficacy of the product.

I’m adamant about making sure that I know what’s in it, making sure it has been tested thoroughly, and it has followed the proper criteria. Because once I give it to a patient I can’t take it back. You have got to know where your source comes from.

What would you say to physicians about why they should explore the idea of utilizing Wharton’s Jelly as a treatment protocol?

I would tell people, if you compare what is out there right now, if you compare amniotic membrane or amniotic tissue products versus PRP product, versus Wharton’s Jelly versus bone marrow, versus lipoaspirate – when you really look at what’s actually in Wharton’s Jelly, you realize that it has a lot of the growth factors that fight against inflammation, which is important to the healing process.

It also has what they call a paracrine effect. That means it does cell to cell repair. So what I mean by that is a cell comes in contact with a damaged cell and it transfers its RNA and DNA to the exosomes or these growth factors or cytokines that help repair the cells that are damaged.

In addition to that, it’s been shown to also have what they call a chemoattracting effect. It causes your good cells to come to this site and act as a homing effect to actually help heal. Those are some of the main reasons why I have moved towards Wharton’s Jelly. I love PRP, yes, it’s great, but it doesn’t have all those other factors. It doesn’t do all of that.

I want my patient to get better. I want patients to have a good outcome, and I want to give them the best-case scenario. In my opinion, Wharton’s Jelly is in the top tier of being able to do that.

There are physicians that are beginning to use Wharton’s Jelly in combination with EPAT Shockwave therapy. Talk about the concept of combining Wharton’s jelly together with EPAT/Shockwave therapy.

Shockwave therapy is really growing because it has the ability to help with the healing process, increase blood flow, and open up the channels that allow the cells to be introduced into whatever you put in that area. I think it’s a great one-two punch combination.

I think that’s important because if you can open up the channels with EPAT Therapy by increasing blood flow to the area, it will start the inflammatory cascade of healing. When added with a Wharton’s Jelly and/or an umbilical cord type product, it is like the perfect storm of healing to me.

We know it works and we know that EPAT/Shockwave therapies have been shown to stimulate the cells to grow and to help with the healing process.

What are the advantages of using the combination of Wharton’s Jelly and EPAT?

This is speculative, but a lot of data is going to come out on this. In my opinion, I think it decreases the pain the patient is feeling. We know that. It also increases the healing rate and increases the susceptibility to get back faster.

I have personally done it on myself. I had lateral epicondylitis in my elbow (tennis elbow). It was really bothering me when I was operating so I used the combination of both EPAT and Wharton’s Jelly and it’s been two years now and I haven’t had any more problems. That has been great for me.

More people are looking for noninvasive techniques. I have patients coming to me saying, “I don’t want to have surgery. I don’t want to do this.”

Well, what if you have a scarred tissue on there? You hit somebody with the EPAT/Shockwave that opens up the channels, fractures some of the fibrocytes, the scar tissue – then you hit them with a Wharton’s Jelly or a regenerative medicine type product. To me that is a win-win and that can be part of the future recommendations.

There are a lot of doctors using Biologics as a stand-alone, and there are many others only using EPAT/Shockwave as a stand-alone. How could these doctors benefit by combining the two together when treating their patients?

They’re missing out on being able to provide the best care for their patients.

Let me say one thing, if I’m down the street and there are two guys that are practicing the same way and one of them says, “Oh, you need surgery. I’m going to cut you tomorrow.”

The other one says, “You know what? Let’s try to do it this way. It’s safe. Let’s try this on you, and if it doesn’t work out, then we can do the surgery.”

I guarantee you; I’ll tell you who will get the business. It’s the guy that takes that journey with that patient.

Regenerative medicine is on pace to be a $15 billion dollar business. So if these doctors are not aware of this or they are not taking advantage of it, then they’re also missing out on an amazing revenue stream.

Overall would you say that this could be a game changer?

Absolutely. When you’re dealing with the elderly lady who is saying, “I don’t want hip replacement, I’m too old. I don’t meet the criteria or I’m not a surgical candidate.” And you take her pain away and she feels better, yes, it’s a game changer.

You can also ask athletes that I’ve known that I’ve taken care of that went from a $20 million to $90 million contract and are still playing. I’d say it’s a game changer.

To me the whole concept of regenerative medicine is a game changer and I’m excited to be involved in it.

Dr. Saadiq El-Amin, MD, PhD, Regenerative Medicine and Orthopaedic Surgeon

Additional Information About Dr. Saadiq El-Amin, MD

Dr. Saadiq El-Amin, MD, PhD, earned his Medical Degree (MD), a Masters Degree in Medical Science (MMS) and a PhD in molecular and cell biology from Drexel University College of Medicine in Philadelphia, Pennsylvania. He received his Orthopaedic Surgery training at the University of Virginia Health Sciences Center in Charlottesville, Virginia.

He furthered his training and education by completing a fellowship in Shoulder and Sports Medicine Orthopaedic Surgery at Hospital for Special Surgery in New York. While there, he served as the Assistant Team Doctor for the New York Knicks and for the St. Johns University under the guidance of Dr. Answorth Allen and Dr. Lisa Callahan.

Most recently, Dr. El-Amin served as the Team Physician for UIS-Springfield Athletics and was the Director of Shoulder and Sports Medicine for the Southern Illinois University School of Medicine (SIU). He was also the Team Orthopedic Physician for the Springfield Foxes Semi-Pro Football Team, Quincy University and Robert Morris College.

He has also served as an Adjunct Assistant Professor for the Department of Electrical and Computer/Biomedical Engineering and Medical Microbiology, Immunology and Cell Biology at SIU. He is currently the Head Team Physician for the Atlanta Silverbacks Professional Soccer Team.

Dr. El-Amin is a member of several medical societies, including the American Academy of Orthopaedic Surgeons, Orthopaedic Research Society, and National Medical Association.

He founded the Laboratory for Tissue Engineering and Advanced Biomaterials while at SIU and multiple biotech companies. He has served on several medical/biotech boards.

His research interests include the area of tissue engineering where he designs biomaterials and ligaments for ACL, elbow and shoulder reconstruction and stem cell technology for medical applications.

He has multiple publications and patents in these areas. Dr. El-Amin has over 40 publications in medical journals, book chapters, has given over 50 presentations both nationally and internationally, and is the recipient of multiple research grants.

In 2017, Dr. El-Amin was recently named “Top Orthopaedic Surgeon” by the leading physicians of the world.