Stem Cells / Orthopedics – Eric Ferkel, MD Video
Opening screen with title “American Health Journal” and swirling
graphics in motion over blurred images of physicians.
[Serious music]
Announcer (V.O.): All types of sports have a potential for injury, whether from trauma,
contact with other players or overuse. Orthopedic surgeon Dr. Eric Ferkel
at Valley Presbyterian Hospital discusses the newest stem cell techniques
to help these injuries heal faster. He defines what a stem cell is and
how the procedure promotes healing.
V.O. visuals: Men in a gym playing a fast game of basketball; men on a team playing
competitive soccer on a field; young men in the starting position on an
outdoor track ready to race; Dr. Erik Ferkel being interview in a studio;
surgery team working on a patient in the operating room; close-up of doctor
looking into a microscope.
Eric Ferkel, M.D.: A stem cell is any cell in your body that essentially can become and differentiate
into a different type of cell…
Visual: Close-up of Ferkel in a suit and tie being interviewed in the studio against
a bright blue and black background. He is introduced with the title “Eric
Ferkel, MD – Valley Presbyterian Hospital” in the lower-third.
Ferkel (V.O.): …depending on what the cell’s lineage is or its background
is. So for example, if we put a stem cell that we take out of your blood,
for example, or we take out of your bone marrow…
V.O. visual: Close-up of cell under a microscope (image below).
(V.O. visuals continued): spinning machine used in stem cell extraction;
plastic tube with blood flowing through it; another view of the machine
with the tube going into the top of it; motion graphic of blood cells
falling from the top of frame (image below).
Ferkel: …and we put the bone marrow stem cells into your ankle, for example,
the idea is to help bring new nutrition to the ankle where the cartilage
injury would be…
Ferkel (V.O.): …in bringing new growth factors there, so these cells can turn
into growth factors and provide new healing and different forms of nutrition
to help increase and expedite the healing process.
V.O. visual: Motion graphic moving up and down a foot and interior ankle showing bones
and cartilage, then spins to show front of foot and toes, then spins again
to show the side of foot and outer ankle area with ligaments shaded in
red (images below).
Announcer (V.O.): Dr. Ferkel describes how an injury is evaluated to determine if stem cell
therapy is the best option.
V.O. visual: A doctor points to an X-ray of foot that shows pins that have been placed in it.
Ferkel: First, when someone comes in with an ankle injury and we obtain imaging
studies such as an X-ray, then followed by an MRI and or a CT scan, and
we identify possibly a cartilage…
Ferkel (V.O.): …injury in the ankles, specifically perhaps on the talus, which
is the bone that makes up the bottom portion of your ankle, or on the
tibia, which makes up the top portion of your ankle.
V.O. visuals: Close-up of a doctor holding a 3-D model of a foot and ankle and pointing
to talus area of ankle; graphic illustration of the foot and ankle with
labels: Achilles tendon (running vertically in the back of the ankle area),
Posterior inferior tibial ligament (located in the top interior of the
ankle toward the back), Posterior talofibular ligament (located under
the posterior inferior tibial ligament), Calcaneofibular ligament (located
under the posterior talofibular ligament), Fibula (the bone located above
the ankle), Tibia (located under the Fibula), Anterior inferior tibiofobular
ligament (located in the top interior of the ankle toward the front),
Anterior talofibular ligament (located under the anterior inferior tibiofobular
ligament), and Talus located under the Anterior talofibular ligament)
(image below):
Ferkel: Based off the size of the cartilage injury, we then determine well, what
are the options that this patient has available to them to help improve
the chances that this will heal…
Ferkel (V.O.): …and get better and have them improve their functionality, getting
back to playing the sports they want to be doing, or just walking and
living a pain-free life.
V.O. visuals: Young woman practicing soccer by bouncing the ball upward with her knees;
another clip of her walking and holding the ball.
Ferkel: So based off of the size of the lesion, your algorithm could begin with
basically going into your ankle…
Ferkel (V.O.): …with a orthoscope which is a little video camera that you put
inside the ankle joint and you look around and you find the lesion. And,
you look at the lesion and you determine ‘ok this is an amenable
to repair,’ meaning that we would usually scrape out where the tear is in..
V.O. visuals: Surgical team working on a patient in the operating room; monitor displaying
the inside of patient’s ankle
Ferkel: …the cartilage and make little poke holes into the bone to help
increase stem cells from in your own bone and…
Ferkel (V.O.): …improve the milieu, which is kind of the environment that the cartilage
is growing in. Secondly, then we would take bone marrow aspirate so we
take aspiration from your bone marrow and put it down into a centrifuge
and get the concentrated amount of bone marrow aspirate. Then after the
surgery is done we would then inject it into your ankle. Studies have
shown that using bone marrow aspirate concentrate or something called
platelet rich plasma, and the jury’s still out on which is better,
or…
V.O. visuals: Close-up of team working on the arm of a patient to remove bone marrow;
technician placing bone marrow vial on top of aspirate device; technician
placing vial inside and closing the lid; two female lab workers sitting
at a desk conducting tests; close-up of technician placing tube vial inside
an empty vial.
Ferkel: …if they’re good in combination, injecting them into your
ankle can help increase the healing of that cartilage injury that you had.
Announcer (V.O.): Dr. Ferkel gives us a case study of a recovery from injury using stem cell
treatment.
V.O. visual: Ferkel walking up the hospital’s main hallway toward and past the camera.
Ferkel: I had a twenty-three year old male who came in and saw me. He likes to
play beach volleyball on the weekends…
Ferkel (V.O.): …here in Los Angeles. Given his activities being in volleyball,
he jumps a lot when he plays volleyball on the beach…
V.O. visual: Young men on the beach playing volleyball.
Ferkel: …especially. And, he came in with pain along his Achilles tendon
and we worked him up, started him doing physical therapy initially. It
was getting a little better, not great. And, got an MRI and showed that
he had tendinopathy, meaning that the tendon was inflamed, wasn’t
torn to a significant extent that you’d want to do surgery on…
Ferkel (V.O.): …and given that he was a young male, wanting to get back to playing
beach volleyball - it was the summertime – we decided let’s
try to do platelet rich plasma for his Achilles tendon. But…
V.O. visuals: Various close-ups of lab technician inserting a substance into an empty
vial; two technicians at a table working with the vials.
Ferkel: …I think for certain patients, this is a young, healthy, active
male, it’s worth a shot, no pun intended, but it’s worth a
shot to take his own platelet rich plasma…
Ferkel (V.O.): …which is taking the blood from his arm, spinning it down, extracting
the stem cells and then injecting it into his Achilles tendon, at the
area where the injury was.
V.O. visuals: Technician placing vials in an aspirate device; close-up of female doctor
holding up vial of stem cells.
Ferkel: So I saw him initially three weeks later and he was telling me how his
pain has essentially not gone away one- hundred percent but its gone away
about eighty percent.
Ferkel (V.O.): And then again, three weeks after that, we had him back out playing volleyball
right now. It’s very rewarding to see these athletes and people
who we are taking care of who are just your regular weekend warrior getting
back out and doing the sport they like to be doing.
V.O. visual: Men playing volleyball on the beach; young men on outdoor race track in
starting position and taking off up the track towards and past the camera;
close-up of feet and ankles of men playing basketball inside a gym; camera
pulls back to show them jumping up to make and block a basket.
Ferkel: There’s so much potential in doing either cartilage treatment or
tendinopathies with stem cells that it’s definitely…
Ferkel (V.O.): …a great opportunity for treating somebody who needs it.
V.O. visual: Teenage boy and girl outside playing basketball on a park court.