Research

Dr. Bunyak has read and analyzed the recent research in musculoskeletal cellular therapies, PRP (platelet-rich plasma), and prolotherapy. Having conducted cellular research at the National Institutes of Health (NIH), she understands the strengths and limitations/biases of data and the resulting study conclusions.

She partners with her patients to development personalized treatments plans based on both the current research and her more than 15 years of experience in the clinic. Below is a selection of recent research and commentary by Dr. Bunyak.

Select a topic to read relevant targeted research. More topics and body areas are coming soon.

Knee
PRP
Stem Cells

Feel BOUNDLESS Musculoskeletal Regenerative Medicine

Dr. Bunyak notes: “A study that sounds like science fiction: Stanford researchers have found that adult skeletal stem cells can drastically increase their ability to regrow tissue and become less mature and more powerful if pushed to regenerate a lot of tissue over time. Like a newt regrowing a limb, the signals that create cells like these may allow us to regrow whole organs in the future. This is the news release about the paper published in the Oct. 24 issue of Nature.”

Look BOUNDLESS Regenerative Aesthetics

Dr. Bunyak notes: “There has been a slew of recent articles supporting the use of PRP, either by injection or with microneedling, for hair regrowth in men and women, and for skin quality enhancement. A series of injections works better than a single treatment, and combination therapies work better than unilateral approaches.”

Feel BOUNDLESS Musculoskeletal Regenerative Medicine

Dr. Bunyak notes: “Recent research has shown that the majority of the healing and anti-inflammatory effects of stem cell injections comes from the molecules and bags of protein the stem cells secrete–their “secretomes” (marketed as “exosomes”)–rather than from transformation of the stem cells themselves. This finding has sparked a quest for the ultimate cell-free stem cell derived therapy as a safer, more widely available alternative. In other words, if what we really want is the milk, instead of bringing cows home, set up farms and buy the milk wholesale. This is one of two recent studies that illustrate this quest, looking to engineer and standardize this process.”

Feel BOUNDLESS Musculoskeletal Regenerative Medicine

Dr. Bunyak notes: “Recent research has shown that the majority of the healing and anti-inflammatory effects of stem cell injections comes from the molecules and bags of protein the stem cells secrete–their “secretomes” (marketed as “exosomes”)–rather than from transformation of the stem cells themselves. This finding has sparked a quest for the ultimate cell-free stem cell derived therapy as a safer, more widely available alternative. In other words, if what we really want is the milk, instead of bringing cows home, set up farms and buy the milk wholesale. This is one of two recent studies that illustrate this quest, looking to engineer and standardize this process.”

Feel BOUNDLESS Musculoskeletal Regenerative Medicine

Dr. Bunyak notes: “Platelet-rich plasma (PRP) formulations continue to evolve. New studies suggest that combining platelets with hyaluronic acid (like Synvisc) or low-dose steroids and preparing the PRP in a low temperature environment may offer advantages over traditional preparation and injection methods. At BOUNDLESS, we are in the process of independently evaluating and testing the above results to continue to optimize our cutting-edge PRP offerings.”

Look BOUNDLESS Regenerative Aesthetics

Dr. Bunyak notes: “There has been a slew of recent articles supporting the use of PRP, either by injection or with microneedling, for hair regrowth in men and women, and for skin quality enhancement. A series of injections works better than a single treatment, and combination therapies work better than unilateral approaches.”

Look BOUNDLESS Regenerative Aesthetics

Dr. Bunyak notes: “An August study from Korea demonstrates excellent results using a product that combines hyaluronic acid filler with PRP, with results that can last up to 2 years (similar to the “vampire facial” approach). This article illustrates the increasing interest in the aesthetic community in combining traditional aesthetic procedures–such as hyaluronic fillers, thread lifts, and Botox–with regenerative therapies such as PRP and cellular treatments.”

Look BOUNDLESS Regenerative Aesthetics

Dr. Bunyak notes: “PDO threads seem to provide a variety of benefits in addition to the visible lifting effect they’re known for. A new animal study explores the effects of PDO threads at the skin level and finds that the threads increase collagen, improve blood flow, reduce fat, and tighten skin–all supporting the visible effect.”

Feel BOUNDLESS Musculoskeletal Regenerative Medicine

Dr. Bunyak notes: “Platelet-rich plasma (PRP) formulations continue to evolve. New studies suggest that combining platelets with hyaluronic acid (like Synvisc) or low-dose steroids and preparing the PRP in a low temperature environment may offer advantages over traditional preparation and injection methods. At BOUNDLESS, we are in the process of independently evaluating and testing the above results to continue to optimize our cutting-edge PRP offerings.”

Feel BOUNDLESS Musculoskeletal Regenerative Medicine

5/13/18 (Du, et. al)

Dr. Bunyak notes: “Platelet-rich plasma (PRP) formulations continue to evolve. New studies suggest that combining platelets with hyaluronic acid (like Synvisc) or low-dose steroids and preparing the PRP in a low temperature environment may offer advantages over traditional preparation and injection methods. At BOUNDLESS, we are in the process of independently evaluating and testing the above results to continue to optimize our cutting-edge PRP offerings.”

Feel BOUNDLESS Musculoskeletal Regenerative Medicine

Management of rotator cuff injuries in the elite athlete

1/13/18 (Weiss, et. al)

Dr. Bunyak notes, “Conservative management of rotator cuff injuries continues to be the “gold standard” in the elite athlete. This includes a comprehensive rehabilitation program, anti-inflammatories, and corticosteroid injections. Newer treatment techniques such as intramuscular dry needling and the use of biologics such as platelet-rich plasma and stem cells demonstrate early promising results; however, these modalities require further investigation to determine their effectiveness.”

Feel BOUNDLESS Musculoskeletal Regenerative Medicine

The effects of injecting intra-articular platelet-rich plasma or prolotherapy on pain score and function in knee osteoarthritis

1/4/18 (Rahimzadeh, et. al.)

Dr. Bunyak notes this text from the Conclusion, “Results of the present study suggested a significant decrease in the overall WOMAC score of patients who undergo either PRP therapy or PRL (prolotherapy). This positive change in the overall WOMAC score led to an improvement in the quality of life of patients with knee OA shortly after the first injection. PRP injection is more effective than PRL in the treatment of knee OA.”

Feel BOUNDLESS Musculoskeletal Regenerative Medicine

Effects of bone marrow aspirate concentrate and platelet-rich plasma on patients with partial tear of the rotator cuff tendon

1/3/18 (Kim, et. al.)

Dr. Bunyak notes, “BMAC-PRP (bone marrow aspirate concentrate therapy combined with PRP) improved pain and shoulder function in patients with partial tear of the rotator cuff tendon.”

Feel BOUNDLESS Musculoskeletal Regenerative Medicine

Tissue source determines the differentiation potentials of mesenchymal stem cells: a comparative study of human mesenchymal stem cells from bone marrow and adipose tissue

12/6/17 (Xu, et. al.)

Dr. Bunyak notes this text from the conclusion, “The epigenetic memory obtained from either bone marrow or adipose tissue favored MSC (mesenchymal stem cells) differentiation along an osteoblastic or adipocytic lineage. The methylation status of the main transcription factors controlling MSC fate contributes to the differential differentiation capacities of different source-derived MSCs.”

Feel BOUNDLESS Musculoskeletal Regenerative Medicine

Mesenchymal stem cell-conditioned medium reduces disease severity and immune responses in inflammatory arthritis

12/1/17 (Kay, et. al.)

Dr. Bunyak notes, “MSC-conditioned media (containing exosomes and signalling molecules) reduces cartilage damage and suppresses inflammation in inflammatory arthritis.”

Feel BOUNDLESS Musculoskeletal Regenerative Medicine

Circulating levels of proinflammatory mediators as potential biomarkers of post-traumatic knee osteoarthritis development

10/20/17 (Panina, et. al.)

Dr. Bunyak notes, “This study shows that ‘patients with early- and late-stage post-traumatic knee osteoarthritis have increased levels’ of biomarkers which may help diagnose the likelihood of future degeneration and which may help target therapies such as A2M (alpha-2 macro globulin). Scientific note: Serum NO, leptin, IL-6, IL-18, and IL-1B correlate with post-traumatic knee osteoarthritis develpement (and may help select targets for A2M therapy).”

Feel BOUNDLESS Musculoskeletal Regenerative Medicine

Benefits of different postoperative treatments in patients undergoing knee arthroscopic debridement

9/25/17 (Vasavilbaso, et. al.)

Dr. Bunyak notes, “HA (hyaluronic acid injections) and PRP (platelet-rich plasma therapy) both help with post-arthroscopy pain and function for arthritis and meniscal tears. In this study, the HA offered more benefit than PRP, and this benefit lasted 18 months.”

Feel BOUNDLESS Musculoskeletal Regenerative Medicine

Conservatively treated knee injury is associated with knee cartilage matrix degeneration measured with MRI-based T2 relaxation times: data from the osteoarthritis initiative

8/9/17 (Hoffman, et. al.)

Dr. Bunyak notes, “Significant knee injuries, as defined by an injury that limits the ability to walk for at least 2 days, are associated with (permanent) cartilage matrix abnormalities as shown on MRI, even without obvious morphologic abnormalities.”

Feel BOUNDLESS Musculoskeletal Regenerative Medicine

Optimization of pure platelet-rich plasma preparation: A comparative study of pure platelet-rich plasma obtained using different centrifugal conditions in a single-donor model

7/9/17 (Yin. et. al.)

Dr. Bunyak notes this text from the paper, “In conclusion, while P-PRP obtained using different centrifugal conditions had similar erythrocyte, leukocyte and pro-inflammatory cytokine concentrations, centrifugation at (specific spin speeds) successively captured and concentrated platelets and growth factors more efficiently with preservation of platelet function compared with other conditions.”

Feel BOUNDLESS Musculoskeletal Regenerative Medicine

Effect of Radiofrequency Denervation on Pain Intensity Among Patients With Chronic Low Back Pain

7/4/17 (Juch, et. al.)

Dr. Bunyak notes, “This high-quality article in JAMA shows that radiofrequency ablation for facet arthritis does not add benefit or relieve back pain beyond a good exercise/physical therapy program alone. The article concludes that this insurance-covered, popular procedure is not as beneficial as previously thought, and recommends that physicians no longer offer this option as a front-line treatment for facet joint arthritis. As the treatment is degenerative, BOUNDLESS never has offered this procedure.”

Feel BOUNDLESS Musculoskeletal Regenerative Medicine

Intra-articular injection in the knee of adipose derived stromal cells (stromal vascular fraction) and platelet rich plasma for osteoarthritis

6/19/17 (Bansal, et. al.)

Dr. Bunyak notes this text from the conclusion, “SVF combined with PRP has a great potential as a therapeutic agent in regenerative medicine especially in orthopedic conditions. The high numbers of MSCs in SVF make it a suitable source for cellular medicine. Preliminary studies suggest that it is a safe and effective method for treating osteoarthritis. Both qualitative and quantitative measurements showed statistically significant improvements during the follow up period of 2 years.”