The Centeno-Schultz Interventional Orthobiologics Fellowships

The Centeno-Schultz Clinic was the first practice in the US to use bone marrow concentrate containing stem cells for orthopedic injuries way back in 2005 by treating joints and low back disc problems. Since then, we’ve continued to advance the art of regenerative medicine and the specialty of interventional orthobiologics. We’ve made many advances in how cells are harvested, processed, and re-implanted. We’ve developed new procedural techniques and devices. As examples, we run a state of the art biology facility that includes a large clean room processing space and a separate privately funded university style research lab. This allows us to custom fit cell based therapies to our patients rather than trying to fit our patients into to what a simple automated machine could produce. As another example, rather than blindly injecting stem cells into joints and hoping that they end up in the right place, we’ve developed new interventional techniques to precisely place bone marrow concentrate in various areas of the MSK system. For instance, we pioneered the percutaneous placement of bone marrow concentrate into the ACL ligament. This technique simply didn’t exist before we realized that many of these patients could avoid surgery by accurately placing bone marrow concentrate into the ligament to heal partial and full thickness tears. Another example of our innovation is in house lab research that lead to a process to dramatically increase the number of stem cells that could be isolated from bone marrow in a same day procedure. 

What is Interventional Orthobiologics?

We believe that due to advances in regenerative medicine, the rapid evolution in interventional cardiology that happened in the 1980-90s to today will happen in orthopedic care. In the 1980s, most major heart problems were treated with CABG. However, a quiet revolution took place that changed the status quo. Cardiologists began experimenting with percutaneous angioplasty. With every passing year from the 1980′s through the 1990′s, fewer and fewer patients needed open heart surgery and a new medical specialty was born – interventional cardiology. As time went by, more and more surgical procedures were switched to percutaneous. We believe the same thing is happening in orthopedic care with interventional orthobiologics replacing more and more surgical procedures using various platelet, cytokine, and growth factor treatments as well as bone marrow concentrate. We also believe that an interventional orthobiologics expert needs to be able to place needle and regenerative therapeutics everywhere from the C0-C1 facet joint to the ankle TT joint or in any accessible tendon or ligament under fluoroscopic or ultrasound guidance. In summary, our fellowship is the best of an interventional spine fellowship combined with the best of a sports fellowship, but focused on the future by providing extensive experience in PRP and bone marrow concentrate treatment.

Interventional Orthobiologics Fellowship Overview and Qualifications

The fellowship being offered by the Centeno-Schultz Clinic (CSC) in Interventional Orthopedics and Regenerative Medicine is 12 months long, interviews typically occur in the first part of the year with the final selections made by early fall.  The fellowship year will be broken up as follows:

• 60% Clinical Care with a focus on the use of various percutaneous bone marrow concentrate and platelet technologies in regenerative medicine.
• 40% Research- The fellow must complete a research project under CSC supervision and submit same for publication. This includes interaction with the onsite research lab.

Qualifications- has or seeking board certification in Physical Medicine and Rehabilitation, Anesthesiology Pain Medicine or Family Practice, Sports Medicine.

1. The candidate will be proficient with basic lumbar spine procedures:
   1. At least 100 performed lumbar joint injections (facets, MBBs and SI joint) under fluoroscopy
   2. At least 100 performed lumbar epidurals (TFs, caudals, ILs)
2. The candidate will be familiar with basic diagnostic ultrasound exams and have experience with needle guidance under ultrasound for basic procedures:
   1. 40 or more performed peripheral joint diagnostic ultrasound examinations (shoulder, knee, ankle, elbow, hip, etc.)
   2. 20 or more performed peripheral joint injections under ultrasound guidance (shoulder, knee, ankle, elbow, hip, etc.)

How do I Apply?

To apply, please contact Ramara Chavez at [email protected] and submit the following information:

• A signed letter by your Program Director verifying the prerequisite training will be completed by the end of your residency (letter attached)
• CV
• A writing sample: A literature review with a maximum of one page in length. The topic is the “correlation between lumbar multifidus atrophy and axial lower back pain and radiculopathy”
• A letter of recommendation from an outpatient MSK attending

We will start interviews via Skype for early candidates in June followed by in-person interviews July and August.