The 5-5-5 Knee Stem Cell Treatment: Hype or Reality?

By Chris Centeno, MD /

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knee stem cell ethics

Herman Cane became famous for his 9-9-9 plan during his presidential bid. Now there’s a new plan in the arena of stem cells brought to us by a reader of this blog, the 5-5-5 knee stem cell treatment. If you get a knee stem cell injection you’ll be pain free in 5 days, have full mobility in 5 weeks, and regrow cartilage by 5 months. But is this hype or reality?  What about knee stem cell ethics?

The 5-5-5 plan came to my attention this week from an e-mail sent by the mother of a patient. She had called one of the Regenexx copy cat web-sites and they got back to her with a cogent and seductive sales pitch about her knees. She had discussed that she had had multiple knee surgeries and was a knee replacement candidate. They then told her about 5-5-5. It sounded a bit hokey so she wrote me about it.

So did the stem cell network that told her about the plan have any evidence from data they had or anyone else had collected to support 5-5-5? Nope. Nada. So let’s break it down and separate the hype from realty in orthopedic stem cell injections for knee arthritis. First, since this was told to a knee replacement candidate, for this to be true we would need some credible data that shows that in most of these patients this is what’s observed. Let’s take pain relief in 5 days. There is nothing published that shows that a patient with moderate to severe knee arthritis will get pain relief in 5 days. In fact, after collecting more data on this topic than anyone else on earth, our data would show that relief generally happens in the first few weeks. How about full mobility in 5 weeks. The statement sounds like the patient will be back to all of the activities they want to perform in 5 weeks. Is this true? While some patients will reach that milestone, most will still be gaining function in the 4-12 week time frame. The big issue with 5-5-5 is the last part, that the average knee replacement patient can expect cartilage regrowth at 5 months. While we’ve seen evidence on MRI of cartilage repair or improvement in patients with smaller cartilage lesions (i.e. holes in the cartilage), the statement that the average knee replacement candidate will get cartilage regrowth in 5 months is irresponsible. To read more about what a responsible statement about cartilage, stem cells, and severe arthritis looks like, check out this blog post.

If stem cell injections in severe knee arthritis don’t work by dramatically regrowing large swaths of cartilage, how do they work? This is a discussion on the topic, but basically they likely work by replacing the lost native stem cell population, improving the nasty witches brew of degenerative chemicals in the joint, deactivating bad cells, and repairing the cells that are having trouble. Are there examples of patients who have regrown cartilage? Yes, see here, here, here, and here.

The upshot? The 5-5-5 plan is hype meant to sell procedures to patients who haven’t done their homework. If you hear someone using this sales pitch, I have some advice. Run…

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Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
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