Ask Dr. C

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It’s that time again where I ask my readers to post their questions in the comments. I’ll choose several to answer in a longer format blog.

How do you get your questions to get answered? Try subjects that would be interesting to everyone. For example, instead of listing your symptoms and test results to elicit a diagnosis, instead, focus on something about your condition that others may find helpful. For example, a doctor said I have cervical stenosis, what does that mean? How is it treated with orthobiologics?

Place your questions below in the comments! I look forward to answering some really great questions this round!

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32 thoughts on “Ask Dr. C

  1. Leonard schaitman

    Does adding HA to PRP boost pain relief? My focus is ankle
    Thanks

    1. Chris Centeno, MD Post author

      Answered in 12/2/20 blog.

  2. poon

    Hello
    I am 60 years old. My MRI states that ” there is partial thickness chondral fissure of the medial facet of the patellar cartilage involving up to 50% of the chondral volume. Please tell me is that common for my age.
    Sincerely
    W.p

    1. Chris Centeno, MD Post author

      Yes, mild arthritis like that is common in 60-year-olds.

  3. Leland J Hoepfinger

    I received stem cells and prp (Centeno) on my right knee fall ’15 and stem cells+ prp left and right knee fall ’16. Osteoarthritis persists and current radiographic report says more deteriation= left knee K-L scale is a 3 and right 4 and hips 2. Symptoms now the same or slightly worse than in ’15. I am strongly considering repeating stem cell/prp treatments but am afraid I may be just be postponing the inevitable??? Total knee replacement would be my last choice , but might be better in a healthy-active 75 yr old male vs ? at 80 or??? Thanks

    1. Chris Centeno, MD Post author

      That would largely depend on longevity. For example, in a 75-year-old who is active and who expects to live beyond 90, then a repeat stem cell/PRP procedure may make good sense. If the longevity is shorter and if you accepted the greater risks of injury die to the knee replacement, then maybe the knee replacement makes sense.

  4. ken Kowalchuk

    How long should the beneficial effects from a PRP treatment last and how often should a person be repeating a PRP treatment?

    1. Chris Centeno, MD Post author

      See https://regenexx.com/blog/prp-injection-recovery-time/ In general, for candidate tendon or ligament issues, the effects can be permanent, based on what I have observed. For joint arthritis, if it’s mild, then the effects can last 1-2 years. If the joint arthritis is more severe, then the response time is usually shorter.

  5. dave nesbitt

    As a pharmacist of nearly 40 years I have followed you and Dr. Hernigou for quite awhile. I had the right knee done 1/19 & the left knee done 6/20. The left knee is starting to get worse and am wondering if the bone stem cells are offered at all Rengexx locations? Would you talk some about WHY bone injections seem to offer longer term relief? Dave Nesbitt PharmD

    1. Chris Centeno, MD Post author

      It’s believed that much of the pain of arthritis comes from damage to the bone. Adding stem cells to this area can help repair that damage.

  6. Dave Nesbitt

    I just read the 12/2 blog and have a question. When using HA w/PRP is given at the same time or a few weeks apart? What are your thoughts in using stem cells + PRP then HA in a month or 2? Does that even make sense to consider? Just for reference, I had my procedure done by Dr Stiene in Cincinnati. The right knee is still 90% better after almost 2 years!!! Dave Nesbitt PharmD

    1. Chris Centeno, MD Post author

      All of the data we have is on giving HA and PRP or stem cells together. Adding in HA after the injection may have a synergistic effect, but it’s likely that injecting them at the same time would work better.

  7. dave nesbitt

    Did you see the CDC is going to recommend quarantining 7-10 days for COVID-19 pts now?

    1. Chris Centeno, MD Post author

      Yes!

  8. Rick Romano

    How far are we away from getting prp and stem cells as a treatment that is widely accepted by insurance companies?

    1. Chris Centeno, MD Post author

      That’s coming, but it’s likely years away. For example, Tricare now covers PRP for a few indications. Regenexx has coverage company by company for about 8 million people. So it’s all getting there…

  9. Greg R Heule

    https://www.facebook.com/watch/?ref=search&v=10155710779441509&external_log_id=d8ae76fa-6db9-4583-8238-a17502c9844d&q=stem%20cell%20burn%20treatment

    This is from 2016 and I just recently saw it. Do you know if there has been any other research on the use of stem cells in the treatment of burns?

    1. Chris Centeno, MD Post author

      Not my area of expertise.

  10. R Kimsey

    Do you utilize micronized amnion chorion joint injections?

    1. Chris Centeno, MD Post author

      No, there is limited clinical data that these injections are helpful for arthritis.

  11. b Brown

    My recent mri showed spinal stenosis with excessive epidural fat. Do you know what this means & have you treated such with orthobiologics?
    This is my first question for “Ask Dr C”

    1. Chris Centeno, MD Post author

      Excessive epidural fat is a rare condition often caused by epidural steroids. Have you had epidural steroid injections?

  12. Allan Kupczak

    Hi Dr. C,
    I’m curious as to your thoughts on peptides for tendon and ligament repair. In particular, BPC-157 is the one I’ve been reading about recently. Thanks!

    1. Chris Centeno, MD Post author

      See https://regenexx.com/blog/what-are-peptides/

  13. Jo Merriam

    ASK DR. C: How old is “too old” for effective stem cell replacement for knee arthritis? Some of us are younger than our chronological age. What physiological markers do you look for in determining who is a good candidate, and who might be “past their ‘sell-by date’?”

    1. Chris Centeno, MD Post author

      See https://regenexx.com/blog/old-age-stem-cells/

  14. Kimberly Bork

    I met a gentleman on the airplane named Neville Dauterive. He says he has been doing
    PRP and Stem cell for 30 years and gets most of his cells from fat. He says he gets a gazillion more cells than blood or bone marrow. He also said he knew you…lol

    1. Chris Centeno, MD Post author

      Huh, never heard of him. I don’t think what he’s saying is accurate. I also can’t much on Google about him…

  15. Jacquelyn A Adams

    I’ve never received a diagnosis on my knees. I’m only bothered by them occasionally for a day or two. I never take anything for pain relief. Inactivity seems to be my enemy. Is there a time too soon to begin receiving injections? Is there more benefit to being proactive rather than waiting for greater symptoms? How do I know?

    1. Chris Centeno, MD Post author

      That’s something that could be addressed by a Telemedicine or local visit. At the top of the page is a link for “Find a Provider”.

  16. Matt Weir

    Why is Regenexx recruiting people on clinicaltrials.gov for six rounds of low back PRP for lower back pain when patients are only paying for one round and expecting relief?

    1. Chris Centeno, MD Post author

      You need to post the link, but I believe that’s a multifidus atrophy study for an experimental approach with MRI follow-up to see if it’s possible to regenerate the muscle. That’s not a common treatment we offer.

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