Home › Blog › Ask Dr. C-Episode 15-Second Knee Stem Cell Procedures and Regrowing Cartilage

The inside of both knee joints shows a loss of cartilage compared to the space seen on the outside of the joints. Puwadol Jaturawutthichai/Shutterstock

Today we’ll cover some issues surrounding knee stem cell procedures. In particular, we’ll go over repeat stem cell procedures and regrowing knee cartilage. Let’s dig in.

Question #1:

“Dear Dr. C,
I was so happy to know that you, personally, can answer some long overdue questions, that’s personal to me.
I had a same day bone marrow stem cell procedures done, on both knees, in Brussels, in May 2018.
My condition is quite bad due to the long toll of competive badminton.
I’ve completely stopped the sport, 5 years now, & currently only doing mild jogging. Recently the pain has returned with more noise, inflammation, dull pain, gliding, the lot. The upside is its happening at different times n I get some good days!!
Please can you advise me on what more I can do to avoid the conventional surgeries.
Many many thanks!
Best regards,
Vanessa TANG”

So this patient had a bone marrow stem cell procedure about 2 and a half years ago and it’s beginning to wear off. What’s next?

This type of stem cell procedure can last on average, from 2-7 years based on the data we’ve collected. What’s usually recommended at the end of that time period is a repeat procedure. Since 2018 we have continued to evolve the procedure, now more aggressively treating the bone in addition to precise image-guided injections of the joints. Why does that matter?

The bone and cartilage in your knee are alive and connected. What happens to one happens to the other. This realization has slowly formed over the last decade as more research has shown that knee pain is much more likely to be present when abnormalities in the bone are detected on MRI. Amazingly, if you have lost or damaged cartilage that’s a less reliable indicator of who has pain.

There’s now new research on how long bone marrow concentrate injections last when injecting just into the joint versus injecting into the bone. At 15 years, the patients who had bone injections had results that lasted much longer. For example, only 1 in 5 of those patients converted to a knee replacement at 15 years (1).

Hence, for this patient, I’d recommend adding in a bone injection with a joint injection for her next procedure. It’s very possible, that based on the research, the duration of the positive effect can be prolonged.

Question #2-Can cartilage be regrown?

I get this question all the time. As I discussed above, lost cartilage is usually not the thing that causes pain. Problems in the bone more commonly cause pain.

Getting back to the question, we have observed many times that small holes in the cartilage can be regrown. For more information on those before and after patient MRIs, see my video below:

However, if you have large amounts of lost cartilage, like moderate or severe knee arthritis, you won’t get large amounts of cartilage regrown. Meaning, we can’t regrow you a new knee if your knee is trashed. Does this matter for your outcome? No. Patients with more severe arthritis do as well with a bone marrow stem cell procedure as those with mild arthritis. Meaning, that the effects of being able to do more with less pain aren’t dependent on regrowing cartilage.

Why do some clinics claim that they can regrow cartilage in patients with severe arthritis? That’s a scam, see my video below:

Thanks for your Ask Dr. C questions! I always like being able to take more time to dig into these issues.

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(1) Hernigou P, Bouthors C, Bastard C, Flouzat Lachaniette CH, Rouard H, Dubory A. Subchondral bone or intra-articular injection of bone marrow concentrate mesenchymal stem cells in bilateral knee osteoarthritis: what better postpone knee arthroplasty at fifteen years? A randomized study. Int Orthop. 2020 Jul 2. doi: 10.1007/s00264-020-04687-7. Epub ahead of print. PMID: 32617651.

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. View Profile