Comparing the Number of Cells in Regenexx Procedures to the Rest…

by Chris Centeno, MD /

regenexx vs other system comparison

You may not know that when it comes to living stem cell procedures that almost all doctors use simple bedside machines. So this morning I’ll educate you on that process and compare the number of cells we use in our stem cell procedures to everyone else. Let’s dive in.

What is a Living Stem Cell Procedure?

Regrettably, most of what you can find today that’s advertised as “stem cells” is a scam. Meaning it’s birth tissue derived from either amniotic or umbilical cords and contains no living stem cells. However, if you want to get a living stem cell therapy, there are really only two options, using your fat or bone marrow. As far as fat is concerned, to get the stem cells out, you need to digest it. That’s illegal per current FDA guidelines. Hence, that leaves your bone marrow as the sole source of a living stem cell therapy that’s FDA compliant.

What You Should Expect From a Bone Marrow Stem Cell Procedure?

First, the doctor performs a bone marrow aspirate. This involves numbing the area by placing a needle into the bone to pull out what looks like thick blood. This is a very critical step of the procedure to maximize the number of stem cells you receive, but regrettably, most doctors don’t do this part well, so they short change their patients.

Where this marrow aspirate comes from matters. For example, many orthopedic surgeons take aspirate from the knee. While this is convenient for the surgeon performing a knee surgery, this shortchanges the patient because this source has fewer stem cells than the pelvis. So a good bone marrow draw usually starts in the back of the hip area.

The next part of the procedure where most physicians place their convenience over what’s best for the patient is the bone marrow draw technique. Most physicians will merely place the needle into the area and draw as much as they can as quickly as they can. The problem? This drastically reduces the number of stem cells available for the therapy. Instead, in order to maximize the number of cells, the doctor should be taking small amounts from many areas.

As a concrete example, yesterday we had a visiting physician who observed two of my bone marrow aspiration procedures. He was clearly surprised by how many sites I drew from on each side. So as I show you the graphs comparing the number of cells in a Regenexx procedure to the bedside machines on the market, realize that beginning with a good draw is the first step in producing the most cells possible per treatment.

The Bedside Centrifuge Problem

Most physicians doing this work use a bedside centrifuge. This is a simple machine that sits someplace in the office that has a plastic kit where the bone marrow goes. So all the doctor or his assistant knows is where that kit goes in the machine and where the “On” button lives. The machine then does what it does and then produces what it produces.

The problem with this set-up, as you’ll see from the cellular numbers below, is that it’s very inefficient at concentrating bone marrow cells. This is why we have always used a much more expensive and resource intensive on-site lab to do this work. In addition, the bedside machines all leave out parts of the bone marrow that contain stem cells, which gets thrown away by the doctor.

How Does Regenexx Stack Up?

Below is a graph showing the number of cells in the final bone marrow concentrate product once it’s been processed. For the common bedside machines on the market we used their published numbers:

regenexx vs other machines

The height of the bars here equals the number of cells per cc delivered. As you can see, the Regenexx bone marrow processing delivers substantially increased numbers.

Knowing the Dose

First, you’ll note that the number of patients that made up this data for Regenexx is 578 whereas the other companies only report 20-40 patient samples. This glaring difference highlights another contrast to what we do. Not that our data has almost 600 samples. Why? We count the cells in every sample for dosing purposes, so this data comes out of the Centeno-Schultz processing lab. The other companies have no ability to count cells, so their data came out of some lab where they sent a few samples for research purposes.

Knowing the dose of what it is you’re injecting is key. At Regenexx we count that cell dose and have dosing guidelines. Doctors who use these machines have no idea how many cells they’re delivering. For example, do they have enough cells to inject both knees? They have no idea.

How Can Regenexx Deliver Better Numbers?

How can Regenexx get these high cell numbers? First, our draw technique is very different than the average doctor. So we’re starting with many more cells than the companies that produced these white papers on their products. In addition, as I said, the problem with bedside machines is that they can’t get rid of the non-cellular portions of the bone marrow at any reasonable level of efficiency. In addition, on the other side of that calculus, they throw away key parts of the marrow that contain cells. Finally, these machines are one size fits all, whereas our processing protocols for our labs are designed to fit the processing to the unique patient sample.

The upshot? As you can see, we deliver far more cells at Regenexx than the vast majority of providers out there. While that doesn’t always guarantee a result, based on the published literature, it improves your chances of success.

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2 thoughts on “Comparing the Number of Cells in Regenexx Procedures to the Rest…

  1. Sunil Arora

    Dr. Arnie Caplan , who named MSCs , says that it is not the number of MSCs which improve the clinical outcome in patients but it is the whole soup, the BMA. This is from his lecture in January 2019 in San Diego at ICRS meeting.
    He also said that there are less than 5 MSCs in a 10 ml BMA from PSIS.
    He also believes that TNC and CFUs are not very accurate methods to quantify MSCs.
    I would appreciate your Comments please.
    Thanks!

    1. Chris Centeno, MD Post author

      Arnie is a bench scientist, so he is likely unfamiliar with the Hernigou data that shows a clear connection between CFU-f (MSC dose) and orthopedic outcomes in multiple papers. We have no data on “the soup” and it’s connection to outcomes, so if you heard that this was personal opinion and not anything based on data at this point. There are many more than 5 MSCs in 10 ml of BMA, so no idea where you would even find a citation that would support this? MSC yields in BMC are generally in the 1 exp 4-5 range for a BMA of 60-120ml, properly obtained. TNCC is not an MSC quantification method, but total cellularity is related to MSC dose. CFU-f is a standard rough metric of the MSCs in a sample. See https://regenexx.com/blog/stem-cell-numbers-mean/

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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