Counting Stem Cells – What’s the Proper Knee Arthritis Stem Cell Dose?

By Chris Centeno, MD /

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knee arthritis stem cell dose

I treated an elderly woman who had arthritis in both knees yesterday with the Regenexx-SD stem cell procedure, which is common. Since we count the number of stem cells harvested, we knew based on our registry research that there weren’t enough cells to properly treat both sides, i.e. she only had enough to effectively treat one side. She brought up that when she had consulted a physician in northern Colorado who did stem cell therapy, his clinic didn’t count the cells. She asked how that doctor would they know if she had enough to maximize her chance of success? The answer was that the other clinic would have no idea. This brought up a great blog topic. Does your doctor know how many cells are being injected? Does he know how many are needed? Why is this important?

Taking stem cells from bone marrow or fat in any individual produces a different number of cells than taking them from another person. In essence, our age, fitness level, genes, and overall health determine how many stem cells live in our bone marrow or fat. In addition, it’s reasonable to assume that there would be a minimum dose of stem cells needed to see an effect for each area treated. However, figuring out that dose takes massive amounts of data from at least hundreds to thousands of patients. Unlike other organizations or automatic bedside machine manufacturers, we’ve been collecting data on dose and outcome for years. Last year we discovered a minimum number of cells that we needed in order to maximize the odds of any given patient having a good result with a Regenexx-SD stem cell knee arthritis procedure.

When this patient yesterday brought up this stark contrast between a clinic that didn’t count cells and our clinic that did, it highlighted a problem. The clinic in question uses a simple bedside centrifuge sold by a national device manufacturer. That device has no ability to count cells and because it requires no specialized training to use, there’s inadequate staff education to count what comes out of the machine (i.e. the medical assistant only knows how to push the “On” button and wouldn’t be qualified to count the cell number manually). This clinic isn’t unique. Pretty much all clinics using bone marrow bedside machines that automate the concentration process have no ability to quantify how many cells they have for re-injection. While some fat stem cell clinics have bought an in-expensive cell counter (usually the Moxiflow), they have no idea what dose is needed because no data has ever been published nor collected to figure out the proper dose.

The upshot? Does your doctor count the cells being re-injected? If not, why not? Has any data been collected by your doctor or affiliate on the proper knee arthritis stem cell dose or what dose is needed to treat your orthopedic problem? If not, why not? Treating a patient without a sense of the proper dose is like driving a car or throwing knives with a blind fold. It’s possible, just not advisable!

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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