The difference between stem cell clinic reality and what’s advertised never ceases to amaze me. Last year one of these magic stem cell pixie dust clinics came to my attention, but I ignored it. However, another colleague has just again brought it to my attention that it references a comparison to Regenexx, so let’s use it as an example of how we stack up to this type of clinic.
Restaurants and Stem Cells
When you look at where you want to eat out this week, you have lots of choices. Because you have loads of experience with having eaten out cheap and expensive, you have some idea of what you get for your money. Obviously, a McDonald’s hamburger is different than a 5-course gourmet meal in a beautiful setting. However, in medicine, patients often struggle to figure out the same type of differences in medical care. Heck, one of my doctor friends had a hard time choosing the best cardiologist for his heart condition. He went to one and a had a procedure done that didn’t work and then went to a second who performed a much more sophisticated version of the same process and that worked well. So if sometimes we doctors can’t figure it out, how can we expect patients to get it right?
The First Warning Signs
Let’s take a look at a Florida stem cell clinic who does a good job of mixing up reality. This provider is a physician with a complex last name, so I’ll refer to him as Dr. G. Let’s explore what’s on the web-site to get a sense of the problems.
From looking at the Dr. G web-site, a huge difference between the Regenexx site and this one becomes apparent. The Regenexx site is now about 2,000+ pages deep with information. Add to that the many books and research publications, and it’s easily 3,000 pages of content. The Dr. G site has about ten pages. So right off the bat, once you peel back the first layer of info, there’s not much there. However, let’s explore those few pages.
For someone who’s been using stem cells for 11 years, it’s always interesting to see how much experience a provider will claim to have. Why? We were the only clinic in the US performing this type of work in 2005. The first physicians outside of our clinic using stem cell injections in orthopedics didn’t begin until much later. So I was surprised to see that Dr. G makes a claim about extensive stem cell experience. Let’s see if that’s demonstrably true or false. The claim:
“Located in …Florida, we are the leader in Adult Stem Cell and Platelet-Rich Plasma (PRP) Procedures. We have performed these procedures for more than ten years with over 90 % results and ZERO side effects.”
Let’s take the first part first. Dr. G has performed these PRP and stem cell procedures for 10+ years. Thankfully, we can easily look this up online. According to the Internet archive, the first on-line appearance of the current domain and web-site for Dr. G is in March of 2014, a far cry from 10+ years ago! There is a second web-site that advertises face lifts and musculoskeletal treatments. That one goes back to November 2010! Curiously, despite claiming to have a decade of experience in stem cells, in 2010 there is no mention of stem cells on that web-site. At that point, the web-site looks to be similar to many cash based Florida practices that advertise that it can manage chronic pain, mostly through the use of opiods. When is the first mention of stem cells? In 2011! So Dr. G has about half the claimed experience. So strike 1.
Now let’s take the second part of that statement. Dr. G reports a 90% success rate and zero side effects. There is no data shown on Dr. G’s web-site. There are no publications listed in the US National Library of Medicine by Dr. G. There are no other publications that support a 90% patient-reported success rate for any of the technologies Dr. G uses. We have recently published the world’s largest safety paper with an excellent side effect profile, clearly beating the surgical complication rates that these procedures help many patients avoid. However, no medical procedure ever devised by man that begins with a needle or cannula taking tissue and placing that tissue back into a patient has zero side effects. In fact, our published side effects are clearly outlined in our publication. So are these statements remotely true? Nope. Stem cell therapy for arthritis and other conditions doesn’t have a 90% success rate and zero side effects. So this data is clearly fabricated by Dr. G or a surrogate. It’s disappointing that all of this looks much more like magic stem cell pixie dust than a real medical procedure.
What Other Claims Tell Us
Dr. G makes a point to compare what he’s doing to other clinics, including Regenexx, so let’s look at this comparison in more detail:
Let’s take these one at a time:
- Gene and cellular tests to evaluate stem cell functions. While this sounds really good, this doesn’t exist. Go Google “Gene and Cellular Tests for Stem Cells”, you’ll get nothing that’s commercially available. Could Dr. G have invented something new here? Unlikely. I expect that what he’s discussing here is not tests that he performs on stem cells, but other tests like food sensitivity testing. While theoretically, these tests could help treatment, no study has every connected these dots.
- Use Bone Marrow, Fat, and PRP. The idea of using fat with bone marrow is appealing, after all, both contain stem cells. The concept was popular in 2011-2013, so rather than follow the herd, we began tracking these cases in our registry and comparing them to bone marrow only cases. In the end, the research didn’t support that this hybrid procedure was worth it – as the fat+bone marrow patients didn’t do any better than the bone marrow only patients. We published this in a peer reviewed journal. It looks like Dr. G never got the memo.
- Processes fat without using chemicals like collagenase. To understand what’s going on with this one, you need to learn a bit more about the different fat procedures being performed for things like knee arthritis. The stem cells in fat are trapped in a collagen matrix, so using just fat, no matter how hard you try to liquify it mechanically, doesn’t free those stem cells. Our research has shown that this isn’t a real stem cell procedure because these cells never make it out of their collagen prison. If you want to get viable stem cells, you have to digest the fat with a chemical, like collagenase, which breaks down the collagen and frees up the stem cells. This is called SVF or stromal vascular fraction and regrettably this is illegal in the U.S. The critical thing to understand here is that since Dr. G doesn’t break down the fat with chemicals, he isn’t performing a fat stem cell procedure, but instead a simple fat graft. So claiming that this fat graft with stem cells locked up and inactive in collagen is a stem cell procedure is like claiming a heart transplant is a stem cell procedure. A heart has stem cells, but those stem cells don’t act in any meaningful way in the host.
- Uses ultrasound guided injections because x-rays can damage cells. It’s always interesting to see physicians with much less training in guided needle procedures try to justify why they don’t use c-arm fluoroscopy. The bottom line is that while ultrasound is ideal for injecting certain parts of joints, tendons, and ligaments, it can’t see other areas. Hence if all you have available to guide your injections is ultrasound, you’re not going to be able to perform sophisticated injections of stem cells. On the topic of fluoroscopy damaging stem cells, unlike Dr. G, we have an advanced research lab where we’ve tested that and saw no issues. In addition, the average fluoro guided injection exposes the patient to about the same dose of x-rays that a pilot flying frequent cross-country trips would be exposed to in a month. Hence, the using x-rays to guide more complex injections would be very minimal risk.
- Improve body functions with hormones and supplements. Again, here you can see the difference between Dr. G and real research based clinics like Regenexx. Several years ago we wondered if adding in hormones and supplements would make a dramatic difference in stem cell function. We performed a clinical study where we optimized the hormones of men and took stem cells before and after that treatment. While the hormones seemed to make other aspects of their health better, they did not improve stem cells. We also did the same thing with supplements by spending an entire year in the lab researching how various supplements could help stem cells in-vitro. In the end, we settled on a formula that looked promising. Is there any evidence that Dr. G has studied anything to make these claims, no! Like the rest of the web-site, the foundation for these concepts seems to be as shaky as any of the others made.
The upshot? It’s always entertaining to me to dissect the inaccuracies listed on magic pixie dust stem cell clinic sites. I always begin with the claim of experience, because if you’re willing to fabricate your resume, you’ll have no issues getting creative in other areas as well. Dr. G didn’t disappoint!