Learning What It Takes to Perform the Simplest Knee Injection

by Chris Centeno, MD /

If you or a loved one wants to avoid getting scammed by a chiropractor, naturopath, acupuncturist, or a physician trying to reinvent his or her career by claiming to be an orthopedic stem cell expert, then learning how hard it can be just to perform the simplest knee injection will jump-start the education you need to protect yourself. Above I have a video that I shared this past week with many doctors to promote an upcoming basic knee course through the Interventional Orthopedics Foundation (IOF). Let me explain.

What Is Interventional Orthopedics (IO)?

IO is very different from surgical orthopedics. The latter involves cutting stuff out or trying to sew back together damaged musculoskeletal structures. The former is a new trend where precise injections of agents that can help tissues heal are used and thus can replace the need for more-invasive surgery.

The Interventional Orthopedics Foundation (IOF) has an entire curriculum that’s broken down into 6 body areas and 85 procedures. The problem is that most of these many different precise injection procedures are difficult to master and learn, and 99.9% of all physicians and medical providers offering platelet-rich plasma and stem cell injections have no idea how to precisely place cells in this many areas. Hence, we helped found the IOF to reeducate doctors worldwide. For more information on IO, see my video below:

Blind vs. Guided Injections

One of the hallmarks of a stem cell scam clinic is that the doctor or midlevel (nurse or physician assistant) performing the injections doesn’t use guidance to inject “stem cells.” I have stem cells in quotes because most don’t use any live cells, just dead amniotic and umbilical cord products. For more info on that type of scam, see my video below:

When guidance isn’t used, the injection is called “blind.” For a knee, even in experienced hands, a blind injector will miss the joint altogether about 20–40% of the time! When guidance is used, the physician or midlevel has to be trained in how to use that technology to make sure they can confirm that the cells are in fact injected in the joint, 100% of the time.

There’s a Lot Going On in Even the Simplest Knee Injection

There are many things that can be injected into a knee. For example, the meniscus, ACL, PCL, MCL, LCL, patellar tendon, and quadriceps tendon are all possible targets for cells. Getting cells to the specific parts of these structures that have problems is very difficult. Today I want to focus on the simplest injection possible, just making sure you’re in the joint itself. To see some of the different things in different parts of the body that can be injected, see my video below:

The video at the top of the page is one of those 85 different videos created by the IOF to teach doctors how to properly inject things like stem cells and PRP into various parts of the body. After they learn what’s in the video, they have to take and pass a cadaver course and then a written test. If you watch it, you’ll see that even for this most simple procedure using ultrasound guidance, there’s much to learn. This includes the following:

  1. Finding a place to inject, which is an art unto itself
  2. Making sure you’re really in the joint and not somewhere else
  3. Avoiding things that will cause more pain
  4. Having a plan B and plan C if this method doesn’t fit the patient’s anatomy

The Scammer Clinic

As I discussed above, the scammer clinic may not use ultrasound or fluoroscopy guidance at all. If they do, here are some other things to look for:

  1. Use of nurses and/or physician assistants (midlevels) to perform the procedures
  2. If a physician performs a procedure, usually that doctor is not trained in interventional orthopedics. The doctor is usually a burnt out ER doctor, cardiologist, internal medicine, family doctor, or similar specialty who knows very little about the musculoskeletal system.
  3. Procedures performed in an exam room in a chiropractic, acupuncture, or naturopathic office. This means there is none of the equipment you would see in a procedure room.
  4. Amniotic and umbilical cord “stem cell” products are used as the primary therapy and billed as young, active, and live stem cells when in fact these products are regulated by FDA to be dead-cell preparations, which have no, or few, viable cells.
  5. High-pressure sales techniques are the norm. Meaning the patients are promised that the therapy is magic, works in just about everybody for just about everything, and if you sign up “NOW” you can save 20% (but the offer is only good for today).

For more information about what to look for in what I call a “Scaminar,” see my video below:

The upshot? At the end of the day, it takes significant training to understand how to precisely inject stem cells into all areas of the musculoskeletal system. If you want to find high-quality doctors, all of our physicians in the Regenexx network are required to take the IOF training. There are also other doctors outside of our network that can take this training. To find out if your doctor is IOF certified, see this link. 

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2 thoughts on “Learning What It Takes to Perform the Simplest Knee Injection

  1. Marie Dugas

    Do you take Plan F Cigna a supplement that pays 100 percent after 189 deductible Medicare? Probably not

    1. Regenexx Team

      Marie,
      While we’ve good progress with employer funded medical plans and medical cost sharing plans because they both have a vested interest in the health of the patient and keeping costs down, Health Insurance does not cover stem cell procedures yet.

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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