The Top 8 Things to Know About Orthopedic Stem Cell Treatment

By Chris Centeno, MD /

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You’re considering orthopedic stem cell treatment, but how do you know which clinic and doctor is the right choice? Today, I’m going to share the top 8 things to know to make sure you get a quality stem cell procedure and maximize your chances of a successful outcome. If your clinic and doctor meets all 8, you can be pretty confidant you’re in good hands.

The Most Important Factors In Orthopedic Stem Cell Treatment

1. Specialty and Training

This makes number 1 on the list because an orthopedic stem cell treatment is only as good as the doctor performing it. It can be the most highly advanced orthopedic stem cell treatment in the world, but if the doctor doesn’t know what he or she is doing, nothing else matters. It’s very, very important that that doctor has training in advanced-imaging placement of needles and cells. Physicians trained in the field of orthopedic surgery, for example, are not usually trained to properly perform image guided injections. Advanced-imaging placement of stem cells requires precise training on specific equipment, and less than 1% of orthopedic surgeons in the United States are trained on the equipment. Watch the video at the top of this post to see the equipment that should be used to get those stem cells into very specific spots.

Find out what your stem cell doctor’s training consists of. In the world of stem cells, many providers ascribe to the “see one, do one, teach one” training methodology after taking a weekend course. This degrades the quality of stem cell treatments as, in reality, more advanced hands-on training is needed to properly perform these procedures. A good way to see if your doctor is qualified is to contact the Interventional Orthopedics Foundation to see if your doctor has been trained in a rigorous curriculum.

2. Cell Source Is Important

This one is simple and straightforward. It’s been determined that the best stem cell source for treating orthopedic conditions is bone marrow, and I’ve shared a great deal of research supporting this over the years. Stem cells from fat just don’t work as well for orthopedic conditions as they are less able to repair musculoskeletal structures like cartilage and tendons.

Find out which stem cell source your provider is using for orthopedic conditions. If it isn’t bone marrow, find another provider. You may also hear about “amniotic stem cells” as you do your research. There is no such thing as commercially available amniotic tissue contains no viable stem cells.

3. Harvesting Technique Is Critical

Bone marrow aspiration (BMA) is the procedure used to harvest bone marrow stem cells. How the BMA is done is critical. Ultrasound or X-ray guidance is imperative to assure the harvesting is being done properly and from the right spots. Notice I said “spots.” Many doctors just harvest bone marrow from one single spot; however, we’ve known for many years that is not the correct way to do a BMA as it reduces the number of stem cells you get. It may be faster and easier for the doctor, and he or she can fit more patients on the schedule that way, but it’s not what’s best for the patient.

Find out how your doctor does a BMA. If he or she is only harvesting bone marrow from one site rather than multiple sites, keep looking because you won’t be getting a top-quality orthopedic stem cell treatment there. In addition, as above, see if your doctor has taken a rigorous stem cell harvesting course like the one offered by the Interventional Orthopedics Foundation.

4. Count the Cells and Know the Dose

There is no other area of medicine in which it is acceptable to have no idea of the dosage of what’s being injected. And while it shouldn’t be OK in the world of stem cell treatments, unfortunately, all too often, the doctor has no idea of the dosage. And not only do many doctors not know the dosage that’s being injected, but it wouldn’t matter anyway because they also have no idea what dosage is actually required for the treatment.

Find out if your doctor knows the dosage required for your orthopedic stem cell treatment, and find out if he or she also knows how to measure the dosage being injected. This requires a sophisticated processing lab (see number 7 below), which most doctors do not have, and this lab is a critical component to a successful orthopedic stem cell treatment.

5. Getting the Stem Cells to the Right Spot

Once injected, stem cells don’t magically know how to make their way to the right spot. Advanced imaging is critical to injecting the stem cells in the specific area of injury. There are a couple of key pieces of equipment your doctor should be using, and you can see these on the video at the top of this post. One is a C-arm fluoroscope, which allows us to place stem cells into specific areas of the spine or deep inside other joints like knees, shoulders, and hips. The other is an ultrasound, which allows for placement in things like tendons and ligament and other structures that are best viewed with this device.  

 Find out if your doctor is using both of these technologies. One or the other device isn’t really enough since some things are best seen with fluoroscopy and some with ultrasound. For example, watch a video of an advanced image-guided injection of the shoulder here to see both technologies being used during a stem cell procedure.

6. Some Meds Kill Stem Cells

Anesthetics are used during a stem cell procedure to numb the area. Certain common anesthetics, such as bupivacaine (e.g., Marcaine), kill stem cells. So if your doctor uses one of these anesthetics during your orthopedic stem cell treatments, this is bad news. On the other hand, if your doctor uses ropivacaine at the proper concentration, this will not kill your stem cells. So the anesthetic used can make all the difference between living and dead stem cells, or, in other words, a successful or an unsuccessful procedure.

Find out what anesthetic your doctor uses during his or her orthopedic stem cell treatments. If it’s bupivacaine (Marcaine), this is not the right place to get your orthopedic stem cell treatment.

7. Level of Lab Sophistication Matters

If numbers 1–6 have been met, and the stem cell clinic has a sophisticated, on-site lab, it’s very likely you’re getting a top-notch orthopedic stem cell treatment. One of the most important things we do as doctors is to tell our patients how we do what we do and to provide transparent results of our work to our patients. Patients need to know that what they are getting is real and that it’s based on prior results, not fiction.

Find out if the stem cell clinic has a sophisticated lab. In addition, find out if they are studying and publishing and if they are maintaining a patient registry and providing their own treatment results (the good and the bad). If so, these are great signs you are in the right place.

8. Safety

At Regenexx, we’ve looked at the long-term safety of our bone marrow stem cell procedures through the International Orthopedics Foundation’s nonprofit registry. We tracked and then published in a top tier medical journal the results of 2,372 patients (or 3,000 procedures) out to nine years. We’re also currently tracking more than 9,000 stem cell treated patients.

Find out what your clinic or doctor does to assure the orthopedic stem cell treatment he or she is providing is safe.

The upshot? If you are considering an orthopedic stem cell treatment, at the very least, make sure your provider has these 8 things covered. Doing so will give you the best chance at success both during and after your procedure.

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41 thoughts on “The Top 8 Things to Know About Orthopedic Stem Cell Treatment

  1. Patti

    Excellent article …. thank you!
    I would like to request a similar post regarding PRP.

  2. Lee Ann Eliakis

    I I am very interested in this procedure. Is there a Regenexx facility in the Las Vegas Area?

    1. Regenexx Team Post author

      Lee Ann

      Yes there is. Please see: http://www.regenexx.com/las-vegas/

  3. Kim Stevenson

    Met with the KC physician, and I am so confident with my choice that I hope to have my procedure done right after Thanksgiving. This article is great as I have had others tell me about other physicians offering this procedure. After checking them out and just asking a few questions I do not at to be the test subject for them!

  4. Helen Kracoff

    Do you have a Regenexx Facility in Florida? We live in Broward County 33062. but will travel to any facility here in Florida.
    My husband has had one stem cell treatment for his right hip, bone on bone.
    He is not a candidate for hip replacement …post or anterior. …health issues.
    Pain when he walks, sits too long, turns over when sleeping. He now uses a walker, electric wheel chair.
    We have become, more or less, homebound…..social activities and people non existent .
    He is 90 years young…..no Dementia or Alzheimer’s….Alert, intelligent, active on the computer, current affairs, stock market, banking, etc. etc…..Extremely competent .
    We are very interested and ready for a new doctor, facility and procedure .

    1. Regenexx Team Post author

      Helen Kracoff,
      Yes, we do, in Sarasota: http://newregenortho.com/, and hopefully in Miami sometime in 2017. Your husband sounds amazing! One of the important things with hips is to make sure they are what’s actually causing the hip pain, as it can be the SI joint, or low back nerves, with pain referred to the hip. Please see: http://www.regenexx.com/hip-replacement-back-pain/ You can begin with the Candidacy Evaluation right from your home by submitting the Candidate form to see if your husband’s hip would be a Candidate for the Same Day Procedure, or would require the Cultured procedure as severe Hip arthritis often does.

  5. James orlowski

    I am getting close for a knee replacement. Had one done and I’m considering stem cell in the other along with my left foot. Full of arthritis.

    1. Regenexx Team Post author

      James,
      Here is some information on knee replacement vs Regenexx and how we approach treating the foot. Please see: https://regenexx.com/our-approach/surgical-risks/ and https://regenexx.com/the-regenexx-procedures/ankle-surgery-alternative/. If you’d like to see if you’d be a Candidate, please submit the Candidate form.

  6. James

    I live in washington state, is there a clinic here? Thanks God bless

    1. Regenexx Team Post author

      James,
      Thank you! Yes there is. Please see: https://orthoregenerative.com Here is the Interactive list of all Regenexx provider Locations as well: https://regenexx.com/find-a-physician/

  7. Barbara

    Do you have a highly trained orthopedic surgeon who does stem cell therapy along with arthroscopic surgery of both knees, located in Arizona? If not, where is one closest to Phoenix, AZ?

    1. Chris Centeno Post author

      Orthopedic surgery is generally ineffective for knee pain, so there would be no reason to get arthroscopic surgery in most cases.

  8. Ms Morton

    Is there a clinic in the Washington DC area?

    1. Regenexx Team Post author

      Ms Morton,
      Yes, Our Washington DC Regenexx Provider, Stem Cell Arts, has 2 locations. Please see: http://stemcellarts.com

  9. Carmen

    Is there anything close to Brea, Ca it’s in Orange County California

    1. Regenexx Team Post author

      Carmen,
      Yes, there are 4 in the general area. Please see: https://regenexx.com/find-a-physician/

  10. Care Consultants

    Excellent article! Thank you for sharing this article. ~ Pain Care Consultants

  11. Sandy

    Is there a Center in the Detroit area of Michigan? I am looking for the closest center.
    Many thanks for this excellent post!

    1. Regenexx Team Post author

      Sandy,

      None in that specific area, but several in surrounding areas. Please see: https://regenexx.com/find-a-physician/

  12. Tammy Lantz

    I live in Indiana where is the closest drs and hospital

    1. Regenexx Team Post author

      Tammy,
      There are 2 locations approximately equidistant. Please see: https://regenexx.com/find-a-physician/

  13. Betty

    I have had recent lower back surgery for stenosis that affected my left hip. That hip is fine. Am now having pain in my right hip. Went to an orthopedic surgeon…was given a cortisone injection …….still have the pain that is intensifying. I am 76 years old and overweight. Should I even consider stem cell therapy? I am losing weight, and am in pretty good health…..am I too old.?

    1. Regenexx Team Post author

      Betty,

      If the right hip wasn’t a problem before the surgery, it would be important to find out what’s causing the pain, as it is not necessarily the hip. Unfortunately, Cortisone injections usually make the situation worse in the long run as they break down cartilage, kill the local stem cells and can damage tendons. https://regenexx.com/blog/new-research-steroids-hammer-stem-cells/ But they can be diagnostic. Please see: https://regenexx.com/blog/surgery-controlled-damage-accomplish-goal/ and https://regenexx.com/blog/pain-after-back-fusion-adjacent-segment-disease/ Your age doesn’t rule out stem cell injections, but until an accrate diagnosis is made and you’ve been examined we could not say whether they would be appropriate in your case.

  14. Elizabeth Stranges

    I saw a knee surgeon who recommended knee replacements z4 years ago. In the meantime. I was diagnosed with rheumatoid arthritis. I take 10mg of prednisone for 3 years plus many different meds for RA. Inhave heard that infusions of stem cells can “reset” your own spleen to manufacture stem cells without the autoimmunity. This was using umbilical cord stem cells. Can Regenexx do anything about my RA? What about my knees?

    1. Regenexx Team Post author

      Elizabeth,
      There is no information that injecting an umbilical cord product IV can treat RA. Given that any such procedure in the US could involve dead cord cells, unsure how this would help your RA. On whether we could help your arthritis, that would require a phone review to determine. The Candidate form is here: https://regenexx.com/the-regenexx-procedures/knee-surgery-alternative/

  15. Dawn Ross

    Does your stem cell therapy provide a promising alternative treatment modality for management of premature growth arrest?

    1. Chris Centeno Post author

      No, our focus is only orthopedic treatments.

  16. Laurie Knoll

    How bout using stem cells from ethical cord. Are you in Myrtle Beach SC?

    1. Regenexx Team Post author

      Laurie,
      No cord product we’ve tested has contained live and viable stem cells. No, we don’t have a location in Myrtle Beach SC.

  17. Candace Klein

    I have ostio arthritis in both knees. Are there any Dr. I the Monterey to San Francisco bay area that does this procedure?
    Thank you,

    1. Regenexx Team Post author

      Candace,
      It looks like Health Link Center in San Rafael, CA would be closest, but here is the Complete list Of Regenexx Physicians: https://regenexx.com/find-a-physician/

  18. Wanda

    What is your closest location to Phoenix AZ

    1. Regenexx Team

      Hi Wanda,
      What is it that needs to be treated?

  19. henry horvath

    Is there one of your treatment centers near Binghamton ny?

    1. Regenexx Team

      Hi Henry,
      There isn’t a Clinic in Binghamton, but there are several approximately equidistant. Please call 855 622 7838 for assistance in finding the best Clinic for your needs.

  20. Holly

    How soon do you know if the procedure is successful?

    1. Regenexx Team

      Hi Holly,
      It depends on what type of procedure to treat what.

  21. Bradley to Bentley

    Are there any offices in the Knoxville TN area

    1. Regenexx Team

      Hi Bradley,
      Not in Knoxville, yet. We do have a Clinic in TN, but the closest location to Knoxville would be this one: https://regenexx.com/interventional-orthopedics-of-atlanta/

  22. Patricia Shaughnessy

    What is the closest Regenexx location to Charlestown, NH which is 10 minutes from Springfield VT?

    1. Regenexx Team

      Hi Patricia,
      Our Vermont Provider is Vermont Regenerative. Here’s the link: https://vermontregenerativemedicine.com/?utm_source=regenexxreferral&utm_campaign=vermont-regenerative-medicine

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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