What’s Possible with Stem Cell Cartilage Regrowth?

By Chris Centeno, MD /

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stem cell cartilage regrowth

As you may have read some time ago, I got to experience what a cartilage lesion can be like in a young person when my son was 14. On a separate note, yesterday, I looked at the before and after MRIs of a twentysomething we had treated and at the same time got a video of my son, both of which prompted me to write this blog. Like my son, this young man had a hole in his cartilage and was treated using cultured-expanded stem cells in Grand Cayman. So what’s possible with stem cell cartilage repair? Let me show you.

Before and After MRIs

While we have seen small cartilage holes heal with a precise, bone marrow-based stem cell procedure that delivers high doses of cells, what we haven’t seen is cartilage regeneration in severe arthritis. Regrettably, despite having the world’s deepest and broadest experience in this field and making this statement, we’ve recently seen scams run by chiropractors injecting dead amniotic stem cells, calling this a live stem cell injection, and promising elderly people with bone-on-bone arthritis that they will regrow new cartilage. So what’s been historically possible with regard to stem cell tissue repair in orthopedics with the right type of live stem cells and a very precise image-guided injection? See my video below for a smattering of those results:

Surgical Cartilage Repair?

There have been many attempts to “fix” holes in knee cartilage through surgery. None of them are perfect, and all of them are very invasive. One of the oldest is microfracture, where holes are poked in the bone to release healing bone marrow. Another is an OATS procedure, where good cartilage plugs are taken from another part of the knee and grafted into the hole. Then there’s ACI, which involves growing your cartilage cells and sewing that into the hole. Finally, recently MACI has recently come on the scene, which is ACI plus a matrix on which cells can grow.

I’ve seen countless patients through the years who have had each of these surgeries and I’ve never seen one produce a perfect cartilage repair. Microfracture often leaves dead bone behind or large bone spurs in the cartilage. OATS generally produces a roughened cartilage surface. ACI and MACI can generally produce results like the one you see above. Hence, if repair can be initiated without surgery, we can save countless patients from severe complications, such as infection, blood clots, and the need for more surgery.

My Son’s Story

My son was an avid trampoline jumper. He would use this almost as a meditative thing, several times a day or after school. Lost in his thoughts, he would jump for hours. He actually mastered multiple types of flips and was pretty impressive, but at age 14 he began to limp. You know what they say: the cobbler’s son has no shoes. Hence, I mostly ignored his pain for a few months, thinking that in a 14-year-old, this had to go away as he put a hold on the jumping. However, it persisted, and one day I caught him having trouble going up and down the stairs, so it was time for an MRI. When I first looked at the films it was surreal as these looked like some of my patient’s images, surely not my 14-year-old. However, he did have holes in the cartilage with a bone reaction in each lateral compartment. This is otherwise known as an OCD, or osteochondral defect.

Obviously, he needed treatment, and I knew enough not to pull the trigger on surgery as I had seen many of these kids operated on in their teens later in life. By the time they were in their 20s and 30s, they all had significant arthritis. Hence, we first tried high-dose PRP, which, regrettably, did nothing. Then a same-day stem cell procedure (high-dose bone marrow concentrate), which also didn’t put a dent in the problem. Finally, I took him down to Grand Cayman, where he got his culture-expanded stem cells dripped on the lesions. Within a few months, he seemed fine, but as his father, I was always hesitant to get an MRI after the procedure. I think I was way too emotionally close to the outcome. What if, despite his lack of pain, the lesions didn’t heal? That’s one thing in a 50- or 60-year-old, but in a 14-year-old?

Eventually, my son went on to become a big runner. I wasn’t sure how I felt about this because I was always afraid something would happen. In fact, at his first big half-marathon race, through the mountains here, I was terrified that he would develop some problem on the trail and be left out there alone! When he came bouncing across the finish line, I knew that he was finally out of the woods. Hence, when he sent me this video yesterday of him doing box jumps, I smiled:

My Patient from This Week

This patient is a bit older, in his mid-20s, but also had a cartilage lesion. This was due to extreme weight lifting and in the kneecap area, but when I first met him in Grand Cayman, he was not walking well. I injected culture-expanded stem cells without surgery and carefully and precisely dripped these on the lesion. His before and after images are above.

The two images on the left are before the procedure and show a hole in the cartilage and a large BML (the large white area in the dark bone). The after images show interval cartilage healing and almost no BML. His symptom reduction matches these images, so this hole in the cartilage is healing without invasive surgery. I’ll hit this again down at our Grand Cayman site in July.

The upshot? Yesterday was a good day. Using the right technology delivered the right way in the right patients, we can get small holes in the knee cartilage to heal. This injection procedure can help patients avoid the need for a more invasive surgery. However, that process is very different from the magic pixie dust approach used in chiro offices where nurses blindly inject dead stem cells from amniotic membrane or fluid, so buyer beware.

The Regenexx-C procedure is not approved by the USFDA and is only offered in countries via license where culture-expanded autologous cells are permitted via local regulations. This procedure is now part of a phase II FDA drug trial in the U.S. 

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18 thoughts on “What’s Possible with Stem Cell Cartilage Regrowth?

  1. Day Snell

    How about injections in the knee for 75 year old

    1. Chris Centeno Post author

      Age is not a factor in determining the outcome, meaning young patients do as well as older patients and vice versa.

  2. Katie Zanto

    I am scheduled to come see you in November for precisely this reason. How big is “small”? My knee dislocated and I pulled “large chunks” off my tibial and femoral gliding surfaces- among other problems. Dr Markle thinks that the Stem- C procedure could deal (help) with my bone marrow edema below one of the lesions. And my ligaments and meniscus also need healing- I want to return to a high functioning knee and have been at the crossroads of a decision to pursue ACL (cadaver) replacement and STEm- C with you – or to pursue a knee replacement.
    Thanks for your insight.

    I am a very healthy 45 year old athlete-
    What do you think-?

    1. Regenexx Team

      Katie,

      Both of the other options you mentioned, Knee Replacement and ACL surgery are irreversible. They are also especially problematic is someone young and active, especially an athlete. Please see: https://regenexx.com/blog/knee-replacements-in-younger-patients/ and https://regenexx.com/blog/long-term-effects-of-acl-reconstruction-surgery/

  3. Mike

    and how is your success rate? (in percent?)

    1. Chris Centeno Post author

      Mike, we treated many different things each with different severity levels, so I would need to know more to answer your question.

      1. Mike

        I mean the success rate for healing cartilage defects.

        1. Chris Centeno Post author

          Again, there would be multiple types of cartilage defects. Size? Is there a BML? Type of lesion? Your age? Any other issues in the knee?

  4. Kathryn Alderman

    If I would like to schedule this procedure, where should I go? Would one of the Regenexx specialist performing it at another country? If so, Where can I schedule at?

    1. Regenexx Team

      Kathryn,
      The Regenexx C procedure is only available in Grand Cayman. We will have our Patient Liaison team contact you to assist.

  5. Brenda Whitney

    I have arthritis exactly where an old menescuc tear was surgically repaired. I do not want knee replacement. I am 62 and very healthy and hold 2 healthcare jobs. Would Regenexx-C help me regenerate cartilage where bone-on-bone is right now?

    1. Regenexx Team

      Brenda,
      Whether Regenexx-C or Regenexx-SDs would be the better in your particular case, will require a Candidacy Review. A similar case: https://regenexx.com/blog/ironman-stem-cell-procedure/ Please also see: https://regenexx.com/blog/stem-cell-treatment-gives-jazzercise-mom-life-back/ and https://regenexx.com/blog/knee-stem-cell-injection/ and https://regenexx.com/blog/getting-a-golfer-back-on-the-links-with-knee-stem-cells/ and https://regenexx.com/blog/knee-arthritis-stem-cell-treatment/ If you’d like us to weigh in, please submit the Candidate form to the right of the blog, and let us know so that we can make sure your Candidacy review is with one of our Physicans who does procedures here and in Grand Cayman.

  6. Derek

    Hi Doc,
    I have a bucket tear in my left medial meniscus that occasionally – depending on the motion / activity – flips and locks my knee. I’m 28 but I’ve had multiple surgeries on each knee over the years (separate meniscus and ACL injuries in each) and so when I had my consultation last month it predictably resulted in a recommendation for Regenexx-SD procedure over a meniscectomy.

    However, I haven’t seen many success stories specific to an acute injury like this (you mostly seem to treat cases of wear and tear in older individuals). Similarly, your blog mentioned that this procedure didn’t work for your son and thus a trip to the Cayman Islands for Regenexx-C was necessary.

    Can you speak at all to cases like mine?

    Thanks in advance.

    1. Regenexx Team

      Derek,
      Sorry that you got that impression – we treat traumatic meniscus tears regularly. The issue is Meniscus surgery is not a “repair’, it is cutting out the torn section which leaves the knee unstable, and the knee cartilage unprotected in that area. The additional wear and tear creates a situation in which toxic chemicals are released, leading to premature knee arthritis. Treating the tear with your own stem cells and platelets eliminates that scenario. Please see: https://regenexx.com/blog/can-you-treat-a-meniscus-tear-without-surgery/ and https://regenexx.com/blog/crossfit-injury-recovery/ and https://regenexx.com/blog/meniscus-treatment-without-surgery/ and https://regenexx.com/blog/meniscus-stem-cell-treatment/ and https://regenexx.com/blog/teen-knee-surgery/ and https://regenexx.com/blog/knee-meniscus-stem-cell-kiteboarder/ While this patient was older, her age had nothing to do with the meniscal flap causing her knee to lock: https://regenexx.com/blog/all-i-want-to-do-is-dance/ Meniscus tears can also be associated with some ACL tears. Dr. Centeno’s son never had a meniscus tear. His problem was much more complex, and he continues to knock it out of the park! https://regenexx.com/blog/running-pins-needles-cartilage-holes-14-year-old/

  7. Ernie

    So I have a chronic ACL tear and a macrated interior meniscus on my left knee. Would stem cell be able to regenerate both my ACL and Meniscus?

    1. Regenexx Team

      Ernie,
      Unfortunately a good percentage of treatment marketed as “stem cell therapy” would have no potential to heal a torn ACL as the umbilical and amniotic products used do not contain live and viable stem cells. We invented the Regenexx percACL procedure which has had great success in healing ACL tears which meet the criteria for Candidacy.Please see: https://regenexx.com/conditions-treated/knee/acl/ and https://regenexx.com/blog/new-acl-stem-cell-infographic/ and https://regenexx.com/resources/videos/ To see if you would be a candidate, please submit the Candidate form here: http://www.regenexx.com

  8. Michael Devaney

    I am 66 years old and have been running for 40 years. I started having issues and MRI done Dec 2018 showed posterior horn tear medial side. I went to Hospital Special Surgery and Dr indicated this type of tear does not do well with surgery. There is some extrusion of cartilage and minor arthritis. Can stem cell heal this tear? I have mri cd and report.

    1. Regenexx Team

      Hi Michael,
      We do treat medial posterior horn meniscus tears. We’ll need more information through the Candidacy process – to do that, please click on the Get started button here: https://regenexx.com/conditions-treated/knee/ Great that you have the MRI CD as you’ll need that for the Candidacy review.

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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