Regenexx Procedure Failure: Hip Arthritis

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regenexx procedure failure

We have always prided ourselves in being transparent about our results. Through the years, while we’ve featured patients who have done well using our procedures, we have also featured patients where the procedure didn’t work. This morning I’d like to highlight a recent patient with severe hip arthritis whose case was a Regenexx procedure failure, but first it’s important to understand how and why hip and knee arthritis differ.

How Hip Arthritis Differs from Knee Arthritis

Most patients would think that hip and knee arthritis are the same disease; after all, they’re both “arthritis.” To understand this difference, you first need to comprehend what usually constitutes arthritis, which is a disease where the cartilage in a joint wears away and the bones react by growing bone spurs. In knee arthritis the disease generally follows this typical progression. However, in hip arthritis things are frequently different.

In comparing hip and knee arthritis, the critical differences are the speed of onset, the extent of bony involvement, and range of motion of the joint. Hip arthritis comes on very fast. Oftentimes from the moment the patient notices significant pain until the joint develops severe arthritis can be a matter of months to up to two years. In knee arthritis the joint usually slowly gets worse over many years. Also, in hip arthritis the bone usually dies off quickly, leaving large voids called bone cysts. In knee arthritis this very rarely occurs. Finally, in hip arthritis there is a rapid and significant loss of range of motion of the joint, while in knee arthritis there can also be loss of range of motion, but it’s usually much less and comes on more slowly.

Why Hip Arthritis Differs from Knee Arthritis

So is there something that accounts for these big differences between the two joints? One theory based on research is that the hip joint has a much lower number of natural stem cells to aid in its upkeep and repair. Another reason for the difference could be the ball-and-socket shape of the hip joint that causes much more pressure on a much smaller area than the more flattened knee joint.

Our Transparency on Patient Outcomes

We have always believed in transparency in discussing outcomes with our patients. For example, we’re one of the few clinics in the world that uses stem cells that has always required our physicians to provide candidacy grades (good, fair, poor), just like you would get with any other medical procedure. In addition, we have spent heavily on registry-based outcome research and posted those annual reports online as well as published this data. Finally, we’ve never been shy about discussing a Regenexx procedure failure on this blog.

To determine candidacy grades, we’ve mined the data in our patient registry to give us guidance about who does well and who is less likely to respond. In hip arthritis, for example, we’ve noted that patients with poor range of motion as well as older patients have a higher chance of a treatment failure. However, this is data collected on many patients. So for example, while our data shows that older age means a decreased likelihood of a a successful treatment, it doesn’t mean that all older patients will do poorly. In addition, it also doesn’t mean that all young patients will do well. These are just averages and statistical analysis on a group.

Over the past several years, we’ve published more data on how hip arthritis responds to stem cell treatments than anyone else worldwide. In fact, nobody is even a distant second. As an example, we’ve published several patient infographics online (see 2013, 2014, and 2015). In addition, we published the world’s largest experience with hip arthritis and stem cells in the peer-reviewed medical literature. What’s interesting about these data sets is that they represent all patients—those who responded and those who had no benefit.

Finally, we’ve never been shy about highlighting patients who didn’t get results. See here, here, here, here, here, and here for some examples. We have also discussed extensively that, all things being equal, hip arthritis patients don’t respond as well as knee arthritis patients. That has also included discussion of specific patient treatment failure after a hip stem cell injection procedure.

Our Recent Hip Arthritis Treatment Failure

XX is a 65-year-old Hollywood professional with a history of a back problem, legs that are different lengths (leg-length discrepancy), and severe hip arthritis. His back had a spondylolisthesis, which means that one vertebra had slipped forward on another. His different-length legs were likely one of the things that contributed to his hip arthritis.

He had tried a cortisone steroid injection, which provided mild temporary relief. He also had tried epidural steroid injections in the past for his sciatica. Finally, physical therapy was no help, and he needed to take narcotics and walk with a cane due to the pain.

Based on the above, a thorough exam, and a review of his imaging, his Regenexx physician documented this in his notes:

Care Plan:

  1. I discussed conservative, injection, and surgical options with risks and benefits at great length today.
  2. Patient is poor SD candidate (poor ROM, age >55)

Despite this pessimistic candidacy, XX chose to proceed with both a Regenexx-SD procedure for his hip and a Regenexx-DDD procedure for his low back. Despite the best efforts of his physician, his treatment was a failure, and he had no relief of his hip pain nor improvement in his function.

The upshot? XX was told he was a poor candidate based on our registry-based research and scientific publications, and sure enough, our prediction was correct for this patient. Does this mean that all hip arthritis patients don’t respond? No, our registry-based research also tells us which patients are more likely to have a good result. In the end it’s this transparency that sets Regenexx apart from many of the clinics out there. We try to be as honest as we can with our patients, and while we’re proud of what we do and have no issues shouting it from the rooftops, we also go out of our way to make sure loads of information is available to patients about how all patients fare so that they can make an informed decision!

To find out if you might be a candidate for a Regenexx stem cell procedure, complete our Regenexx Procedure Candidate Form online.

Category: Hip

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26 thoughts on “Regenexx Procedure Failure: Hip Arthritis

  1. Terry Varney

    I underwent Bi-Lateral Hip Stem Cell Therapy In Aug of 2015 for AVN. I couldnt walk then and I can now 6 months later although I still have pain I believe that this procedure is working. If you want more info on my case contact Dr Grant Pagdin in Kelowna BC Canada. I get my MRI done in May 2016 to see if the re is any progress in healiing and I may do it again as long as there is some type of progress

    1. Regenexx Team Post author

      Terry,
      Stem cells have been used in Europe for AVN since the 90’s and the results can be quite dramatic. We get so many requests for treatment from Canada, glad there is someone there doing good work.

  2. Dennis

    Thanks for your transparency and honesty, Regenexx. In my eyes, and likely many others, admissions like this boost your already high credibility.

    1. Regenexx Team Post author

      Thanks Dennis!

  3. Judy G.Ehrenthsl

    Just has stem cells to my right hip! Starting week 4 after the stem cells were inserted! Leg feels heavy, still hurts but leg does not want to collapse under me anymore. I was told it can take many more weeks and months to see results! Hoping for a great outcome! Know it is very early yet! Wondering if this is normal at this point?

    1. Regenexx Team Post author

      Judy,
      That’s wonderful news! Stay in touch with your doctor as only he knows specifically what he found on exam and how he treated it…but it sounds like good progress!

  4. Glenn Onorato

    I had hip osteoarthritis in my left hip had all 3 procedures done, Prolotherapy, Stemcells, and PRP, on January 23 2014 I got my stemcells, my hip is strong I am walking 3+ miles a day and playing full equipment Ice Hockey twice aweek. This has been a life changing experience for me. Dr. Kramberg and his team in New Jersey are great.

    1. Regenexx Team Post author

      Glenn,
      Ice Hockey! That’s wonderful news…thank you for sharing it! We agree Dr. Kramberg and his team are great!

  5. John Taylor Sr.

    I had right r/shoulder surgery, three massive full thickness tears w/ right long head of the bicep tendoniesis. Would I still benefit from your procedure. Surgeon says it was a heroic effort. I also tore three tfcc and scaffoid lunate ligament and cartilage in my wrist in two places. Please respond in kind thanks.

    1. Regenexx Team Post author

      John,
      Many of our patients are post surgical, as so many of the common orthopedic surgeries set the stage for arthritis and other issues. This however, sounds like traumatic injury. There are likely ways in which we can help, and we’d be happy to take a look. What kind of shoulder and wrist function do you currently have?

  6. chris

    So the man’s uneven legs are creating what you have previously termed biomechanical pressure? Is there a way to measure/quantify this?

    1. Regenexx Team Post author

      Chris,
      Unfortunately it’s measured in the negative ways in which the body compensates. When the length of someone’s legs is off by more than 1 cm (about 1/3 of an inch), the risk of having knee arthritis in the shorter leg is about doubled when compared to patients with legs of equal length, causing “short leg knee arthritis”. The shorter leg takes slightly more impact on walking, so it makes sense that over years, millions of these tiny increases in impact can wear away more cartilage on that side. For some patients with longstanding LLD, other parts of the body like the spine can adapt by curving, but of course in something as intricately interconnected as the human body, biomechanical changes to one thing have consequences elsewhere.

  7. anthony

    I was diagnosed with osteoarthritis in my right hip. The studies on hip replacement surgery did not impress me. After talking to Dr Bond in Lafayette Louisiana, the decision was made, stem cell was the choice. I had the procedure in August 2015. Definitely a difference for the better. True there are bad days, but the good out number the bad
    .thank regenrxx, and Dr bond

    1. Regenexx Team Post author

      Anthony,
      Glad to hear you’re doing well! Dr. I will pass your comment along to Dr. Bond as well. Thanks for the update, and the wisdom…

  8. Joanne Banos

    5 weeks ago, I had a stem cell procedure on my left severely arthritic hip. I was told I was a candidant, so I decided to go ahead with it. I have a physically active job, and am on my feet pounding the floor for 10 hours each shift. I first felt a little better, but now I feel I’m going backwards, because of my job. I want to have hope that this will turn around for the better as weeks go by. Am I being realistic at this point ?

    1. Regenexx Team Post author

      Joanne,
      It’s not unusual to feel better early on, as the initial internal swelling often creates stability. The actual results are usually apparent in about 3 months, but can take as long as 6-9 months. If you have concerns, please contact your treating physician as given that they dd the exam and treatment they would be in the best position to advise. If you need our assistance in contacting them, please let us know.

  9. Glenn Waldron

    Wow, the 65 year old Hoolywood guy you describe above is so me. I’m 65. Was told in my mid 20’s I had DDD in back. My rt knee started giving me trouble about same time. I’m pretty sure my rt leg is a little shorter. Disc surgery in low back in early 40’s, rt knee scoped about a year later, again at 51. In my late 50’s both hips started hurting some especially after sitting for a while then standing. Pain is on the outside of hips on both sides, no groin pain at all. I believe it is trochanteric bursitis. Then in early 60’s told I have Grade I Spondylilolithesis. Oh, by the way told last May I need Shoulder replacement on rt shoulder. Obviously, I have no idea which way to turn. I’m very active, go to gym almost every day and only take about 375 mg of Naproxen a week. The pain warrants taking more, just fight through. I have looked into stem cells but I have so many areas of concern, I can’t risk out of pocket coverage with such a chancey outlook for positive results. Can you please help me in any way? Thanks.

    1. Regenexx Team Post author

      Glenn,
      It sounds like your shorter right leg could have set the whole thing in motion, rather than being a consequence. Importantly, Naproxen and all NSAIDS are very damaging to your joints’ ability to repair. Replacing that with good quality fish oil would be a very good move. Another way to help your joints rather than damaging them would using the Advanced Stem Cell Support Formula as that formula was a result of a year’s worth of research with human mesenchymal stem cells. The hope would be that those additions might calm things down enough to select one or two areas of treatment. http://www.regenexx.com/regenexx-advanced-stem-cell-support-formula/

  10. mariann

    I had Regenixx treatments a couple years ago and was disappointed it did not work. I have a long history of DDD and multiple spinal fusion surgeries over the course of several years. Not sure if I was just a bad candidate to begin with or possibly a different approach could have been taken? Thank you for any insight you can offer.

    1. Regenexx Team Post author

      Mariann,
      Was this a hip procedure? It would be wonderful to be able to say that Regenexx Procedures work 100% of the time, but unfortunately no medical procedure does. The Spinal Fusions could have been a factor, but if you let us know when and where you were treated we can look back and take a look.

  11. GEORGE

    68 YO MALE– I just had my right hip done at HSS, I was told it was to far gone for stem cells. Right now things are great. I feel brand new.
    My question is my left hip feels fine but the x-ray shows it narrowing. Am I a good candidate for stem cells or should I wait for pain?

    1. Regenexx Team Post author

      George,
      When you say “narrowing”, I assume you mean that the space between the bones is narrowing due to lack of cartilage? Hips are quite different than knees and hip arthritis can progress very quickly. It would be a good idea to be evaluated for treatment at this point so that we could stem further degeneration. To see if you’re a candidate, fill out the Candidate form is on this page: http://www.regenexx.com/the-regenexx-procedures/hip-surgery/

  12. Alex

    Regenexx,

    Thanks for your great blog. You write that this patient’s hip was not improved by the procedure but what about his lower back? Did the DDD treatment help his lower back?

    1. Regenexx Team Post author

      My understanding is he did report some low back improvement, but stopped treatment due to the hip treatment failure.

  13. Marilyn

    I had stem cell treatment to my right knee. I was not able to use the infrared heating pad for the first 2-3 days, will this affect the stem cell outcome? I had a good stem cell count initially. If I use the infrared heating pad the remainder of the six weeks as directed will my stem cells be alright? Can I use the infrared heating pad and the Baby Quasar Plus Red Light together or must I choose the infrared heating pad or the Bby Quasar Plus Red Light to enhance the stem cells for good results?

    1. Regenexx Team Post author

      Marilyn,
      What doctor treated you?

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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