Regenexx Procedures: What To Expect
What Is a Regenexx-SD or Degenerative Disc Disease (DDD) Procedure?
Regenexx-SD is Bone Marrow Concentrate that contains your stem cells. These cells are harvested and reinjected on the same day.
For most patients, however, the recommended protocol is a series of injections of your customized cells that happens over the course of about a week depending on each unique situation. These injections include a prolotherapy pre-injection, the bone marrow aspiration and the re-injection procedure of the Bone Marrow Concentrate, and a blood draw and post-injection of Regenexx proprietary platelet-rich plasma concentrations a few days later.
This process applies to procedures for the knee, hip, shoulder, hand, wrist, foot, ankle, elbow, and spine. The process for spine conditions includes an extra step of antibiotics given to reduce the risk of infection along with an epidural containing platelets.
First Day (Pre-injection)
Your first visit involves an injection of a special hypertonic dextrose solution that creates a mild inflammatory environment that is conducive to healing. The purpose of this part of the procedure is to cause the same kind of acute inflammation that might occur during an injury. To use a farming metaphor, this step is like tilling the soil. Your first visit will take between 30 and 40 minutes.
Second Day (Bone Marrow Concentrate Procedure)
On the morning of your bone marrow concentrate procedure, you will lie on your stomach on the procedure table where a local anesthetic will be applied. The physician will then draw bone marrow from the back of your iliac crest using precise image guidance. The doctor will draw from both hip bones. Some patients will be given an oral sedative to help to ease anxiety and relax the muscles prior to the bone marrow draw. The procedure we use is called a bone marrow aspirate which is significantly less invasive than a painful bone marrow biopsy. This draw takes 30-60 minutes. The bone marrow aspiration process is often described by patients as being only mildly uncomfortable and is typically well tolerated.
While your cells are being processed by a Regenexx lab technician, you will have some downtime to relax and to eat lunch. The re-injection into the areas needed takes place between three and eight hours after the bone marrow aspiration. Local anesthesia is used to numb the area and the patient’s bone marrow concentrate is precisely reinjected using real-time imaging guidance (ultrasound or fluoroscopy). Patients may be asked to stay in the clinic 30-60 minutes after re-injection. This procedure typically takes 60-80 minutes.
Regenexx SCP is a super-concentrated version of platelet rich plasma that contains growth factors from your own body which support the Bone Marrow Concentrate in doing its natural job of healing. Regenexx SCP is made from the platelets in your blood in our on-site lab by a skilled technician who can include more of the blood components that encourage and support your body’s natural healing process while removing other components that cause unnecessary inflammation and discomfort. Blood is drawn from a vein in your arm and processed and prepared in our lab. The blood draw takes 15-30 minutes.
A few hours later, the SCP is injected into the treatment site and works in conjunction with the Bone marrow Concentrate. Platelet lysate (PL), which is a Regenexx developed procedure in which the platelets are “Lysed” meaning opened to act as immediate release of growth factors rather than the slow release of SCP may be used depending on what is being treated.
The injection of the bone marrow concentrate produces a micro injury in the joint. As a result, expect the joint to be sore for one to three days. Your physician may prescribe pain medicines that will not hinder the healing caused by the procedure. Patients can additionally take Tylenol but are asked to avoid NSAIDs. You will be asked to keep the joint as still as possible for 30-60 minutes after the procedure. Do not take a bath for three days, but a shower 12 hours after the procedure is fine. For the first day after, you should limit activity on the joint. Wear recommended braces or boots if prescribed.
As time goes on the pain that generally become less severe and frequent. You will be given specific instructions by your Physician specific to your issue and your procedure. Most patients are able to resume light activities after 5 to 7 days, some sooner. Usually at 6 to 8 weeks patients begin to resume a more vigorous exercise schedule. Most of our very active patients are able to return to their regular routine in 6 weeks and push their performance to higher levels in 8 to 12 weeks. Most patients notice continued healing over many months. Our outcome data suggests peaking at 1-2 years out. Results vary by patient and depend on the condition of the area treated, age, and general health.
What Is a Regenexx Super Concentrated Platelet (SCP) or PL-Disc Procedure?
The Regenexx Super Concentrated Platelet (SCP) Procedure and Platelet Lysate (PL) uses growth factors from your blood to promote repair of damaged tissue.
For most patients the recommended SCP or PL protocol involves a blood draw and an injection on the same day. This process applies to procedures for the knee, hip, shoulder, hand, wrist, foot, ankle, and elbow.
The process for spine conditions includes an extra step of antibiotics given to reduce the risk of infection along with an epidural containing platelets. Also, Platelet Lysate is often recommended for back and spine treatments due to its fast release and reduced inflammation.
On your procedure day, blood is drawn from a vein in your arm. This blood is then processed and prepared in our lab for re-injection within 24 hours. We use this blood to prepare an injection of highly concentrated platelet rich plasma containing the growth factors isolated from your blood. This blood draw takes 15-30 minutes.
During a second visit, this platelet rich plasma is injected under image guidance into the treatment site. This procedure takes 20-30 minutes.
The Regenexx SCP and PL injections produces a micro injury in the joint. As a result, expect the joint to be sore for one to three days. Your physician may prescribe pain medicines that will not hinder the healing caused by the procedure. Patients can additionally take Tylenol but are asked to avoid NSAIDs. The goal is to allow the stem cells to attach and then to protect them while they differentiate into various tissues. For this reason, you will be asked to keep the joint as still as possible for 30-60 minutes after the procedure. For the first day after, you should limit activity on the joint. Wear all recommended braces or boots.
Most patients report a modest improvement in the first month. You will notice that as time goes on your pain that occurred before is less severe and frequent. Most patients are able to resume light activities after 5 to 7 days. Usually at 6 to 8 weeks patients begin to resume a more vigorous exercise schedule. Most of our very active patients are able to return to their regular routine in 6 weeks and push their performance to higher levels in 8 to 12 weeks. Improvements will continue throughout this time period. Most patients notice continued healing over many months. Our outcome data suggests peaking at 1-2 years out. Results vary by patient and depend on the condition of the area treated, age, and general health. kick-start your normal healing process to encourage your body to heal itself. Regenexx’s proprietary lab processing allows us to remove nearly all of your white and red blood cells so that what is being injected contains only what your body needs to help repair damage. This difference between Regenexx’s super-concentrated PRP and most other PRP is visible. The usual standard fare PRP is reddish in color because it still contains a significant number of red blood cells while Regenexx’s PRP is amber in color. In addition, Regenexx PRP is more concentrated by a factor of 3X – 5X above what a basic bedside centrifuge machine can produce for physicians. Our in-vitro experiments demonstrate that this produces better tissue healing in tendon injuries and better stimulation of the local stem cells.
Platelet lysate is a highly specialized derivative of platelet-rich plasma (PRP). Normal PRP isolates platelets from the blood which slowly release growth factors into the site of the injury over the course of roughly one week. In some cases, however, our research shows that a faster, more intense release of healing factors creates a better healing response. Platelet lysate accomplishes this by stripping all of the growth factors out of platelets and making these available for immediate use. Regenexx’s proprietary platelet-lysate processing technology is now on its third and fourth generation as we’ve learned better ways to encourage fast release of growth factors.