What are mesenchymal stem cells?

As first described in 1988 by Dr. Arnold Caplan, mesenchymal stem cells are progenitor cells that have the power to differentiate into mature tissue cells.  They are directly responsible for healing damaged tissues after injury.  Upon encountering damaged tissue, they release proteins that decrease inflammation and trigger growth of new connective tissues and blood vessels, stimulating tissue repair and regeneration.  In the case of severe damage and cell death, these cells have the ability to turn into healthy versions of the damaged or destroyed cells that they encounter.

What is the stem cell therapy?

At Regenerative Orthopedics we take stem cells from your own bone marrow or from your own fat or both.  Under sterile conditions, they are then washed, concentrated and isolated under direct supervision by Dr. Smith in our office laboratory. We combine these cells with platelet rich plasma isolated from your blood drawn at the same time we harvest your cells.  This mixture is then injected into the affected area.

How does stem cell therapy work?

Every joint in the body and most tissues contain stem cells that are responsible for maintaining health in that location.  Degeneration of tissues or joints occur when the stem cell population becomes depleted and that structure losses its ability to heal itself as a result of injury of the natural aging process. Stem cell therapy is an attempt to repopulate tissues or joints with stem cells thereby restoring the body’s ability to heal itself.

Do the stem cells come from my bone marrow or fat?

Upon establishing that you are a candidate for treatment, we will decide whether to harvest stem cells from your bone marrow or from your fat or both. We recommend most patients undergo a minor arthroscopic procedure just prior to the stem cell treatment called microfracture where small holes are made in the end of the affected bone.  This is in effect a bone marrow harvest as it allows stem cells from the bone marrow to enter the joint.  Because these are not concentrated, the second part of the procedure will consist of harvesting Adipose derived stem cells or in other words stromal vascular fraction and using these stem cells to augment the procedure by injecting them into the affected joint.

What is Adipose Derived Stromal Vascular Fraction?

Adipose tissue consists of adipocytes (fat cells) and the stromal vascular fraction (SVF).  The stomal vascular fraction which contains millions of unused stem cells is harvested through a process known as lipoaspiration.  Lipoaspiration is performed under local anesthetic in the office using a small instrument slightly larger a hypodermic needle.   About 60 ml of fat is aspirated during lipoaspiration which differs from liposuction in which volumes of up to 6 ,000 ml of fat is removed.  Once the fat is obtained, the stromal vascular fraction is isolated in the lab through a process that involves washing the fat then mixing it with an enzyme that causes the stem cells to detach from the fat cells. Final isolation involves the use of a centrifuge for final separation of the cells.  These cells are then mixed with PRP and isolated from the patient’s own blood.  Prior to injection, the mixture is then activated using photo-modulation.

What is Bone Marrow Aspirate Concentrate?

Bone marrow is rich in growth factors and stem cells.   We are able to obtain these cells in the office under local anesthesia in a very simple procedure that requires a relatively small amount of bone marrow and only one puncture site.  This is vastly different that harvesting bone marrow for transfusion for cancer therapies.  This technique will be utilized in the event that the patient has minimal fat deposits from which to obtain stem cells.   Unlike SVF, bone marrow stem cell aspiration is not concentrated and so the amount of stem cells that can be isolated from this technique decrease with increasing age.  For most patients, their bone marrow will be utilized and accessed through microfracture as described above.

How soon might I notice an improvement?

Because these therapies stimulate the normal growth and repair processes, they rarely provide immediate relief unlike steroid injections.  However, the results are much longer lasting.  Typically, it takes between two and eight weeks before patients notice significant improvement.

Are the results permanent?

These treatments are intended to reverse tissue damage and degenerative changesbut they do not stop the natural aging process which starts again once the tissues have regenerated.  Overall, these therapies should provide good relief of pain from two to six years after treatment.  Patients will require repeat treatment throughout their life as they get older and joints continue to degenerate.

Does insurance cover the cost of these treatments?

No.  Although these treatments are done worldwide and have been proven an effective alternative for treatment of pain related to damage and degeneration of joints, they are still considered experimental and not covered by insurance plans.  Payment is due at the time of service.

What can I do to optimize my outcome of stem cell therapy?

Maintain a regular exercise program that is not excessive.  Eat well and get enough sleep.  Avoid excessive alcohol drinking and no smoking.  Dr. Smith will also recommend an appropriate vitamin supplement to optimize stem cell function.

Do you culture or save my cells?

Regenerative Orthopedics does not culture, manipulate or save your cells.  The process we utilize to obtain your stem cells results in the harvesting of cells in the range of 2 to 4 million stems cells and so there is no need to manipulate or grow your cells in the lab.

Why are Regenerative Orthopedics Institute fees much lower than other stem cell clinics?

We keep our office overhead down by maintaining a small office staff and a small but adequately sized office.  We also keep advertising to a minimum because most of our patients are referred by other patients and word of mouth referrals.  This allows us to pass our cost savings on to you the patients.

Conditions we treat with stem cells:

  • Osteoarthritis of any joint
  • Sports injuries including but not limited to tennis elbow, rotator cuff tears, torn meniscus, chronic ankle sprains, hamstring strain and Achilles tendonitis
  • Over use syndromes such as plantar fasciitis
  • Avascular Necrosis
  • Fracture non-unions

Conditions we do not treat:

  • Back and neck pain
  • Cancer