What are stem cells?
First, when we say “stem cells” that can mean many different things. There are embryonic stem cells, adult stem cells, induced pluripotent stem cells, blood stem cells, etc. We are going to focus only on human adult Mesenchymal Stem Cells (MSCs), the same-day treatment is called Mesenchymal Stem Cell Therapy. These MSCs can be found in most tissues and serve as local “repairmen” for damaged or aged tissues.
For orthopedic purposes, we can obtain MSCs from the bone marrow or adipose (fat) tissue of the same patient (autologous). The only true stem cell procedure currently allowed in the U.S. is an autologous bone marrow concentrate procedure. This is a procedure where a needle is placed into the iliac crest (hip bone) and bone marrow is aspirated out. We can then process that sample to concentrate the portion of the bone marrow that has stem cells as well as many other cells that can aid in healing. Then after obtaining detailed diagnoses of the problems, we can inject those cells precisely in the areas of need using image guidance.
Also, note that there are no true orthopedic stem cell procedures in the US involving birth tissues such as amniotic fluid or umbilical. These off the shelf allogenic (coming from someone else) products do not have live and functional stem cells, and even if they did, it would be illegal to use those cells.
Cultured stem cells
When the Centeno Schultz clinic first started offering orthopedic stem cell therapy in 2005 as part of an IRB-approved medical study, we were able to use autologous cultured stem cells. We would perform the same bone marrow aspiration, but we were able to isolate and grow those MSCs out. Once the marrow was concentrated, we could put them in a natural growth medium that comes from the same person’s blood platelets. The result is to take the relatively small number of MSCs found in a sample bone marrow, (10,000 to 1million) and expand them to a population of 10 – 100+ million. This process takes 2-4 weeks. In general, the more stem cells, the more potential for regeneration and the higher ability to treat more areas. We first published on this technique for hip cartilage and meniscal regeneration. However, based on FDA guidelines since then, these cultured MSCs are classified as a drug and are not currently approved in the U.S. Thus, for select patients they could go to Grand Cayman island for this type of treatment.
Same-day stem cell procedure
Despite the inability to no longer use cultured stem cells for orthopedic treatments, we have found great success in using the same day autologous bone marrow concentrate procedure, what we call our Regenexx SD procedure. Since we are the pioneers of this procedure for orthopedics, we have optimized every step of the procedure from obtaining stem cells, concentrating stem cells, and placing them exactly where they need to be to provide the best results. See this video to see how we are very different.
Also, since we are dedicated to research, we have published the most peer-reviewed papers of any other clinic on the safety and effectiveness of bone marrow concentrate (same-day stem cell procedures) for orthopedic conditions than any other clinic. Also, we are continuing to track our patients in a registry and publicly provide an unfiltered update of results per body area on a monthly basis. Dr. Centeno also comprises a summary of all the orthopedic stem cell papers on a yearly basis.
Research and results on same day stem cells
At this time there is still lots more research to be done but there is already a plethora of research showing bone marrow stem cells help improved pain function and healing with various orthopedic problems. First, you want to know that autologous bone marrow stem cell therapy is safe. We published the world’s largest safety paper on 2,372 patients showing these procedures were much safer than any surgery and no increased risk of cancer. Research has shown that autologous Mesenchymal stem cell therapy can help with arthritis in the shoulder, hip, knee, ankle, and the thumb. It has been shown to help heal tendon and ligaments tears such as the rotator cuff and ACL tears. Stem cells have also been shown to help with degenerative disc tears. Stem cell therapy can treat nonunion fractures and bone necrosis (bone tissue dying off) as well. Finally, bone marrow stem cells can be used to augment some surgeries such as rotator cuff surgery and spinal fusion.
The bottom line
Mesenchymal stem cell therapy is an emerging field. We at the Centeno Schultz Clinic and Regenexx were pioneers in that field and have developed best practices protocols to use this therapy safely and effectively. We along with others have published good results using stem cell therapy to treat various orthopedic conditions relating to arthritis, bones, tendons, ligaments, and the spine. There is already of lot of supporting evidence which continues to grow yearly. For anyone with musculoskeletal or orthopedic problems you should look into orthopedic stem cell treatments as they are safer than surgery and can address the underlying problems, unlike medications or steroid injections that just mask the pain. However, be careful when choosing a stem cell clinic as quality and expertise vary considerably. Look at this guide to help you know what questions to ask to make sure it is a legitimate practice.