I went to a Chiropractor and was considering “amniotic” or “umbilical” stem cells. It’s much cheaper. Why should I go with you?

Amniotic and/ or umbilical cells are very different from the type of cells we use (autologous mesenchymal stem cells and platelet-rich plasma). Amniotic/ umbilical cells are taken from the umbilical cord of a newly born infant and then injected into joint sites to try to mimic what we do. The biggest challenge with this attempt at treatment is that the cells are completely dead by the time they are injected. The best case scenario is that those injections act like a growth factor- there may be some growth associated but it’s mostly a placebo effect.

Do you use embryonic stem cells?

Absolutely not. The FDA prohibits us from using embryonic stem cells. Any cells we use come directly from your body.

What type of stem cells do you use?

We use autologous mesenchymal stem cells. We derive these stem cells from your bone marrow through a relatively painless and quick aspiration procedure. We process your sample in our lab by our highly trained lab manager and your isolated nucleated stem cells are then injected back into your joint with the aid of precise image guidance.

What’s the difference between bone-marrow derived mesenchymal stem cells and adipose-derived mesenchymal stem cells?

Our studies have shown that both adipose derived and bone marrow derived mesenchymal stem cells are effective in treating orthopedic conditions. The former is obtained by performing liposuction on the abdomen, from which providers attempt to isolate and nucleate mesenchymal stem cells from the removed fat. We obtain, isolate, and nucleate our stem cells through the use of a relatively painless aspiration of bone marrow, done with a small gauge needle that has a drill on the inside. Our studies have indicated that bone-marrow derived stem cells are more effective in the short, mid, and long-term regeneration efforts for orthopedic conditions, though studies also indicate that adipose-derived stem cells may be useful as well.

Why is red wine approved?

Red wine is dense in resveratrol, which is commonly found in dark berries like red grapes, blackberries, raspberries, blueberries, etc. The benefits of the Resveratrol contained in 6 ounces of red wine significantly outweighs the negative impact of the sugar and alcohol. Much more than 6 ounces of red wine or literally any other type of alcohol is a strictly net-negative impact.

What does Resveratrol do for me?

Resveratrol has a wide host of benefits; everything from joint lubrication to soft tissue elasticity to the rebuilding of collagen, heart health, and many more wonderful benefits. In addition to being found in dark berries, Resveratrol is usually sold as a supplement at most supplement stores and is included in our Advanced Stem Cell Support Formula, which is complementary with a Stem Cell (SD) procedure.

Can I drink white wine instead of red wine?

Unfortunately no. White wine has no Resveratrol, which is the ingredient that makes Red Wine permissible. White wine has a lot of sugar and contains alcohol, meaning it is a strictly net-negative impact on procedures.

Can I have beer?

Unfortunately no. Beer has no Resveratrol, which is the ingredient that makes Red Wine permissible. Beer is dense in carbs and contains alcohol, meaning it’s one of the worst possible things you can have with this type of procedure.

I talked to Dr. So-and-so, who can do PRP (platelet-rich-plasma) for much cheaper than you. Why are you much more expensive?

There are many reasons that we are a little bit more costly than alternative providers in the market. Firstly, Regenexx literally invented interventional orthobiologic treatment. Regenexx owns virtually all patents on lab processing, has produced well over 50% of the published research on orthobiologics, and are the industry leaders in continued R&D.

Secondly, the product that we use is radically different from that of our contemporaries. The vast majority of alternative providers use a bedside centrifuge. Basically, the care giver performs a blood draw, puts the sample in the bedside centrifuge and spins down the product, and blindly injects whatever comes out. This means the provider has no idea whether or not there is adequate volumes of cells, is unaware of the concentration of the cells, is unable to determine if the cells are viable, etc. Worst case scenario this process can be very ineffective at deriving the appropriate volumes, concentrations, and types of product to treat specific orthopedic conditions. Regenexx, on the other hand, uses a flexible lab platform and research to back up our products. Through the use of our lab, we are able to generate over 25 different types of blood-based products, ranging from 2X to 20X concentration, platelet lysate, and everything in-between. Our research has proven that certain volumes and concentrations and types of product are most effective in treating specific conditions. For instance, a 1 cm tear in the medial meniscus needs different volume/ concentration/ type of product than a full thickness rotator cuff tear, just as nerve damage in the wrist will be markedly different from intra-articular degenerative osteoarthritis in the foot. With our research, we are able to ensure that we create the exact product necessary to treat your specific condition(s). Literally every other provider is unable to replicate that process.

Finally, we ensure that the correct product needed gets to exactly where it needs to go with the used of precise guided imagery. Depending on the joint location and type of condition, we will either use Ultrasound or Fluoroscopy (live xray) to ensure that the product gets exactly where it needs to go with an incredibly high degree of accuracy (within 1 mm). It’s common for alternative providers to blindly inject into the joint with virtually no way of confirming that the product gets where it needs to go. Even worse yet, some alternative providers will actually intravenously inject the product, meaning they inject it into the blood stream. This has proven to be completely ineffective at treating ANYTHING, and is actually a big risk for complications.

Does the FDA sanction what you do?

The FDA highly regulates what we do. Anything that we take out of the body we are required to inject back into the body within 24 hours. Otherwise, the product technically becomes a manufactured pharmaceutical, for which we (and every other domestic provider) do not have a license. The FDA considers us to be “investigational” meaning that there is strong clinical evidence that what we do is extremely effective at treating orthopedic conditions. We are not considered “experimental” or anything else ambiguous in that manner. In order to get any further endorsement, the FDA wants 20+ years of double-blind correlative studies, which is financially and practically impossible for us to provide at this time. We have a plan to get to FDA endorsement, though it will take time to get there. It’s also worthy of note that no medical procedures are “FDA approved”. Even a traditional knee replacement isn’t considered “FDA approved”, though it is past the point of being considered “investigational”.

Why doesn’t my insurance cover the procedure?

There are several main barriers to insurance coverage for regenerative medicine (stem cells and platelets). The first barrier is that, because these types of treatments are so new, there is limited data and research on the short and long-term outcomes. Key entities, including the FDA and major insurance carriers, want considerably more data prior to endorsing such treatment. It will probably take another 15-20 years to get sufficient data for these entities to be satisfied with the body of data. Additionally, regenerative medicine isn’t very popular with orthopedic surgeons. The average knee replacement can cost anywhere from $25k-$75k, and our procedures cost considerably less. Added to the cost differential, there are upwards of 25,000 practicing orthopedic surgeons in the US, while there are only ~110 doctors licensed to do this type of treatment. This creates a challenge in access to care. As of today, Regenexx can only support less than half of 1% of the total need for orthopedic procedures in the US. Until we are able to get that number considerably higher mass market insurers will not cover us because it will afford inequal access to care for their patients/ customers.

What is covered by insurance?

Literally everything else is covered by insurance in some capacity: consultations, X-rays, ultrasound, physical examinations, follow ups, durable medical equipment, bracing, medication, physical therapy, follow ups etc.

What are success rates for the procedure?

Success rates are highly dependent on candidacy ratings. We force rank our patients into one of six categories; good, good to fair, fair, fair to poor, poor, and not a candidate. These ratings are based on several criteria, including physical examination, review of imaging, patient activity level, onset of pain, history of acute injury, history of surgical intervention, etc. Patients in the “good” category have ~75% odds of deriving ~75% improvement from the procedure. Patients in “good to fair” have ~65-70% odds of deriving ~65-70% improvement; “fair” have ~50-60% odds of ~50-60% improvement; “fair to poor” have 35-50% odds of 35-50% improvement, “poor” have ~30% odds of deriving ~30% improvement or better, and “not a candidate” have no prediction for odds or improvement. Expected outcomes can be positively influenced with adherence to post-procedure protocol and restrictions, diet, physical therapy, adherence to bracing recommendations, and medication restrictions.

Why do I have to do physical therapy?

Physical therapy is extremely important with regenerative medicine. Any time we are attempting to re-grow, re-structure, or strengthen connective tissues (tendons, ligaments, musculature) physical therapy becomes very important. Patients need to actively use structures within the confines of set post-procedure protocols and within the scope of a structured physical therapy regimen. This ensures that patients maximize their odds of tissue growth and strengthening, minimizes the chances of adverse outcomes, and virtually eliminates the possibility of atrophy or tissue degradation.

Do older patients have less viability in their stem cells/ platelets?

No. In fact, elderly patients tend to have higher concentration of platelets and certain growth factors in their draws. Our research has strongly indicated that age has very little if any impact on viability for orthobiologic treatment. Certain medical conditions (osteoperosis, active cancer, lupus) may preclude patients from going through treatment with Regenexx. Joint candidacy is a much stronger indicator of expected outcomes for procedures.

Will my stem cell procedure/ platelet procedure regrow cartilage?

Our studies have indicated that although some patients do regrow cartilage that this is not universally true. What is perhaps more important to note is that cartilage loss is rarely a primary driver or indicator for joint pain and function. In the knee, for example, the meniscus is typically much more important than cartilage. We have excellent outcomes with treating torn, frayed, damaged, and/or surgically removed menisci, meaning that our chances of helping patients with both cartilage and meniscus damage/ loss are actually very high.

How long does it take to perform a procedure?

Times depend on treatment type, severity of conditions, amount of orthobiologic product needed, and number of joints. For platelet cases, most blood draws last between 30-60 minutes, initial physical therapy consultations last around an hour, lab processing of the sample lasts 2-5 hours, and the injection can last anywhere from 15 minutes up to 90 minutes. For stem cell cases, prolotherapy always lasts only 30 minutes, bone marrow aspirations take about an hour, lab processing of bone marrow lasts anywhere from 2-5 hours, and the stem cell injection will last somewhere between 30 and 90 minutes.

How long do procedures last?

It’s a little tough to answer this question for several reasons. First and foremost, the procedure has developed dramatically since inception. We are getting better results that last longer than ever before, accordingly, historical data isn’t a good indicator of current or future results. Secondly, length and quality of results is highly dependent on each patient. Everything from initial candidacy, procedure type, adherence to post-procedure protocols, proper execution of physical therapy, dietary and medication restriction adherence, lifestyle, weight, etc. can all have a huge impact on the quality and duration of outcomes. With that being said, we consider these types of treatments to “stop the clock” on degenerative Osteoartrhitis for at least 5 years, though healing of acute soft tissue injuries may very well be permanent.

Will I need repeat treatments?

It’s possible and depends on many factors. If degenerative osteoarthritis is a primary driver for pain and function, chances are that you might need an additional treatment somewhere down the line. Follow-on treatments can vary greatly from patient to patient. Some patients may only need aspirations in order to drain excess synovial fluid. These treatments are done free of cost for our patients. Other patients might require a prolotherapy booster, which there will be no charge for the first 2-3 injections. More than likely, worst case scenario patients would need an SCP booster, which is considerably lower in price than Stem Cell therapy or even a stand alone SCP treatment.

Will this prevent me from doing surgery in the future?

Absolutely not. Regenexx procedures will not preclude patients from having any sort of surgical intervention in the future.

I saw a study that stem cells lead to a heart attack- does this happen with you?

More than likely, the study you saw was referencing Intravenous (IV) injections. Studies have indicated there is significant risk in these types of procedures and they yield questionable results, at best. We only inject orthobiologics directly into joint sites with the use of live guided imaging. It would be nearly impossible for our injectate to enter the blood stream and thereby impact anything outside of the affected joint.

How long is recovery?

Most patients will be fairly uncomfortable for the first 2-3 days following treatment. For that time period we will write a script for a narcotic-strength painkiller to ease the process for patients. Pain significantly subsides by the 3rd day or so, and should return to pre-procedure pain levels by about the second week. The first six weeks will be characterized by waves of inflammation, and this is the most crucial window for adherence to protocols and proper execution of physical therapy.

Can I treat multiple joint sites at once?

Potentially. We are limited in the number of joint sites we can treat by several factors. Firstly, there is a limit to the amount of local anesthetic that we can safely use in a patient. In other words, using sufficient anesthetic to numb 4+ joint sites would be unsafe for the patient from an anesthetic perspective. We are also limited by the volume of product we are able to generate from a single bone marrow aspiration or blood draw. We cannot treat more joint sites than is required of the yield of the draws that we do for obvious reasons. Additionally, it is necessary to consider the post-procedure protocol when evaluating viability for multiple joints. I.E. most patients are restricted to shoulder slings for 2 days – 2 weeks following a Regenexx treatment. If patients have both shoulders treated at the same time they will have a hard time independently dressing/ bathing/ driving/ performing day-to-day activities.

Do stem cells/ platelets stay where you inject them?

Absolutely. All of our injections are done with an extremely high degree of precision, and the techniques we use ensure that the right product gets to the right structure in the right joint and nowhere else. We do not do intravenous injections, which would result in the majority of the product being entirely wasted.

How are you sure that the injections get to exactly where they need to be?

Our physicians use live guided imaging to ensure the product gets exactly to where it needs to go. Depending on the joint site and structure, this may be through the use of Ultrasound and may be through the use of fluoroscopy (live x-ray).

How long has Regenexx been doing procedures?

Dr. Chris Centeno, the founding physician for Regenexx, began experimenting with autologous orthobiologics nearly 20 years ago. The procedures we are doing today really began to take shape around the year 2005. The Regenexx procedures have continually improved over the last ~15 years and the procedures we are doing to day are demonstrably better/ more effective than anything we’ve done in the past.

What is the difference between Regenexx and other providers?

First and foremost, Regenexx is the inventor, lead researcher, and patent holder on regenerative medicine treatments with the use of autologous orthobiologics. Everyone else that is attempting to do such procedures are only mimicking what Regenexx does without access to most of our data/ research, proprietary techniques, lab processing, treatment plans, etc. Another big difference between Regenexx and other providers is the use of our flexible lab platform. Our research has led us to have a high degree of fidelity on specifically which type of product, which concentration of such product, how to inject said product, and impact of timing on said injections. With our flexible lab platform, we are able to generate exactly the type and volume of product needed to treat very specific conditions. For example, a full thickness tear of the rotator cuff in a shoulder with partial retraction will need very different volume, concentration, and type of product than performing a hydrodissection in a wrist or slight fraying of the achilles in a heel. Our competitors almost invariably use a bedside centrifuge, meaning they put the blood/ bone marrow/ adipose tissue in a centrifuge and then inject WHATEVER comes out into the joint. We actually count our cells and ensure the proper concentration, viability, and nucleation of cells, while our competitors could potentially be injecting nothing more than indiscriminate liquid. We only inject our patients using live-guided imagery. This means that we use Ultrasound or Fluoroscopy to ensure that the product gets exactly to where it needs to be. Most of our competitors blindly inject product into joints, having no way of ensuring product gets to where it needs to be, and certainly precluding them from treating specific tears in individual structures in joints. Finally, our results truly speak for themselves. Our outcomes are markedly better than literally any other provider trying to mimic what we do. Most alternative providers inform their patients that they will need 3-5 treatments to derive the proper benefit, while our patients only require one treatment. While our treatments may be a little more expensive than those of our competitors, the quality of results and lack of need for repeat procedures ends up making Regenexx a more affordable options for most patients.

Can I do a procedure if I’m anemic?

If your hematocrit is below 30 or your hemoglobin is below 10 we might not be able to do a procedure. If your hematocrit is between 30-36 or your hemoglobin is below 12 we may try to limit the blood draw or bone marrow aspirate volume.

Can patients with cancer do procedures?

Patients that have active cancer and/or are undergoing chemotherapy or taking immunosuppressive drugs for cancer are unable to do procedures until they are given the go ahead from their oncologist.

What side effects are there with procedures?

Side effects with Regenexx procedures are rated as minimal to low and generally only last a short while after the procedure. For the first 48-96 hours after injection, patients experience an elevated level of pain, which is normally rated as a 5/10. We will write a script for a narcotic strength painkiller to get patients through this initial window. Otherwise, we expect significant swelling in the joint site for up to 6 weeks following the injection that sometimes will come and go in waves (significant swelling for 3-5 days followed by no swelling for 3-5 days). It’s not uncommon for swelling to continue past the 6 week mark, but the vast majority of our patients have minimal pain after the first 2 weeks.

What are the risks with procedures?

Any time the skin is broken there is inherent risk for infection. This risk is managed by thoroughly cleaning the aspiration/ injection site prior to breaking the skin and proper adherence to post-procedure protocols. Any time blood based/ bone marrow-based products are handled in a laboratory situation there is a risk of cross-contamination. We have never had an incident of cross-contamination, and the risk is thoroughly controlled in our sterile lab through the use of single-chain custody of the sample and product. Additionally, most patients will experience discomfort for at least a few days after the procedures and potentially upwards of 2 weeks. The vast majority of patients rate the pain as very tolerable and state that the pain is not a deterrent when considering Regenexx procedures for other joints in the future.

Can I use HSA/ FSA funds for procedures/ consults/ etc.?

We recommend speaking with the HSA/ FSA entity prior to attending a billable visit, but we have never had any issues with our patients getting approval to use HSA/ FSA funds for Regenexx appointments or follow-on care.

I don’t trust information on your website- is there other research published to support your claims?

We recommend doing research in an un-affiliated, peer-reviewed research repository for completely unbiased research and studies on regenerative medicine. The most popular repository is Pub Med, which can be found by searching for “Pub Med” in a search engine or going to the website at: https://www.ncbi.nlm.nih.gov/pubmed/

Can I take essential oils?

Yes, just be sure to avoid using supplements that have anti-inflammatory properties if possible.

Can I just be on the Keto diet?

The Keto diet emphasizes the virtual elimination of carbohydrates, which benefits regenerative medicine procedures nicely. However, Keto encourages a macronutrient breakdown that is high in fat and virtually indiscriminate in fat source while limiting protein intake. Our studies indicate that a higher protein intake and controlled, moderate fat intake is more positively impactful for these types of procedures.

What’s the benefits behind being on the Paleo or Low Glycemic Index diets?

These diets will help stabilize blood sugar and insulin levels, which allows the body to naturally respond to the introduction of orthobiologics and growth factors. Inflammation is key in regenerative medicines, and these diets ensure that patients avoid foods that will either prevent or exacerbate the bodies’ natural healing and inflammatory properties.

What are the benefits of Resveratrol?

Resveratrol has a wide host of benefits for general health and joint health; everything from cardiac function to regenerative properties. For the purposes of our procedures, Resveratrol helps with joint lubrication, soft tissue elasticity, the rebuilding of collagen, and encourages the body’s ability to naturally heal joints.

What is in the Stem Cell Support Formula?

Our Advanced Stem Cell Support Formula has many ingredients that encourage the body’s production of stem cells, aids in joint lubrication, soft tissue elasticity, and rebuilding of collagen. Those ingredients include Glucosamine, Chondroiton, MSM, Turmeric Curcumin, L-Carnosine, Resveratrol, Bitter Melon Extract, and Bioperine.

Do you have statistics on patient outcomes and successful rates?

We do. We have been collecting patient outcome data for quite some time and we regularly and openly publish the results with the public. To view this data, visit our Outcomes Page.