Regenexx Blog
10-23-18
Dr. Chris Centeno
Click for embedded links:
https://www.regenexx.com/blog/regenerative-medicine-education/helping-you-understand-all-the-confusing-things-youve-heard-about-stem-cells/
It's a mess out there. We have more providers who don't know what they don't know than we have providers who know what they're talking about. As a world expert in regenerative medicine, today I’d like to help you understand all of the confusing things you’ve heard about stem cells.
In 2005, myself and my partner, John Schultz, were the first human beings on earth to use stem cell injections to treat common orthopedic conditions, such as knee and hip arthritis, degenerative disc disease, and rotator cuff tears. Since then, we’ve published more scientific data on the clinical use of stem cell injections to treat these problems than any other single author worldwide. Our Colorado HQ staff has trained physicians in regenerative medicine from dozens of prestigious universities, including Stanford, Baylor, the University of Michigan, the military, etc... We see patients not just from Colorado and all over the U.S. but from all over the world (watch our video above to see US and world maps showing where our patients come from). So when I say I’m a world expert, unlike most others making that claim, I truly can back that statement up.
The Confusing Things You’ve Likely Heard About Stem Cells
It seems there are clinics on every corner today marketing their stem cell treatments, some quite aggressively. Today, I’m going to break these claims down and help you understand all of the confusing things you’ve likely heard about stem cells.
1. We Have Vials Containing Millions of Live Stem Cells
Regrettably, this is a scam. You might see this being advertised by some chiropractors, naturopaths, or acupuncturists pushing amniotic or umbilical cord products as stem cell treatments. These vials, however, contain no living cells, and, in fact, these amniotic and cord products are FDA regulated to be nonviable, or dead, tissues. In addition, in our university-equipped lab here at our Colorado clinic, we have tested these products because if they had millions of stem cells, we’d use them, but no living cells were found in any of the products we have tested.
2. Severe Knee Arthritis? We Can Grow You a New One
Severe knee arthritis occurs when you’ve lost a significant amount or all (bone-on-bone knee arthritis) of your cartilage. Beware of the before and after X-rays, these clinics show you, however; a simple trick of the machine can make it seem like arthritis is more or less severe than it really is. Take a look at the two images in the video of my own knee. I do not have knee arthritis, but by simply tilting the X-ray beam, it looks like I do. The before image on top shows a very narrow space between the bones (making it appear I have lost quite a bit of cartilage); the after image on the bottom (the accurate one) shows more space and no evidence of arthritis.
If there really is severe knee arthritis, bone marrow stem cells may help relieve pain and improve function, but they simply can’t grow you a new knee! Any clinic claiming this is scamming you. They're simply tilting the x-ray beam in their favor.
3. Stem Cells Magically Know Exactly Where to Go
The idea here is that precise guided injections are unnecessary; stem cells just somehow magically know exactly where they are needed. In fact, when injected intravenously, 97% of stem cells will end up in the lungs (this is called the pulmonary first-pass). If the target is your knee, those stem cells stuck in your lungs aren’t going to be much good. In addition, when your provider injects blindly into your joint, meaning injecting without precise image guidance, he or she may not be injecting into the joint at all. The only assurance that the correct structure is being injected is precise image guidance, such as real-time fluoroscopy or ultrasound.
4. Fat Has More Stem Cells
This is not true and is based on a fourth-grade math error. When you add up all of the stem cells in bone marrow, which is what we use, and fat, it’s about the same. Bone marrow stem cells, however, have been shown in multiple research studies to be better for orthopedic uses. We do occasionally use fat when necessary. However, we let what's wronmg with the patient make that decision.
5. Liposuction Is Less Invasive than Bone Marrow Aspiration
This is false. Research has shown that liposuction is about 100–1,000 times more invasive than a bone marrow aspiration. I do have to perform liposuction from time to time when I do need to use fat, and it involves liquifying the structural fat tissue in the body in an aggressive manner so the tissue can then be sucked out. The only way that happens is with copious elbow grease. A bone marrow aspiration, by comparison, involves inserting a needle into the bone and drawing what looks like thick blood—it is basically a fancy blood draw.
6. Just Inject the Knee or Hip Joint and Call It Good
If the goal is the best chance at a successful outcome, it’s not quite this simple. We inject, instead, specific structures inside these joints that may be damaged. That’s much more complex than just simply injecting inside the joint, and it’s only something an interventional orthopedic physician has the proper training to do. This is not something an orthopedic surgeon, interventional spine doctor, and certainly not a nurse has been trained to do. It requires highly specialized training that involves both fluoroscopy and ultrasound. It takes years to get good at these complex and precise injections.
7. We Only Use Ultrasound Because Fluoroscopy X-Ray Can Kill Stem Cells
This is not true. We’ve tested this in our lab and found no impact to stem cells when using X-rays. Fluoroscopy (real-time X-ray imaging) is a very expensive technology, about three-four times as much as ultrasound imaging, which is why most clinics don’t use it. Any clinic that performs stem cell injections should have both technologies because certain types of injections require fluoroscopy while others work better using ultrasound.
8. Our Bedside Machine Is the Best
Pretty much any clinic out there that you see uses a one-size-fits-all bedside machine. It’s not a very sophisticated technology. Instead, we use a flexible lab platform, meaning we have a specially equipped lab where we process everything and can custom tailor your cells to your needs. In addition, our flexible lab platform concentrates significantly more stem cells than a bedside machine can produce. Finally, with bedside machines, you don’t know the dosing, meaning you have no idea how many cells you’ve concentrated. With our flexible lab platform, we do know the cell count, so we know the dose as well as how much to inject to get the best results.
The upshot? I hope this helps orient you to what's real and what's hype. Stem cells are a helpful tool in orthopedic care that can prevent the need for surgeries, but that only works if they are used by experienced hands. However, right now, most of the providers you can find have no idea what they're doing. So be careful out there!
10-23-18
Dr. Chris Centeno
Click for embedded links:
https://www.regenexx.com/blog/regenerative-medicine-education/helping-you-understand-all-the-confusing-things-youve-heard-about-stem-cells/
It's a mess out there. We have more providers who don't know what they don't know than we have providers who know what they're talking about. As a world expert in regenerative medicine, today I’d like to help you understand all of the confusing things you’ve heard about stem cells.
In 2005, myself and my partner, John Schultz, were the first human beings on earth to use stem cell injections to treat common orthopedic conditions, such as knee and hip arthritis, degenerative disc disease, and rotator cuff tears. Since then, we’ve published more scientific data on the clinical use of stem cell injections to treat these problems than any other single author worldwide. Our Colorado HQ staff has trained physicians in regenerative medicine from dozens of prestigious universities, including Stanford, Baylor, the University of Michigan, the military, etc... We see patients not just from Colorado and all over the U.S. but from all over the world (watch our video above to see US and world maps showing where our patients come from). So when I say I’m a world expert, unlike most others making that claim, I truly can back that statement up.
The Confusing Things You’ve Likely Heard About Stem Cells
It seems there are clinics on every corner today marketing their stem cell treatments, some quite aggressively. Today, I’m going to break these claims down and help you understand all of the confusing things you’ve likely heard about stem cells.
1. We Have Vials Containing Millions of Live Stem Cells
Regrettably, this is a scam. You might see this being advertised by some chiropractors, naturopaths, or acupuncturists pushing amniotic or umbilical cord products as stem cell treatments. These vials, however, contain no living cells, and, in fact, these amniotic and cord products are FDA regulated to be nonviable, or dead, tissues. In addition, in our university-equipped lab here at our Colorado clinic, we have tested these products because if they had millions of stem cells, we’d use them, but no living cells were found in any of the products we have tested.
2. Severe Knee Arthritis? We Can Grow You a New One
Severe knee arthritis occurs when you’ve lost a significant amount or all (bone-on-bone knee arthritis) of your cartilage. Beware of the before and after X-rays, these clinics show you, however; a simple trick of the machine can make it seem like arthritis is more or less severe than it really is. Take a look at the two images in the video of my own knee. I do not have knee arthritis, but by simply tilting the X-ray beam, it looks like I do. The before image on top shows a very narrow space between the bones (making it appear I have lost quite a bit of cartilage); the after image on the bottom (the accurate one) shows more space and no evidence of arthritis.
If there really is severe knee arthritis, bone marrow stem cells may help relieve pain and improve function, but they simply can’t grow you a new knee! Any clinic claiming this is scamming you. They're simply tilting the x-ray beam in their favor.
3. Stem Cells Magically Know Exactly Where to Go
The idea here is that precise guided injections are unnecessary; stem cells just somehow magically know exactly where they are needed. In fact, when injected intravenously, 97% of stem cells will end up in the lungs (this is called the pulmonary first-pass). If the target is your knee, those stem cells stuck in your lungs aren’t going to be much good. In addition, when your provider injects blindly into your joint, meaning injecting without precise image guidance, he or she may not be injecting into the joint at all. The only assurance that the correct structure is being injected is precise image guidance, such as real-time fluoroscopy or ultrasound.
4. Fat Has More Stem Cells
This is not true and is based on a fourth-grade math error. When you add up all of the stem cells in bone marrow, which is what we use, and fat, it’s about the same. Bone marrow stem cells, however, have been shown in multiple research studies to be better for orthopedic uses. We do occasionally use fat when necessary. However, we let what's wronmg with the patient make that decision.
5. Liposuction Is Less Invasive than Bone Marrow Aspiration
This is false. Research has shown that liposuction is about 100–1,000 times more invasive than a bone marrow aspiration. I do have to perform liposuction from time to time when I do need to use fat, and it involves liquifying the structural fat tissue in the body in an aggressive manner so the tissue can then be sucked out. The only way that happens is with copious elbow grease. A bone marrow aspiration, by comparison, involves inserting a needle into the bone and drawing what looks like thick blood—it is basically a fancy blood draw.
6. Just Inject the Knee or Hip Joint and Call It Good
If the goal is the best chance at a successful outcome, it’s not quite this simple. We inject, instead, specific structures inside these joints that may be damaged. That’s much more complex than just simply injecting inside the joint, and it’s only something an interventional orthopedic physician has the proper training to do. This is not something an orthopedic surgeon, interventional spine doctor, and certainly not a nurse has been trained to do. It requires highly specialized training that involves both fluoroscopy and ultrasound. It takes years to get good at these complex and precise injections.
7. We Only Use Ultrasound Because Fluoroscopy X-Ray Can Kill Stem Cells
This is not true. We’ve tested this in our lab and found no impact to stem cells when using X-rays. Fluoroscopy (real-time X-ray imaging) is a very expensive technology, about three-four times as much as ultrasound imaging, which is why most clinics don’t use it. Any clinic that performs stem cell injections should have both technologies because certain types of injections require fluoroscopy while others work better using ultrasound.
8. Our Bedside Machine Is the Best
Pretty much any clinic out there that you see uses a one-size-fits-all bedside machine. It’s not a very sophisticated technology. Instead, we use a flexible lab platform, meaning we have a specially equipped lab where we process everything and can custom tailor your cells to your needs. In addition, our flexible lab platform concentrates significantly more stem cells than a bedside machine can produce. Finally, with bedside machines, you don’t know the dosing, meaning you have no idea how many cells you’ve concentrated. With our flexible lab platform, we do know the cell count, so we know the dose as well as how much to inject to get the best results.
The upshot? I hope this helps orient you to what's real and what's hype. Stem cells are a helpful tool in orthopedic care that can prevent the need for surgeries, but that only works if they are used by experienced hands. However, right now, most of the providers you can find have no idea what they're doing. So be careful out there!