Are hip stem cells magic? I’ve been embroiled this past few weeks in a monumental project that is the Regenexx 2013 stem cell registry download. I think our poor bio statistician cringes every time he sees me bounding around the corner headed for his office! It’s a massive job, taking 30+ hours a week on top of seeing patients and myriad other responsibilities. Not only is it time consuming, it’s expensive and challenging, as like any massive data set, there are valuable clues hidden in the data, but finding them doesn’t come easy. So this was the context in which I recently received an e-mail from a reader to check out a series of new YouTube videos, one on using stem cells for hip arthritis.
As I watched the video, a white background is interrupted by an older man in a lab coat who appears to be a physician. The doctor explains how through the magic of stem cells all types of arthritic hips will be miraculously healed. He says that you can stop the progression of hip joint arthritis with stem cells. He also states that if you add in the magic of human growth hormone, all of this will work even better. He seems to be selling some new age breakthrough that will make the blind see and the crippled walk. Since we just released data from our registry showing older patients don’t do as well with same day stem cell injections for hip arthritis and we will likely release data next week showing that arthritic hips with poor range of motion don’t do as well either, I was dumbfounded about where this guy got this information. He seemed to be the antithesis of everything I had been slaving over this past month.
I then checked out the web-site associated with this hip arthritis stem cell miracle. The doctor is using a simple bedside centrifuge to isolate one fraction of the bone marrow that contains stem cells (we currently isolate two fractions to yield about 20-30X as many stem cells as these machines). In addition, this physician looks like he just took a course on the topic and added magic stem cells to his practice, as he’s an internist who does age management medicine and cosmetics. In other words, he dabbles in stem cells as a driver for additional income in the practice. His web-site also claims that HGH will miraculously make your stem cells better, whereas our lab data from 2007 showed that it only increased proliferation by an unimpressive 15%.
Where did the hip stem cell miracle hype originate? My best guess is it’s source is a misunderstanding of our 2006 paper as well as some of the before and after MRIs from our web-site! Since I appear to be the source, it’s my job to clean up the mess. Our 2006 case report published in the journal Pain Physician was on one gentleman with very severe hip arthritis who did seem to have evidence of new beneficial bone in his hip. However, while this gentleman got some help, he ultimately went on to a hip replacement. There are no other publications out there showing any improvement in hip arthritis patients treated with stem cells, so where else could his information have originated? Our site has an unpublished case report on a different patient with extremely severe hip arthritis who did have some impressive changes on MRI, but this patient was treated with something this doctor isn’t using-isolated and culture expanded mesenchymal stem cells (Regenexx-C procedure). In both of these cases, patients with severe hip arthritis had post injection MRI’s that looked nothing like what this physician is hyping. They had severe arthritis where the joint reformatted a bit and function got a bit better, but they still had severe arthritis. At least one patient ultimately opted for a hip replacement and the long-term result of the other patient is unknown as he was lost to follow-up.
These new YouTube videos highlight a very big, mounting problem-stem cell hype being sold by physicians who don’t have any idea of what the literature or registry results show. They learned how to do stem cells in a weekend course somewhere. It’s very unlikely that because of their base specialty that they have any idea of how to accurately place stem cells into the area being treated (many use no guidance). Outside of where to place the bone marrow in the simple bedside machine and which button to press, they have no idea of what it is they’re injecting. Despite all of this, stem cells are being bolted to a medical practice built more on alternative medicine and cosmetic hype than any attempt to add to the science of what these cells can and can’t do.
The upshot? Based on our registry data and clinical experience, a stem cell injection for hip arthritis can help. Based on our data going back to 2005, cultured stem cells work much better for hip arthritis than the same day stem cell procedure that this gentleman is hawking. However, if you’re younger and have good hip range of motion, same day stem cells may the way to go, but if you’re older than 55 or have very poor hip range of motion, a same day hip stem cell injection is less likely to help. In addition, all of that data was collected on a specialized lab based procedure that produces much more concentrated stem cells than can be produced by bedside machines. Will Human Growth Hormone (HGH) make a difference if you’re older? Unlikely based on our in-vitro data showing an unimpressive 15% increase in cell activity. In addition, it definitely won’t address the poor hip range of motion issue that may prevent a great result. Our clinical team is hard at work on new procedures that may address poor hip range of motion issue (percutaneous capsuloplasty) and that may hopefully allow these patients to get a better result. However, this level of interventional sophistication isn’t what’s being hyped on YouTube, as the level of skill needed for this procedure type isn’t possible for an internist with experience in age management and cosmetics. Buyer beware!!!
RegenexxCayman is an independently owned and operated medical services provider operating exclusively in the Cayman Islands and is not part of or affiliated with the Centeno-Schultz Clinic or any U.S. Regenexx Network provider. The Regenexx-C procedure licensed by RegenexxCayman is not approved by the U.S. FDA for use in the United States.