It’s a Wonderful Life is a Christmas classic. In this movie, the main character gets in a rut and questions whether he should have ever been born. He’s then met by a ne’er-do-well angel who grants his wish and shows him a world where his town has gone to pot (or Potter). In the end, he realizes the huge impact he’s had on his little world, and everyone lives happily ever after. This week, when I posted our newest low-back-disc research paper, most physicians were grateful to have more data on the topic, but one sales rep (who wasn’t happy about our data from months back that demonstrated that the device he sells didn’t work well) was more upset by the paper than excited. Yesterday, as I went about my day, this got me thinking. What would the world of orthopedic stem cell injections be like if we had never existed?
At Regenexx, we’ve always spent generously of our time and resources on tracking patients and studying things in the lab. This makes sense to me, given that we invented orthopedic stem cell injections to treat common things, like knee and hip arthritis and degenerating low-back discs. However, a lot of people have gotten quite a ride on our research coattails. Meaning, the registry-based research that we have been able to publish has formed the basis for thousands of providers and companies to begin offering stem-cell-injection procedures and devices worldwide. Don’t believe it? Let’s take a look.
All that existed before our first publications in 2006/2007 on using culture-expanded stem cells and bone marrow concentrate to treat knee and hip arthritis were papers focused on treating osteonecrosis. These used bone marrow concentrate in primarily surgical procedures (CORE decompression). Given that I’ll be using my April 2017 Orthopedic Bone Marrow Stem Cell Research Summary, there’s a copy below at the thumbnail. If you want to check anything I’m writing, just click on the image and you’ll get the PDF with active links to the studies in each circle icon.
For the earliest physicians getting involved in using stem cells for orthopedic purposes in 2009–10, this is all they could hang their hat on from a research perspective if someone called them on the carpet for injecting knee and hip joints with stem cells:
So the only evidence base that existed that “stem cells” were safe after being injected into joints was that n=227 safety paper published by Regenexx. That paper featured a coauthor from Harvard. So if you’re one of the very few physicians who began using stem cells prior to 2011, you’re welcome.
In the 2011–2012 time frame, this field went from a handful of physicians offering orthopedic stem cell treatment to dozens who jumped on board. In 2011 we published our larger paper on safety with some efficacy data, now up to 339 patients. So if you got called on the proverbial carpet back then for injecting stem cells into joints, tendons, or discs, what could you give your medical board to make sure you didn’t lose your license?
Again, if you began injecting stem cells into knees and hips to treat osteoarthritis in 2011–2012, we made up about two-thirds of the safety data you would have been forced to use to defend your procedures.
As of April of 2017, our patients made up approximately 50% of all patients who had their results and complications published. So right off the bat, if Regenexx didn’t exist, the research base for this field would be far behind its current state.
Let’s look more closely at how the field would be different for each procedure now being commonly performed:
Here is what these summaries look like in graph form:
We also have far more data online, which includes the ten thousand patients whose stem-cell-treatment registry data is shared and updated monthly on our website:
If you are a physician performing stem cell injections for the knee, hip, shoulder, or low back, if Regenexx didn’t exist, as you can see above, you would literally be operating in a world where not much was known about what you’re doing. If we adjust for the fact that many of the injection-based studies used above were with culture-expanded mesenchymal stem cells and not bone marrow concentrate (same-day procedure), there’s even less evidence outside of Regenexx. Bottom line? You would have a hard time defending what you’re doing.
If you’re a patient, the multitude of offerings for stem cells you see that now exists, in large part, because Phillipe Hernigou paved the way in the ’90s with bone procedures and because we paved the way for injection-based procedures in commonly injured and arthritic joints. It’s just that simple.
If you’re an orthopedic sales rep selling stem-cell-related devices, thank your lucky stars we exist. If we didn’t, I expect your sales would be a fraction of what they are right now, and most of you would have never heard of this space by 2017. So while you might hate that our independent lab tests don’t always agree with your marketing collateral, your current job literally depends on us being here.
The upshot? As of April of 2017, Regenexx research has dominated what we know about stem-cell-injection procedures for commonly treated orthopedic problems. If we had never existed, the amount we know about the safety and efficacy of these procedures would be a minuscule fraction of what it is today.
*DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.
Providers listed on the Regenexx website are for informational purposes only and are not a recommendation from Regenexx for a specific provider or a guarantee of the outcome of any treatment you receive.
About the Author
Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…