A while back, I booked a hotel room and learned a lot about the differences between the real deal and a copy of a copy. The hotel room looked great in the pictures, so I excitedly booked it online. When we got there, perception and reality were quite different. The really hip furniture that looked great online, turned out to be badly executed and flimsy. It was clear that the whole experience had been crafted to look great in a photograph. Once we laughed about it, it stuck in my craw that night that I had somehow missed the mark on this one.
In many ways, this lesson also applies to stem cell clinic reviews. This became clear this week, when I evaluated a patient who had his knee treated with a same day stem cell treatment at a university. The treatment didn’t work.
When I began to ask questions about what the other doctor did, it wasn’t long before I heard the first serious problem. The copy treatment had shorted this gentleman in the number of cells harvested. Rather than trying to maximize the number of stem cells taken from his bone marrow by drawing small volumes of cells from 3 – 5 sites on each side of his pelvis, the doctor had taken larger volumes from only three sites on one side.
We’ve known since the 1990s that drawing smaller volumes from more bone marrow sites maximizes the number of stem cells. Our own internal research has confirmed this many times. Why didn’t this university physician know this? He had taken a weekend course on stem cells from the manufacturer of the automated bedside centrifuge that he used and the instructor (who I know) never bothered to educate himself in the published literature.
The next critical error during his university stem cell procedure was to inject both knees without knowing the dose of what was being injected. Why was this an issue? Our recently published research showed that there should be a minimum total number of cells injected into each knee from the isolated bone marrow. However, this university physician didn’t have the capability to count the number of cells that were available. Based on our proprietary processing technique, which extracts many more stem cells from the bone marrow than an automated bedside centrifuge can muster, the likelihood of a patient his age having enough cells for a bilateral knee injection is only 21%. This means there’s about an 8 in 10 chance that his knees received too few cells to produce the desired results. This was of course compounded by the fact that the draw technique described above reduced the number of stem cells that were in the sample before it was even processed by the machine.
There were many more little things, like the fact that a pre-injection wasn’t used, or that the procedure was performed in an exam room, rather than a formal procedure room with fluoroscopy and ultrasound capabilities like the four we have in Colorado and around the Regenexx Network.
The upshot? This patient had visited someone who I consider to be a good and solid medical provider, and who is more knowledgeable about PRP and stem cells than most of the doctors out there who are performing these procedures. Despite that, there are stark differences between what a Regenexx provider does to maximize the likelihood of a successful outcome and what was done for this patient. While I can’t guarantee this patient a successful outcome from his Regenexx procedure, I can absolutely assure him afterwards that everything that we can do in 2016 to maximize his procedure outcome has been done.
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.…