We’ve treated a slew of pro athletes through the years, and I can honestly say that I have never had one agree to have his procedure filmed. This is why it was surprising to see a TMZ video of Terrell Owens, former NFL player, getting bone marrow stem cell injection procedures. Having said that, the video gives an excellent window into what I would consider a low-quality stem cell procedure. Let me explain.
My New Stem Cell “Botched” Series
Part of the reason for the new series is to call out the truly crazy and scammy stuff happening in stem cell therapy. In addition, part of it is to educate patients and physicians about the base standards for what defines a high-quality versus a low-quality therapy. Today’s video is in the latter category, as Terrell Owens definitely got a real stem cell procedure, but the quality could have been far better.
Quality in medicine has always been an elusive thing. While it’s easy to see and measure in cars and consumer devices, it’s not so in medicine. The only way patients can separate the wheat from the chaff is to get educated about the procedures they’re considering. However, there is often no way to benchmark what a surgeon or provider does behind closed doors.
The Terrell Owens Stem Cell Procedure
The good news is that unlike scam amniotic or cord blood “dead” stem cell procedures, it’s likely that “TO” did get a real stem cell procedure. In addition, a physician specialist was performing the procedure in an operating/procedure-room setting, rather than a nurse in a chiropractor’s office. So there are things to like about this procedure.
Having said that, the video is complete enough to find a few big issues with this procedure that can educate the public about quality. We can break the problems with this procedure into two basic issues:
- Poor harvest technique will cause too few cells to be taken.
- Too many areas were treated.
Let’s explore that a bit further.
Too Few Cells Taken
It’s often hard for patients to conceptualize that how the bone marrow aspiration procedure is performed matters. In fact, both Phillipe Hernigou (the only guy on earth who has been doing bone marrow concentrate procedures longer than I have) and I agree. The more cells you get and use in an area of treatment, the better the outcomes. Phillipe has published a number of papers that have shown this as have others. We also published a 2014 dosing paper on knee osteoarthritis that showed the same thing. Dose matters.
One way you can increase the dose in a bone marrow stem cell procedure is to perform a meticulous and time-consuming bone marrow aspiration (BMA). This is the procedure where you take the stem cells from the bone marrow. How the BMA is performed is critical to the eventual success or failure of the stem cell injection or surgical procedure.
For the scientific citations that support my assertions below, please see the video below about bone marrow aspiration. For a synopsis of the Terrell Owens procedure, please see my video above, at the top of the page.
Location, Location, Location…
To start, you need to draw from the site that has the most cells, which is not the front of the hip or the knee but the back of the pelvis in an area called the PSIS.
HENCE, THE FIRST THING ABOUT THIS STEM CELL HARVEST THAT’S WRONG IS THAT IT’S BEING DONE IN THE RELATIVELY STEM CELL POOR FRONT OF THE PELVIS (CALLED ASIS).
Why would anyone draw here? It’s often easier for surgeons to have the patient in this position. However, it compromises stem cell yield.
The Big Pull Is Big Bull
A good stem cell harvest takes time. However, many physicians don’t want to take the time. As an example, a medical colleague and I mused over the weekend that the average physician who performs these procedures sticks the trocar into the bone and pulls as much bone marrow as is required. We call this “the big pull,” and it’s a surefire way to dramatically reduce the number of stem cells in your draw. Why? The number of stem cells dramatically declines after the first few ccs of the draw. Basically, after about 10 ccs, you’re just drawing blood from the body as the marrow space is connected to the blood vasculature system.
HENCE, THE SECOND THING ABOUT THIS HARVEST IS THAT THE DOCTOR DRAWS 30 CC OF BONE MARROW IN A SINGLE PULL. THIS DRAMATICALLY REDUCES THE STEM CELL CONTENT OF THE SAMPLE.
How do you perform a proper bone marrow stem cell draw? In short, for this type of entry, this provider would have needed imaging guidance to drive the trocar deep and then taken small 5 cc samples as the trocar was extracted. That didn’t happen; in fact, all the provider seems to do is to turn the handle of the trocar, which won’t do that much if you’re drawing from the same site.
See my video below for more details on how to perform a proper BMA based on the peer-reviewed literature:
Dosing Versus Sites Treated: Spreading Out a Good Thing Too Far Is a Bad Thing
If all this video showed was a poor-technique bone marrow draw from the wrong side of the patient, then “TO” would be in the same place as about 80% of patients out there who get these procedures. Because he’s still young and fit, if all they were treating was his knee, the procedure may have been fine. Meaning his stem cell counts may have been high enough to compensate for everything the physician was doing to hamstring the procedure. However, there was more that finally caused me to make this my second episode of “Botched” Stem Cell.
You can hear the nurse in the TMZ video call out a long list of items they intend to treat with this procedure. In fact, it’s 10 areas! This includes both knees, bilateral triceps, bilateral shoulders, right hip greater trochanter, lower back, hamstring, and groin! As stated above, the dose for each of these matters! In our average, much better accomplished multisite draw from the right site, with advanced lab-based processing and dosing, we would likely get enough stem cells to treat two large joints. This provider is trying to stretch far fewer cells to four large joints and five tendon areas. Not to mention we have no idea what he’s doing with the low back.
REGARDLESS OF WHAT HAPPENED OFF CAMERA, THERE IS NO WAY TO DRAW ENOUGH BONE MARROW IN A SINGLE SITTING TO PROPERLY DOSE AND TREAT 10 AREAS.
The upshot? We have providers out there who can perform a high-quality bone marrow stem cell procedure. They are part of our network and there are even some who aren’t Regenexx providers. These doctors draw from the right area, take the time to perform small aspirations from many sites, and only treat a few areas based on dose. As you can see by this video, they are, however, few and far between. So seek out these high-quality providers. You’ll be glad you did!