What is regenokine? This past week I evaluated a patient from Connecticut who works in finance. He had been to Germany to get the Regenokine treatment on his low back, which didn’t work. He had educated himself quite extensively about his spine and relayed some fascinating things about the state of the art of spine care in Germany. In addition, I explained to him the differences between PRP, a stem cell treatment, and Regenokine.
Regenokine is a rebranding of an old technology called Orthokine. What is it? Well let’s start first with what it’s not. It’s not a stem cell treatment, in fact it’s a serum anti-inflammatory treatment used extensively in the U.S. by large animal veterinarians. In that world, it’s largely been replaced by the much more effective platelet rich plasma (PRP). Why. Orthokine was a great replacement at the time (in the 90s and early 2000s) for steroid anti-inflammatories. Regnokine is made by taking the serum from blood and incubating it with zinc etched glass beads. It’s believed that it’s rich in IRAP (Interleukin 1 Receptor Antagonist Protein) which is a natural anti-inflammatory. There are no growth factors to prompt healing like PRP or stem cells, hence many vets have now moved in the direction of more effective PRP. How effective is Regenokine? IRAP is not very effective for knee osteoarthritis based on the published research.
What was interesting about this gentleman’s Germany experience was the technology mismatch with the U.S. He knew that in the United States (where most of interventional pain management was born) the standard of care for injecting IRAP or anything else in his facet joints of his low back would be x-ray or other active guidance where the needle was watched as it entered the joint. However, what did he find in Germany? They took a CT Scan of his low back (which is below the U.S. standard of care which would be an MRI) which exposed him to about 100 times more radiation than was necessary. Did they use that CT scan to guide the needles into his facet joints? No, they used it to draw a map with pen on his back of where the facet joints should kind of be located. What’s the likelihood that they got into his facet joints with that approach? Slim. Why do it this way? Your guess is as good as mine as it’s so far below the U.S. care standard and it would never fly here.
Here’s what this patient had to say about his trip to Colorado for Regenexx:
“My trip to Colorado was without a doubt the best orthopedic experience I have ever had. Getting an hour to talk with you about my problems, a thorough MRI and ultrasound diagnosis, and coming up with a plan for me to get my back stable in a way I can return to the activities that I love seemed revolutionary comparison to the rushed visits I feel I receive at other clinics. The specific multifidus focus from the MRI I think will be a game changer in how I rehab. Everyone in your office was incredibly professional, in particular Jessica did an excellent job fitting me in to a very busy schedule that you guys have and creating time so that I could get my shoulder done as well.”
The upshot? Regenokine is not regenerative, but a natural anti-inflammatory shot that lasts for about 6-9 months and has generally long since been abandoned by U.S. vets for more effective platelet rich plasma. In addition, as I’ve blogged before, the interventional spine standard of care in Europe is much different than in the U.S., so buyer beware!