18 February 2012

The Regenexx Stem Cell Procedure for my Knee



In my last blog post, I discussed the problems I have had with my knee, the recent injury causing meniscus tears and about the alternative treatment I elected to have instead of surgery. Well this week I underwent the treatments for the Regenexx SD procedure on my right knee and so far things are looking good. In fact, I just finished a very brief and very easy spin session on my bike (on the trainer, not outside). Although my knee does not have 100% range of motion, it is returning quickly.

The procedure involved the following treatments over a period of days:
  • Day One, Pre-Injection - Injections to the knee to cause your body to think that the knee has been injured. This causes red blood cells to rush to that area so that the body can begin healing itself.
  • Day Two, Blood Draw - Took blood from my arm to be spun down to get the platelets.
  • Day Three, Bone Marrow Harvest - Draw bone marrow from my hips early in the morning to be spun down to extract my own stem cells. Return a few hours later to have platelets and stem cells injected into the knee, directly into the tears in the meniscus.
  • Day Four, Blood Draw - Took more blood from my arm to be spun down
  • Day Five, Post-Injection - Inject the knee with the platelets to encourage healing. This is like adding more fertilizer to the knee.

These treatments were focused on my torn meniscus and, overall they went really fast throughout the week. I don't have a problem with needles, so it wasn't a big deal, though my knee did get sore throughout the week from having so many injections. The procedure to harvest the bone marrow was a bit strange because, once the doctor had me numbed up, he was putting his body weight on you to drive a needle into your hip bones to get to the bone marrow. They are actually going into the bones in the small of your back called the iliac crest. It's uncomfortable, but not painful. I definitely felt the injection of the stem cells because they put the needle right into the meniscal tears for the injection. Afterward it felt like my knee had been reinjured for day or so, that wasn't fun but it was much better than surgery. During the treatments that were performed, they were using a special x-ray to observer the proper insertion of the needles. This was pretty cool because I could watch what they were doing and see the needles going into my knee and hips.

After all these injections, my knee was filled with a lot of fluid, so there was some swelling, I did not have full range of motion and I was limping because of this. But that seems to be returning pretty quickly as I can do stairs pretty easily now and my limp is nearly gone.
  • Days Six and Seven - My knee felt like it had been reinjured and my back was a bit sore.
  • Day Eight - My knee is doing much better today. The pain is gone from the knee and it is hardly sore at all, but now my lower back is definitely sore deep in there, especially when I sit in a hard chair or the seat in a car. It's not painful, but when I sit down without being gentle it definitely gives me a jolt and makes me think, 'Oh, that's sore today!'

For the first three days or so afterward, they tell you not to do much, just take it easy. After that, you can begin cycling and swimming for two weeks, but not full-on. They still tell you to take it easy. By the third week, you can walk as much as you like and by the sixth week you can begin integrating back into the activities you did previously, adding 20% per week. Additionally, I need to take collagen and hyaluronic acid supplements daily now to help maintain the cartilage in the joints. Somewhere between 6-12 weeks after this procedure, I will probably have my knee injected again to focus the ACL. There is a partial tear in the ACL, but not as bad as the meniscus which is what was causing most of the pain.

This treatment is really new and not yet standard by any means. Although they have treated over 1100 people and had good success in most cases, it's still not a procedure that you can get anywhere in the United States. Right now, it's only offered in Broomfield, Colorado and a few other clinics in the US. In fact, the two doctors behind the Regenexx procedure are embroiled in a law suit with the FDA over one of their procedures. There's some really great discussion on the Regennex Blog and in a Forbes article titled Stem Cells and the Lawsuit That May Shape Our Medical Future. I am fascinated by the law suit because it seems to me that the FDA is favoring someone who offers an alternative treatment and basically playing politics instead of being objective on the whole thing.

One common question that I've received is whether or not insurance covered the cost of the treatment and the answer is no. For me, this was an easy decision based on what happened with my previous surgery some 24 years ago. When I had surgery to reconstruct my ACL, literally the following week they began doing a different surgery through an arthoscope that was much less invasive and required far less recovery time. Because of this change right after I had my surgery, I was left feeling like I received the tail end of the surgical treatment technology at the time. I decided that I did not want to feel that way about having another procedure on my knee. My goal was to feel like I tried the newest proven techniques and treatment for my injury and I feel I have met that goal with the Regenexx procedure.

The other item that figured into this for me was what I read about folks who had surgery for a torn meniscus and wound up worse off. Either they had part of the meniscus removed or enough shaved off that it affected the stability of the knee permanently. I didn't want to chance winding up worse off than I am now because I am so active. I can still have surgery if I ever need to, but I'm hoping that won't be necessary.

Because the procedure is not covered by insurance, the very next question folks ask is how much it cost. This is where I explain the cost relative to the surgical procedure that I was scheduled to have before I discovered Regenexx. Consider the following numbers comparing the cost of surgery vs. Regennex:

SurgeryRegenexx
Procedure Costs$7000+$5600
Hospital Costs$8000-10,000+N/A
Physical Therapy5 months+ (2-3 times/week)6-8 weeks (1/week)
Downtime (no activity)4-6 weeks3-5 days
Covered by Health InsuranceYes, partiallyNo

There are certainly trade-offs here and everyone needs to make their own decision. Of course, at least part of the traditional surgery is covered by insurance, but not 100% of it. For me, the decision was rather easy to forgo the surgical option because I didn't want to chance having my knee wind up in a worse situation than where I started and I didn't want to take so much down time. Now only time will tell if this was a good decision.

Follow Up

To read the follow-up to this blog entry, please read A Follow-Up on the Regenexx Stem Cell Procedure for my Knee.

I have also written about having the Regenexx treatment for my left knee later in the year: The Regenexx Stem Cell Procedure For My Left Knee.

33 comments:

  1. How about an update now that it's been 2 months? I've been reading up on Regenexx and it would be great to hear a report from an unbiased source. I glanced back over your post and didn't see if you specified which procedure you had: Regenexx SD or Regenexx C?

    Thanks for you candid description!

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  2. @Amy, check out my latest blog post to see a report of my current status:

    A Follow-Up on the Regenexx Stem Cell Procedure for my Knee

    BTW, I had the Regenexx SD treatment.

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  3. Hi,Bruce! I am so interested about Regenexx,because i have knee osteoarthritis. Please,tell me,is Regenexx a solution for me? I'm not from USA, I'm from Romania. My name is Cristina Bumbaru. Thank you in anticipate ! Friendly regards! My email adress is- cristina.bumbaru@gmail.com

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    1. I know that Regenexx can be used to treat osteoarthritis, but I'm not the doctor. I'm just a patient who has had success with Regenexx in both my knees now.

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  4. Hi Bruce, how is your knee feeling? I'm thinking going this non invasive procedure (Regenexx). please update.

    Thanks

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  5. Hi Bruce can you tell me what sort of negatives there are thanks

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    1. Below I list a few of the negatives from my point of view:

      * The fact that the treatment may not work 100% for you. The Regenexx website talks about this in different areas, saying something about the treatment working for different people to varying degrees.

      * The fact that most health insurance does not cover the treatments. The Regenexx treatments are quite costly and not typically covered by insurance.

      * The fact that Regenexx is only offered by a limited number of orthopedic physicians. In the three years since I have had the Regenexx treatments, I'm sure the number of doctors offering it in the US has grown. But I haven't kept pace with this aspect of it.

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  6. My doctor says that the Regenexx procedure does not work on people of my age (63) where the cartilage has worn to the point of bone on bone. I looked on the Regenexx web site and really didn't see much about who is NOT a candidate for this treatment. Reading between the lines I am thinking this procedure is really for younger folks where there is no bone on bone contact and enough cartilage left for the stem cells to work with. Yet I saw a video about a 73 year old gentleman who raved about his treatment at the one other clinic that does this. I am confused

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    1. PS thanks for doing this blog!!! It is a great service to many. Just wondering if you came across anything on bone on bone.. Thanks again.

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    2. I was told by other doctors that the Regenexx treatments would not work on me, that it was not proven at all. Good thing that I did not listen to this advice and sought out the treatments myself ;-).

      My recommendation to anyone who asks me is to speak directly with the Centeno-Schultz Clinic yourself about your specific situation. This is the clinic that invented and carries out the Regenexx treatments, you should speak with them about an evaluation of your situation.

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  7. How long did your back hurt from the bone marrow. I was told they would be doing for bone marrows the same day.

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    1. The day of the bone marrow extraction it was just uncomfortable. It was the 2-3 days afterward where the pain set in and increased. From there it got better over the next several days.

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  8. Hi Bruce,
    Thank you for your great blog. I am considering the SD procedure for my meniscus tear but I am a terrible person dealing with pain so I am very concern about the step of injecting the stem cells back into the meniscus tear. Is really painful? Do they use any kind on local anesthesia for that?
    Thank you very much for your help! I hope you are doing great from your injuries!

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    Replies
    1. Hi Sergio, the injection of the stem cells back into my knees was different with each knee. The injections to the knee with the torn meniscus was uncomfortable, but not painful. The injections to the knee without any injuries (it was just loose) was pretty painful. From what I've heard from others, there is no way to predict your experience. It really depends on your injuries, your body, etc. My recommendation is to communicate openly with your doctor about your concerns beforehand and prepare properly for the procedure. Good luck!

      Bruce

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    2. Thank you very much for your time Bruce! I really appreciate it that! Tomorrow, Tuesday, I have my appointment bringing the MRI and report to see if they can help me. Thanks a lot!

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  9. Thanks, Bruce, for such useful information. I note that you have not mentioned wearing a brace on your leg after the procedures. Was this not done at the time you had yours done? You seemed to have significant incapacitating pain. I am worried that I could be unable to fly back home ( 3 hour flight ) the day after my last procedure ( platelet injection ).

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    1. I did not wear a brace after the procedure. Neither did I need a knee brace prior to the treatment nor was this recommended to me by my doctor.

      I did have pain afterward, enough that I would not want to sit immobilized in an airplane seat the following day for hours. I'm not saying it could not be done, you just need to know your body's limits and probably have something to take the edge off the discomfort like Tylenol (do not take NSAIDs as they promote bone growth over tissue growth).

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    2. It may be that braces were not a part of the treatment at the time you had your work done. I am hoping that the amount of pain that you experienced was greater than average. I have communicated with one guy who had both knees done at the same time and had so little pain that he did not need any medication ! I will definitely have extra strength Tylenol with me, just in case. I am told that I will need to wear an adjustable knee brace for 4 to 6 weeks to offload pressure on the part of the knee that is damaged. The offload pressure is gradually reduced over that time. This seems to be standard procedure now.

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  10. David, 18 March, 2016
    I have arthritis in both shoulders, bone-on-bone. Do you think Regenexx would work for me.

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    1. My recommendation is to get evaluated by the doctors at the clinic. It costs you nothing.

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  11. Great blog Bruce! I've actually been blogging about my Regenexx journey for the past year too. I think it's so important we spread the good news of procedures like this. It took me many years to find a solution to my avascular necrosis and I'm so thankful that I did! Here a link to all my posts: http://www.itsjustabadday.com/regenexx-avn-procedure/

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  12. Now that I have gone through the stem cell treatment I say that immediately after I had the stem cells injected into my knee, I was unable to put any weight on that leg. It was much too painful to walk on it even with the brace on my leg. That night the pain was quite bad even though I was taking painkillers.This was on a Wednesday. On Thursday I was not in pain unless I tried to walk ... I was wishing I had crutches ! I was scheduled to fly home the following Saturday but there was no way I could handle that. I had to postpone my flight to the following Tuesday. Even then, I was walking slowly and with difficulty. It seems that the amount of pain a person will have is not predictable, although I did talk to two women who were at the clinic at the same time I was and were having the same treatment for their knees. Both were going through the same type of pain that I was.
    It is now six weeks since I was at the clinic and I have not noticed any improvement in my knee, but that is not unexpected. I am going for physiotherapy once a week and I am hopeful that I will see improvement over the next few months.

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    1. Any updates on how you are feeling?

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    2. My knees are doing great. Unfortunately I have bigger problems now in that I'm recovering from a spinal cord injury that I experienced in 2014.

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  13. I had my stem cells injected at the end of March, 2016. At the beginning of August I went back to Denver to get PRP ( platelet rich plasma ) injected into my knee. This was to promote healing in one spot in particular ( tibia ) that was still sore. Time will tell if it works.

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    1. I had the PRP (aka Regenexx SCP) injections that I documented in another blog post here:

      http://bsnyderblog.blogspot.com/2012/09/the-regenexx-stem-cell-procedure-for-my.html

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    2. Hi Bruce, How are you feeling now? Any improvement in your knees?

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  14. Hi Bruce, How are you feeling now? Any improvement in your knees?

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    1. My knees are doing great. Unfortunately I experienced a spinal cord injury almost three years ago. So I have bigger issues these days.

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  15. Hello Bruce, I recently got Regenexx treatment for my partial ACL tear, and it's been almost 3 weeks. The swelling has mostly gone, but I have not noticed any signs of improvement in my knee stability. How long after your treatment did you feel the difference in your knee?

    Thanks

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    1. Stability comes from a combination of how well the soft tissue has healed and how strong the muscles that control the knees are. Depending on how long you've had the partial tear, muscle deterioration tends to take place pretty quickly. My advice is to give it the necessary time that your orthopedic doc is recommending and follow all instructions provided. Also, I strongly recommend seeing a physical therapist who knows how to work with Regenexx patients. Where did you have your treatment, in Broomfield, CO or elsewhere?

      The other thing I will say is that proper physical therapy is the key even if you think you are ok! Coming from someone who has experienced three major knee injuries and a spinal cord injury, proper PT will save you, but you must follow it and be very dedicated to it.

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    2. Thanks Bruce, I will focus on physical therapy.

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