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:

	Surgery	Regenexx
Procedure Costs	$7000+	$5600
Hospital Costs	$8000-10,000+	N/A
Physical Therapy	5 months+ (2-3 times/week)	6-8 weeks (1/week)
Downtime (no activity)	4-6 weeks	3-5 days
Covered by Health Insurance	Yes, partially	No

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.