KNEEtalk

The OSTEOARTHRITIS DEPARTMENT => KNEE ARTHRITIS - Articular cartilage repair => CARTILAGE REPAIR - Stem cell procedures (eg Regenexx) => Topic started by: rob8647932 on December 16, 2007, 06:23:45 PM

Title: Regenexx injections - Stem Cells
Post by: rob8647932 on December 16, 2007, 06:23:45 PM
Does anyone know anything about the newly patented injections of Regenexx. It says it is a mixture of bone marrow stem cells (taken from your hip) and blood from your vein. This mixture is then injected into your knee. Clinical trials have resulted in ~ 30% cartilage regrowth. Not bad.
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on July 01, 2008, 12:33:07 AM
I have been wondering the same thing..  Sounds great if it works? Has anyone on this list heard or had any involvement with the folks in Colorado?
Title: Re: Regenexx injections - Stem Cells
Post by: believev on July 01, 2008, 05:40:58 PM
I tried to call the company but can't get anyone to answer, or call me back.

I'm a little supicious of that.  I want to ask my knee doc about it.

I wish we can find someone who tried it.

Title: Re: Regenexx injections - Stem Cells
Post by: Kaputt_Knee on July 01, 2008, 05:55:49 PM
There is work being done actively by Dr Jürgen Toft at the Alpha Klinik in Munich. If you google their web site you can read a little about it. He is very pro-active in maintaining a biological solution for as long as possible.

I am hoping to get the permission of my health insurance to be evaluated by him to see if I am a suitable candidate. Anything that will postpone the TKR for as long as possible.

http://www.alphaklinik.de/en/toft/news/Stem_Cell_therapy

Sue  ;) in Germany
Title: Re: Regenexx injections - Stem Cells
Post by: Saverio on August 20, 2008, 09:37:49 PM
I had the regenexx procedure done on my left knee in March '08.  I am 57 yo, with bone on bone in both knees.  I have had 4 operations (2 in each knee) since 1996.  I have gone to the best OS's in USA and they all said let me know when you want TKRs done.  I love playing tennis and wish to ski again.  I had scheduled 2 TKRs in Jan '08.  Just before Xmas '07 I saw a news clip of regenexx on TV.  I looked them up and researched them.  I thought what do I have to loose.  It's my own stem cells and it's only injections.  I cancelled my TKR's and went to Denver.  After 1 month my left knee started to respond to PT.  It got stronger almost every week.  I could feel the quads were not atrifing.  I am now playing more singles.  I am scheduled for the treatment on my right knee in September.  Hope to be skiing this winter.

Title: Re: Regenexx injections - Stem Cells
Post by: rob8647932 on August 25, 2008, 03:52:04 PM
Savario,

How many injectons did you have and how long did it take to feel better? Did you have any restrictions.

Thanks
Title: Re: Regenexx injections - Stem Cells
Post by: loua on August 25, 2008, 05:42:33 PM
I filled out the online form and got a response back within a few hours.  I have emailed back & forth with them several times.  They are supposed to open an office in Fla. soon.
Title: Re: Regenexx injections - Stem Cells
Post by: 60schld on August 27, 2008, 11:52:47 PM
Saverio,  Please give us all the details. :D   I am dying to find out all I can.  :) ;D
Thanks!!
Title: Re: Regenexx injections - Stem Cells
Post by: darlp on September 03, 2008, 11:50:17 AM
Here's the response I got:

In response to your email, Dr. Centeno and his associates are having good success in treating patients with OA/DJD of the knees as well as degenerative disk disease, with loss of cartilage, with our non surgical procedure.  The best method for them to give you their feedback to whether you could benefit from Regenexx is to review your most recent MRIs or x-rays.  If you would be interested, we would be happy to do this. 

Our website www.regenexx.com has the most updated information regarding the procedure along with Dr. Centeno’s latest publications.  Regenexx is currently only available at our Denver location although we plan to open in Florida later in the year.  The procedure involves drawing our patient’s blood and bone marrow, growing their stem cells in our laboratory for approximately 3 weeks and then injecting the stem cells into the affected joint.  Patients come to Denver for an overnight stay for their blood and bone marrow draw and then for up to 9 days for a series of injections to place the stem cells.  This timeframe is dependent on the course of therapy prescribed to address your particular issues.

Please let me know what additional questions you may have or how I may assist you.

Thank you for your interest.

All the best!

Kelly Fulton, RN
Regenerative Sciences
Unleash the power of your stem cells

Title: Re: Regenexx injections - Stem Cells
Post by: 60schld on September 08, 2008, 10:43:10 PM
To darlp- I ermailed them also and the reply was identical.  I guess it's their form letter.  Still,
I'd much prefer hearing from someone who actually did it?!  Let's hope we have some people
out there who have tried it.  Best Wishes :) :D 8)
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on September 12, 2008, 05:00:28 PM
Have any of you folks read this press release from Dr Joe Maroon Neuro Surgeon to the Pittsburg Steelers?

http://www.pittsburghlive.com/x/pittsburghtrib/s_578202.html

There are overachievers, and then there is Dr. Joe Maroon.

Three or four days a week, he swims an hour at Sewickley YMCA, beginning at 5:15 a.m., before heading to his job as vice chairman of the department of neurological surgery at University of Pittsburgh Medical Center. He'll operate, see patients or both, and then he'll bike or jog for about an hour.

Every weekend, Maroon does his own version of a triathlon, swimming one to two miles, biking 50 to 75 miles and running between eight and 15 miles in one day. Last weekend, it was a 1.5-mile swim, 75-mile ride and 12-mile run.

"The problem is I have to double that for Hawaii," Maroon said.

Maroon, who is the Steelers' neurosurgeon, is in training for the Ford Ironman World Championship in Kona, Hawaii, this October.

The race consists of a 2.4-mile open-ocean swim, 112 miles of biking and 26.2 miles of running.

Maroon is 67 years old and will be 68 at the time of the race.

A year ago, Maroon's colleagues were telling him his racing career was over.

The trouble started five years ago, when the Sewickley resident was competing in his fifth Ironman race and injured his left knee. He continued to race, but his last major competition was in 2005, when he finished in sixth place in his age group in the triathlon at the Senior Olympics, held in Pittsburgh.

Last year, Maroon was told by two orthopedic surgeons that he was going to need a knee replacement.

That was unacceptable.

"They told me if I had an artificial knee, I'd never run again," Maroon said. "I could walk, but I'd never run again."

Maroon started researching on the Internet and found Dr. Christopher Centeno and his Colorado-based company, Regenerative Services. Centeno developed a procedure called Regenexx, in which he extracts stem cells from a patient's own bone marrow, cultivates them, then injects them into the affected area to regenerate bone and cartilage.

Eight months ago, Maroon got the first of two injections into his left knee, and last weekend he completed a half-Ironman distance race in Muncie, Ind. He finished fifth in his age group and qualified for the Ironman World Championship in the process.

The procedure, which costs $5,000 to $7,000, is not covered by insurance. Maroon knows of no one in the Pittsburgh area doing similar work.

Centeno said that while his typical patient is active and between 40 and 60 years old, Maroon will be the first to go on to compete in an Ironman.

"I kid Joe that I think he's the biggest overachiever that I know," Centeno said. "We're thankful he did well."

This will be Maroon's third trip to Kona.

"I started 20 years ago doing triathlons," he said. "Each year I just increased the bar, just like I do with my training now. That's the remarkable thing about it; you see what your body can do and adjust to."



Karen Price can be reached at [email protected] or 412-320-7980.
Back to headlines

Title: Re: Regenexx injections - Stem Cells
Post by: 60schld on September 12, 2008, 10:25:50 PM
Hi, I have read this and everything else I could find.  Somehow I just need to hear more from
more ordinary folks?!  You can never be sure it's not a media, advertisement. ??? ::) Hope
someone else is able to report. ??? :) 8)
Title: Re: Regenexx injections - Stem Cells
Post by: mayme on September 13, 2008, 12:31:43 AM
I'm like you 60schld, I'm incredibly intrigued by what I'm reading about Regennex but would sure love to hear from some "real" folks.

I have to tell you though, I am mightily impressed that one of their success stories is the vice chairman of the Pittsburg neurological surgery dept. Not too shabby.
Title: Re: Regenexx injections - Stem Cells
Post by: plantgeek58 on September 13, 2008, 05:16:03 PM
I decided to look up Dr. Centeno's company after reading this post and ran across something that very much disturbs me. The FDA recently sent his company a notification that he is in violation of their regulations and that they may seek legal action against him if he doesn't comply. As a Biotechnology student, I had to learn all about the processes by which new medicines and treatments get approved, and it appears that Dr. Centeno has simply decided to bypass all of this and simply bring his treatment to market without FDA approval.

This product is considered a new drug because it is used to treat human disease. There are testimonials to that right on his website. As such, the product is subject to FDA regulation, but Dr. Centeno has not gone through the proper procedures to get FDA approval. He has not filed an Investigational New Drug Application, nor has he gotten an approved Biologics License. Do we even know if there have been any clinical trials conducted? Without these, how are we to know about any potential side effects and how often they may occur?

 FDA regulations were put into place to safeguard the public against false claims or untested and potentially harmful medicines. I am highly suspicious of anyone who isn't willing to go through the proper channels to get his/her product approved. It can be a long, drawn out process that takes years to complete, but the fact that it is so thorough means that in the end, you can be sure of having a product that is truly effective without being harmful. As much as I would like to believe in this product, I would urge everyone considering it to use extreme caution.

There is one other consideration also. If the product doesn't get FDA approval, insurance companies will never cover the procedure and patients will continue to have to pay out of pocket for it. Anyone considering the treatment should ask the company whether they will still be charged if the harvested cells fail to grow in the lab. My OS has stated that that sometimes happens with cells grown for ACI, but patients are still responsible for the full fee.

Here is the link to the FDA letter, if anyone wants to read it:
http://www.fda.gov/CBER/compl/regen072508.htm
Terre
Title: Re: Regenexx injections - Stem Cells
Post by: 60schld on September 13, 2008, 09:06:39 PM
Hi plantgeek58
             Thank you soooo much for that info.  It's just the type of thing I've been looking for
and how do we know that Dr.Maroon and Dr. Centeno are not in business together?  Nobody
has actually seen Dr. Maroon's medical records?? We're all just believing everything because
we are seeking miracles.  Still, maybe someday it will be a really viable, workable treatment. ???
                       Hopeful, yet very cautious :o :D
                                                                  60schld
Title: Re: Regenexx injections - Stem Cells
Post by: mayme on September 13, 2008, 11:05:51 PM
Hi Guys,

I think this is excellent news that the FDA is investigating Regennex. If there are irregularities and improprieties, let's bring them into the bright light of day asap.

I'm glad to know that the FDA is closely scrutinizing Regennex--it protects and benefits us all. Now, let's see how Regennex handles this matter.
Title: Re: Regenexx injections - Stem Cells
Post by: 60schld on September 13, 2008, 11:36:00 PM
Hi to all! :D ;D  I just got through re-reading the FDA letter.  Did anyone check the name of the
sender-Mary Malarkey!!!  Is that for real?  What a coincidence!! ??? ::) ;D ;D



Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on September 14, 2008, 01:42:57 AM
I spoke to my USC affiliated surgeon in Los Angeles on Monday about stem cell therapy.  Osiris & the University of Southern California USC have been doing clinical trials with mesenchymal stem cells.

http://www.osiristx.com/clinical_trials.php

& they have had fast track clearance to their end. See the following headlines from  their own website.

"FDA Fast-Track clearance expedites stem cell therapy"

"Osiris is also evaluating Chondrogen, an injectable formulation of mesenchymal stem cells, for arthritis in the knee. "

From my understanding Osiris wants to create a one shoe fits all approach. I.E. Make one batch of mesenchymal  stem cells and package it to everyone. Dr Centeno just cultivates your own stem cells, & puts them back into the body they came from.

I know a lot of people have great faith in the US Federal government & that its institutions like the FDA always err on the side of caution, but have any of you good folks noticed the financial mess that the USA is currently suffering from?

The FDA IMHO is far from perfect no matter how well intentioned!  Most people on this newsgroup will be familiar that Matrix Autologus Chrondrocyte Implant (MACI) procedure is available in Australia UK Germany Spain to name but a few countries. The FDA has yet to allow Genzyme to go ahead with MACI distribution here in the USA. Like I said I don't think that the FDA is perfect

FWIW, my surgeon is happy to let me try this procedure out, & aside from the risk of getting someone else's cells into my knee, he doesn't see the down side risk as huge. I have scheduled my appointment with Dr Centeno.

Title: Re: Regenexx injections - Stem Cells
Post by: 60schld on September 14, 2008, 01:54:49 AM
Hi mccartjt :D 
               Please don't forget your KG pals.  Be sure to keep us posted about your procedure.
 8) :)!  I wish you every success 8) :D!!
               
Title: Re: Regenexx injections - Stem Cells
Post by: plantgeek58 on September 14, 2008, 04:17:32 PM
Mccartjt,
I will agree with you that the FDA isn't perfect. I don't think any government agency is. But I have come to understand that they do a much better job of protecting us than most people realize. I would rather have an agency that is a little too cautious than one that is too quick to jump on the bandwagon of every new product out there. And as you just pointed out with the Osiris stem cells, when they do feel that a new drug or treatment is worthy, they will go ahead and fast-track it.

Do you know the reasons that MACI is being held back? Perhaps there are some valid concerns with the procedure. Having done extensive research myself on ACI, I found out that there are a lot of complications that can arise with the procedure, the most common being graft overgrowth. Approximately half of the patients undergoing the treatment have to have further surgery to correct problems with it. Also, the cartilage that forms isn't always hyaline, but more often results in a mixture of that and fibrocartilage, resulting in a less strong graft. There may be something similar going on with MACI.

With all of its problems, the US still has the best standard of medical care in the world and this is due in large part to the strict standards and controls to which physicians and researchers are held. Other countries are able to bring products and treatments to market sooner because they don't have these controls, but that isn't always a good thing. Sometimes patients pay the price for the lack of safety and efficacy studies. Do you recall the Thalidomide tragedy of the 1950's? It resulted in thousands of deformed babies in Great Britain. The US was largely spared, because our public health director wouldn't allow the product to be marketed here. She wanted more safety studies. As a result, the only cases over here were those whose doctors obtained it on the black market.

My biggest concern with Dr Centeno is that he isn't going through the proper channels to get his product certified. Therefore, we really don't know what the drawbacks may be. Even if the product consists of cells taken from your own body, they still have to be cultivated in media containing all kinds of nutrients and chemicals. That alone poses a slight risk of allergic reaction or contamination by foreign matter. And how do we know that the injected cells are actually forming hyaline cartilage? Have Dr. Centeno's patients undergone any followup studies to evaluate this? Have there been any instances of the cells growing where they shouldn't or growing uncontrollably? These are just a few of the questions that clinical trials could help to answer.

I'm not saying that this product may not work. I sincerely hope that it does, for all our sakes. But I seriously question Dr. Centeno's judgment. Osiris is going about things the right way and has been rewarded by beiing fast-tracked. Why doesn't Dr. Centeno want to do things properly? He isn't doing the majority of patients any favors by not seeking approval. Until he does, this product will only be available to those who are able to afford it, which means poor or middle-class patients may be out of luck.

OK, I'm getting down off my soapbox now. I wish you luck with the treatment and will look forward to hearing how you progress.
Terre 
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on September 14, 2008, 11:50:21 PM
Terre

Thanks for your spirited thoughts. I am not so  sure that US medical care is the best in the world. That can only be decided on a case by case basis. Orsiris stem cells are stem cells, just not your own.

I am not going to debate MACI procedures that is outside the realm of this particular blog.

Here's a thought for you, what if Dr Centeno's procedures do in fact have permission, and that Mary Marlarkey assumptions are incorrect with her interpretation of the law, FDA and other factual stuff?

Dr Centeno is probably practicing medicine as he feels his doctorate allows him. As for the cultivation of stem cells that is done with your own blood, so no outside risk of allergenic reaction. Naturally enough if the result is positive in that the procedures do in fact regrow hyaline cartilige, (which can actually be measured on a Testla 3.0 MRI machine) would you want your knee sliced open to check that 's it hyaline cartilige? I don't think so. If my result comes out well, trust me I won't be allowing any digging into my knee anytime soon. 

You can read papers co-written by Dr Centeno here, http://tinyurl.com/6483a2

You can read papers co-written by Dr Wakatani  here http://tinyurl.com/5qebjm  &

http://tinyurl.com/566tns

Your assumption as to why Dr. Centeno might "want to do things properly?" may well  be ill founded. I suspect that your assumptions are based on the "Online lynching trial" of Dr Centeno's clinic via a letter posted on the FDA's website. Factually that is what that FDA open letter to Dr Centeno's clinic is an "Online lynching"

Fact is stem cells have been shown in the papers published above  that " hyaline-like type of cartilage tissue " has been regrown from stem cells. So is the procedure bullet proof? No. Is there risk? Yes.  From the people I've seen online on this URL

http://www.youtube.com/results?search_query=regenexx&search_type=&aq=-1&oq=

 they seem healthy to me.
Title: Re: Regenexx injections - Stem Cells
Post by: mayme on September 15, 2008, 12:44:33 AM
Dear Terre & Mccartjt,

Please keep posting. Both of you seem highly informed & insightful. The more we debate this -- the more knowledgable we become -- and then we all win.

Terre, I did question one of your comments re: MACI v. ACI. You pointed out that maybe MACI is not FDA approved in this country since it might have some of the same complications as ACI -- and you pointed out some very valid & serious drawbacks with the ACI procedure.

Yet the ACI procedure has received FDA approval & is practiced daily in this country.

I believe I understand the point you're trying to make but even with all the clinical trials & even with FDA approval, drugs are pulled off the market because of serious & even fatal unexpected side effects.

Of course we don't want to open the floodgates & willy-nilly approve all drugs & procedures but it's certainly not a perfect system.

Please keep posting and thank you both for taking the time to iinform us all!
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on September 15, 2008, 03:21:28 AM
Mayme

There are drawbacks to every procedure, MACI /ACI / Injections. However, my surgeon who is a teaching orthopaedist at USC and other clinics, has been following the Osiris procedures with USC Keck School of Medicine. My own stem cells he's okay with, Osiris's stem cells are another ball of wax.

I am getting the procedure done on me, so I've been researching this step as thoroughly as possible, it is my body after all.  I had seen the open lynching of Dr Centeno 's clinic via the FDA letter before it was mentioned on this blog. I  have no problem that someone with too much time on their hands @ the FDA were in fact speaking beyond their legal  limitations. 

As for if this procedure will or not get FDA approval is moot. If you'd pay money for a house why not pay for your health? The world is full of people that have paid for plastic surgery, why not pay for orthopaedic injections too? This procedure is similiarly expensive as breast augmentation in Beverly Hills,  so I have a good chance at fixing my knee for the same sort of money.

 Life is about the quality of life. I have friends who have homes on the Cote d' Azur & the quality of life that goes with their choices, this one is mine for the quality of my life..

I'll keep you posted as to how it goes.
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on September 15, 2008, 03:33:39 AM
Mayme

One more thing, this last peer reviewed paper

http://tinyurl.com/5n4mvc

Published on September 9th 2008 was

Co-authored by Dr Centeno, & (among other doctors,) Dr David Karli of the Steadman-Hawkins clinic of Vail, Colorado.

http://www.steadman-hawkins.com/physicianKarli.asp
Title: Re: Regenexx injections - Stem Cells
Post by: plantgeek58 on September 15, 2008, 02:28:11 PM
"Open lynching?!" That is nothing more than a cheap shot, Mccartjt. All FDA transactions have to be made open to the public, which is why this letter appeared on their website. And if you read it closely, you may recognize that it's purpose is to inform Dr. Centeno that he is in violation of several of their regulations and to request compliance. As I stated before, his product is classified as a new drug and is subject to FDA regulation. He does NOT have permission to bring this product to market, because he has not filed an Investigational New Drug Application nor does he have a valid Biologics License on file with them. He does not have the right to practice medicine this way, doctorate or not. All researchers are subject to the same regulations and he is in violation of the law. The letter does warn him of legal consequences, and if you seriously think that the agency is overstepping its bounds in this regard, you are 100% wrong. FDA regulations concerning biologics carry the full weight of law behind them. If the agency thinks that the violations are serious enough or if Dr. Centeno refuses to comply, they DO have the legal authority to force the shutdown of his operation. Ms. Malarkey is not overstepping her legal limits in warning him of the consequences of noncompliance. BTW, nice comment about her. Way to belittle someone about whom you know absolutely nothing. I can assure you that people who work for the CBER do NOT sit around looking for ways to make trouble for innocent people.

I'm glad you have the kind of money to be able to spend on a procedure like this, but my point was that there are a lot of people out there who struggle just to keep themselves and their families sheltered and fed, let alone having to pay for medical care. Not everyone in this country can afford to buy a house and not everyone is going to be able to afford this procedure. It's going to remain the purview of those who have money to spare unless it becomes FDA approved and is picked up by insurance companies.

As for the cells being cultivated in your own blood alone, that also is not true. It takes a lot more than just blood to get cells, even mesenchymal stem cells, to grow in a lab environment. It isn't as easy as you think. I know this from experience, having had to grow bacterial, yeast and mammalian cells in my lab classes. The nutrients and chemicals that normally would be replenished regularly by the body must be supplied to the media in the lab. A typical growth medium may contain more than 20 elements, not all of which are the same as that which is found in the body. So yes, there is a risk, albeit extremely small, of allergic reaction. There is also the risk that an undetected cancer cell may be harvested and propagated along with the healthy cells. Again, the risk is very small and as you say, there are risks with every procedure.

Mayme, point taken about the drugs that get pulled from the market because of unexpected side effects. I suppose I should have said that 'most of the time' there are no surprises. Given the thousands of new drugs that come out every year, though, such instances are relatively rare. There would be many more if we didn't have the safeguards that we do.

OK gang, this is probably going to be my last post on the subject. I've made my points as succinctly as I can and I refuse to take part in a pot shot session, which seems to be the direction in which the discussion is headed. I apologize if I've offended anyone and wish you all well.
Terre
Title: Re: Regenexx injections - Stem Cells
Post by: mayme on September 15, 2008, 03:38:41 PM
Terre,

Don't you dare stop posting! The information you are sharing with everyone is invaluable. I know you and Mccartjt both feel strongly about your positions and that's what makes this site awesome.

I'm thrilled you brought the FDA letter to our attention & I'm thrilled Mccartjt brought articles about Regennex to our attention. Knowledge is power and you two are helping us all. I think I'm like most people on this site; we want to learn as much as we can about any procedure we're considering and that includes the good, the bad and the ugly!

I've learned more about Regennex & how the FDA regards this new procedure in the past few posts than I've been able to learn in the past six months--compliments of you two!

You can tell by the number of "hits" on this blog that lots of people are paying attention.

Don't leave us girl! Stay on here & keep punching! We need you both!

Many thanks.
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on September 16, 2008, 03:19:07 PM
Terre

Thanks for your posting.

I feel that you may have missed one of the most important parts of that letter posted by the FDA.  That it is FDA's position / (mis-) interpretation of the law that says that Dr Centeno has created a new drug. What if Dr Centeno attorneys disagree with that position and actually has the law on his side? Then he's just practicing medicine, might that not be the case?

Your assumption of guilt (with out trial) of Dr Centeno & his clinic's practices goes against all of the "Jurisprudence" that America holds dear to its proverbial heart. To quote your letter here "All researchers are subject to the same regulations and he is in violation of the law." Well  what then if Dr Centeno is not in breach of the law? Does he get redress?  Then the original posting on the FDA's  website could well be perceived as an "Open lynching"

Please don't begrudge me the chance to repair my knee, because I can afford to pay for it. That is truly  & totally unfair. In fact as  much as I don't want to pay for it out of my own pocket & actually have  my insurance pay for this, is that they  currently won't pay. Two years from now maybe this procedure might be available from insurance companies with the full blessing of the FDA.

In fact all the on going research with Dr Centeno's procedures will add to the body of knowledge for the future of medicine, as shown by his postings on the National  Library of Medicine. What if Dr Centeno's struggles actually help millions of people fix their bad joints are you against that too? Or would you not stand to benefit from it in the long  run. Don't forget in the greater scheme of things the cost of the Renenexx procedures is way way cheaper than debridement/Arthroscopy / MACI /  ACI operations. Insurance companies would jump at the chance of a cheaper solution than TKR.

One thing I can say confidently is that Ms. Malarkey may be overstepping her position (unless of course you are in fact Ms Marlarkey). Time will tell how this whole story unfolds.

Terre I wish you all the best.
Title: Re: Regenexx injections - Stem Cells
Post by: plantgeek58 on September 16, 2008, 04:58:59 PM
Mccartjt,
I don't begrudge you the choice of treatment for your own knee. That decision is yours and yours alone.

However, Dr. Centeno absolutely does not have the law on his side, no matter what his lawyers may argue. This product is cell-culture based and its clearly stated purpose is to treat human disease. Therefore it unequivocally comes under FDA regulation as a new biologic drug. Your statement that the agency is interpreting the law is mistaken. The FDA has been granted authority by the US courts to CREATE the laws governing biologics. The regulations are very clear and are NOT open to interpretation. They ARE the law. Compliance is mandatory.

There is nothing in the FDA letter that could be perceived as a 'lynching'. It is a simple notification. It does not attack Dr. Centeno's character, nor does it denigrate his product. It states the violations and requests compliance, AS PER THE LAW.

I have nothing against this procedure or the valuable research Dr. Centeno is doing. It may well be a valid and less invasive treatment option for tissue damage. My objections are the methods by which this physician is going about the testing and marketing of the product.

Finally, as I've stated before, insurance companies are not going to back any treatment that does not have the FDA stamp of approval, no matter how effective it appears to be. It will simply continue to be considered experimental and coverage will be denied. Furthermore, actual long term success/failure rates for the treatment have yet to be established and this is another factor that insurance companies take into consideration. If the treatment turns out to not offer lasting benefits, or if its success rate is relatively low, then it still won't be picked up by the companies in preference to TKRs, which have a success rate of approximately 90%. Insurance companies tend to prefer a sure thing over a treatment that may or may not work. 

Terre

Title: Re: Regenexx injections - Stem Cells
Post by: 60schld on September 17, 2008, 01:21:06 AM
 Hi out there :D :D  Wow this discussion is fantastic!!  I agree with mayme, I have learned more
from this post since you guys are sharing some truly valuable info and opinions :D 8).
Keep it coming!!  8) :D  thanks-  60schld
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on September 17, 2008, 03:59:32 AM
Terre

Please tell me what ever happened to due process? What ever happened to being innocent before proven guilty? The FDA / the US Government has laws in place. Typically it is a court that decides in matters of the law, not you (unless you are a judge)  nor I.


 Since I am not a FDA attorney assigned to this case, nor the attorney for Dr Centeno I won't debate these points with you. It is suffice to say that there are plenty of attorneys in the USA that can do all the jaw boning needed in any interesting case. I do know from experience that there can be interpretation of the law, which is why one employs an attorney & that these folks usually meet in a court of law. It is in this area that your assumptions about Dr Centeno's procedures maybe incorrect. I will agree with you too on one point that compliance of the law is mandatory. I am confident whatever the law is it will come out in the fullness of time, you can sleep soundly on knowing that.


Your assumptions that insurance companies won't embrace Dr Centeno's procedures may well be unfounded too. Do you currently know the success ratios that Dr Centeno's procedures are experiencing?  & the alternative Osiris procedure of their MSC's has only a 30% success ratio in the phase 1 & II trials.

One of my real issues is with the FDA is that I've been waiting for 3-4 years for them to make its mind up about MACI here in the USA & they have yet to get off the fence. If I lived in the UK I'd be back to health by now..

 Dr Joe Maroon gave Dr Centeno a glowing reference with him back to running 13 miles, then cycling 75 miles & swimming over a mile  all in one day and qualifying for the Hawaii Ironman too boot! Whilst two other orthopaedists offered Dr Maroon only a TKR with its miserable quality of life issues. As for how Dr Centeno goes about his business of helping patients be thankful that people are saying extremely good things about his procedures.

Finally if you want a sure bet in life count on paying taxes and dying.
Title: Re: Regenexx injections - Stem Cells
Post by: plantgeek58 on September 17, 2008, 05:20:24 AM
I'm not debating the legal issues with you anymore. We simply are going round and round in circles and as you say, it will come out in the fullness of time. Just one final thought. Have you considered the terrible precedent it would set if this case were to come to court and the doctor were allowed to continue distributing this product without going through the proper procedures to ensure its safety and efficacy? It would open the floodgates for other companies, who may not be as scrupulous, to attempt the same thing. We could end up back in the days when physicians were able to make any claims they wanted about their products, whether or not they were true. Many thousands of patients in those days suffered because of it. I don't want to see that happen again, and that's why I feel so strongly about this issue.

As for testimonials, they have a tendency to give one a biased view, because they only encompass the people who have had success with the procedure. How do you know that these people are the rule rather than the exceptions? Reading all these glowing reports, it's easy to get fooled into thinking that everything always goes perfectly and you can expect near miraculous results. What about the folks who have not benefitted from the treatment or who have had indifferent results?  You rarely get to hear from any of them , which is why I've always viewed testimonials with a grain of salt.

I know there are a lot of people out there reading these posts. I mean, I'm happy that folks are finding the discussion between myself and Mccartjt useful, but I would really like to hear some other opinions on this subject. How about it people? Let's really open up the debate and see what others think about all this.

Terre
Title: Re: Regenexx injections - Stem Cells
Post by: Kaputt_Knee on September 17, 2008, 09:57:38 AM
I'm jumping in Terre with my 2 cents!

I work in the medical devices field and have to translate documents for submission to the FDA prior to our products getting the OK. We are an OEM manufacturer of these devices - i.e. we produce the items for other companies to market under their brand name as well as manufacturing the same products for marketing under our sales name. We find that the FDA is very parochial at times - fast-tracking what they feel are home-based products and questioning identical products produced "outside" of the USA. So sometimes perhaps there is "home advantage" here. We produce devices for companies all over the world by the way and I am responsible for translating and editing all the regulatory affairs documentation required in English. So it is not just the FDA I have experience of.

I am also based in Germany where this stem cell treatment has been in use for some time, BUT only using your own stem cells. All research using stem cells gained from other sources is currently very heavily policed and largely illegal. For example the use of foetal stem cells is banned. So on one hand our legislation is behind that of the USA (use of foreign stem cell material) and ahead in other (use of own stem cells). I have had incorrectly placed tunnels in my knee filled with bone marrow taken from my shin by the way which is based on the same principle. The bone marrow cells will calcify to form bone.

The use of your own stem cells, harvested from the illiac crest (not sure of the spelling there, we call it the Beckenkam) is not that common but it is practised by a number of leading knee specialist practitioners here. Dr Jürgen Toft, formerly from the Alpha Knee Clinic in Munich is one leading knee surgeon using this technique. He has a book about arthritis and the various options for preserving the biological knee for as long as possible (available in English). For those who can read German, his new web site is up and running at this location: http://www.knie.de/start?t=1&ksid=53d0af615f2bff58bbeccc02233bb7b0. I am assuming that an English version will be produced soon. The change from the Alpha Clinic is due to problems that arose with the Spinal Surgery section of the Alpha Clinic by the way! Nothing to do with the Knee Unit. The old Alpha Clinic web site in English is also still available but for how long I do not know. The new site is pretty well a duplicate.

I am following the developments in this field very closely as I have been told that I am a candidate for a TKR in the future - I hope to keep that future as distant as possible. Currently my insurance does not pay for this treatment but have yet to establish why. It may simply be a cost thing I do notice that it is a procedure carried out largely on patients with private health insurance. I will talk to my surgeon about it to find out if I can about my options at a later stage. Fortunately according to him, I have no arthritis in my knee to speak of. However, 3 other surgeons who were in there as well say it is between grade 3 and grade 4 - go figure, I can't work it out! I like my new surgeon's diagnosis best!  ;D

I think that the discussion should continue but let's leave the lawyers, emotional language, etc. out of it. Everyone has their own point of view, and sorry none of us are impartial, we all have our own points of view based on our individual needs and experiences. It would be nice to hear from people who have undergone this treatment personally, not just the references from glossy web sites! As someone says, no one is going to post about failures on their promotional web sites are they  ;) It would also be interesting if a practitioner were to post but I feel that is unlikely  :(

Keep the discussion going guys please!

Sue  ;) in Germany

Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on September 17, 2008, 04:43:54 PM
Terre

My point has been all along that if you are not an attorney & have no direct knowledge of the discussions / letters / medical facts between Dr Centeno's clinic and the FDA, you are in no way able to give 100% accurate opinion.

You have stated previously that Dr Centeno's clinic & processes were " in violation of the law". & to date you've decided not to retract that statement, so please tell me, since when did you alone become a court of law in the USA?

Factually all the laws of the USA are open to determination, that is why we have "The Supreme Court" & the constitution. Why if there is nothing to debate would the Supreme justices ever sit and hear arguements?

As for opening the flood gates of dodgy procedures, there are  laws already in place already. How about this notion that "The Regenexx  procedure" turns out to actually be legal  as the law now stands? Where would your position then be? Would you want the laws to now change?

The way in which the FDA has approached his particular clinic is not unlike the financial termoil that is going on in the US economy right now.  Both have been handled IMHO badly! If the FDA had approached, & interviewed Centeno & co to understand the processes maybe the letters you've seen wouldn't be on a website right now either?

If you would care to read the FAQ on their website

http://www.regenexx.com/about-regenexx/common-questions/

In fact the clinic goes into great detail regarding "Is this procedure FDA-approved?"



Title: Re: Regenexx injections - Stem Cells
Post by: plantgeek58 on September 18, 2008, 06:23:29 PM
First let me apologize if I've begun to sound judgmental. I am trying to state the facts as I know them and my opinions based on those facts. That is, after all, what these forums are all about. That being said, I stand by every statement I've made. I believe that this procedure does fall under FDA jurisdiction. Obviously, so does the agency, or they would not have sent out that letter.

I did read the FAQ page. Here are a few of my thoughts about it.

Addressing the question of no interstate commerce involved in this procedure:  did I not read somewhere that another doctor is going to soon be setting up a clinic in Florida in order to begin treating patients there, using Dr. Centeno's technique? If he is teaching the procedure to other physicians, who are then going to be practicing in other states, does that not constitute interstate traffic? Sure seems like it to me. Take a look at question 42: 
"42.    Why don’t other doctors do this yet?  We are training other doctors in the technique. "

Regarding the FDA not approving surgical procedures:  What is ACI if not a surgical procedure? The FDA does regulate such procedures if they involve the use of products that come under the heading of new drugs or biologics. In my opinion, Regenexx falls into this category.

Concerning the statement that the doctor is simply practicing medicine as he is sees fit:  This procedure, in my opinion, is not part of standard medical treatment, but is an experimental new treatment involving a biologic agent. Again, I feel that it needs to have FDA approval.

Question 6 addresses the success/failure rate. It is stated that a survey was sent out and 80% of those who responded expressed satisfaction with the procedure. Pretty vague here. It doesn't mention exactly how many people responded to the survey. Only about 100 people have been treated so far. That isn't a huge database to begin with. What if only 10% of those surveyed responded, which is a pretty standard rate for surveys. That's just 8 patients. What about the rest? Surveys in general are not good indicators of success/failure rates. There are too many factors that can skew the results. Statistics gathered from followup studies tend to be more objective, but this procedure is so new, it will probably be a while yet before really accurate data is obtained. Again, just my opinion, based on what I've learned in my Probability and Statistics class.

Final thoughts-the whole arena of stem cell therapies is very new and it may well be that the current laws and regulations need to be changed to accommodate them. I do believe that there needs to be regulation, to protect the public, and I feel that the FDA is the best agency for the job, in spite of its imperfections. Doctors are human beings, and not all of them are trustworthy, which is why I feel that standards should be set that apply equally to everyone. These therapies are the wave of the future. They look to be extemely promising and yes, I do hope to be able to benefit from them myself. I would be happy to consider this procedure or something similar, but I also want to know that regulations are in place that will minimize my risk from it .

Sue, Danke vielmals fur die Auskunft. (Hope I said that correctly-don't know how to get the umlauts in there). You've made some interesting comments and pointed out some facts that I didn't know about the FDA and its attitude towards foreign-made products. Please keep posting with us. Every bit of information we get makes this discussion more useful, as Mayme and 60schild have said. And I will try to keep the debate from becoming personal.
I did visit Dr. Toft's webpage, but am going to have to come back to it with dictionary in hand. My German has gotten quite rusty from lack of practice.
I agree with you that it would be great to hear from someone who has undergone the procedure or from a medical professional. Anybody out there with those qualifications?

Terre
Title: Re: Regenexx injections - Stem Cells
Post by: Kaputt_Knee on September 18, 2008, 09:38:50 PM
Hi Terre and any other interested parties!

the Alpha Clinic site with the English pages is still operating, even though the clinic is no longer functioning under that name

Here is the link http://www.alphaklinik.com/

There are some explanations in English but the German pages have more detail.

Have fun finding info and please pass on what you can - this is an interesting thread.

Sue in Germany
Title: Re: Regenexx injections - Stem Cells
Post by: 60schld on September 18, 2008, 10:45:28 PM
Hi everyone :D 8),  I am finding all of this so interesting.  Kaputt_Knee I have heard from some
others out of country that our FDA is tends to be parochial.  I am very cautious and tend to lean
towards plantgeek58.  But since OA has fast been becoming one of our nations leading health
problems,  I think it would be in the financial interests of our big medical insurance companies to
reserve a section of their profits for the funding of these kinds of "new age", treatments.  I
believe if real money(which is what it ultimately boils down to) were to back these things, the
FDA might "fast track" more new procedures.  I don't know if it is any comparison, but look at
Bill Gates and his funding for research and treatment for AIDS.  I am grateful for Dr. Centeno
and Dr. Toft and whoever else can shed some hope for us.  Certainly, more money would help
to keep the research etc. a little less of a risk for all. 8)     60schld
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on September 19, 2008, 04:30:52 AM
Terre

I am absolutely amazed, as here you go again, spouting your versions of legaleze. 

" Addressing the question of no interstate commerce involved in this procedure:  did I not read somewhere that another doctor is going to soon be setting up a clinic in Florida in order to begin treating patients there, using Dr. Centeno's technique? If he is teaching the procedure to other physicians, who are then going to be practicing in other states, does that not constitute interstate traffic? Sure seems like it to me. "

Do you actually know what the term of "Interstate commerce" means as it referred actually to in law, (& not your hypothetical conception of what the law might be,) vis a vis Dr Centeno's procedures?  I'll answer this one for you ~ probably not!

I have to say that am learning more about you Terre & I am going to make an assumption here, you are probably a salesperson, since every time I ask you a direct question you refuse to answer it. Yet you carry on back where you started from have yet another go at Dr Centeno & his clinic! That Dr Centeno & his clinic  is doing something that may directly & positively impact millions of peoples lives, seems moot to you.

Dr Centeno is regulated by the State of Colorado health authorities among others. If he steps out of line & breaks laws its his license to practice medicine that is on the line. As some one that has worked for years as any doctor has, you can rest assured that most of them won't intentionally break the law. That your knowledge of Dr Centeno's procedures & legal standing is lacking, is not my fault. Perhaps you should study proctophobia since your opinions come less than well thought out?
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on September 19, 2008, 05:25:16 AM
Terre

As for one of  your last comments, specifically about interstate commerce, Dr Centeno's website answers that question for any one who cares to read it..

http://www.regenexx.com/about-regenexx/common-questions/

"Rengerative Sciences Inc., (RSI) conducts all surgical procedures within the State of Colorado.  There are no interstate aspects to the procedures conducted by RSI that invoke FDA jurisdiction under the Public Health Service Act (PHSA), which requires an interstate nexus."

As for your opinion yet again...

Regarding the FDA not approving surgical procedures:  What is ACI if not a surgical procedure? The FDA does regulate such procedures if they involve the use of products that come under the heading of new drugs or biologics.

Per the FDA's  website

http://www.fda.gov/opacom/morechoices/mission.html
&
http://www.fda.gov/comments/regs.html

FDA is the federal agency responsible for ensuring that foods are safe, wholesome and sanitary; human and veterinary drugs, biological products, and medical devices are safe and effective; cosmetics are safe; and electronic products that emit radiation are safe. FDA also ensures that these products are honestly, accurately and informatively represented to the public. Some of the agency's specific responsibilities include..  It goes on..etc.,

No where does the FDA say on their own website that they regulate surgical procedures. They do regulate drugs that go over state lines as those then fall under "Federal" laws. If its interstate procedures its probably health boards of Colorado that have intervention. 

While we are getting educated here,  have a read here about defamation,

http://en.wikipedia.org/wiki/Libel


Title: Re: Regenexx injections - Stem Cells
Post by: Kaputt_Knee on September 19, 2008, 09:49:06 AM
Terre

I am absolutely amazed, as here you go again, spouting your versions of legaleze. 

" Addressing the question of no interstate commerce involved in this procedure:  did I not read somewhere that another doctor is going to soon be setting up a clinic in Florida in order to begin treating patients there, using Dr. Centeno's technique? If he is teaching the procedure to other physicians, who are then going to be practicing in other states, does that not constitute interstate traffic? Sure seems like it to me. "

Do you actually know what the term of "Interstate commerce" means as it referred actually to in law, (& not your hypothetical conception of what the law might be,) vis a vis Dr Centeno's procedures?  I'll answer this one for you ~ probably not!

I have to say that am learning more about you Terre & I am going to make an assumption here, you are probably a salesperson, since every time I ask you a direct question you refuse to answer it. Yet you carry on back where you started from have yet another go at Dr Centeno & his clinic! That Dr Centeno & his clinic  is doing something that may directly & positively impact millions of peoples lives, seems moot to you.

Dr Centeno is regulated by the State of Colorado health authorities among others. If he steps out of line & breaks laws its his license to practice medicine that is on the line. As some one that has worked for years as any doctor has, you can rest assured that most of them won't intentionally break the law. That your knowledge of Dr Centeno's procedures & legal standing is lacking, is not my fault. Perhaps you should study proctophobia since your opinions come less than well thought out?

Mccartjt

To my mind it is you that sounds like the salesperson and this latest post is a personal attack on somebody who is honestly questioning why a procedure that enjoys success in many other countries and while not yet widely practised, is freely available, is not yet as freely available in the USA.

I'm sorry but you are repeating yourself with these replies, constantly referring back to the Regenexx web-site. Who else in any other state in the USA is performing this procedure? I've read the Centeno web site and I am curious about the possibility of using this technique to prolong my active life. Although allowed in Germany, we too have very few practitioners, as far as I know only Dr Toft in my area. Why is this when according to Regenexx it is only a surgical procedure? The general health insurance schemes here also refuse to pay for the treatment but will pay for expensive invasive surgery such as TKR and other such routines. I am absolutely certain that it is not all a dreadful cunning plot to prevent those without private health care to stay in the "dark ages" of joint surgery. According to the web site this procedure would save all health insurance schemes millions as there are no hospital stays, prolonged course of intensive PT or rehab centre stays and result in more people remaining economically effective and contributing their coffers. Even revisions would be cost efective according to the testimonials!

Sorry for the cynicism there - I'm a European and we are are cynics from birth, especially when it comes to dealing with public entities like health care!  ;)

OK this is a new procedure, new ideas can be slow to catch on, but ligament replacement therapy has developed rapidly from none through artificial ligaments to autogenous now on to allograft in less than 25 years. Techniques have changed from major open knee surgery to minimally invasive in fairly record time - I know this from personal experience and have the scars to prove it  ;) And that is from medical treatment in Austria, France, the UK and here in Germany, so I'm hardly being parochial/patriotic here!

Can we stop trying to score brownie points in Law 1001 and get on with the discussions about these treatment please. I would like to read about the culturing of the cells in vitro - what is used - does it classify as a surgical or a physical treatment? Does anyone KNOW why there is no federal acceptance but it seems to have local state level acceptance? I have read Dr Toft's glossy pages and I have read those mentioned here. Does anyone know of any other examples? Does anyone know if respected specialists who are moving in this direction (Steadman, Hawkins et al are also in Colorado aren't they?)?

Sue
Title: Re: Regenexx injections - Stem Cells
Post by: Saverio on September 19, 2008, 01:15:32 PM
To All,

I am an actual recipient of regenexx back in March '08 and I posted my experience on this forum.  I am not getting into the legalities of tis procedure and the FDA.  I can only talk to my experience.   After the injections in my left knee, may I emphasize, it's only injections not surgery.  That in itself is a big relief since I have gone thru 4 knee surgeries without any improvement.   Dr. Centeno advised to not do any pounding for a month.  For the 1st month I could walk and bike.   After that I started to play tennis again and do some heavier rehab.  I could feel my knee getting stronger week to week.   Make a long story short,  I started playing singles again.  I just got back from regenexx for a 2nd bone marrow withdrawl.  I will be getting the injections in my right knee starting Sept 29.  A friend of mine also came out and will be getting injections in her right knee.   I will keep all posted on this website of our experiences.  BTW I was bone on bone in both knees.

Saverio
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on September 19, 2008, 02:49:00 PM
Sue & Saverio

Thanks for both for your comments. Whilst I have repeated myself it was on a point of provocation by Terre. Yes was my attack personal? Absolutely. When Terre (or anyone) sat in judgement of Dr Centeno's procedures in her mythical "Court" yes I did become insensed. Dr Centeno doesn't to the best of my knowledge post on this blog and has no one to defend him or his practice. I am against wild rumours because once started are almost impossibe to get under control.

I don't want to be talking law 1001, but people need to control what they are saying,

As for why the procedure does not fall under the FDA reguluations its probably because its not practiced "Federally" ie across state lines. You go to Colorado to get the procedure done. I can't even have the marrow draw done and shipped to Colorado. So no, the process intentionally does not fall  under FDA processes.

Medical insurance companies around the world pay for "Known" working medical procedures. They can't go out on a limb (or whim) easily. The story below of Viven Thomas is well documented

http://en.wikipedia.org/wiki/Vivien_Thomas

With out Dr. Viven Thomas's work millions of babies would have died. It takes guts to be a pioneer. Dr Centeno has clearly got strong opposition from Terre, here on this website. His clinic currently walks a fine line of legal arguement & medical science to get help to people with bad joints, bones and the like. Like I've previously mentioned I've been waiting 4 years for the FDA to approve MACI without success.

ACI is also a procedure that could be used in my condition, however my surgeon strongly recommended against it. To point "ACI is a procedure that you don't want the pain from" is precisely what my surgeon has told me for my particular condition.  My surgeon, also gave me his thoughts on what Centeno was doing, that he was extremely brave, ~ too brave for my surgeon's comfort level!

FWIW I have consulted with Dr Toft in Germany (& no doubt he does great work) I chose not go down his suggestion of treatment for my condition. There is, Dr David Karli of the Steadman Hawkins clinic who is involved with Centeno you can read his bio here

http://www.steadman-hawkins.com/physicianKarli.asp

Dr David Karli co wrote some of the papers published on NLH

http://tinyurl.com/5n4mvc

Finally I think I posted 3  links to Dr Centeno’s website which after all when we are discussing his procedures and techniques I don’t feel is excessive.

Saverio, finally to your points I wish you all the best with your procedures and recovery. Loss of knee cartilage is very difficult to deal with. I hope it turns out well.

For anyone else reading this blog, its important to do your own research as to the options / alternatives available for your condition and wish anyone that is in pain a speedy recovery from what ever ails you.
Title: Re: Regenexx injections - Stem Cells
Post by: plantgeek58 on September 19, 2008, 09:26:12 PM
Mccartjt,
personal attacks are not acceptable under any circumstances. I have repeatedly stated that my posts reflect only my opinions, I have twice apologized for anything that anyone might find offensive and I have tried to confine my comments to the issues at hand. Yet you continue to take pot shots at me. I have asked the moderators to look at this thread. Until I hear back from them, I will no longer be posting here. If and when I do return, it will be only to respond to others' postings.

I do hope that everyone else will continue the discussions. Saveiro, I would be very interested in reading more about your experience.
Terre
Title: Re: Regenexx injections - Stem Cells
Post by: Kaputt_Knee on September 19, 2008, 10:23:18 PM
OK we have an actual recipient on board.

Saverio, can you please explain how you came to this therapy (why, etc., if possible) and exactly how it all panned out? There are many of us here who have, for whatever reason, only here say on which to base our own opinions. Not exactly informed opinion really when you analyse it  ;D ;D I am, despite my profile info, almost 58 and have almost all the medial meniscus in my left knee shaved away. The lateral is very healthy and not in need of any TLC from some demented "salami slicer" of an orthopaedic surgeon. The discrepancy between the two sides is going to cause me problems. I am and always have been a hyperactive sports fan (Phys Ed teacher, ski instructor, national level volleyball player, diver, paraglider, climber - get the picture?). I want to continue for as long as possible with most of my sports - OK I'll give up the volleyball and field hockey! But the skiing and mountain based sports - NO WAY JOSE  ::) I live in the Alps for God's sake - why should I?

Please can you explain more about the actual processes involved as YOU UNDERSTAND them. What would be of particular interest is any personal evaluation of "before & after", how the pre-procedure evaluations were carried out and most importantly what you feel about the effects on your body at the time of your treatment and subsequently.

You have only been in this situation since March this year, so only a maximum of 6/7 months max.: with the best will in the world this is hardly a long term evaluation  ;) Do you feel that you will need further injections to resolve your particular problems?

Mccartgt - please if you want to gnaw away at something, please do it elsewhere as you are currently doing nothing except souring an open and adult discussion about an interesting new procedure. I have looked at all the links you have posted but currently view most of them as, at best interesting but not that informative, and at worst simply advertising similar to that of the quacks that turned up in towns and beat their own drum! It is very easy to take pot-shots on forums such as this, but a little more constructive discussion is what most of us would appreciate.

Terre, I have also reported the thread for monitoring but not to be locked as I feel with a little less emotion we could all learn something here.

Sue
Title: Re: Regenexx injections - Stem Cells
Post by: 60schld on September 19, 2008, 11:54:43 PM
Yes I'd like to chime in ??? ???. Saverio, what happened to you?  How are you feeling?  As you
can read from this thread, we ALL want to know!!  Write soon :D :D
Title: Re: Regenexx injections - Stem Cells
Post by: 60schld on September 20, 2008, 12:12:15 AM
My computer/ browser was not working for a while.  thanks Saverio, I just found your latest
post.  How encouraging :) :)!!
Title: Re: Regenexx injections - Stem Cells
Post by: Dr. Centeno on September 20, 2008, 02:47:42 AM
 :)  Hello,

This is dr. Centeno.  Wow, I must say that when somebody told me about the bulletin board i didn't know what to expect.  I'm a bit bowled over on the amount of discussion our little clinic has caused.  To set the record straight, we have been working with regulatory council for 3 years on our needle based, surgical procedure.  We have responded to the FDA unititled letter and we believe we have anwered all of their questions.  This is a surgical procedure and not a new biologic drug.  We have been communicating with the FDA and they have had no response, so we assume that we have answered their questions. 

If anyone has any questions about the www.regenexx.com (http://www.regenexx.com) / Regenexx procedure, please don't hesitate to write me at [email protected]

Chris Centeno, M.D.
Title: Re: Regenexx injections - Stem Cells
Post by: Saverio on September 21, 2008, 01:37:56 PM
I see that Dr Centeno posted.  That's good.

Sue and 60'schld requested more details from me.  I'll do my best.

I am 57 yo 5'9" 175 lbs.  I post stats so you know I try to take care of myself.  I have always been very active..tennis, racquetball, skiing, jogging, biking etc.   I don't remember the exact year but over 12 years ago, I had my 1st knee operation on my right knee.  The OS said it looked like hamburger.  10% of my lateral meniscus was left and bone on bone in small areas after that surgery.  I could still ski and play singles but not to the level I was used too.  I wanted my old knee back so 2 years later I went to a well respected OS in the Harrisburg, PA area.  In fact he was the OS for Penn State Football team.  We talked about a meniscus transplant and agreed to have it done if my knee could sustain it.   He did a scope of my right lateral compartment and determined there was too large of damage to my articular cartilage.  He did not do the transplant but did more cleaning.  More lost cartilage.   He told me I was a candidate for a TKR but I was too young to recommend one at the time.   In the meantime he recommended an unloader brace and hylagan injections.   I wore the brace and tried the injections.  The injections didn't help.  I was determined there should be a better solution to my knee.  In the next year on a Vail ski trip, I went to the Steadman-Hawkins clinic for an evaluation.  It was the same.  TKR was the only remedy.  In 1999 while playing tennis, my left knee went out.   The same OS did surgery and removed most of my left lateral meniscus and some articular cartilage.  Bone on bone in my left knee.   Now I was wearing 2 unloader braces.   After a year or so someone suggested that I see a foot doctor.   The foot doc said  I pronate on both feet thus the damage to my lateral sides.  All my shoes wear out on the outer sides.   He prescribed foot orthodics to remedy my condition.  They were terrific.  I felt I had a little bit more mobility and I didn't have to wear my braces.  Basically the orthodics redirected the forces through my legs more evenly through my knee joints.   I thought to my self "Why don't the knee docs talk to the foot docs ?"  If they did I could have at least saved my left knee.   In my opinion the medical profession does not help you prevent injuries but are like auto mechanics after the damage is done.

So now I can't ski and am limited to doubles tennis.   I do bike to strengthen my knees, but it's almost a losing battle because the pain in the joint prevents building strength in adjoining muscles.  I'm sure you all have found this out.   I was still determined that there is a better solution.   I was hoping the medical profession would advance enough to solve the cartilage regeneration problem.   I found the Stone Clinic in San Francisco.  Dr. Stone is a premier OS who has developed a biological knee replacement procedure (www.stoneclinic.com).  In October of '07 I went out for an appointment.  He evaluated my MRI's.  He suggested two options.  A TKR or his biological knee replacement.  Based on what he saw on the MRIs he felt he could do the BKR.  The next day I had my 4th knee surgery (left knee).  The outcome was not good.  He said he tried like hell but could not find enough cartilage for his BKR to adhere to.   Since he did my left knee, which was the better one, we didn't have hope for the right one.   TKR was the last resort.   He informed me the metallic knees now have rotating platforms (15%), which help active people and last longer (15-20 years).  He convinced me that I could ski again and play singles, it all depended on how much PT I was willing to put in.  I scheduled 2 TKRs for Jan '08 with Dr. Stone.   Just before Xmas I caught a news clip on TV of this stem cell process for damaged joints (regenexx).  I looked into it and since it was my own stem cells felt it could do no harm.   Knowing that TKRs are not reversible,  this would be my last hope for a natural fix to my knees.  It's only injections.  I don't know why DR Centeno calls it a surgical procedure.  It must be some technical jargon.  I cancelled the TKRs and scheduled a trip to Denver for the regenexx procedure.    The 1st appointment is an evaluation interview with a DR followed by the bone marrow withdrawal if you are a candidate.    This is done in one day, actually less than half a day.   The marrow and blood withdrawal only takes about 30-45 minutes.   The bone marrow is withdrawn in 6 locations on you back hips (3 on each side).   He did 7 on me because he felt there wasn’t enough bone marrow with 6.   First he numbs the area with anesthesia (needle injection) and then withdrawals the bone marrow.   This is all done in about 15 minutes.  A nurse then withdrawals a pint of blood.   About 10 days later, I made my 2nd trip to Denver to receive the injections.  There are a series of 4.  1st there is an injection of an irritant into the joint to ready the area for the stem cells.  A couple of days later the stem cells are injected.  There were 17 million for me.  I was told this is on the low side, but everyone is different.  I wanted both my knees done but since the count was low they did only one.  You must stay off your feet for 1 hour after the stem cell injections.   A couple days’ later growth factors are injected.  There are 2 injections of these 2 days apart.  That is it.  He advised to not do any pounding for 1 month and you will know after 3-4 months.

My experience was I could walk and bike for the 1st month.  I did not play any tennis or hard rehab.  After a month I did some longer bike rides and slowly worked some tennis in.  I could feel my left knee getting stronger every week.  There was no pain in it or cracking.   I could feel the muscles actually firming up and getting definition.  None of the past 4 surgeries had these results.  I am now playing singles tennis again but I am waiting to get my right knee done before I tackle the slopes.

Saverio
Title: Re: Regenexx injections - Stem Cells
Post by: 60schld on September 21, 2008, 09:01:04 PM
Thanks Saverio,  I am 56 and a former distance runner. From the very start, at 25, I had custom made orthotics for my severely pronating feet, so I understand completely the biomechanics behind the knee/foot relationship.  I thought that would prevent any serious knee problems-no such luck :o >:(!  Eventually, those miles just wore my knee out.  Does Dr. Centeno give age limits on this procedure? ???  Do our stem cells age too much or are incapable of regenerating?  Is this why you were not able to have enough for both knees?  Best of everything, you are a real pioneer :D!!  60schld 8)
Title: Re: Regenexx injections - Stem Cells
Post by: joew on September 22, 2008, 06:07:16 AM
Saverio,

Thanks for the details.  Just two questions:
1.  How was the cartilage in your patellofemoral joint before the injections (i.e. the cartilage under you knee cap and the cartilge in the femoral trochlear groove where the kneecap glides)?
2.  Do you plan to get an x-ray to see if the joint space has actually increased?  Based on the way you feel, it sounds like it probably has.

Joe
Title: Re: Regenexx injections - Stem Cells
Post by: Kaputt_Knee on September 22, 2008, 08:23:55 AM
Thanks for that detailed account Saverio. It is really interesting to read both your history and your account of the procedure.

When will you have the second knee done do you know yet? I believe here the stem cells are collected under a general anaesthetic but I'm not sure - just remembering a photo from the Alpha Clinic site. As I have a real horror of needles that would suit me fine!  ::)

How did you feel during the immediate post injection time? Did you have any kind of physiotherapy or were you advised to do nothing particularly other than take it easy for the first month?

Please can you post regular updates so that we can follow your progress? It is much more informative hearing from an actual patient even if it is a subjective point of view.

Sue
Title: Re: Regenexx injections - Stem Cells
Post by: Saverio on September 28, 2008, 01:36:00 PM
To All,

My friend (her 1st) and I (my 2nd) are going out to Denver tomorrow to receive our stem cells.  We were out there 2 weeks ago for the bone marrow withrawals.   There are 4 injections (see my previous post).  We'll be all done by Oct 8.   I'll post again then.

Saverio

Title: Re: Regenexx injections - Stem Cells
Post by: Kaputt_Knee on September 28, 2008, 02:38:40 PM
Good luck Saverio - I look forward to reading your posts afterwards.
Title: Re: Regenexx injections - Stem Cells
Post by: Kaputt_Knee on October 04, 2008, 12:23:56 PM
Any updates Saverio? I know you are there for another week yet but I think we would be interested in an interim report. Do you have any evaluation work done on your initial transfer?

This thread obviously interests people as it literally hundreds of reading hits, if not so many posts.

I notice that there is nearly always someone reading this every time I check the Boards!


Sue
Title: Re: Regenexx injections - Stem Cells
Post by: slyguy1 on October 05, 2008, 01:44:14 AM
Interesting thread.....Saverio could you elaborate on what you did as far as recovery....i take it you were bone on bone which is painful just thinking about it....and to go into the activities in such short amount of time.....the muscle definition around your knee....you never had any pain at all? It is incredible just thinking about the whole thing
Title: Re: Regenexx injections - Stem Cells
Post by: lizsherr on October 07, 2008, 05:07:20 PM
Hello All, I am Liz, Saverio's friend.  I just had the stem cell procedure done on my right knee.  Saverio and I have been going back and forth to the clinic together for each step.  I have to tell you all that it is not anything to be afraid of.  I am the worst needle patient in the world but I was treated so gently and even had a volunteer hand holder, Deb, Dr Ceneteno's nurse.
The first trip of stem cell withdrawal and blood was really nothing like I imagined.  My mind was conjuring up images of the sceen in a horror movie I had seen as a kid.  What a relief when I found out how painless it was.  It went quickly and I only felt a little prick with the numbing needle.  Now we are back here for the 4 steps to complete the whole thing.  I have to admit that I did say ouch a few times during the irritant injection.  That was probably because my knee is pretty sore to start with and I was not too happy about having anything done to it.  By the time we got to the 3rd step yesterday, for the growth factor, I took a valium and a pain pill an hour before and then it was a piece of cake.  Tomorrow is the last injection, I am not at all concerned about it.  Then it's back home to see if my 39,600 million stem cells are doing their job.  Wish me luck,  Liz
Title: Re: Regenexx injections - Stem Cells
Post by: Saverio on October 07, 2008, 05:20:09 PM
To all,

I am still out in Denver.  I confirmed with Dr. Centeno that it was him who posted on this thread.   I had the bone marrow withdrawal on a separate trip on Sep 16th.    If it's your 1st time you go thru a candidate interview, which is a bunch of questions.  Dr Centeno did the withdrawal.  He numbs 6 locations on your back hips area, 3 on each side.   The marrow is withdrawn which takes about 15-20 minutes.   This time there was no pain.  Last March (my left knee) there was some pain.  I believe it was due to a different younger Dr performing it in March.  That is my opinion.  I should say here I have a high pain tolerance.  After the withdrawal, the nurse took a pint of blood.  That's it for the withdrawal appointment.

Last Tuesday (Sep 30) I had the irritant injection.  The nurse 1st checks your vitals and you go right in for the injection.  I had it done in my right knee lateral joint and under the patella.  I was laid on my back with my right knee bent up in about a 90 degree angle.   A movable x-ray machine is used so the Dr can locate the targeted area.  This can all be seen on the monitor.  This is used for all injections.  Kind of neat.  Dr. Centeno performed the procedure.  He first numbs the area waits about 5 minutes then injects a dye to insure penetration to the area.  The irritant is then injected.  It all took about 10-15 minutes.   You can feel a little prick from the numbing needle and that is about it.  Pretty simple procedure.   I did have discomfort that evening when the numbing agent wore off.   The intent is to irritate the joint and ready it to heal when stem cells are received.

On Thursday, I had the stem cells injected.  Dr Centeno again.  25 million cells were processed this time.  Last March there was only 17 million.   I believe again it's a factor of your own marrow and maybe the extractor.  Again just my opinion.   For comparison my friend had 39.6 million cells.  Again, a nurse takes your vitals and you go right in for the injections.  This time I am sitting on the end of the table with my right leg hanging over the end.  The x-ray machine is used,  numbing agent 1st then he waits about 5 minutes.   Dye again is injected to insure correct area penetration.   He injected about half the stem cells into my lateral joint then he waited about ten minutes and injected little more than half what was in the tube.   Waited about ten more minutes.    I am repositioned on my back and right knee up in the 90 degree position.   This is a better position for injection under the patella.   He had to stick me 2 times because he had a hard time locating the dye into the right area.  This is a tight location.  This was probably the most painfull of all the procedures.  Only because he was poking around to find a good path.  Once he found it, he injected the remaining cells.   They have you remain 1 hour on the table before you are released.   That's it for the stem cell injection.  There was no pain that night as there was with the irritant injection.

Yesterday was the growth factor injection.  This is processed from your own blood.  Dr. Schultz performed this one.  Same steps.  Vitals 1st, numbing agent, dye for location and then growth factors in lateral joint and under the patella.  In all took about 20 minuntes.   I'll post when it is completed tomorrow.

Saverio
Title: Re: Regenexx injections - Stem Cells
Post by: 60schld on October 08, 2008, 06:37:19 AM
Thanks Liz and Saverio :D :D!! Your posts are very interesting and informative.  I will be very interested to see your progress as the procedure heals 8) :).  Best of luck to both of you!!!
Title: Re: Regenexx injections - Stem Cells
Post by: Kaputt_Knee on October 08, 2008, 06:55:16 AM
I echo 60schld's sentiments Liz and Saverio. It certainly is interesting here about how the cells are collected, cultured and then returned to your body. Perhaps there is hope for us ancient sportsmen and women after all  ;D ;)

Currently the procedure is only available here under private medicine and it cost's a bomb. But the more rich people who are used to trial this the better the chances of our mainstream HIs accepting it as a viable alternative to current cut and sew  :D


Sue in Germany
Title: Re: Regenexx injections - Stem Cells
Post by: MrPotatoKnee on October 12, 2008, 02:48:10 PM
Hello all. Briefly: I'm a 36 yo male who's experienced right knee problems since age 6, brought about by an exploratory op to remove a bone chip after a fall. Synovitis diagnosed. Arthroscopy and meniscus trim at age 14 after several years of periodic 'flare ups' brought about by minor knocks during contact sport or long/hard running/sprints. Haemangioma diagnosed. Corrective surgery discouraged because of age. Over next 10 years reduction in flare ups but locking and clicking more pronounced. Age 27 meniscus trim and wash out. Since then flare ups rare but in the last year, pronounced reduction in range of motion (can't fully extend, resulting in significant muscle atrophy). Just had an arthroscopy & wash out on Thursday and OS' first words in recovery room were 'not good news, chronic arthritis. No cartilage left to trim.'
That wasn't too brief, thanks for staying with me!
As an active, fit, fairly strong, agile bloke (5'6", 157lbs) this really isn't good news so in between icing and exercising my knee I've been trawling arthritis sites and knee message boards as I'm determined not to have to consider knee replacement. A few years ago I read about a couple of footballers from over here who'd gone to America to have cartilage grafts with a fair degree of success so this thread is of great interest because it's a significant progression from that technique. It'd be great to hear how the most recent treatments have transpired with Saverio and Liz as I want to pre-empt my OS who I'm pretty sure will recommend stopping most activities I enjoy and consider knee replacement. I'm 36!
This message board is a great source of information and inspiration and helps keep me feeling positive about my future and options so any insights or pointers would be welcome.

Best,

Darren (London)
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on October 26, 2008, 04:05:19 AM
Hello All

Its the weekend and I am now back from Denver, after my first set of re-injections, on Thursday. I had the bone marrow draw 2 1/2 weeks ago. I am having the "Layering" technique as its described. This means instead of 3/4 injections over 10/12 days  which Saverio had I get 1 injection every month or so, for three months.

I 've not much detail to add other than I felt a little faint during this first re-injection procedure. In terms of overall pain its not that bad. I've had several arthroscopies over the years and this is a lot less invasive and less painful.

I had 21 million stem cells injected into my knee, this time around. It will take time to see if my outcome is successful. I am very hopeful.  As I type I am sitting in front of the TV wearing my infra red heat rap on my knee, its part of the recommended protocol. I'll give you updates as I have new stuff to add.

Hope you both, Saverio & Liz are doing well.

Best wishes

Mccartjt
Title: Re: Regenexx injections - Stem Cells
Post by: 60schld on October 26, 2008, 04:13:52 AM
How wonderful mccartjt I wish you the best :D :D.  It's very exciting, I can hardly wait for your next post!!!
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on October 26, 2008, 04:16:27 AM
To anyone reading this

One more thing that I forgot to mention, the doctor has given me two bouts of "Prolotherapy" for my slightly weaker left / damaged knee. Like I said in my earlier posting, it will take time to know how my left knee turns out with the prolotherapy and Regenexx procedure. I'll keep you all posted.

Mccartjt
Title: Re: Regenexx injections - Stem Cells
Post by: 60schld on October 26, 2008, 08:41:35 PM
mccartjt-I know you will be getting back to us on your progress.  When you do, could you include the "state" of your knee(s) before treatment-i.e. what were your problems?  Thanks,            60schld :) 8)
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on October 27, 2008, 12:31:28 AM
60Schld

I have retro patella damage with opposing damage on the femur with grade 3 damage both sides. Meniscus & ligaments are all fine. I can walk but realistically no running or no walking more than about 30 minutes on  a treadmill. So I am not a serious case but it was painful after going running or heavy cycling. I would get a sore knee after about 1 hour on  a bike. If I got out of the saddle and started pushing hard that would aggravate my knee something wicked.  I've had several arthroscopies but I need to rebuild the cartilage.
Title: Re: Regenexx injections - Stem Cells
Post by: Saverio on October 29, 2008, 08:39:48 PM
To All,

Tomorrow will be 4 weeks since my last stem cell injection.  It's going about the same as my left knee.  My right feels good and more solid.  It felt good enough that I enrolled in a 2 hr/day for 5 days tennis clinic.  It is conducted on Har-Tru clay courts which are soft courts.  I don't think I would have enrolled if it was hard courts.  There has been no swelling or heat in the knee after each session (3 so far).   I will be doing my regular biking and strengthing of the knee starting on Sunday.  My goal is to get more strength and fuidity in the right knee so it balances with the left.  I'll keep posting.

Saverio

 
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on October 30, 2008, 03:27:45 AM
Good for you Saverio,

I'll not be done with my injections until just before Christmas. It it all pans out right what a Christmas present!

The immediate pain/gait for walking is all but gone. I am week post 1st injection. Taking the tablets & getting the infrared heat on the knee as I type. I am not fully walking up stairs yet but easing into it one day at a time.

Please keep in touch.

Mccartjt
Title: Re: Regenexx injections - Stem Cells
Post by: Kaputt_Knee on October 30, 2008, 07:46:13 AM
Thanks for the updates guys! It is really interesting for those of us seeking solutions.


I have a question though - during my last big operation my surgeon found that I have NO arthritis but am now down to a mere sliver of a medial meniscus which he has said will cause me trouble in the future. The lateral meniscus was whole and extremely healthy - he implied that the shaving of the medial may have been unnecessary and or heavy handed. All my previous operations on this knee agreed Grade 3 to Grade 4 arthritis. So does this operation only work on lesions or do I have a chance with my meniscus? what would be my chances?

I have the chance to go to Dr Toft in Munich for similar treatment IF it will work on meniscus problems. At 58 I am not a candidate for the transplants, even if it were done here in Germany.

Sue
Title: Re: Regenexx injections - Stem Cells
Post by: Saverio on October 30, 2008, 11:08:21 AM
Sue,

I don't know what to tell you.  I'm not an MD.  But it makes logical sense that it would help the meniscus since it is cartliage, only different than the articular cartliage coating the bone.

Sam
Title: Re: Regenexx injections - Stem Cells
Post by: rob8647932 on October 31, 2008, 01:41:31 PM
If you check the website testomonials, you can see the  person with the the meniscus that was healed.
Title: Re: Regenexx injections - Stem Cells
Post by: thevoice on November 02, 2008, 08:18:47 AM
is the cost allowed to be posted on this forum? I assume its the same amount for all people?
Title: Re: Regenexx injections - Stem Cells
Post by: believev on November 09, 2008, 02:58:20 PM
wow. i can't believe how this thread developed. I posed on it a long time ago and forgot about it. 

I am very curious to the cost of the procedure. I had heard around 5k, but I can't even remember where I heard that.  Anyway, did the dr giv eyou any time frame on how long the relief can last.  If the peole on here get that kind of relief even for 5 years, thats a huge step forward in my book.  I pay a couple thousand every year on just insurance deductibles and crap like that.

I am seriously considering this procedure.  I am in a different camp than some here, but I am young only 30.  If I can stave off a microfracture or even a Oats procedure, then its worth it. 

This is very encouraging.  I emailed that doctor form Pittsburgh who had it done, the guy who ran the marathon. I went to pitt, so I hope he responds to me.  I also emailed the doctor who does the procedure, I"m not sure if he will even work with me, since my defect doesn't show up on mri.  I had 4, they all say perfectly normal.  BUt its not, and whenI had the scope they confirmed that.

anyway, can one of you please give me a cost estimate?  If you would feel better sending me a message, thats ok too

THX
Title: Re: Regenexx injections - Stem Cells
Post by: mayme on November 09, 2008, 10:08:12 PM
Hi Believev,

Go to the Regenexx website, click on FAQS and then scroll down to Insurance Coverage. You'll find the exact cost of the procedure there.

Good luck!
Title: Re: Regenexx injections - Stem Cells
Post by: believev on November 10, 2008, 12:20:30 AM
yeah i saw it, its more like 7-8.5k.  yeah so i was under a bit.  OH well I really dont think its a secret, they're saying the average is 7,000 to 8,500.  Again more than I thought but still not an unbelievable amount if it works the way the results say.

thx for that.  hey if this works, I'll spend it.

i'm still trying to get in touch with that professor from Pitt.  I'd love to hear form him.
Title: Re: Regenexx injections - Stem Cells
Post by: thevoice on November 10, 2008, 09:02:15 AM
There micro stem cell treatment sounds intresting - they fill the defect with tons of stem cells and allow the defect to heal. I am sirprised others arent using/offering this treatment in the west. I have heard of treatments in singapore which use stem cells so maybe it is being used in other parts of the world.
Title: Re: Regenexx injections - Stem Cells
Post by: Dr. Centeno on November 12, 2008, 02:19:33 AM
Dear all,

This is Dr. Centeno again.  A long standing knee patient from the east coast just sent me this e-mail.  I asked his permission to post it because I thought it was interesting not only from a treatment/results standpoint, but also from an insurance standpoint. 

" I am 6o years old ,a successful college tennis coach and am an avid golfer,skier and tennis player. I have had 13 knee surgeries prior to coming to see the Centenoclinic.All orthopedists I saw told me I would need a arthroplasty for my three compartment  maligned arthritic grade 3-4 left knee.Dr Centeno took a chance with me,but it worked!His autologous mesenchymal stem cell transplant worked.It has given me pain relief,greater range of motion and functionality.I am a slow healer,but 90 days post op I started seeing the benefits of my trip to Denver.I was told by everyone I spoke with,insurance would not pay!Well,I did not give in to that advice. My insurance company denied my charges twice,the first was reviewed by a General Physician.I said to myself,how much to they know about stem cell advances?None.My second appeal was reviewed by a general orthopedist who did not specialize in knees!I said to myself again,how much does he know in reference to Mesenchymal Stem Cell transplants?The answer in my mind,none!My third appeal was suppose to have been done by a independent  panel orthopedist outside of the insurance company who does specialize in knees.
    My insurance company decided to approve my appeal once they found out I found 2 Medical Physician's work  in Japan who do the same work with Medical data to prove it's efficancy.The insurance company kept telling me that  they needed to see long range studies.Well,I pointed out to them Synvisc only has short term relief and that has approval by both the FDA and insurance companies worldwide.Quite costly for a 3-5 month pain relief and it was not according to what they told me.It also said in policy regulations,specilal consideration would be given in certain circumstances.Next,I decided to look at my policy written policies on coverage.Well,my RN girlfriend and myself found three  Professional Provider Coding CPT codes that did not relate to cancer patients.1.For blood derived hematopoietic progenitor cell harvesting transplant ,per collection 2.For blood derived peripheral stem cell harvesting for transplantation per collection 3.for bone marrow or blood derived peripheral stem cell transplantation,autologous.Once I showed the grievance officer these CPT codes,they called me the next day and approved my appeal.I got full refund to the shock of everyone except myself.I never got discourage in the 5 months of endless research I did.Some MD's and scientists were helpful in my quest to gather medical evidence proving the insrance company was wrong,others were not!Google.com was my best friend,they located everything for me.I also want to put in a pitch for the IMS therapy and Rolfing was a tremendous help in activating muscles that have not moved well in years.It was every penny and time I put into the pursuit of reimbersement.I plan to return to Denver In march 2008 to have more treatment!

Mike"
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on November 12, 2008, 04:42:32 AM
Dr Centeno

WOW! is all I can say. Great news for Mike! WOW!

John M
Title: Re: Regenexx injections - Stem Cells
Post by: believev on November 12, 2008, 12:56:52 PM
another thing along the same idea as the last posts,  I called my insurance company today and they are checking into this for me.

I have a health savings account that I can use through work.  If I can use that money to pay for the regenexx procedure, that is a big discount.  That money is saved before taxes and I get a 4% match.  That will be a significant discount.

Not too bad.  If they can allow me to pay for it.  I'm also having them check into partial payment and stuff.  Battling insurance companies is rough but they didn't complain at all when my doctor ordered 4 mri's and 2 bone scans over the past 12 months and everyone of those tests came back perfectly normal. Not to mention PT 3 times a week for 5 months at 100 bucks a pop.

got to go, getting myself a little too worked up here.
Title: Re: Regenexx injections - Stem Cells
Post by: rob8647932 on November 13, 2008, 08:45:45 PM
Dr. Centeno,

Do you know which CPT codes these are?

Thanks
Title: Re: Regenexx injections - Stem Cells
Post by: Saverio on November 15, 2008, 12:11:46 PM
I'm glad to see more constructive posts on here.  This is all good stuff and I hope beneficial to knee arthritis sufferers.  I am now 6 weeks, 3 days since last stem cell injection for my right knee.  I am doing my rehab and up to 25 miles on my road bike (just 1 steep hill).  I did take a tennis clinic( 5 straight days of 2 hrs on soft surface) 2 weeks ago.  My right knee had no swelling or pain.  It is getting stonger.  Yesterday I took a fast cardio tennis session (continuous running on hard courts for 1 hour).   I am very pleased with the way my right knee is responding.  I will be increasing my rehab as I feel my knee is responding positivley to it.

Saverio

Title: Re: Regenexx injections - Stem Cells
Post by: believev on November 15, 2008, 04:53:11 PM
Saverio

this is great. I"m so glad your keeping us all in the loop with your progress. Yes we need ONLY constructive posts on here... we're all on the same side as far as i'm concerned.

I am extremely interested in this procedure.  What you're doing now is already what I would love to get back to.  I have a exploratory scope setup to see what the extent of my damage is ( AGAIN ).   My doctor and I are meeting thursday of this coming week I'm going to ask his opinion of the stem cell stuff.   I just want to make it clear that I dont want to wake up with a suprise microfracture or oats.  Especially the oats, since that taking hte good cartilage is irreversible.  If I can get him to agree to that, i'm going forward with that plan.  I"m at the point where I can't stand for very long anymore.

My take on it is this.  If I can get a diagnostic scope done, figure out how bad it is, then before I try microfracture or aci or oats or whatever he suggests, I may try this stem cel procedure.  WHat do I have to lose?  The only thing is the cost, and I'm at the point where I dont care anymore, if a few people on this board can have this kind of success, its worth my time and research.

I just want to thank u for keeping us in the loop...

If i try thee procedure and its bogus, or doesn't work, then I can always have surgery at a later time. 

Title: Re: Regenexx injections - Stem Cells
Post by: believev on November 16, 2008, 12:39:46 AM
Hey everyone, I just wanted to note one more thing.  I sent Dr. Joe maroon an email.  He is the professor who had the regenexx treatment in his knees and was able to train and complete in a triatholon (including a 26mile run).  He DID respond to me and said the treatment was a year ago and he's been doing great ever since.  He said the company is legit and worked great for him.  It is really starting to open my eyes to this procedure.  I dont want to paste the exact email in, but I did get a very encouraging response.

I thought I'd share that with everyone.  I emailed him through my unversity's website.  He is a professor where I went to college, so I figured  it'd be worth a shot. 

The more info I get about this company the better I feel.  I had a great conversation with a fellow board member today and we discussed the company, it really seems promising.  He is currently going through the procedure and is active on this thread.  I'd love to hear from more people who tried this procedure also.  This gives me hope.

ONE MORE THING.  I believe this type of procedure will be tax deducitable.  I know there are irs rules and stuff, but its worth a look under the medical expenses thing.

see ya.

Take care.
Title: Re: Regenexx injections - Stem Cells
Post by: Kaputt_Knee on November 16, 2008, 08:25:46 AM
Hi Fellow seekers of solutions!

I picked up on a link to a centre in Germany doing similar work - The XCell Center in Cologne (www.xcell-center.com (http://www.xcell-center.com). I've filled out the initial online enquiry forms as well as read all the info. They were very quick getting back after my first email (a couple of hours, if that!).

The treatment seems to be the same as in Centeno Clinic. They are upfront about costs - currently €6,545 excluding any transportation and hotel/accommodation. To me that is doable even if I have to pay for myself.

I'll let you know when the medical review people get back to me - it may be a no for me as I am looking to rebuild meniscus in order to prevent arthritis.

You can choose your language as the site is multi-lingual. Looks the same in many aspects as the Colorado set up except that it is not controversial here in Germany, just very very new!

Sue in Germany
Title: Re: Regenexx injections - Stem Cells
Post by: thevoice on November 16, 2008, 08:31:03 PM
i have a small hole in my artcilcar cartlifge on the medial colyde, its about size of a finger nail and is to the bone, i have been told the rest of the knee is normal. Would either of these stem cell treatments help in my case and fill the hole in.
Title: Re: Regenexx injections - Stem Cells
Post by: believev on November 17, 2008, 01:06:22 AM
Thevoice, you are in a very similar situation to me.  I think they would.  THe problem is the cartilage is worn out or damaged in a small focal area.  This stuff if it is done right will help regrow new cartilage in that area.

I am considering it.  I still need to find out more.   I have been gathering as much info as I can the past few weeks.  Check out youtube.com too there are some nice videos from the doc on there.
Title: Re: Regenexx injections - Stem Cells
Post by: Jen Passarelli on November 21, 2008, 02:48:44 PM
Hello all,

My name is Jen Passarelli and I am the Scheduling Coordinator for the Regenexx procedure here in Broomfield, CO. I am so excited to have run into this thread, and see the curiosity and excitement from everyone about the procedure.

I also wanted to take the opportunity to post some information about the procedure (this can all be found at www.regenexx.com, as well).

We use the procedure (for knees), typically, to regenerate lost cartilage from osteoarthritis, or to repair torn meniscus. The procedure costs about $7000, and would involve at least two trips out to Colorado - usually, one for the initial examination, blood and marrow draw, and the other about 14-17 days later for 4 injections over 10 days (this is the re-injection process). As of right now, we've done just over 250 procedures (about half of those being knees), and have seen an 80% success rate.

Our procedure is not covered by insurance (though as I'm sure you've all seen from Dr. Centeno's post above, we're getting closer!!). However, we are more than happy to provide you with a copy of your bill to submit to your health insurance if you wish.

I welcome any of your questions about what we do here, and our consultation process. Please do not hesitate to contact me if there's anything else I can answer for you.

Jen Passarelli
Scheduling Coordinator for the Regenexx Procedure
Centeno-Schultz Clinic and Regenerative Sciences Inc.
303.495.4014
[email protected]

Title: Re: Regenexx injections - Stem Cells
Post by: believev on November 22, 2008, 02:44:25 AM
Jen

HI I think I talked to you on the phone once before.

Is there a medical procedure code for this?  My insurance would consider reimburseing me under a few general clauses, but they want that procedure code.  Its like a diagnostic code the doctor gives me.  They paid for all kinds of otehr pain management stuff, I'd like to try and get something back if I have this done, but I need that first.


anything that you can provide would be a great help.  I think others on here want that as well, thats why I posted this instead of messageing you privately.

thx
Title: Re: Regenexx injections - Stem Cells..
Post by: mccartjt on December 03, 2008, 06:20:23 AM
Even horses get bad knees!!

I know that this is posting is  off topic, but the technology is very similar, "Horses getting regenerative medicine for repair of their tendons " .. Mesenchymal Stem Cells  and all. For anyone that is interested.

http://www.thehorse.com/ViewArticle.aspx?ID=13147&nID=16&src=RA

vetmed.ucdavis.edu/ceh
Title: Re: Regenexx injections - Stem Cells
Post by: believev on December 08, 2008, 06:52:39 PM
mcartjt hey - i haevn't talked to you in a while.  I'm wondering if your noticing any improvemetns frmo your injections.  I had my exploratory scope alst week.  Turns out my cartilage was doing really good actually I had to have some abnormal scar tissue removed said it was causing most of my problems.  we'll see

How are you doing? Talk to you soon.
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on December 09, 2008, 04:17:20 AM
Hi Believev

Good to hear from you. Perhaps you'll not be needing any of this type of therapy at all! So much the better. Your outcome sounds good. Just one thought though, what initially caused your problems?

I have some great news to report, my knee is definitely feeling better. Its been about 3 weeks since my second re-injection when I got 35,000,000 stem cells injected into my knee. I am now 7 weeks into receiving stem cells. So far I've received 56 million.  I have to say its kinda weird when you believe what you've read, (about the likes of Dr Joe Maroon), but don't think that the same positive outcome can happen to you.

This weekend has been good, getting some exercise without going wild, so lets just say that my knee is definitely improving, I think the cells are working.  BTW its my body so I should have a good  idea!  My wife has noticed my better attitude too which has becomes infectious.

One thing happened over the weekend. I was over at a friends place.  They had a small house warming party to celebrate homeownership!  I got into a conversation about local surgeons with someone sporting a walking stick.. Turns out that she'd had a TKR in the past three weeks, after a disasterous microfracture with a not to competant surgeon, six months ago. It only goes to show, you have to be very careful when picking your doctors.

Good luck to you all!

John M
Title: Re: Regenexx injections - Stem Cells
Post by: believev on December 09, 2008, 05:14:10 PM
hey yeah I just had a spot of articular cartilage that wore down in a little area for no reason at all.
They think it mgiht have been from an old injury only because the rest of my knee is really healthy.

This doc told me the old procedure to try and stimulating some healing did a great job and although the area is a bit thinner than the rest of my knee it looked really good.  Said the rest of knee was "pristine".  So I asked why I was having so much trouble, he said the scar tissu and abnoral tissue around the area was causing some friction and rubbing.  Thats probably why my knee was popping and clicking so much.  Since he cleaned that out ("he told me he did not touch any cartilage, just the scar tissue") all the popping and stuff is gone.  Its only been 6 days since my scope and I already feel better than I did befor the op.  He said in the future if I still ahve trouble he'd discuss other options but he is really pleased with the looks of it in there.

Meniscus was 100%. all other articular cartilage was 100%, Just this 1cm by .5 cm area of little wear, and the area thats thin eh said was even smaller than that.  He told me he didn't even measure it becasue it was so small.  However it IS on a weight bearing area so that will complicate matters if ti gets worse.

gave me no restrictions, but said take it easy for a few weeks.  I have no swelling, none that I can see, just dissolvable stiches that will go away. Little bumps over the incision portals. no big deal.  I have to wait 3 months.  He said that stem cel stuff is very promising, I asked him if he had anybody who tried it, and he didn't knwo of anyone.

If it still bothers me I will definatley consider this before I get a major op, if thats in the cards.

I'm glad to hear you are doing well.. you still have one more injection right?
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on December 09, 2008, 05:31:18 PM
Believev

Yes I have one more injection to go. I had some clean up with my last arthroscopic surgery 18 months ago and got my knee running without the clicking and popping too for a while. I suspect though that the compromised surface of my patellofemoral joint eventually gave rise to yet another plica / scar tissue. Just prior to the Regenexx procedure the clicking and popping was back. I have noticed though that that element of my problems  have since lessened.  My knee is still its a work in progress. Take care.

John M

Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on December 18, 2008, 07:10:55 PM
To all bulletin board members

A couple of updates since my last post.

On 11/20 I had a 36 million stem cells re-injected back into my left knee, in the Regenexx clinic
By 12/13 I was able to row on a Concept 2 rowing machine for a continuous 30 mins. I got off the rowing machine with 1 on a scale of 1 to 10 of pain in my affected knee.  The last time I was on same rowing machine at my local gym about 4 years ago all I could row as 12 minutes before having to give into the pain in my knee. I really believe that my condition is improving.
12/17 (yesterday) I have received the last of my stem cells a final 20 million, so my totals are 76 million stem cells over 3 re-injections.

Today 12/18 my knee is a bit tender but nothing too bad. I am hopeful by May / June 2009 time I am fully recovered from an injury that happened to me 40+ years ago. As for getting healthier, getting on the rowing machine gives me a great workout and I feel fantastic overall as a result of listening to some music and pulling my 'Oar' thru 6000 meters of water!  Good luck to all of you!

John M
Title: Re: Regenexx injections - Stem Cells
Post by: NikkiE on December 19, 2008, 01:32:57 AM
PLease please please open a  clinic in Australia!!
Title: Re: Regenexx injections - Stem Cells
Post by: rob8647932 on January 11, 2009, 07:35:56 PM
John M,

I have had 3 regenexx injections in my right knee. It is definitely improved. It had some trochlea arthritis and focal defects. There is less tenderness and almost no clicking or popping.

Unfortunately my left knee gave out 1 month ago with some stiffness and swelling. This knee has had 2 microfractures and 1 plica / synovitis cleanout. The symptoms seem exactly like the plica / synovitis problem. I am afraid of any more surgery and will be trying the Regneexx on this knee. Do you think the stem cells can "reconstitute" the scar issue. I wonder (if the plica is hypertrophied and thickened) if it can shrink the plica and make it like healthy plica / synovium?  I have to try it. Thanks
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on January 15, 2009, 06:53:16 AM
Hi Rob8647932

I didn't know that you went ahead and had the procedure done. Good for you! We should keep in touch to see how our knees are progressing. I just re-read this thread to discover that this is your first posting since getting your injections. So how long has it been since your final injection? How is your pain level now? Were you bone on bone prior to getting injections? What type of injury do you suffer from? Did you get a substantial amount of stem cells injected during your procedure?

To your specific question about plicas I think I re-grew one post my last arthroscopy 18 months ago. I was cleaned out in June 2007 and started these injections in October 2008. I had a bad clicking whilst climbing a staircase typically to my bedroom. Yes I do feel that a plica can be "Welded" back into the joint over time with the addition of new stem cells. My clicking has softened. Its not completely disappeared but it is certainly less pronounced.

 I've been re-reading this particular thread recently to see how long it should be before I experience maximum re-growth of cartilage. No doubt with no blood supply going thru cartilage (as I currently understand it~ I may be incorrect with this assumption) it takes a good deal of time to from what I am gathering to see the final marginal increase in relief of pain/ growth of cartilage. My current understanding is 90 days from the final injection one should see a great improvement then post that sort of time whilst ones condition may improve its does so at a more slower pace. Overall my knee has improved for sure.

With regime that I went thru, I'm now 4 weeks post my final injection, and I have my ups and downs of how my knee behaves. I will keep you all posted as time goes by. Rob8647932 if you could do the same it would help us all get a more clearer picture of what to expect. I wish you good luck on your second knee's progress.

JM
Title: Re: Regenexx injections - Stem Cells
Post by: rob8647932 on January 15, 2009, 03:56:51 PM
Can you call me on my cell.

330-212-4101
Title: Re: Regenexx injections - Stem Cells
Post by: sp7 on January 19, 2009, 02:49:41 AM
This is all so interesting and wonderful. I hope all goes well for those who have taken or are now taking or soon will be taking the Regenexx treatment.

At the local, very large university where important stem cell research is going on, I asked questions of a biomedical engineer involved in stem cell research on the regeneration of damaged human joint cartilage. He told me one has to find out these things about any stem cell treatment:

1) Does the culture (used for cell expansion) involve fetal bovine serum? Fetal bovine serum could be the source of contamination (like mad cow disease).

2) How is the MSC (mesenchymal stem cells) culture expansion process kept free of contamination?

3) How are the MSCs delivered to the target in the knee? Are the cells carried by a biomaterial scaffold or are the cells injected to the joint without the carrier?

4) Lastly, how is the repair evaluated?

[end of the questions he gave me]


On Question 4 above, is MRI used to check for degree of and quality of repair after MSC treatment? Or, after MSC treatment, is arthroscopy really the only way to know how successful the MSC treatment was? Or is 'success' simply subjective and based on how the patient feels months after MSC treatment?

I wonder if MRI can detect lesions in articular cartilage before any treatment, before any repair. [I'm keen on knowing if MRI detects lesions in the articular cartilage on the underside of the kneecap and in the femoral groove.] Do any of you know?

Perhaps Dr. Centeno will read this and give us answers or helpful info.


Thanks

Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on January 19, 2009, 03:34:53 AM
SP7

As I have had the treatment, I can illuminate some what of the process. Questions 1 & 2 clearly are best directed and answered by Dr Centeno himself. With regard to question 3 the stem cells are injected directly into the knee with a needle and syringe with the aid of a floroscopy machine ~ a fancy real time X-Ray machine in their procedure room. There is no biomechanical scaffold akin to MACI. MACI would need a full blown surgery to get it physically inside the knee.

Question 4 is somewhat personal for two reasons in that if your cartilage repair works you'll know it, which is  the whole point of the procedure. The final MRI will cost money too! If you knee is working fine do you really need to spend another $400 on a final MRI just to confirm what your body physically knows?

 Personally I can now row about 20 minutes on a rowing machine before I get inkling of pain. That is a definate improvement on my prior condition.  I am told that I can see more improvement over the next 2-8 months also. If I so choose I can get an MRI with a Tesla 3.0 magnet and the MRI can be compared to a previous MRI side  by side to see increases in cartilage volume. To one of your final questions yes & no MRI's may (or may not)  pickup lesions in your defective cartilage, but some times surgeon's like to look inside your knee too, to see what's going on bio-mechanically.

I hope that this helps.

John M
Title: Re: Regenexx injections - Stem Cells
Post by: sp7 on January 19, 2009, 03:55:14 AM
SP7

...... With regard to question 3 the stem cells are injected directly into the knee with a needle and syringe with the aid of a floroscopy machine ~ a fancy real time X-Ray machine in their procedure room. There is no biomechanical scaffold akin to MACI. MACI would need a full blown surgery to get it physically inside the knee.

 Personally I can now row about 20 minutes on a rowing machine before I get inkling of pain. That is a definate improvement on my prior condition.  I am told that I can see more improvement over the next 2-8 months also. If I so choose I can get an MRI with a Tesla 3.0 magnet and the MRI can be compared to a previous MRI side  by side to see increases in cartilage volume. To one of your final questions yes & no MRI's may (or may not)  pickup lesions in your defective cartilage, but some times surgeon's like to look inside your knee too, to see what's going on bio-mechanically.

I hope that this helps.

John M


Thanks John for this useful info. I'm happy that the treatment has helped you and that you can do the physical things you enjoyed in the past. May the improvement continue for you.

In regard to the floroscopy machine, was your body covered well with a lead apron with only your knee exposed? Of course I ask because I understand that such a device bombards the body with a great deal of radiation. And I know that the length of time that one is in the floroscopy machine is important too, when one is concerned about the radiation. How long was the radiation focused on your knee?


Thanks
Title: Re: Regenexx injections - Stem Cells
Post by: Dr. Centeno on January 19, 2009, 02:37:51 PM
Some questions were posted and a current patient wanted me to answer them.  These are the questions I found:

1) Does the culture (used for cell expansion) involve fetal bovine serum? Fetal bovine serum could be the source of contamination (like mad cow disease).  No, we avoid all animal products for this reason.  We use a proprietary autologous platelet lysate for culture expansion.  This is esentially the growth factors taken from the patient's own blood platelets.

2) How is the MSC (mesenchymal stem cells) culture expansion process kept free of contamination?  We use common antibiotics in culture. 

3) How are the MSCs delivered to the target in the knee? Are the cells carried by a biomaterial scaffold or are the cells injected to the joint without the carrier?  The are injected with fluoroscopy.  We have used scaffolding at times, however instead of a scaffold, we often use a micro injury model. 

4) Lastly, how is the repair evaluated?  We have used both 3.0T MRI with T2 mapping and patient response.  In the past 6 months we have used less MRI post-op, as recent research has shown high field MRI may be harmful to chondrocytes (cartilage cells), see http://www.ncbi.nlm.nih.gov/pubmed/17804262?ordinalpos=20&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum . 
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on January 20, 2009, 05:31:06 AM
SP7

To your question about the floroscopy machine, they take an image they then stop using the machine. The needle is placed where the doctor expects to inject stem cells, so no you're not sitting there all the time exposed to radiation its not a video cam after all!! Its just on for a millisecond to take the image.

 Per Wikipedia http://en.wikipedia.org/wiki/X-ray_image_intensifier floroscopy machines use low doses of radiation in comparison to regular x-ray machines.

John M
Title: Re: Regenexx injections - Stem Cells
Post by: sp7 on January 20, 2009, 09:53:57 PM
SP7

To your question about the floroscopy machine, they take an image they then stop using the machine. The needle is placed where the doctor expects to inject stem cells, so no you're not sitting there all the time exposed to radiation its not a video cam after all!! Its just on for a millisecond to take the image.

 Per Wikipedia http://en.wikipedia.org/wiki/X-ray_image_intensifier floroscopy machines use low doses of radiation in comparison to regular x-ray machines.

John M


Again John, thanks for the information. It's good that the radiation is so briefly on.
Title: Re: Regenexx injections - Stem Cells
Post by: rob8647932 on January 24, 2009, 05:20:38 PM
I had Regenexx on my left knee on 1/19/09.  My symptoms were extreme pain and inflammation. I was ready to have surgery. The MRI showed mild arthritis. This MRI did not seem to jive with my symptoms. However, I had these symptoms before and even had surgery for it. Post surgery the diagnosis was synovitis, plica syndrome, and mild arthritis. This time my self diagnosis was a repeat of the synovitis. After discussing with Centeno he said that the Regenexx is a major / permanent anti inflammatory. So I decided the Regenexx was a better option than cortisone or surgery. 3 days after Regenexx I have had major relief. Not perfect but much improved. Hopefully this will continue to improve. By the way I have no major restrictions. I am walking, stretching, and even doing a little biking with minor resistance.

Title: Re: Regenexx injections - Stem Cells
Post by: sp7 on January 24, 2009, 06:03:57 PM
I had Regenexx on my left knee on 1/19/09.  ............After discussing with Centeno he said that the Regenexx is a major / permanent anti inflammatory. So I decided the Regenexx was a better option than cortisone or surgery. 3 days after Regenexx I have had major relief. Not perfect but much improved. Hopefully this will continue to improve. By the way I have no major restrictions. I am walking, stretching, and even doing a little biking with minor resistance.



Well, this is more very good news. Thanks rob8647932 for the report. I hope all goes well for you and that there's continued, lasting improvement for your knee.
Title: Re: Regenexx injections - Stem Cells
Post by: BearsCubs on January 26, 2009, 05:59:46 PM
Hi. I too have had Regenexx done and just returned from Denver for my third injection (1/21/09). I have dealt with both Dr. Centeno and his associate, Dr. Schultz. I find them both to be upstanding and caring physicians.

Anyway, bone marrow draw was in May 08, first injection in Jun 08, second in July, and just had the third one. I can honestly say I believe my knee is much better (lateral left meniscus tear/w moderate to severe arthritis). I play ultimate frisbee and was told by my regular ortho after he scoped my knee in Apr 08 that I need to quit or face a TKR within 10 years. I wanted to tell him go fly a kite, but I maintained professional demeanor.
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on February 05, 2009, 06:38:18 AM
Lee

Its been 8 months since the FDA open letter was posted by Miss Malarkey via their website. Since you are the attorney here, on what grounds can a Federal agency (FDA) start regulating an intra state issue? I can't see how they would have standing in a Denver court.

I am sure any attorney could put up a spirited defense to have the FDA's attorneys petition thrown out of court, just in chambers!  I suspect that the FDA has weighed up their options and have decided rightfully with the law as it now stands their petition would not hold up. I mean does it really take 8 months to prepare a lawsuit to shut someone down?

OTOH  & with all things considered should laws change then the out come could well be different.

On the issue of safety, Dr Centeno would have his patients files as evidence of GMP & the clinical outcomes.

My own surgeon was not too impressed with the clinical trials allowed for Osiris and their allogeneic stem cells, & in fact he strongly recomended against becoming one of Osiris's guinea pigs in their recent clinical trials.

JM
Title: Re: Regenexx injections - Stem Cells
Post by: Tailwind on February 05, 2009, 04:29:18 PM
Lee

Thanks for the post. I am scheduled to begin this procedure soon.

I am an attorney involved with financial matters. I have friends and former colleagues who work for the government in areas related to my work. While they would never come out and say "I am working on an enforcement action against X company", at times it is possible to predict who may be the subject of an inquiry based on other things these people do and say and who they are talking to. I have two questions for you. Do you have such information and is that the basis for your prediction? Also, are you certain that the FDA's response to Regenexxwas silence, or could this matter have been resolved between Regenexx and the FDA in some other non-public way?

Thanks!
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on February 06, 2009, 05:15:34 AM
Lee

A couple of points here come to mind.

1) What is the FDA going to do if Dr Centeno's patients mostly have positive outcomes? & better out comes than Osiris 's clinical trials? Then the genie is truly out of the bottle?

2) I 'd like to know what was the intent of your original posting ?

JM
Title: Re: Regenexx injections - Stem Cells
Post by: Saverio on February 12, 2009, 02:50:15 PM
Hi All,

I haven't posted in a while.  Thought I check in and give an update.  It is almost 5 months since my regenexx treatment on my right knee.   I had my left knee done in March '08.  I am very glad I had both knees done.  I am able to play singles tennis 3-4 times a week.  I have even played 4 days in a row once.  The major difference I have experienced is that there is hardly any inflammation after I play.  I still ice my knees after playing but even pros do that.  I do it because it's the smart thing to do at my age (58).   I have also noticed that I am benefitting more from my exercises.  I feel my knee joints are getting stronger.  Pre regenexx there was too much pain for the surrounding muscles to strenghthen.

There is a thread on PRP started by GB that is interesting.  PRP sounds similar to regenexx but without the stem cells and a whole lot cheaper ($200-$600).  I did some checking.  I was just wondering if there are more people who have undergone PRP treatments on the knees.

Saverio
Title: Re: Regenexx injections - Stem Cells
Post by: 60schld on February 12, 2009, 11:13:23 PM
 Thanks for your post Saverio, glad you are doing well.  Could you please let us know what PRP is and exactly where is this thread?  I'm not understanding the abbreviations.  Thanks, 60schld :D
Title: Re: Regenexx injections - Stem Cells
Post by: Saverio on February 13, 2009, 01:50:14 PM
60schld

PRP is Platlette Rich Plasma.  There is a thread started http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=46074.0  under Injections in the joint.

Saverio
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on February 13, 2009, 06:36:45 PM
Hi Saverio

It sounds like you are doing well. I hope your condition continues to improve.

I've had a conversation with another former/current patient of Dr Centeno. Its was his experience that some where after 90 days post final injection (& up to six months), that major real improvements may take place in one's injured joint. Whilst personally I've probably been too keen with my overall physical rehab, I have to hope I've not damaged the current stem cell procedure ongoing in my knee. I am hoping that (based on his experience)  in the next month to 4 months time my repairing stem cells, will start turning into cartilage in my knee .

This technology is all so brand new it doesn't surprise me that big pharma is interested in following this thread of how people in the real world get their bad joints fixed.

Good luck to all

JM
Title: Re: Regenexx injections - Stem Cells
Post by: Saverio on February 14, 2009, 02:00:03 PM
JM

You are right about this technology being new.  Food for thought.  Imagine being one of the 1st patients to receive a Total Knee Replacement.  How scary is that.  We are in the same category for receiving stem cell treatment to enhance cartliage growth.  And we are doing great.

Saverio
Title: Re: Regenexx injections - Stem Cells
Post by: thevoice on February 15, 2009, 07:33:38 PM
I have read so many articles of compaines planning on doing stem cell trials to repair cartalidge that it must be in double figures now. I really hope this technogoly moves forward quick and becomes the reconsized standard of treatment for cartalidge defects/ware and tare etc I think this could happen within the next 5 years and we could see things like microfracture/ACI/MACI/knee replacements for arthritis become a thing of the past.
Title: Re: Regenexx injections - Stem Cells
Post by: Dr. Centeno on February 16, 2009, 11:22:21 PM
Wow!  I'm always amazed at how the internet is such a great discussion generating tool.  It's been a few months since I checked this site.  Just to clarify a few points:

1.  I was surprised to see Lee Bucker posting here.  I know Lee owns a commercial cell therapy industry blog and I have communicated with Lee as he relayed.  My comments to his concerns are posted at http://celltherapyblog.blogspot.com/2009/02/regenexx-vs-fda-2009.html?showComment=1234374420000#c5662649568093779579

2.  We have used prolotherapy for years and still use this technique.  Prolo is what I call Regenerative Medicine 1.0.  It's the injection of a substance to prompt an inflammatory healing response.  It works great on ligaments and chronic tendon enthesopathies.  It brings the patients own growth factors and cellular mechanisms to bear.  The upside of prolo is that it's very inexpensive and simple to deploy.  The downside is that because there is big biologic variability in growth factor quality, blood supply, and healing potential of patients, it has a reasonably high failure rate.  However, because of it's low expense and ease of use with limited downside, it's a great technique to try. 

3.  PRP and BMAC have also been discussed here.  PRP uses a bedside centrifuge to spin down platelets and concentrate them.  Platelets have all kinds of great growth factors including PDGF, TGF-beta, IGF, FGF, etc...  This type of technology is great for helping to heal things that are close to healing on their own.  Hence it's been used by many athletes to get them back into the game more quickly.

BMAC is what Dr. Lee does.  It uses a bedside centrifuge to spin down the nucleated cell fraction of a bone marrow aspirate.  About 1 in 50,000-500,000 of those cells is a stem cell capable of orthopedic repair.  We used BMAC in 2005-2006 and even published one interesting case report.  See http://www.ncbi.nlm.nih.gov/pubmed/16886034?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum  The problem we experienced was that BMAC didn't have enough stem cells in it to help most patients.  After we used it for a year and treated 10 patients or so with pre/post MRI's, we abandoned it in favor of what the research community has done for years, which is to grow mesenchymal stem cells in culture to much larger numbers.  There is a post on this issue here: http://www.regenexx.com/2009/02/bone-marrow-nucleated-cell-concentrate-bmac-is-it-concentrated-enough/ 

I would call these centrifuge based treatments (PRP and BMAC) that concentrate autologous (the patient's own) blood products "Regenerative Medicine 2.0". 

4.  I would call what we do "Regenerative Medicine 3.0".  This is what has gotten big pharma and it's representatives so upset.  In our medical practice, we isolate and then culture expand mesenchymal stem cells in our state of the art cGTP lab in Colorado.  This allows us to deploy thousands of times more stem cells capable of orthopedic repair than could be mustered with the 2.0 techniques (BMAC).  We didn't start seeing reliable results with patients until we started using this procedure to grow stem cells for short periods of time in culture.  While using a centrifuge and doing this at the bedside is easier, you just can get enough orthopedic repair cells in my opinion. 

Hope this helps.  Thanks for the kind words!

Chris Centeno, M.D.
Title: Re: Regenexx injections - Stem Cells
Post by: slyguy1 on February 20, 2009, 04:36:48 AM
For someone who has had microfraction....which also involes the bone marrow forming a matrix. Would it be too late to have a stem cell procedure? My thinking is that the area of bone that is drilled will eventually be arthritic with time and anything else done would not be effective. One other question....microfraction healing time is very long....at least a year in some cases but progress beyond that is minimal....with this procedure do you have to be reinjected after some time to continue getting benefit? Thanks for the great info....
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on February 20, 2009, 05:56:49 AM
Hi Slyguy

Your question is a real and valid question for maybe someone who is more knowledgeable than the folks on this board. I have had the procedure done and have found that Dr Centeno and Dr Schultz both professional and courteous. Perhaps an email directly to Regenexx's clinic might help here?

I will share this with you, most people's outcome on stem cell / cartilage regrowth therapy, is unknown at the begining. We all hope for the best, when you get your bone marrow draw, however there are numerous factors that determine the final outcome of your procedure. I am two months post my final injection and my condition is still improving. I was able to row for 20 mins this evening without pain. Yes my knee is getting better & stronger!

Good luck to you. 

John Mc
Title: Re: Regenexx injections - Stem Cells
Post by: rob8647932 on February 20, 2009, 02:22:21 PM
Slyguy,

I have had mutiple microfracture surgeries with limited success. I had the Regenexx in both knees post microfracture with some success as well. It seems to be a work in progress. The Regenexx can only help whatever arthritic condtion is going on. Best to ask Centeno though. But I am sure it would NOT be contraindicated.
Title: Re: Regenexx injections - Stem Cells
Post by: BearsCubs on February 20, 2009, 05:00:50 PM
SlyGuy,

I'm in (was) the same boat as you, having a microfacture during a scope on 4/30/08 and not liking the "quit playing sports" prognosis the ortho gave me. So actually on a whim I entered "microfracture" into google about a week later, and up popped a you tube video from Dr. Centeno that was about 9 minutes along explaining microfracture and then his procedure. The rest, as they say, is history and I had my bone marrow draw in late May, first injection in mid June, second reinjection in mid July, and then just had my third and hopefully final one (not that the injection itself is bad, but the travel to and from can get expensive) in mid January.

Since this procedure is still relatively new I'm sure long term results won't be known for a while. What I CAN tell you is that my knee feels much better and am looking forward to return to ultimate frisbee very soon. Take care.
Title: Re: Regenexx injections - Stem Cells
Post by: Dr. Centeno on February 28, 2009, 02:34:36 PM
CSU is doing a research study for the Steadman-Hawkins foundation where they place mesenchymal stem cells in with a micro fracture treatment.  This is an equine study and the results won't be available until fall of 09.  Other animal models have shown that this process forms better cartilage than MF alone. 
Title: Re: Regenexx injections - Stem Cells
Post by: BearsCubs on March 01, 2009, 02:16:38 PM
Dr. Centeno,

Since I had both procedures performed (mf and cells, albeit roughly 7 weeks apart) I'll be VERY interested to hear the results of that study.

Take care.
Title: Re: Regenexx injections - Stem Cells
Post by: Dave1 on March 04, 2009, 10:46:20 AM
Hi All,

I am new here but NOT new to cartilage pain. 

I have a 15 x 10mm cartilage defect in my left ankle with a subchondral cyst.  The rest of my cartilage is well preserved.   My ankle just now is pretty stable however I cannot play any sport.  I will be in Europe in April and was looking at stem cell implantation from the German company ‘X – Cell’. 

I have a question for Dr Centeno.  The main difference between Xcell and Regennex is that X cell  offer only one injection where as Regenex grow the cells into large numbers then do a 2nd or even 3rd injection two to three weeks later.

X cell comment that by growing the cells you offer the chance of side effects in the future and say they would NOT consider doing this. I would welcome Dr Centeno’s comments on the single injection procedure offered by X Cell.

I am looking at Stem cell  as alternative to MACI surgery.  The MACI  procedure involves taking a 'spec' of healthy cartilage from your knee, growing  the cartilage in then lab, then implanting the grown cartilage into the defect.  This involves breaking the ankle and involves a year's recovery.

Hope to hear from you,
Dave
Title: Re: Regenexx injections - Stem Cells
Post by: BearsCubs on March 04, 2009, 10:33:05 PM
Dave,

I'm sure Dr. Centeno will give the more complete technical rundown, but from someone who's had Regenexx I really don't think there's too many side effects to worry about. At least none that I have personally experienced since they are your own cells going back in.
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on March 05, 2009, 12:17:03 AM
Dave

I am not familiar with a Subchondral cyst, however I've been thru the process of MACI versus Regenexx, & went with the Regenexx procedure for my knee for several reasons. First reason was cost, Regenexx is much easier on the wallet. Second reason was less invasive. Third reason MACI isn't [email protected] the moment in the USA & I am based in California so that made that decision easier to make,  as there's a lot more hassle getting MACI in Spain / Germany/ Switzerland than a few flights to Denver.. Fourth reason is rehab ~ an open knee procedure with MACI or ACI is horrendous with a 12 month rehab protocol!

On another note Dr Centeno discussed earlier in this thread his experience  with BMAC ( which I believe is is what X-Cell says they are doing)

See below,
"We used BMAC in 2005-2006 and even published one interesting case report.  See http://www.ncbi.nlm.nih.gov/pubmed/16886034?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum  The problem we experienced was that BMAC didn't have enough stem cells in it to help most patients. "

To X-Cells comment of the side effects of growing cells outside your body that are unknown, Osiris is basically doing (with the FDA's blessing) that at the moment with Allogenic stem cells in their stage I/II trials.  See  http://www.osiristx.com/clinical_trials_chondrogen.php  and are seeing success albeit not nearly as good as Dr Centeno is seeing.  See results here http://investor.osiris.com/releasedetail.cfm?ReleaseID=278696  (Allogenic being person neutral stem cells in their product offerings)

Also recently I noticed this on the web,  http://www.orthosupersite.com/view.asp?rID=37347 American Academy of Orthopaedic Surgeons (AAOS) have launched the The Biologic Orthopaedic Society (BOS)

From that website “BOS is a collaborative effort of several eminent scientists who recognize the immense potential of biologics to improve orthopedic care,” Randelli added in a statement. “We want to share what we have learned in our own labs, to compare results, collaborate on promising treatments and disseminate this important information to the orthopedic community at large.”

So the direction that AAOS and now the BOS are going in is in furthering what Dr Centeno has shown working.

As for my own knee's condition, its still improving and I am only 10 weeks into the recovery.

John M
Title: Re: Regenexx injections - Stem Cells
Post by: thevoice on March 05, 2009, 09:39:12 PM
intresting stuff, where can we find more info out on the CSU stem cell study?
Title: Re: Regenexx injections - Stem Cells
Post by: thevoice on March 08, 2009, 09:35:03 AM
A company in Austrialia called Mesoblast are currently trialing stem cell injections into the knee joint. In animals models 1 injection seemed to improve things for up to 1 year, there now doing studys in humans. I think they have quite high hopes for this and are hoping for a 2012 release all going well.

Does anyone know this method differs from Regenexx methods?
Title: Re: Regenexx injections - Stem Cells
Post by: Dr. Centeno on March 08, 2009, 04:31:44 PM
Thanks to all for the kind words and the great discussions. 

ACI is what Genzyme does with Carticel.  They take cartilage cells, grow them to bigger numbers in their lab, and then send them back to the surgeon to implant.  To hold them in place, the surgeon must disect out a piece of the fibrous covering of the bone (periosteum) and then place the cells below that flap. The surgeon then sews the flap back down.  This adds allot of time to the procedure, so many surgeons would prefer micro fracture as it's much faster (but also more invasive). 

MACI was developed in Europe to try and make ACI easier.  In this procedure they take the cells and then place a pig based collagen membrane over the area.  The idea is that the collogen acts as a growth scaffold and produces better cartilage, as well as making the surgery less invasive (since you're not discecting out a flap of periosteum).  However, it's still a big and invasive knee surgery.

As far as growing cartilage cells, Genzyme has been doing that for a decade with it's Carticel product.  There is nothing dangerous about that process of culturing cells, but many scientists believe it can cause "hypertrophy" in cartilage cells, which means that they don't work as well.  There are several European companies who have been working on ways to produce less "hypertrophy" in growing these cells and thus improve the outcomes of ACI/MACI.

Once mesenchymal stem cell procedures become more common, they will likely replace all the cartilage transplant and cartilage cell culture procedures.  The reason is that cartilage cells were never built for repair, they are simply building blocks.  The analogy I give my patients is that cartilage cells are like bricks without the mason.  Since they are cells that are alive, they have some limited ability to rearrange and maintain themselves as well as produce their own mortar (called ECM), but they can't do much complex repair without a brick mason.  Dumping a ton of bricks on a construction site and forgetting to hire the mason won't get you far towards building a new brick house.  If you have special living bricks (cartilage), you may get a pile of bricks that can become a disorganized lump of bricks.  This is the reason why cartilage cells are so hard to get to work to repair holes in the cartilage.

Mesenchymal stem cells (MSC's) are like bringing in the bricks and hiring a mason to put them together.  They can differentiate into cartilage cells (bricks) and also have a brick mason function where they coordinate repair (things like bringing in new blood supply).  MSC's are primed for repair.  As a result, when compared head to head in animal studies, they always beat out transplanted cartilage cells when it comes to fixing a hole in the cartilage.

As far as growing cells and risks, I have a really detailed blog entry on this located at http://www.regenexx.com/2009/02/stem-cells-and-cancer-buyer-beware.  The bottom line is that limited culture expansion of a mesenchymal stem cell line has been well studied.  The research to date would suggest that this process poses negligible risks.  We have 400 patients now in our tracking database with no issues detected, with about 50 of those undergoing high field MRI surveillance of the MSC transplant site and a scientific publication on this topic that has been submitted for publication. 

In summary, MACI is an improvement over ACI.  However, at the end of the day, they are both big surgeries that place only the bricks at the construction site.  MSC's are like bringing the bricks and a mason to assemble them into a repair. 
Title: Re: Regenexx injections - Stem Cells
Post by: thevoice on March 16, 2009, 10:16:15 PM
thank you in depth info Dr. Centeno. When do you see stem cells being used mainstream for knee cart issues? how far off do you think we are in years?
Title: Re: Regenexx injections - Stem Cells
Post by: NikkiE on March 25, 2009, 10:03:47 PM
Yes I'd like to know some kind of time frame too. Its starting to look like my next option will be surgery. If it's only estimated to be a few years til we're using stem cells then I will hang on.
Title: Re: Regenexx injections - Stem Cells
Post by: powerlifter on March 30, 2009, 02:12:05 AM
This has been so informative. Thanks, Dr. Centeno.

I've been reading this board with horror. Surgery seems to hurt as many as it's helped. It comes off as a bunch of guesswork. It's like we're still doing medieval chop-work, just with much smaller tools. It seems we finally have a technology that really assists the healing process instead of just cutting parts up and doing makeshift patchwork.

My own problem can be managed with rest, ice, liniments, "vitamin I" and compression. I powerlift and can still practice the squat and deadlift with neoprene knee sleeves. Jumping and especially running are what set my plica off. I'm now hopeful that if I start saving now, I can afford this therapy and be able to run without fear of permanently crippling myself. I just hope the government doesn't muck things up and force me to have to travel outside the country to get treatment.
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on April 02, 2009, 06:26:53 AM
Dear Powerlifter

I've read recently that the FDA are trying to change the rules on bone marrow/ stem cells and have them re-classified as drugs! Effectively they, (FDA/ & Big Pharma) want to shut down Dr Centeno & his clinic. Dr Centeno has countered that arguement with the fact that IVF clinics are regularly getting sperm and eggs together and that seems to be fine, yet bone marrow "Tissue" are now to be classified as drugs.

Go figure this is your taxpayers dollars at work. If anyone has recently noticed the economy is in great shape (i am saying this with sarcasm) all thanks to our wonderful governments intervention!

Long may Dr Centeno and his clinic keep doing his great work!

JM
Title: Re: Regenexx injections - Stem Cells
Post by: abbaroodle on April 03, 2009, 05:00:15 AM
Hi guys,

I am a lurker who unfortunately has a long-standing injury.  I have heard regenexx mentioned a few times in other places, so when I saw this thread, it caught my attention.

While I find the science really exciting, I also find Regenexx and the way it is being carried out pretty worrisome.  For starters, clinical trials require approval by an Institutional Review Board (IRB) which reviews the trial for safety in order to protect the participants.  Regenexx uses the Spinal Injury Foundation's IRB which is directed by none other than Dr. Centeno himself which is clearly a huge conflict on interest!!!  Furthermore, most new clinical trials are free and do not cost thousands of dollars for the priviledge of being one of the first guinea pigs!

I also find Dr. Centeno's marketing approach quite worrisome.  The regenexx procedure seems to have an every growing list of injuries it can cure.  He has many websites and YouTube videos, including the video which shows a patient who got his knees replaced and now regrets his decision since he can no longer try regenexx or any other alternative.  He also went ahead and added in his procedure into wikipedia entries ("Alternatives to Hip Replacement" for example), and seems to promote his procedure widely using any opportunity he can to attract the media and gain attention.  Yes, he is trying to share what he has to offer and "protect" patients from surgery and using any opportunity he can.  But I also feel like he should not be making a small fortune off of a new, experimental procedure.

While I am sure Dr. Centeno is trying to help his patients, I am concerned that he is pushing an untested therapy without taking appropriate precautions targetting people who are vulnerable and willing to try anything to be able to live and exercise without pain. 

Just my thoughts.  Please proceed with caution and know that just because we dont know the risks and dont expect too many associated with a procedure doesnt mean they dont exist!!!  And just because there are some great stories of success doesnt mean it will help you.

Thanks!
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on April 05, 2009, 06:08:36 AM
Abbaroodle

I have something to share with you. We have all read your link from the FDA's website many moons ago. That is old news. If the FDA's open letter & stated postition had a real legal leg to stand on they'd have shut him down many months ago.

Dr Centeno has explained that body tissues / MSC's are not drugs . The FDA regulates drugs that cross state lines. I suspect that the FDA are in breach of their own remit. Across the US, IVF clinics are mixing eggs and sperm without major interference with the use of labs, & the procedure that Dr Centeno has pioneered is essentially done in similar labs. If Dr Centeno breaks Colorado state health rules I am sure that Colorado can shut him down too. Colorado has state attornies don't forget! 

 Having had the procedure, which finished in December 2008, I am now in recovery mode, & this evening I went for a run/walk of over 1 hour. I am feeling great! I have been doing lots of rowing on my Concept2 rowing machine, & today's run/walk felt great. I've gone down a pant size in the last 4 months & each and every week I am getting fitter. Is my knee perfect yet? No; am I much improved? Yes.

Osiris has had (FDA blessed) clinical trials with a similar product called "Chondrogen", that is not autologous but allogenic. My own surgeon believes that the allogenic way forward is dangerous and that autologous is the only way to go. http://www.stemcellnews.com/articles/stem-cells-knee-repair.htm . In fact my ortho surgeon is one of the teaching surgeons at USC where the aforementioned trials were carried out so I feel that I have weighed the pros and cons of this procedure well before diving in.

You may not like Dr Centeno's marketing approach, however are the treatments working?

As for your assertation that this technology is untested, I suspect that the 400+ patients (as opposed to the 48 patients on Osiris trial) that Dr Centeno has seen & treated might have a different opinion. As each week goes by Dr Centeno has increasingly more clinical evidence that his procedures are working.  I do share your concern that there are charlatans out there in the field of stem cells, its my opinion that Dr Centeno is one of the good guys.

JM
Title: Re: Regenexx injections - Stem Cells
Post by: GJJ on April 05, 2009, 05:49:14 PM
Hello,

I am desperately waiting for a review from the state since my  insurance company will not cover the Regenexx procedure but rather are ok with total knee replacement.  I have seen about 12 orthos and they all differ on the pronosis.  One mistake by one doctor 10 years ago set up a domino effect.  I won't go into the drama. Microfracture should not be allowed especially when you were not aware of it. What was a simple biomechanical issue turned into a growing problem that no surgery will correct.  Based on the research and from following this site, I have concluded that the orthos push for unnessary surgeries that make conditions worst.  I have been waiting for 10 years for a non invasive treatment.  I am not even close to total knee but will end up there if pro active treatment is not provided.  I have been reading and watching the progress on the Regenexx treatment and the FDA should focus their attention else where on others who don't care who they hurt just so they make a buck.  It's my body and mind and I hate when others dictate what is right for me pretending they are doing what is best for me rather what is best their bottom line.  Your body will heal with a little non invasive help.  Stem cell therapies are the future.  Europe has been doing it for years.  We need to leave the politics out and focus more on patient care. >:(
Title: Re: Regenexx injections - Stem Cells
Post by: Saverio on April 06, 2009, 12:44:13 PM
Well said GJJ  ! ! !
Title: Re: Regenexx injections - Stem Cells
Post by: Dr. Centeno on April 07, 2009, 08:46:33 PM
Dear all,

I only check this discussion board periodically, so I was surprised when I happened upon "abbaroodle" who has been "lurking" for awhile, but who only registered four days before his post.  Let me answer his "worries" one by one:

1.  We performed two years of "free" research before we ever decided to see the first commercial patient.  My partner and I spent hundreds of thousands of dollars treating these patients for free, establishing a lab, paying for MRI's, etc...  This went through an HHS registered IRB.  This IRB had various physicians, physical therapists, and community members.  Their job was to review studiy designs so that patients were protected.  I no more control this group of people than I control any other group of people.  I was not able to vote on any project in which I was involved.  In fact, they required that we start slowly, only approved a handful of patients, etc...  Their approach was to allow us to crawl, then walk, then jog.  Again, this process of going back and forth to the IRB took two years without a single subject paying for care, in fact it continues in some applications to this day.

2.  As I have said, the FDA has no authority over the practice of medicine.  A better summary of the issues is located at http://www.regenexx.com/2009/03/adult-stem-cells-now/.  It's interesting to note that the same day abbaroodle registered is the day that this Regenexx blog post went out. 

3.  The FDA process ensures patient safety?  Give me a break.  Celebrex, Vioxx, Plavix, Zyprexia, Paxil, Heparin.  This is a very short list of instances where the public was absolutely not protected by the FDA process. 

4.  The Regenexx procedure has a growing list of things that can be "cured".  This is absurd.  We treat joints.  These have always worked well for us and detailed descriptions of MRI results are discussed at http://www.regenexx.com/about-regenexx/regenexx-blog/.  We have also treated ligaments/tendons and non-healing fractures.  We tried lumbar discs early on, but had poor success, so we waited some three years before treating any commercial patients.  The story on this development is located at http://www.regenexx.com/2009/02/stem-cells-and-disc-repair/.  While this now works well, it demonstrates that we don't release an application to paying patients until we're convinced it can help some people. 

Like any medical procedure, Regenexx may or may not work for any individual.  As a result, the patients on this board will attest to the fact that we go through great lengths to categorize patients into GOOD, FAIR, or POOR candidates fro what we do.  We only tell about 20-30% of the patients whose knee MRI's we review that they are GOOD candidates.

5.  We are "pushing" an untested therapy.  As you all know, the research showing that arthroscopy is effective for knee pain has come under some fire, for more details see http://www.regenexx.com/2008/09/arthroscopic-knee-surgery-alternative/.   The research shows it's not effective.  What are these knee patients supposed to do?  Sign up for a life changing knee replacement?  Patients have choices in 2009, some will choose to get knee replacements and some will choose other things such as ACI, micro fracture, MACI, SynVisc, the Regenexx procedure, etc...  The surgical procedures on this list have gone through no FDA approval process, yet are performed every day. 

Why this post from abbaroodle? 

What the cell therapy industry desperately wants is your adult stem cells to be classified as a drug.  While this makes no sense from a medical and safety standpoint, it really helps the big pharma business model.  A group of physicians have come together to oppose the FDA's position on this issue, see www.stemcelldocs.org.  Patients have also come together to oppose the FDA's position on adult stem cells, see www.safestemcells.org.  Any of you who don't want the FDA and big pharma to make drugs out of the cells in your body, the Safe Stem Cells site is a great place to gain some perspective of what's at stake.  The stories that patients with terminal diseases have posted there can give you a quick jolt of reality as many of these patients will likely perish before the FDA and big pharma get around to figuring out how to commercialize adult stem cells as a drug (see http://safestemcells.org/Patient_Voices.html).  While we don't treat these things (we're strictly ortho), other doctors will be opening stem cell labs to help these people. 
Title: Re: Regenexx injections - Stem Cells
Post by: BearsCubs on April 07, 2009, 09:04:34 PM
There's a common label for people like "abbaroodle" that I'm sure we've all heard - for sure if you visit any sports team's fan message board:  TROLL.

I've had the Regenexx procedure on my knee and would do it again in a heartbeat.

I encourage anyone interested in having your voice heard regarding battling the FDA and big Pharma to register at the patient web site Dr. Centeno gave, www.safestemcells.org.
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on April 08, 2009, 05:12:09 AM
BearsCubs

I've signed up already. I have also noticed that Dr Centeno has published a great deal of his clinical work recently on his own website. If you suffer from a multitude of ortho conditions I am sure we can all learn something from his published experiences.

JM
Title: Re: Regenexx injections - Stem Cells
Post by: thevoice on April 10, 2009, 10:37:52 AM
whats the next step in stem cell treatments - do they need to be held in 3d scaffolds for better healing to the injured area?

Dr. Centeno do you foresee a court battle with the FDA and if so whats chances of winning...I totally agree with you about it should be allowed to be used saftely and freely as stem cells our our own bodies and not drugs.
Title: Re: Regenexx injections - Stem Cells
Post by: sugarbranch on April 21, 2009, 11:51:55 AM
I am sending a copy of my MRI and after surgery notes to Denver with my fee for my evaluation.  I had my 3rd surgery on Jan 13 09 and they did remove debris in my right knee but was not really much relief.  I am 49 F  and almost wheel chair bound with severe  muscle waste in my right leg. I have been very active with horses all my life.  I am told that I am not old enough for a tikr but really do not want one anyways.  I am going to give this a try if they accept me.  I could care less if it is FDA approved or not as I do not feel that they give 2 hoots about my health and well being but if they can fill me full of meds that I would have to take daily that have severe short and long term effects that cost lots of money, that in turn make me need more meds that have bad effects and cost more money....I do not trust the FDA and feel safer knowing this is not connected to them.  I will post after I know what is going on and if accepted, the results.  I will do just about anything to return to normal.  I want my active life back and dream of being able to ride and care for my horses again.  I would also like to be able to go dancing & 2 stepping again.  Actually, it would be nice to just be able to walk without severe pain.  I have bone on bone throughout most of my knee and a bakers cyst.  It is ruining my life.  My thoughts are FDA bad   DENVER   GOOD!!!
Title: Re: Regenexx injections - Stem Cells
Post by: GJJ on April 21, 2009, 08:31:00 PM
You go for it!

Surgeries do no good and FDA does needs to go after the real crooks and stop pretending to care for real people.

Keep us posted.

I am still waiting to hear from state.

Good Luck!
Don't give up.
Title: Re: Regenexx injections - Stem Cells
Post by: abbaroodle on April 24, 2009, 03:43:28 AM
Hi guys,

Wow, guess this isnt a group that likes to discuss subjects that dont have an easy answer! I forgot that the definition of a troll is anyone who disagrees with you.   ::)

I really dont want to go through and argue points one by one.  Its up to you as a potential patient to decide whether or not regenexx or any other procedure or treatment is right for you.  Just know that there are risks out there.  And there is no guarantee it will work.  (And you are right.  There is no guarantee surgery will work either!) 

Just a few thoughts on stem cell therapy in general.  This is not specific to Dr. Centeno or regenexx since you all clearly have done way more research about him than I have.  This is simply my own thoughts for any patient considering any stem cell therapy.

The International Society for Stem Cell Research (ISSCR) (http://www.isscr.org/clinical_trans/index.cfm) (http://www.isscr.org/clinical_trans/index.cfm)) has put out a handbook that has some really good guidelines about what to look for in a clinic and a stem-cell treatment. http://www.isscr.org/clinical_trans/pdfs/ISSCRPatientHandbook.pdf  For example, they feel it is necessary to have pre-clinical animal-based trials to ensure there are no longer-term problems like tumor growth, and patients need longterm monitoring to ensure limited risk to them. Also, ensure that your cells will be used for no other purposes, either clinical or research, without your explicit permision in the future.  Finally, ask about who will cover costs for emergency treatment just in case something goes wrong. 

Who knows.  Maybe the ISSCR is really just a lobby-group run by FDA and some big pharma to try to shut Dr. Centeno's clinic down.

Here is a link to a very, very well respected journal.  (One of the most-frequently read journals among scientists.)  They have published many articles on stem cells.  I will let you read it for yourself.  But note a few highlights below.

http://blogs.nature.com/reports/theniche/2008/03/patients_paying_for_stem_cells.html

"At a press conference in Half Moon Bay, California, a panel of highly influential officials and researchers in stem cell science said they were alarmed at “medical tourism” in pursuit of questionable and potentially harmful stem cell procedures. The only established stem-cell treatments are for a handful of blood diseases, they said, but advertisers promise cures for every imaginable disease."

"“It’s clear from those letters that there’s desperation with a complete lack of sophistication” in the ability to assess procedures, said Landis, head of the NIH Stem Cell Task Force. “Without that people will do things that are not in their own best interest.” Patients don’t know (or necessarily care) about established standards for clinical research, particularly that patients are rarely asked to pay for experimental procedures, and that they must be adequately informed of potential risks and benefits and the questions a trial will answer." 

"Patient desperation is “an invitation for exploitation,” said Daley, president of ISSCR and an associate professor at Harvard University, adding that one has to be very suspicious when asked to pay thousands of dollars to pay for treatments thousands of miles away. Patients should be asking questions such as whether researchers are affiliated with established medical centers and have published in scientific journals."

Here is another nature article.  It focuses more on international stem cell treatment, but I think it hit some good points. 

http://www.nature.com/stemcells/2008/0812/081211/full/stemcells.2008.157.html

"The society condemned stem cell tourism, saying that shady clinics exploit patients' hopes and could jeopardize "legitimate progress of translational stem cell research."1 Researchers worry clinics promote unreasonable expectations for how quickly mainstream work will progress and generate bad publicity that could tarnish the entire field."

In many cases, claims are unrealistic.  "Caulfield and colleagues described the claims as "optimistic" and "unsubstantiated by the peer-reviewed literature." Benefits of treatment were overemphasized and risks were underemphasized."

"Sometimes, "clinicians may be justified in attempting medically innovative stem-cell based interventions in a small number of their seriously ill patients," but in such cases, they should be moving toward a clinical trial." 

Before you decide to try something new, try to keep an open mind and educate yourself as much as possible from both the supporters and those against a new treatment. Then make your own, more informed decision.

Happy healing!  I am totally jealous of everyone who is out running and biking in this gorgeous weather!!!
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on April 26, 2009, 10:14:46 PM
Abbaroodle

As for the peer reviewed clinical studies of whether MSC's work & create cartilage
http://tinyurl.com/5qebjm ,  http://tinyurl.com/566tns & http://tinyurl.com/6483a2  should suffice anyone's curiosity.

As I am replying to only your second post on this blog, (& I have read both), you've yet to mention exactly what condition you are suffering from.  So what is the real reason for posting here?
Title: Re: Regenexx injections - Stem Cells
Post by: celltherapy on April 30, 2009, 04:51:55 PM
I have removed my previous posts from this board. To see my take on Regenexx see http://www.celltherapyblog.com

--Lee
Title: Re: Regenexx injections - Stem Cells
Post by: blues on May 07, 2009, 05:34:16 PM
Hi Folks,

I found this forum after doing some online research about stem cells and knees.

I am a 53 year old male, had a basketball injury to my right knee when I was 19. The torn lateral meniscus was removed and I continued on with life, like everyone else in those days, with a knee that has always given me trouble. 3 arthroscopic surgeries (1979, 1986, 2002) later to "clean it up" have done nothing but leave me with an arthritic knee which greatly diminishes my quality of life. I can't walk or stand for long periods, climb stairs or ladders without pain and difficulty. As a sports/travel photographer, I get a lot of "snap, crackle, pop" when getting in position to take photos. Exercise has never been able to build my quads to the point that my knee feels stable. This story is probably repeated on this board many times a day.

I love to play golf, but have been reduced to only playing a few times a year, mostly because it takes weeks to recover from the inflammation. I just have gotten to the point of "its not worth the pain" to play any more.

I recently (I think) sprained my MCL, which caused a re-thinking of this old, tired knee thing and I have started looking into a replacement. Of course, as a long-time knee problem sufferer, my insurance excludes anything regarding that knee, so I have to pay for  any treatment out of my pocket.

I have had a physical therapist look at my films over the years and he encouraged me to start looking into stem cell work on knees, his logic being, once you go down that TKR road, there is no going back. So here I am, having gone to Dr. Centeno's website and filled out the prelim form to start the consultation process.

I have learned a lot in the past few hours of reading here, and thank all of you for your input. I live in Texas, so a quicky flight to Denver is no big deal for me. My eyes are wide open and I've drunk the Kool-Aid.

I'll let y'all know how it goes, if I even qualify, etc.

Cheers,
Joe

Title: Re: Regenexx injections - Stem Cells
Post by: kripple on May 20, 2009, 09:59:33 PM

The procedure, which costs $5,000 to $7,000, is not covered by insurance. Maroon knows of no one in the Pittsburgh area doing similar work.


Interesting.  So the procedure costs between $5,000 to $7,000 for me to receive two injections into my knee.  That sounds perfectly reasonable. 
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on May 22, 2009, 04:36:27 PM
Hello Kripple

We thank you for your sarcastic posting. Clearly this being your very first post on this particular blog its probably safe to suggest that you might be an Internet Troll.

http://en.wikipedia.org/wiki/Internet_troll

In Internet slang, a troll is someone who posts controversial, inflammatory, irrelevant or off-topic messages in an online community, such as an online discussion forum or chat room, with the primary intent of provoking other users into an emotional response[1] or to generally disrupt normal on-topic discussion.[2]

Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on May 22, 2009, 04:46:55 PM
In the interests of folks who 's knees maybe in bad shape, I know of one person that has just recently had a double TKR performed on both his knees..  See URL below,

http://tinyurl.com/pmnlch

I posed him the question below

"Having had your both your knees, TKR'd, if you could do your knee procedure all over again would you have opted (now knowing what you do) for stem cells for your knees as a first alternative to TKR?"

Mccartjt, I believe this was faster route.(TKR)
Now, knowing the degree of pain that I went through from the operation and therapy and still are going through now. I would have done the Adult stem cell injections. The pain is severe. On a scale of 1 to 10 the first two weeks were close to 9.5 most of the time. If I only had one done I would not have dad the other one done. "


Indeed an important lesson for people with bad knees! Avoid the TKR if at all possible!!

Happy Memorial day weekend to all...

JM


Title: Re: Regenexx injections - Stem Cells
Post by: 60schld on May 23, 2009, 12:45:26 AM
To Kripple,  I follow this discussion closely, and while I admit the procedure is not cheap, there is a lot more involved than just 2 shots!  There is prep, growing stem cells etc.  I would think you would know that if you really followed this forum.  However, I find everyone's opinions worthy.  In the end,the simple fact of success rate will prevail.... discussions or not!  Happy Memorial Day weekend 8)
Title: Re: Regenexx injections - Stem Cells
Post by: kripple on May 24, 2009, 05:08:15 AM
Hello Kripple

We thank you for your sarcastic posting. Clearly this being your very first post on this particular blog its probably safe to suggest that you might be an Internet Troll.

http://en.wikipedia.org/wiki/Internet_troll

In Internet slang, a troll is someone who posts controversial, inflammatory, irrelevant or off-topic messages in an online community, such as an online discussion forum or chat room, with the primary intent of provoking other users into an emotional response[1] or to generally disrupt normal on-topic discussion.[2]




Or perhaps it's my first post because that's generally where one begins when they join a board?  Logic is your friend.  Use it every now and then and things will make much more sense to you.
Title: Re: Regenexx injections - Stem Cells
Post by: blindy on May 24, 2009, 06:11:46 PM
I see valid points from both sides--those who realize that the FDA is here to protect us from quackery and those who have been given hope that Dr. Cetano may provide a solution for lifelong suffering.

One of the problems I have with the FDA is that a number of drug company executives have sat on its board and I can't believe they are objective. I look at drugs like Crestor that lowers cholesterol yet had subjected 29 people to deadly rhabdomyolysis in the pre-trial clinical studies. How many drugs pass FDA scrutiny for political reasons? I'm sure the balance of the FDA's work is good yet I look at how medical invention evolves and have to think of Ignatz Semmelweis, the founder of germ theory, who was put into a mental institution where he later died for bucking the conventional views of medicine. 80 years later, he was discovered to be correct. A lot of good that did Ignatz and so many people he might have saved from harrowing disease.

On the other hand, I do understand that we need standards and good points were made here about any Tom, Dick and Harry setting up a clinic without guidelines and killing people. It's a dilemma but I'm looking at the body of work that Dr. Centano has done and have yet to hear of a patient who has complained about his clinic. Isn't it people like Dr. Centano who create lifesaving breakthroughs because they have the guts to fight for a cause? Of those 250 patients who have experienced his procedure, I would think any disgruntled patients would have used this forum to speak their mind. I haven't seen that. I have seen people give him rave reviews.

Let me tell you my story. I had county track records for the 440 in high school. I used to run like the wind when I was 17 and almost felt as though I was flying. What a rush! Then I went out for a pass, made an extreme cut and tore my medial meniscus. In the 1960's they didn't have arthroscopes and had to go into the knee capsule. My recovery was slow and I could never run well again. I have had 7 knee surgeries (debridements, removing bone chips and two high tibial osteotomies (the first was a failure and caused foot palsy for a year; in fact the leg was not angled properly and the whole thing had to be done over). I, like many of you, have suffered arthritic pain my whole life, have given up sports that I love because I simply couldn't perform any more. After a while, you learn to try to put all this in the background but it is always there in its haunting unconscious way and when the knee acts up and causes two weeks of disability at a time, I try to suck it up and move on.

Two years ago, I discovered that both my hips were shot. I researched everywhere to find a solution. I contacted Dr. Centano and sent in my mri's. They were honest. My hips were so out of round that even if new cartilage was formed, it would be worn down. They were honest about that and didn't look to sell me a bill of goods.

I am now 6 months recovered from bi-lateral hip replacement and still have pain in my left femur when I walk and lingering pain on my right side when I sleep that shoots into my knee. My surgeon was excellent and has done 14,000 hips but surgery is not a perfect science and hopefully, I'll fully recover.

That brings me to my knee. I am a vital person who loves life. As many of you, that has been compromised for decades by this painful and debilitating knee. From being a star athlete to a semi disabled person, the transition is tough and doesn't end. I have a great business that is now starting to take off and I will be able to work whenever I want and the money will keep growing. All that becomes meaningless if I can't dance, play golf, and be my active self.

So I ask, if Dr. Centano's procedure doesn't bring me to the promised land and even if it has some question marks, who else is offering me hope? I have communicated with his office and have found my experience with them to be very positive. My business is based upon building trust and positive relationships. With Dr. Centano, I see a man who may or may not be working within the system, but what I have experienced in my due diligence is a feeling of trust towards him and his people. I don't want the government to take that one hope away from me.

And what if it does work? And what if he actually can get me back to a normal life and do so for others? I doubt anyone on this forum is here without suffering horrendous, life limiting challenges because of his or her knee issues. I see someone who is challenging the status quo and people are benefiting on an incredible level.  I am 63. If I have to have a total knee and suffer a possible revision sometime in my 80's that's not something I want to think about but I'll do this if nothing else can work. With that as an alternative and all the suffering from recuperation, Dr. Centano's procedure seems not only appealing but the most rational choice.

It is easy for us to criticize and judge without personally knowing the man. It is always harder to assume that some people might really be iconoclastic but honorable nonetheless. We look at our politicians, the banking establishment, the oil companies and at cable news (which is all about ratings and has nothing to do with news) and we get jaded;  we believe that everyone has a secret agenda and is ready to rip us off. I believe that in the midst of this, there are a class of honorable people, striving to do good. Until I see otherwise, I believe Dr. Centano is one of them.

Blindy
Title: Re: Regenexx injections - Stem Cells
Post by: Saverio on May 25, 2009, 02:08:52 PM
Hi All,

If you read this sections posts you would know I am a 2 time recepient of Dr. Centeno's regenexx procedure (once in each knee).  I am doing great and am planning to go back for another procedure in my right knee.  I wanted to take this time to inform you of 2 prominent Orthopedic clinics that are using or looking into Stem Cells.  One is the Stone Clinic (http://www.stoneclinic.com/stemcells).  Dr Stone did do a microfracture on my left knee and I scheduled with him bi-lateral TKRs before I found regenexx.  The other is Steadman-Hawkins (http://www.shsmf.org/).  They also are world reknowned.    I do believe stem cells is the future of cartliage restoration.

Saverio
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on May 29, 2009, 02:34:38 AM
Saverio

I think the genie is soon going be out of the box. NEOSTEM  see stock price here  http://finance.yahoo.com/q?s=NBS

& press release here...

http://finance.yahoo.com/news/NeoStem-Obtains-Exclusive-prnews-15197487.html?.v=1

JM
Title: Re: Regenexx injections - Stem Cells
Post by: 60schld on May 29, 2009, 03:40:12 AM
Saverio,  Since you were one of the first on this forum to post your experience, do you think this procedure is going to be a permanent fix, or will we need to redo it every so often?  Thanks, 60schld
Title: Re: Regenexx injections - Stem Cells
Post by: Saverio on May 29, 2009, 01:16:05 PM
I've only had 2 procedures and can only speak on my experience.   I have noticed improvement in level of pain (discomfort) and mobility after each procedure.  Are my knees back to where I want them?  No.  But there is marked improvement.  Given that I only have about 10% of my lateral meniscus in each knee, doing nothing I believe wear and tear will break down any improvement over time.  My hope is that as I receive more procedures the technology will advance to a level where the improvement is greater.  This is still better than any microfracture I have done.   And defintley a better alternative than TKR.
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on May 30, 2009, 03:13:45 AM
Saverio

Do you know how many stem cells you've had injected into each knee so far? I've have had a total of 75million on my left knee..
Title: Re: Regenexx injections - Stem Cells
Post by: Saverio on May 30, 2009, 12:49:45 PM
Left knee = 25 mil,   Right knee =  29 mil
Title: Re: Regenexx injections - Stem Cells
Post by: slyguy1 on June 01, 2009, 06:32:08 PM
Would anyone have any comparative success of this versus ACI procedures. I understand ACI is very invasive open surgery and very long recovery but on a longterm basis is ACI more permanent than stem cell proc? Any websites with meaningful info on this?
Title: Re: Regenexx injections - Stem Cells
Post by: NikkiE on June 02, 2009, 01:48:32 AM
Left knee = 25 mil,   Right knee =  29 mil

That's a little cryptic!

Is this how much cartilage has been regenerated>?
Title: Re: Regenexx injections - Stem Cells
Post by: Saverio on June 02, 2009, 12:51:14 PM
Nikkie,

It simply means Dr.  Centeno injected 25 million stem cells in my left knee and 29 million in my right knee.
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on June 02, 2009, 04:24:56 PM
Slyguy1

I am sure that in time that info you are looking for will be available. The Osiris  Chondrogen procedure was with either a low dose 50 million or a high dose 150 million stem cells, (read more here.. http://investor.osiris.com/releasedetail.cfm?ReleaseID=278696 )  I've had half that number. Osiris patients have had some success. Although those stem cells were 'supposedly allogenic' not autologous. There's a big issue for me at least with allogenic v. autologus.

Sly to your point of ACI very invasive, yup you are correct on that one. 12 months rehab plus the chance of overgrowth too with an additional arthroscopy needed also. When you 50+ years of age, a 12 month rehab akin to what an NBA basketball player would have to endure is frankly a bit too excessive unless you are basketballer! I want to grow old 'Gracefully' I don't have time to live at the gym..

That NeoStem has licensed the Regenexx procedure for (essentially China) Asia I am sure over time there will be more clinical evidence coming out.
Title: Re: Regenexx injections - Stem Cells
Post by: slyguy1 on June 03, 2009, 03:30:42 PM
Hi mccartjt......being an active person most of my life i don't mine spending time in the gym but i am definitely not interested in competitive sports just keeping fit and holding onto what i have is my personal goal. So what is the issue of allogenic vs autologus? I am thinking that the most successful candidates are the ones with minor lesions that have not been compromised by any other surgical procedure such as microfraction which is what i had done. I think i posed this question a while back but had no clear cut answer. My microfraction has run its course and i have been holding off as much as possible for such a procedure but i don't know if it will help me....most os out there laugh at the idea....thanks for your imput

Sly
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on June 03, 2009, 06:24:24 PM
Slyguy1

Autologous means cells that originally come from you. Allogenic are donored cells that can come from anyone. ~ You are unsure of their lineage, thus unsure if the donor had undiscovered AIDS or other ailments etc.. The Regenexx procedure for generating stem cells to regrow your cartilage, come from your own bone marrow, so theoretically no chance of contamination. (There is always some risk in any procedure). Osirsis did their phase II/III study on a drug called Chrondrogen which is allogenic (this is almost identical to Regenexx). Osirsis in this situation represents "Big Pharma".

I will digress here, one "Big Pharma company" markets "Lamisil" for toe nail fungus. The three month treatment plan costs $1000.00 for the tablets.  My insurance company wouldn't pay for the treatment & I have a good PPO medical plan. I went to see a skin specialist doctor  and he told me a $10.00 jar of Vics Vapor rub will cure toe nail fungus. What do you know 3 months later my toe nail fungus is gone & no $1000.00 course of Lamisil.  So much for big pharma. Big pharma is looking out for themselves.

This is probably the heart of the matter with Regenexx and FDA. The FDA 's approval process is skewed towards big pharma = expensive money making procedures to fatten Pfizer/Merck/GlaxoSmithKline's profits. With Regenexx the procedure for 1 set of 3 injections is about $7000.00. I have a friend that has had a double total knee replacements. So far his surgery (without all the physio) bill has come in at $100,000+. The pain was 9.5 against 10 for two weeks post surgery & then loads of rehab. His course with Regenexx might have cost him about $16-20,000.00 & a lot less pain.

Sly

As for your condition, I'd get in touch with Regenexx and see what they can do for you..

Good luck!

JM
Title: Re: Regenexx injections - Stem Cells
Post by: slyguy1 on June 05, 2009, 03:53:11 PM
.......on the lamisil i believe there is a generic version that your insurance will pay for in case if you ever need it again.....but hey if vicks works for you great:) As far as cost goes i believe the ACI procedure is about the same (100,000+) and if you can grow the same cartlige with half the recovery time....it is just too good to be true is what my gut feeling says....have a good one:)
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on June 06, 2009, 04:49:54 AM
Sly

Yup the Vicks Vapo rub worked well. As for the recovery time, cartilage takes time to grow. You can't cheat the growing time needed. The recovery post ACI is extremely difficult, your muscles atrophy etc, that's not the case with Regenexx.

Lets get this clear, Regenexx so far hasn't given me perfection, but my knee is much better. Do I  believe in the procedure? Well I am scheduled back at their clinic for another procedure in 2 weeks. & I am paying..  JM
Title: Re: Regenexx injections - Stem Cells
Post by: loryc00 on August 15, 2009, 02:22:01 AM
Hi Dr.
I have been researching things to help my husband.  He was hit by a car in Oct of 2008 he is only 37 years old and they are wanting him to fuse his ankle!  I am not satisfied with this procedure and recovery for it.  He had a open ankle fracture,  where his cartilage was completely cut up by the accident.  Now after debrement   and drilling he has more pain than before and can't get off these crutches.  His cartilage was pulled away they said this last surgery.  He also broke his femur and has knee issues now.  He has plates and screws in both the femur and ankle.  Do you think he would be a good candidate for this.  Also we live in Florida and have read that you are trying to start doing it here.  If so when and where??  Is usf doing it I see them mentioned in a few articles.  Thank you so much
Lorrie Campbell
Title: Re: Regenexx injections - Stem Cells
Post by: slyguy1 on August 17, 2009, 03:53:12 PM
hey mccartjt..........how is your progress coming along....do you have any updates?
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on August 25, 2009, 07:29:51 PM
Hey Slyguy1

I had a bit of a setback. Not with my knee but with my back. I have extolled the benefits of rowing on Concept 2 rowing machine previously. I've done nearly 1/2 million meters of rowing since my 3rd injection in December 2008. Back in late May I rowed one day for about 22 minutes and "Cricked" my back. Clearly I had a defective rowing stroke, & like a fool I carried on for an additional 3 minutes until I could row no more. I didn't realize at the time the pain I was about to cause myself for being stupid and not "Listening" to my body. That basically laid me very low for the last 3 months. Ten days ago as a direct result of that injury my back was screamingly sore. I emailed Dr Centeno and, as a result I got an MRI done for my lower back.

From my knee prospective, in the last 4 months I've had one more re-injection (my 4th) into my knee. For rehab since late May I’ve been doing a lot more cycling as opposed to rowing. I have purposely been getting out of the saddle to stress my knee whilst riding that slight irritation of the joint promotes cartilage growth. I have noted that during this time my knee has been less sore (post workout) with each progressive outing on my bike.

So I had pre-injection appointment with Dr Centeno on Monday 24th August.  At the same time he took a look at my overall condition. Dr Centeno checked the alignment of my hips, knee and back in an effort to correct what was giving me my back pain. We discovered that I did in fact have a very mild showing of sciatica. Dr Centeno administered some IMS (similar to acupuncture) and I have to say now my back feels much better as does my overall muscular / skeletal alignment.

 I am now waiting here in Bloomfield until tomorrow, when I will get my 5th re-injection with Dr Centeno.  As my condition changes I’ll keep you in the loop. I do feel better now than I was last September 2008. For me that's what makes this worth while.. JM
Title: Re: Regenexx injections - Stem Cells
Post by: slyguy1 on August 28, 2009, 10:30:48 AM
JM......thanks for the update....sorry about your back situation...i know the feeling....it seems it is a given with all knee problems that some back problem will surface at some point. It is hard to believe how the quad muscle atrofies so quickly.....i took about a week off from working out and i can feel my knee pain coming right back....have a good one.
Title: Re: Regenexx injections - Stem Cells
Post by: emoney on September 29, 2009, 11:23:27 PM
Does anyone have any more updates on this? 

Here is my history:

- 41 yr old male - 35 years of soccer, skiing, court sports
- severe patellar and quad tendinitis / osis on both L and R knees - almost identical
- grade 3+ chondromalacia of trocular groove (big hole just under patella)
- tried 1 year of PT, stretching, etc, and Prolo - got stronger and more flexible, but not better
- did scope and debridement of patella AND quad tendons on BOTH knees 8/08....did 6 months of PT, etc.

I am now worse than I was before.  It used to be that I could ski or play soccer, and then it would hurt for a few days and I had to rest, ice, etc.  Now I cannot even start to run or anything without pain.

I have been speaking / emailing with Regenexx for a couple of months and am seriously considering this.  I have also spoken with Steadman-Hawkins.  Dr. Karli there has been doing PRP a long time, and also have recently been doing BMAC.  In addition, Dr. Karli worked with Dr. Centeno and others on a trial paper or something, so I have to imagine that they are looking at this as well.


Anyway, Saverio, Mcartjt, etc. - I have asked Jen at Centeno's office if I could speak with someone who has done this before...but do you have any more updates?  Part of what concerns me is not having numbers, other than 500 people have done this...


Title: Re: Regenexx injections - Stem Cells
Post by: Saverio on September 30, 2009, 12:01:29 PM
My update.  I am playing singles tennis almost everyday and climbing up the local ladder.  I couldn't do this before regenexx.  I was limited to doubles and had to take a days rest in between.  Sorry don't have any numbers just my history.

Title: Re: Regenexx injections - Stem Cells
Post by: emoney on September 30, 2009, 08:44:53 PM
thanks - I will see who they let me speak with.  Sounds like you are doing well
Title: Re: Regenexx injections - Stem Cells
Post by: Saverio on October 01, 2009, 12:38:55 PM
I want to be clear.  Yes I am doing better than before regenexx.  I work hard at rehab to maintain strength.  Before regenexx I could not strengthen my knees because of the pain.  Are my knees 100%?  No... but they are stronger.  I do believe there will be a 100% cure for osteo arthritis using stem cells in the near future.  I am waiting for that day.

Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on October 05, 2009, 04:50:56 AM
Emoney

I am 5 injections into my left knee.  I am improved, & not yet perfect. I 've one more injection to go and I've been doing a lot of cycling & swimming to get my joint to change the stem cells injected into it, into cartilage. Knowing how long it takes cartilage to grow, I am at least 6-9 months away from knowing where I'll end up.  On another note Dr Centeno has helped my back enormously with an injection of platelet lysate into my L5/S1 joint 10 days ago.  I'd been in agony on and off since May with my bad back.. So my hurting bones  & joints are still improving courtsey of the folks at Regenexx.
Title: Re: Regenexx injections - Stem Cells
Post by: rob8647932 on October 06, 2009, 11:50:46 PM
I have had 4 injections in my right knee. I had a grade 4 defect in the lateral aspect of the trochlea. It was about 10 x 10 mm in size. It is improved but I still have the arthritic crunching. I have at least a couple more injections to go. Hopefully I will get another round of improvement. Centeno is not recommending any pre injection to roughen up area nor is he putting any restrictions post Regenexx. I am following Centeno's recommendations.
Title: Re: Regenexx injections - Stem Cells
Post by: macetini on October 25, 2009, 12:20:05 PM
Hi everybody, first post here.

I'm 25 yo male, 5 years ago a had partial partially menisectomy ( bucket handle type of tear, the rims are whole ), they removed around 20%. I'm very active, fit and flexibile( I weightlift and do cardio almost every day ). I never had any meniscus problem since and my knee doesn't hurt, but I want to be able to stay active in years to come. My hyaline cartilage is preserved and I don't have any signs of osteoarthritis. I am interested in meniscus regeneration. In one Regenexx report there was like 23% meniscus regeneration. I'm interested in the procedure, anybody has any toughs?
Title: Re: Regenexx injections - Stem Cells
Post by: emoney on October 27, 2009, 05:00:11 PM
thanks to saverio, mccartjit, and rob - sorry I have been off-line a while

I am still conversing with with Jen at Regenexx about some questions.  In particular, there are some things I will have to do that I did not know about:

1 - some kind of "unloading" knee brace?  not sure how much this costs....also, how can you wear 2 at once?  I have the identical prob in both knees
2 - manually do 30 mins of ultrasound every day

Did you guys have to do this?

thanks

I may also do PRP locally here as well .... they just started it here and I think my surgeon feels bad and would do it for free....but I will check with Centeno first
Title: Re: Regenexx injections - Stem Cells
Post by: Saverio on October 27, 2009, 11:44:04 PM
emoney,

I did the ultrasound and still do it every morning.  It makes my knees feel good.  Dr. Centeno did not suggest the unloader braces,  but I use to wear them about 10 years ago during playing tennis.  I would think anything that helps releave forces in the knee joint during healing is a good thing.  I have starting using an inversion table every morning and after I play tennis.  I do believe I get benefits from the hanging. 

Saverio

Title: Re: Regenexx injections - Stem Cells
Post by: emoney on October 28, 2009, 02:16:45 PM
thanks Saverio - I appreciate it.  I just need to figure out all the ramifications of this. 

I travel every other week for work, and I have 3 kids under age 10, so if I have to spend an hour a day doing various rehab activities, it is complicated...

thanks again
Title: Re: Regenexx injections - Stem Cells
Post by: Saverio on October 28, 2009, 03:19:37 PM
emoney,

The uktrasound is easy.  I do it in the morning while checking emails and doing PC stuff. 

Saverio
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on November 10, 2009, 04:43:22 PM
Hi Everyone

I am now six injections of stem cells into my left knee. That will be my last visit to Dr Centeno for a while. However I did get a PRP injection yesterday to help convert the stem cells that were injected into my knee a week earlier into hyaline cartilage. Dr Centeno when asked suggested that I have a PRP inject into the knee a week  after my stem cell re-inject, with a second inject of PRP in my knee two weeks later. I'll keep you all posted. Who knows I may yet have a third inject .. If you get MSC Mesemchymal Stem cells injected from Dr Centeno, it may be smart to get PRP after the stem cell re-inject procedure to continue to promote the cartilage growth.

Good luck to all of you.

JM


Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on December 08, 2009, 03:54:45 AM
Hi Everyone

Its been a month since my last posting. I've had 2 PRP injections into the same knee where I had MSC stem cells injected in the last 4 weeks. Not much to say other than I 've been doing some swimming in the mean time and  been swimming somewhere between 3000 + 4500 yards a week to help promote the growth of cartilage in my knee. My knee is feeling okay but not as yet any major improvements.

However I have seen the following publication

http://tinyurl.com/yj4a3bz

On the national library of medicine. This study should help people make a judgment call on the safety and complications issue of the Regenexx procedure. No doubt there will be more studies comeing out from Dr Centeno in the future. I personally am pleased to see that this peer review study might help calm some of the naysayers of what Dr Centeno has been doing with MSCs. I wish him all the best..


 On another note my back which I injured in May is getting much better.  I got an injection of Platelet Lysate and Dexamethazone (steroid) as an epidural injection adjacent to my L5/S1 joint on October 23rd 2009. After about two weeks most of the sciatica pain appeared to disappear. After about 5 weeks the benefits of the tiny amounts of steroid did in fact wear off. However since the injection I've done lots of swimming and my back is feeling currently way way better. Right now I am unsure if I'll need any further help on my back. Only time will tell.


Good luck to you all

JM
Title: Re: Regenexx injections - Stem Cells
Post by: Lottiefox on December 08, 2009, 04:08:46 PM
Hi everyone from the wet and cold UK!

This is a fascinating thread. A bit of background - I'm 40 years old, previously very active female into regular gym sessions, dance, trekking etc. Started having anterior left knee pain this year and it got steadily worse. Didn't respond to Physio, developed delightful crepitus on leg extensions, started to view stairs with horror (esepcially going down them carrying anything), generalised ache, pain, swelling etc etc all those hideous problems that come with a knee problem. Laid off impact activity after a summer of more outdoor type sprints and runs and took some NSAIDs....still no real relief. I'm not in screaming agony but I am restricted with walking for very long, can't pivot, certainly can't run...got an MRI about a month ago and it showed a small (not sure how big) osetochondral deficit in the medial femoral condyle and early degeneration of the cartilage behind the patella (a fair bit from the images as far as I can see). All fits with the pains and aches and noises. So, now its there in black and white!

Went to see an OS privately. Someone recommended as doing a lot of our UK footballers etc. Well, he might be good with a scalpel but he had the bedside manner of a serial killer. Looked at MRI, prodded my knee 3 times, got me to stand in front of him and announced I needed OATS on the femoral defect and ACI on the patella. Oh and get that bunion chopped off as well. All would be fine, yes it was major surgery but all very run of the mill, 12 months rehab and a leg splint and I'd be back to my normal life. If I preferred he could do some microfracture but that wouldn't last as long. Or he could just do a "wash out" but that might not help at all. Or I could do nothing and be crippled by OA sooner rather than later. £160 well spent - I wish I'd saved it and got my worry lines topped up with Botox.

Hmmmmmmmmmm........ ::)

So, here I am with a virgin knee with some areas of difficulty. My tendons and ligaments are all OK, my fat pad is inflamed but I guess thats a reaction to the rest of the trouble. I'm extremely interested in the Regenexx concept. I'm a big believer in the body working with itself to heal and whilst I'm not expecting new knees I'm not keen to submit to extreme surgery with dubious outcomes and a huge amount of possible pitfalls. Any thoughts on whether my type of problem could be helped? How would a non-USA person go about finding out more?

I'm so encouraged by some of the stories on this thread. I'm not jumping into any form of treatment at the moment, but this seems like a promising route that might, just might, bring better results than the russian roulette of MFX/ACI/OATS etc....

Thanks in advance

 :-*
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on December 11, 2009, 06:16:09 AM
LottieFox

You bring up a very good point. If the only tool in your toolbag is a hammer then everything looks like a nail!. In much the same way if you were a trained surgeon, then every patient has an "Appointment" booked in your operating theatre!

There are some new procedures coming up, one is a variant of microfracture with mesemchymal stem cells (MSC s) that is practiced by Dr Khay in KLSMC http://www.klsmc.com/ & I've heard rumour that at the Steadman Hawkins clinic they are doing something similar. I am told that these results are coming out with "Hyaline like" cartilage, as opposed to fibrocartilage. There is also the European offices of Genzyme that are pushing MACI or matrix autologus chrondocyte implants, check out www.maci.com for more info.

For stem cells implants are available in Europe, at www.xcell.com however X-Cell don't expand the MSC's in a lab. Dr Centeno does expand the drawn cells in a lab and puts back millions of stem cells to work for you. When asked why he expands cells in a lab, he said that doing a BMAC -(Bone Marrow Aspirate Concentrate) with a bedside centrifuge, to get stem cells together meant - re-injecting a patient with sub-optimal amounts of stem cells back into the damaged joint and not getting a great result.

There is also this going on in the UK http://www2.hud.ac.uk/sas/comment/pab100409.php that is worth reading. What ever you choose good luck..


John M

Title: Re: Regenexx injections - Stem Cells
Post by: Lottiefox on December 11, 2009, 10:40:40 PM
John,

Thanks very much for taking the time to reply. I've followed your responses to Regenexx with interest. I'm guessing the results are still going well for you?

I've been in touch with both X-Cell and Regenexx and am far more impressed with the latter. X-Cell are extremely keen to "sell" their product, and whilst I'm sure they do excellent work I feel more comfortable with the information, analysis, procedure and general approach that Regenexx seems to have. As you say, they use different methods that seem more firmly anchored in medicine and I like the conitnual improvement approach they advocate. Very early days with a lot to explore but I'm going to send my MRI and notes to Regenexx for their views. Its less money than 20 minutes with a scalpel happy UK surgeon! Given the current state of the pound, the treatment in the US works out at a very affordable rate (less than a private arthroscopy at the moment!!!) and even with flights to Denver its well within reach. I'm due a delayed honeymoon so perhaps Colarado might be in the offing in 2010!

Thanks again.

Lottie  :D
Title: Re: Regenexx injections - Stem Cells
Post by: blues on January 08, 2010, 05:09:55 PM
Lottie,

May of 2009 I was like you, researching my options (see previous post on this thread 07May09). Although my knee wasn't virgin, I was still looking into the Regenexx option. After doing more research and reading Dr. Centeno's comments, I realized that the cheapest, and maybe the most practical thing, a knee pain person can do is start with prolotherapy. I'm not trying to hijack this thread with prolo stuff, but my experience with prolo has been good and I may not need Regenexx.

With all the experienced folks who have gone through the Regenexx procedure, I'm willing to be corrected, but you may not need to go to the extreme expense and travel of Regenexx. If you look at this stem cell repair path, prolotherapy, followed by PRP, followed by Regenexx or its equivalent, then the logical starting point is prolo.

I live in central Texas and have easy access to both San Antonio and Austin prolo doctors. After researching the procedure for a few days and talking with every dr. within a 200 mile radius, I opted to go to the Center for Spine, Sports, and Physical Medicine in Tomball, TX to give prolo a try.

I won't go into the details here, as I think that info would be better on a prolo thread, but after 3 prolo injections and another scheduled in a couple of weeks, I am thrilled with the results. My acute pain, caused by a torn MCL responded almost immediately and my chronic knee pain from years of OA is now all but subsided to the point that I can get in much more pain-free exercise and my leg muscles are responding accordingly. Anyone wanting more details, feel free to PM me.

My point here is, do your homework. If it seems that prolo or PRP might help, then give them a try first. My logic was, and I think it was sound, if they don't work, you're not out much money. If they *do* work, you're still not out much money and your knee feels tons better.

Also, an FYI for others considering Regenexx, I have heard that the Regenexx folks may be looking to *franchise* the technology to other practicing prolo and PRP centers. If that happens, we'll all have better access to it.

I'll take this opportunity to thank all of you folks who have posted your experience with Regenexx. This board is a valuable learning tool.

Joe
Title: Re: Regenexx injections - Stem Cells
Post by: Lottiefox on January 08, 2010, 06:19:30 PM
Hi Joe

Many thanks for your views and comments - very interesting. I have to say I am not as up to speed on the whole prolo concept as a stand alone treatment. Perhaps I need to do some more reading! I can say that my MRI images finally reached Regenexx yesterday and I'm hoping to have my telephone consultation with them in the next few days. I have plenty of questions to ask and clearly, they need to comment on whether my knee is a suitable candidate.

Great to hear that your knee has made such good progress,

All the best

Lottie  :)
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on January 10, 2010, 12:34:55 AM
Joe

Dr Centeno & Dr Shultz @ the Regenexx clinic do actually believe in prolotherapy. I have had prolo from both of these doctors prior to getting stem cells injections. The prolo creates a microinjury from what I understand and that starts the articular healing process. The emphasis of prolo here, is that the Regenexx team use the prolo to get the joint sticky to more readily absorb/bond with your stem cells when they are injected two or more days later into your joint.

My orthopaedic surgeon however does not believe in prolo, and when I asked him, he would not even administer a prolotherapy injection! The problem with prolo (on its own) is whilst some doctors believe that it helps, prolo+ stem cells should consistantly give a better result. The stem cells here being the important part of having your own living cells re-injected into your knee on top of prolo to grow back (in my case the missing) cartilage.

It is also public knowledge that Regenexx procedure has been "Licensed" to Neostem Inc for procedures in China, and Stematix Inc. in So. America. So yes in time, I am confident there will be other doctors, implementing what Dr Centeno is doing in other parts of the US, in the not too distant future.

Joe just so you know torn ligaments do respond well to PRP, so if you get yourself a shot or two of your own PRP for the torn MCL that should help your outcome. Joe, I too believe in doing my own research. I had a orthopaedic surgeon that scheduled me for an operation on his operating table when prior to that scheduled surgery he didn't answer my questions, I didn't turn up for the surgery! Yup you have to do your own research!

Good luck to you all

John M
Title: Re: Regenexx injections - Stem Cells
Post by: rob wilson on January 13, 2010, 07:55:29 PM
I have had 1 Regenexx in my left knee that helped my condition a little. It seems I have medium arthritis including 2 microfractures. My symptoms are pain, crunching, swelling, and stiffness. I have had numerous opinions from doing a total knee to just a diagnostic scope/scar tissue cleanout or I could wait and do more Regenexx. I am tired of not being able to walk the dog and want an answer. I will have the diagnostic scope on 1/29/10 and then the OS can determine how the cartilage looks (he says it is very difficult to determine cartilage quality on MRI). then we can determine if I need more invasive surgery. Another option before total knee might be http://www.arthrosurface.com/.

Do you think Regenexx or PRP 2-3 weeks after surgery would help in minimizing more scar tissue after surgery? Thanks
Title: Re: Regenexx injections - Stem Cells
Post by: rob wilson on January 13, 2010, 07:56:23 PM
I have had 1 Regenexx in my left knee that helped my condition a little. It seems I have medium arthritis including 2 microfractures. My symptoms are pain, crunching, swelling, and stiffness. I have had numerous opinions from doing a total knee to just a diagnostic scope/scar tissue cleanout or I could wait and do more Regenexx. I am tired of not being able to walk the dog and want an answer. I will have the diagnostic scope on 1/29/10 and then the OS can determine how the cartilage looks (he says it is very difficult to determine cartilage quality on MRI). then we can determine if I need more invasive surgery. Another option before total knee might be http://www.arthrosurface.com/.

Do you think Regenexx or PRP 2-3 weeks after surgery would help in minimizing more scar tissue after surgery? Thanks
Title: Re: Regenexx injections - Stem Cells
Post by: Lottiefox on January 15, 2010, 11:55:27 AM
Hi Rob

Sorry the knees have flared up again. I'm no expert but I know when I spoke with Dr Centeno he said they have worked with people in conjunction with surgery - e.g. using stem cell injections alongside procedures such as microfracture, so I guess that stem cells or PRP could well help with healing post any surgery you might have. Perhaps an email to Dr Centeno to clarify?

Good luck on the 29th, hope they can bring you some relief.

Lottie  :)
Title: Re: Regenexx injections - Stem Cells
Post by: rob wilson on January 15, 2010, 02:52:49 PM
Actually I have changed my approach. I am going to try more injections before I jump to a scope surgery. We shalll see if my wallet can handle it. I am not even convinced my problem is cartilage. It could be inflamed synovium. Either way the injections should help. Surgery should always be LAST resort. I almost died in a back surgery.
Title: Re: Regenexx injections - Stem Cells
Post by: Lottiefox on January 15, 2010, 10:42:58 PM
Well, I think I share your tendency to avoid surgery if at all possible. So, back to Regenexx? I may see you there!

Lottie  :)
Title: Re: Regenexx injections - Stem Cells
Post by: rob wilson on January 16, 2010, 07:06:58 PM
I have a new protocol with assistance from JM. 3-5 days before Regenexx I get prolotherapy to get the area inflamed for the stem cells. Then the Regenexx injected and then 2 weels after the Regenexx I get PRP to provide a nice environment to sustain the stem cells. If my money holds out I will try this until I get rid of this pain and inflamation whatever is causing it (arthritis or plica or both). If this does not work the last resort is a scope. However, my knee has had too much surgery.
Title: Re: Regenexx injections - Stem Cells
Post by: rob8647932 on February 11, 2010, 02:27:18 PM
After 2 Regenexx and 3 PRP injections, I have gotten a little better but not enough to be out of pain or be able to walk without pain. I guess I will go ahead with the scope and hope it does not require any more microfracture surgery. However, I might try the Regenexx after surgery to increase its effectiveness.
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on February 14, 2010, 12:22:43 AM
Hi All

A little update on my condition. I got a third PRP on the 18th of January for my left knee. I had been using a treadmill I had in my house every other day and run/walking 3 miles per day. Then my treadmill broke and I've been in Las Vegas on a trade show with very little time to workout or run. I managed today to get a 3 mile walk / run in on a local school running track and 2 hours later my knee hasn't any pain at all. I think that the treadmill I have feels like its easier than actually getting on a foam running track.

On the running side of things I am now running around a track that has a football field in the center of the running track. So what I've been able to do is walk the semi circles at the ends of the track and run as hard as I can the long 100+ yard legs of the lenght of the football field. I have a lovely feeling as I relax here on a couch on a Saturday afternoon!

My bulging disc  (L5/S1) has been sore from time to time but I've found that running actually helps take away the pain! Oh and let me tell you all the pain was wicked last September. Dr Centeno gave me a Platelet Lysate/Dexamethazone epidural for that too in September and my life has been liveable since. The more running (within reason) I do the better I feel!

I hope this blog helps people I know Dr Centeno has certainly helped me!

JM

Title: Re: Regenexx injections - Stem Cells
Post by: rob8647932 on February 16, 2010, 04:30:19 PM
Went to see Dr. Centeno (Regenexx) yesterday. After telling him that my left knee pain started after having my piriformis muslce (buttocks) removed, he immediatlely thought that some of my pain was due to quad and VMO muscle trigger points and tightness. He did some intramuscular needling that goes deep into the muscle. I did have many trigger points in these areas and my knee pain was immediately less. He recommended this IMS needling, rolfing, and myofascial release. Unfortunately we only have the myofascial release in the Cleveland, Ohio area. Hopefully this will loosen my quad and VMO knee muscles and stop the knee arthritis from being aggravated. Even if I have the scope surgery it will not eliminate the tight muslces so I have to address the muscle issue first and see where I end up before any scope.
Title: Re: Regenexx injections - Stem Cells
Post by: mickeyj on February 25, 2010, 05:17:37 AM
Hi! I am thinking of getting these injections soon  if I am a candidate.Is there anyone with severe OA of the knee that can give me some info.I have bone on bone severe 4th stage OA and walk with a cane,but am in good shape, can ride a bike and swim,just very painfull to walk.Would like to hear from someone who has a similar OA knee problem and has had the Regenexx procedure. Thanks.
mickeyj
Title: Re: Regenexx injections - Stem Cells
Post by: Lottiefox on February 25, 2010, 08:49:25 AM
Hi there

I too am considering Regenexx and have found Dr Ceneteno to be extremely professional and helpful in considering my case. He has reviewed my MRI scans and OS reports and provided an opinion on the potential for Regenexx to help. I am not bone on bone but do have significant patella wear and a small medial condyle lesion. If you go back through this thread you will find some posts from a member called Saverio who had the injections and I believe he was at the bone on bone stage and had been recommended for a TKR in both knees. There are also other stories and more feedback from people who have been through the process. Only the clinic can comment on your actual suitability however as clearly we all have different knee histories. My feeling is that it may be worth a try as it has less of the risks associated with a failing surgery, and stem cell research is developing all of the time. Alternatively I am exploring surgery that combines stem cells with a procedure, to get the best of both worlds.

Good luck with your decision

Lottie  :)
Title: Regenexx injections - Stem Cells -- Caution
Post by: pvr on March 19, 2010, 06:52:56 PM
I am 35-year-old male with good health conditions no medications or health issues.

I had most of my meniscus removed from a surgery 6 years ago, a year ago pain started and had another partial meniscectomy. After two months of the second surgery, pain started again in the knee. If I go to the surgeon I know I would loose my meniscus totally, I started reading about the PRP, prolotherapy and Regenexx procedure.

After much thinking and reading and taking to friends I finally arranged money for Regenexx procedure. I had my Merrow draw in third week of February,2010.

During the time of draw Dr. John Schultz evaluated my MRI very well and identified the MCL needs some treatment and then treat the cartlage and meniscus. Dr. John Schultz done little of acupuncture to relieve the stiffness in muscles, which worked very well, and prolotherapy to tighten the knee, which really helped me a lot. He is very confident in his work and analyzed my knee very well. I felt that the knee reacted good for the prolotherapy and I don't need the bandage for the knee until few days ago where the pain started increasing.

I was very hopeful about the re-injections, I got the BAD NEWS from Dr. John Schultz after three weeks that the culture failed and there are no stemcells to reinject. They have a QA on the cells before the culture. I have been waiting for three weeks for the correct answer why it failed and the next course of treatment. There is no response to the few emails I sent, either by the Centeno-schultz clinic nor Dr. Schultz it self.

I volunteered my self to Dr. Schultz that I will do any kind of blood test to see if there is some thing wrong with me, He said there is nothing needed at this time. How would I know, if some thing happened in the storage and culture resulting in the failure? or if there is some thing which is unknown in my blood/stem cells resulting in the failure. I have no answers to the above questions, I am really hopeless right now and pain in my knee increasing day by day.

I spend around $5000 for initial evaluation, marrow draw, registrations, air travel etc. till now and disappointed waiting for a response from Centeno-schultz clinic. I want to tell to the people that being in good health doesn't guarantee the positive results, there may be unknown which may result in failure. I am not saying any thing negative about the Centeno-schultz clinic because I still believe in their procedure and we have so many other people on the forum writing about their response.

I will update my status when any thing changes.

Contrats to the people who got the Regenexx injections and recovering.
Title: Re: Regenexx injections - Stem Cells
Post by: Dr. Centeno on March 20, 2010, 01:47:42 PM
pvr,

Sorry to hear about your culture failure.  Mesenchymal stem cells are generally very finicky cells, and if you look at the research about 10-20% of the time, there will be a failure of the cells to grow.  Through years of experience growing cells, having our patients get off certain medications we know are bad for cells, and other tricks, we've generally reduced that to 5% or less.  Most culture failures are in high risk groups such as the very old, patients on certain perscription medications, peri-menopausal women, and patients with certain blood serum abnormalities, etc...   We also offer patients a shared risk option where you can pay a little more for the first draw and get up to three draws for about the price of 1 1/2.  Dr. Schultz can comment on the specifics below.

Dr. Centeno
Title: Re: Regenexx injections - Stem Cells
Post by: MSC on March 20, 2010, 07:10:44 PM
PVR,
Hi this is Dr. Schultz.  I too was disappointed about your culture results.  I am confused as to your post dated March 19.  I did response both by e-mail and telephone regarding possible explainations for your culture results.  In a different but recent e-mail I outlined discussed treatment options.  You responded to my e-mail, thanking me for the encouragement and describing your current clinical condition 5 hours prior to your post on kneeguru. ?

In fairness to others please review your first sentence.

We have treatment options to help you with your ongoing pain.

I am committed to getting you better.

JRS

Title: Re: Regenexx injections - Stem Cells
Post by: pvr on March 20, 2010, 09:41:47 PM
Update from me,

After the last email on March 3rd, Dr. John Schultz wrote me back on March 19th. afternoon.

He said that he is still looking for a solution, he has other options but needs IRB approval. I will be patiently waiting for his next email. I am very eager to know what would be other alternatives. Hopefully that will work and relieve me from the pain in my knee.

Update 10:42 PM EST

Dr. John Schultz, Nice to see you in the forum as well as Dr. Centeno, Thank you very much for your responses.
 
Going to the specifics of the dates, I received the culture failure news on March 1st and until March 3rd, Dr. John Schultz was in touch discussing about the possible reasons, We exchanged few emails every day and he is very response.
What I wrote is "I have been waiting for three weeks for the correct answer why it failed", i.e after 3rd of march. One of the possible reason which we discussed on 3rd of march is having a elevated triglycerides which I have(I should have specified this in my original post).

Dr. John Schultz, the timings which were listed on the forum are UK timings/server timings(5 hrs ahead of US EST timings), I made my original posting on this forum around 2:00 PM EST  on 19th. I got your email at 3:25 PM EST on 19th. I responded at 5:09 PM EST on 19th.

From the past few hours I exchanged few emails with Dr. John Schultz, which he said that the failure of the culture is most likely due to the condition of my elevated triglycerides, which is based on the clinical Experience.

To all, I want to make a point, that there is still unknown in the stem cell culture and the rate of success you can have may vary. The reason I went to Centeno-Schultz cllinic was because they have the wast experience and been in this field from so many years, But still there is unknown factor.

Dr. John Schultz is still committed to treating my condition, I do still believe that the stem cell is the only solution instead of the surgery, I will continue to work with Dr. John Schultz until it is feasible for me.

I will update in the forum if there are any updates.
Title: Re: Regenexx injections - Stem Cells
Post by: Dr. Centeno on March 22, 2010, 10:30:31 PM
No doubt there are unknowns, as there are in most new medical procedures.  We do have more experience with this procedure than anywhere else in the world, but we still learn new things about applying this procedure to patients.  In particular, the elevated triglycerides issue does appear to be significant and we've only now seen it in enough of our >450 patients and about 1,000 culture expansions to strat seeing a good statistical trends.  :)
Title: Re: Regenexx injections - Stem Cells
Post by: Scooter72 on June 06, 2010, 12:57:19 PM
No doubt there are unknowns, as there are in most new medical procedures.  We do have more experience with this procedure than anywhere else in the world, but we still learn new things about applying this procedure to patients.  In particular, the elevated triglycerides issue does appear to be significant and we've only now seen it in enough of our >450 patients and about 1,000 culture expansions to strat seeing a good statistical trends.  :)

Let me preface by saying, I am not asking for a diagnosis here.

Dr. Centeno, I am a person who has had microfracture surgery approximately one-year ago, in the trochlear groove of the lateral femoral condyle.  My lesion was VERY large; I believe it exceeded four centimeters in length.  I am currently playing football (which really is a minor miracle), albeit I have discomfort after every match.  Supartz shots do not provide long-term relief.  I anticipate that with my level of activity, playing football 2x/week and lifting weights ~2 hours/week total, the microfracture will eventually "fail", given the nature of what it is.

What kind of success have you had in your clinic, for patients with previous microfracture surgeries?  I am very interested to hear from you, despite the general negative rantings that two ortho friends of mine have given your technique.  I am in the molecular biological sciences, so I understand everything about your procedure down to that level.  I have to admit, on paper, it seems sound, however (as my friends have iterated), practice usually differs. 

ps- Please don't take my mentioning other ortho's negative feelings, as an insult.  I just wanted to highlight that I am examining the clinical aspect.  And besides, I am sure you are used to the intense skepticism.
Title: Re: Regenexx injections - Stem Cells
Post by: Cstein on June 22, 2010, 05:37:34 AM
I am going in for an MRI that I will be sending to Dr. Centeno so I can start my review process.

My last MRI showed 1cm moderate chondromalacia and a 7mm intra-articular osteophyte. This all occured in the rehab period post oats procedure.

I see alot of you are mentioning arthritis and "bone on bone" but do any of you have any bone spurs/ osteophyte developments?

I may have a dissecan where the chondromalacia was and I'm trying to decide whether I should have another arthroscopy to remove the loose fragment cause I believe it may be opening up more damage. I've had 4 prolotherapy's with glucosomine and HGH and my knee has improved significantly, but I feel the dissecan is still causing issues. I can't play any sports but I'm walking well and could jog if I needed too.

I'm willing to try anything to avoid another 2 months of non-weight bearing.. I had an inch of quadriceps wasting after my oats and I only got back about half of it with rehab. I can't afford to go through all that again. Microfracture is my last resort, I am just hoping the lesion does not get too big.

Great thread btw, I am going to go back and read it twice. Its hard to keep up with who had what done and what each persons starting point was.


Title: Re: Regenexx injections - Stem Cells
Post by: rob wilson on June 22, 2010, 03:19:43 PM
If you can afford it I believe you should continue the prolotherapy and add in the Regenexx. Hopeuflly this will enable you to avoid any further surgery. Even if you did have surgery it would enhance the results by doing the the prolo and Regenexx post surgery.
Title: Re: Regenexx injections - Stem Cells
Post by: Cstein on June 23, 2010, 04:38:51 AM
If you can afford it I believe you should continue the prolotherapy and add in the Regenexx. Hopeuflly this will enable you to avoid any further surgery. Even if you did have surgery it would enhance the results by doing the the prolo and Regenexx post surgery.

Thanks Rob for your advise,

I do want to continue the prolo but I wasn't sure if it could be done in combination with regenexx. I absolutely don't want another surgery, but if I find I have another dissecan, I will have it removed pending what regenexx recommends.

I noticed in your signature you had HGH with abrasion how did that work out for you? you can email me @ [email protected] if you prefer to keep this thread on topic. thanks
Title: response to ended by moderator re: something gone wrong?
Post by: GJJ on June 28, 2010, 09:17:02 PM
Moderator,

People need to be aware of the good and the bad.  Please do not hide the truth that there are cases where something can go wrong.  People need to make the decisions if the process is good or bad for them.  There is no way everything is going to be perfect but we still are entitle to have the truth and we can decide if it is someone who really is just mad or there was an error in the process.  You need to stop blocking posting that provide bad results.  We can decide to believe or not.

I would like to know what went wrong.  I am entitle to know my options and not the good selling points.  Its my knees and my life.

GJJ
Title: Re: Regenexx injections - Stem Cells
Post by: The KNEEguru on June 28, 2010, 10:51:33 PM
Dear JGG
I am not sure what it is that you are referring to. Perhaps it is the post I edited today on a new thread from a new member who had never before posted?

I am the owner of this site, not just a moderator. It is really up to me what I block. I do not take kindly to being told that I "need to stop blocking posting that provide bad results". I have a responsibility to protect my website organisation from any post that in my judgement might end up as a libel issue against my organisation.

Indeed I very seldom block posts, although I have recently had several spammers whose profiles I edited to remove the spam link.

KNEEguru
Title: Re: Regenexx injections - Stem Cells
Post by: sparky52 on July 02, 2010, 12:40:24 AM
I am 52 fit thin and eat right and dont smoke or drink. I have no meniscus and severely osteo arthritic (stage 3-4) medial compartment of the right knee. 14 days ago I had a cocktail of my stem cells/prp and fat from my buttock injected into my right knee medial compartment after debridement by Dr. Nathan Wei in of thew Maryland Arthritis Center in Frederick MD. The stem cells were aspirated from my iliac crest and reinjected into my knee within an hour of aspiration. So far the pain is gone and there were no complications. Dr. Wei projects regrowth of .4mm of articular cartilage in 6 months and a total of.8mm in 12 months. I will be non weight bearant for 4 weeks total  post op then a slow rehab. I spent about $8K on the treatment. Significant but cheap if it works. Of course, there is no hope of insurance compensation.
There is a philosophical disagreement on the matter of cell expansion between Centano/Schulz at Regenexx and Dr. Nathan Wei. Wei feels expansion of cells and multiple re-injections is unnecessary adding no benefit. Regenexx feels very differently about this and has their own quite rational point of view. I hope Wei is right, but have no real opinion myself. Wei was a lot closer and easier for me.
Has anyone out there had Regenexxx and had their regrowth thickness measured at least 6 months post op or better yet 12 months post op?
As typical cartilage thickness at peak is about 4mm, .8 regrowth is significant but I'd rather get 3mm.
Since PRP is part of the cocktail for both Regenexx and Dr. Wei I wonder if post op prolotherapy with PRP every couple or three months would augment growth since it clearly occurs for at least 12.
Anyone who has relevant info here please feel free to email. I am not really interested in being critical or creating controversy, just gathering good info.
 
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on July 04, 2010, 07:01:05 PM
Hi Sparky52

The difference between with Dr Centeno's procedure versus Dr Wei procedure is that Dr Centeno' s procedure (from what I can gather) is the lab expansion of your own stem cells. Dr Wei is taking BMAC spun down in a centrifuge then injected via a needle back into your knee. Relatively speaking the procedure you have gone thru is isn't hugely different from a PRP injection, where blood is drawn and spun in a centrifuge and PRP is injected back into the knee? Am I incorrect in this assumption?

I am curious to know, if the procedure you have had is almost identical to PRP, why should it be so expensive with a $8000.00 price tab?

On another note, Dr Centeno has now published studies, on safety and efficacy of his procedures, links to which you can find on his website,

http://www.regenexx.com/about-regenexx/researched-and-effective-stem-cell-procedure/

On basis of your joint's condition improving, I do wish you all the best of good fortune! & Please keep us all informed as to how well your out come is.

JM




Title: Re: Regenexx injections - Stem Cells
Post by: karto on July 17, 2010, 11:56:57 PM
Hey fellow sufferers lol I am new to this board but have been reading posts and am taking place in Dr Centeno's webinar this week. But, I was just curious if anyone knows how having cortisone in your system affects a stem cell extraction? My OS wants to give me one and i wouldn't mind having one but I'd rather speak to Centeno first because if I am a candidate for Regenexx I want to get started ASAP
Title: Re: Regenexx injections - Stem Cells
Post by: karto on July 18, 2010, 12:00:54 AM
PS can anyone who went through Regenexx post their outcomes, especially including what category they were placed in? like, poor, fair, good, etc... thanks

i'm curious to know if people who were rated poor had good results
Title: Re: Regenexx injections - Stem Cells
Post by: Dr. Centeno on July 19, 2010, 03:35:37 PM
We don't know who GJJ is either.  We have published the good and the bad at http://www.ncbi.nlm.nih.gov/pubmed/19951252.  We believe we are one of the very few medical clinics offering stem cell therapy at this level who has taken this step of publishing the complications of >200 patients in a peer reviewed medical journal.  I am almost done with a 339 patient complications report that will hopefully be submitted for publication in another peer reviewed medical journal in the next few weeks.  It again will post all complaints reported about the procedure or that we pick up on periodic active surveys of our patients.  Both of these papers show that our procedure is dramtically safer than surgical alternatives, but it is not in any way shape or form risk free, as no medical procedure is risk free.  PRP, BMAC (same day stem cell procedures), micro fracture, ACI, MACI, meniscus transplants, knee replacements (partial or complete), all carry medical one on one patient risk.  In summary, Regenexx is a procedure that to date and after 5 years of observation and more than 1,000 procedures, has a better safety profile than surgery and it's risk profile is similar to other needle based alternatives (PRP, BMAC, SynVisc or other HA preps). 
Title: Re: Regenexx injections - Stem Cells
Post by: Godwin on August 13, 2010, 03:44:59 AM
So, I was just going to sent in my consultation form and MRI but now I see the FDA has filed suit asking for a court order for Dr Centino to stop his Regenexx work.  What does this mean in the real world -- Is Dr Centino going to open up in China or New Zealand?
Title: Re: Regenexx injections - Stem Cells
Post by: men-at-arms on August 13, 2010, 05:00:58 AM
I just got off the phone with someone from Regenxx in Colorado; she had called me back in Hong Kong to explain that the FDA ruling has only impacted for now Regenxx's procedure to expand and freeze storage the stem cells for later use. They are sorting that out legally with the FDA. In the meantime, Regenxx is still able to treat patients with same day extraction and injections. I was told that the effectiveness of the treatment remains the same. The cost of the injection per time will be $3000, and since the average is up to 3 times per patient -- the average total cost will be about $9000 but will be dependent case by case. This is to be compared to $8000 previously.

Having spoken to the rep. from Dr. Centeno's clinic -- I will be sending in my MRI and on-line patient form then my $200 fee once they are ready to review my case.

BTW -- I'm an expat American living & working in Hong Kong, so I actually have access to alternate stem cell treatment in East Asia. But I'm keeping all options open at this point.

Hope that helps~!
Title: Re: Regenexx injections - Stem Cells
Post by: rob8647932 on August 13, 2010, 03:29:45 PM
One large difference between the previous method and the new same day method is that with the same day method you have to do a bone marrow extraction EVERY TIME. In other words 3 vs. 1. However it is still a good option to the more invasive options.
Title: Re: Regenexx injections - Stem Cells
Post by: men-at-arms on August 13, 2010, 05:45:28 PM
I understand the extraction is done under anesthesia. Would that be general or local ?
Title: Re: Regenexx injections - Stem Cells
Post by: WestPoint on August 13, 2010, 05:58:50 PM
Surely this would affect the amount of cells reproduced...
Title: Re: Regenexx injections - Stem Cells
Post by: rob8647932 on August 13, 2010, 06:43:03 PM
I never had any anesthesia. He just numbs up the area a lot. There is not much pain.
Title: Re: Regenexx injections - Stem Cells
Post by: men-at-arms on August 14, 2010, 07:31:41 AM
Numbing it up a lot ? Sounds like that's local anesthesia then. I'd imagine that if there were zero anesthesia at all -- having a needle stuck in all the to inner bone to extract the marrow -- would be quite painful to most people.
Title: Re: Regenexx injections - Stem Cells
Post by: slyguy1 on August 14, 2010, 08:03:53 PM
question for men-at arms......since you have access to healthcare over there in hong kong is the cost of most procedures like aci or maci any cheaper there compared to the US?
Title: Re: Regenexx injections - Stem Cells
Post by: men-at-arms on August 14, 2010, 08:39:35 PM
Not in Hong Kong, but yes it is .. in Taiwan. ACI or modified ACI is performed in Taipei by Taiwan University Hospital which has developed a proprietary approach I think to do with the scaffolding. I did not dive into too much detail on researching ACI or modified ACI in Taiwan regardless of the cost because I was told by Doctors there that I was NOT a good candidate for ACI/MACI in that those procedures focused on rebuilding damaged articular cartilage, while the big damage in my right knee and partially in my left are all meniscus damage. That's my personal situation with ACI/MACI. Also, I did not get an exact quote for ACI surgery in Taiwan but was told by the OS I had asked about it that the surgery was not considered expensive. Despite economic prowess in Taiwan in recent decade, per cap income when compared to USA is still lower. If ACI for typical Taiwanese is considered affordable -- when compared to the cost of ACI Stateside (funny -- I also don't know what amount that is) is definitely going to be considered lower.

There is one surgery I know the cost to both in USA and in Taiwan and perhaps this may serve as a "price comparison model". If you are familiar with a new procedure called Lap-Band which is for weight control -- Lap Band surgery as I know in the States run 20K~30K. In Taiwan -- the cost when converted to USD is 6,000 Dollars. So, that's what .. about a third of the lower USA range.

BTW -- in recent years Taiwan has experienced a significant rise in "Medical Tourism" due to the exact reasons of high quality of medical service and competitively affordable costs of medical treatment.

So, thanks for the question -- it was valid and in my wheel house. ;)

question for men-at arms......since you have access to healthcare over there in hong kong is the cost of most procedures like aci or maci any cheaper there compared to the US?
Title: Re: Regenexx injections - Stem Cells
Post by: slyguy1 on August 15, 2010, 04:44:59 PM
Thanks for the info....sounds like you are in good status having your cartlige intact. You have a greater chance of success....good luck
Title: Re: Regenexx injections - Stem Cells
Post by: men-at-arms on August 15, 2010, 08:28:47 PM
Thanks for the kind words. I figure we're all in the same boat more or less.

I dunno about how "good of shape" I'm in. I've been told by let's see 4 or 5 OS I'm candidate for TKR once it is bone on bone that due to the fact a simple X-ray shows the gap where normal meniscus cartilage should be is so narrow now that the leg is not in a straight alignment. I understand that I manage to grind that down like a tire loosing air over a period of 6 month jogging from 6km~10km 4 times a week if I could maintain after the first OS told me I had patella inflammation and crooked knee cap bone and it was important to lose weight and did not advise me not to jog initially. The last OS wasn't sure how long I'd be able to hold off TKR but estimated I have but 20% meniscus remaining. Hence this thread and meniscus regeneration, collagen implants, meniscus implants are of interest to me.

The last thing I would want is TKR. The invasiveness of the procedure, the long rehab time and pain, the lack of durability of it, and lastly the fact that traditional currently approved medicine wants to cut away my natural knees thereby excluding me for all the new things that are being done, including advancement of tissue engineering is a real red light for me. Unlike my parents' generation thinking, my thinking is to question "doctor's opinion" and not take it as final & gospel.
Title: Re: Regenexx injections - Stem Cells
Post by: WestPoint on August 26, 2010, 07:24:32 PM
I'd be interested to know if anyone who has had arthritis and been treated by Dr. Centeno could tell us whether each lesion was treated seperately, or if an injection was made to the general area where the lesions collect. If indeed he does treat each lesion seperately, does he put the needle into the bone and make mini-microfractures?

Please enlighten us about the details of this part of the treament.
Title: Re: Regenexx injections - Stem Cells
Post by: rob8647932 on August 27, 2010, 04:20:17 PM

Best to ask Centeno. He can treat mutiple lesions most likely. 2 might be max. The protocol is to do a roughening up on a Friday and the Regenexx on a Monday. But that was the OLD protocol. Everything might have changed with the FDA Trial.
Title: Re: Regenexx injections - Stem Cells
Post by: WestPoint on August 27, 2010, 10:32:53 PM
I always thought that people with arthritis have multiple lesions, as opposed to a focal lesion or two. Maybe my understanding is wrong.

Sorry Rob, what do you mean by roughening up? Can you tell us more about the procedure that you experienced?
Title: Re: Regenexx injections - Stem Cells
Post by: rob8647932 on August 28, 2010, 09:59:56 PM
The roughening up was an injection of dextrose (like prolotherapy) into the area of the defect. This causes additional inflammation in the area that the stem cells naturally go to that injured area.
Title: Re: Regenexx injections - Stem Cells
Post by: WestPoint on August 28, 2010, 11:10:06 PM
When you say into the area of the defect, do you mean that the cells were released directly into the hole, or generally around the area of the defect. Did it involve touching the cartilage/bone area with the tip of the needle?

Were you able to see the procedure on the x-ray machine used? If so, does it look clearer than an MRI? Were you able to see your defects?

Thanks
Title: Re: Regenexx injections - Stem Cells
Post by: rob8647932 on August 29, 2010, 08:26:43 PM
WestPoint,


Yes to each question. You can see the needle on fluorscope as well you can usually see the defect.
Title: Re: Regenexx injections - Stem Cells
Post by: WestPoint on August 30, 2010, 03:40:05 AM
Thanks Rob.

Hope everything works out.
Title: Re: Regenexx injections - Stem Cells
Post by: Joost on September 05, 2010, 10:46:13 AM
Hi Guys,

hope you are doing well. Just wondering if there is anyone who knows If Dr. Centeno's approach has results in meniscus regrowth  ?

Cheers.

ps: I am currently doing yoga and it has benefitted me a lot on the knee. So I would recommend this. It also benefits the rest of your body and is a great way to challenge yourself !
Title: Re: Regenexx injections - Stem Cells
Post by: Dr. Centeno on September 09, 2010, 12:12:39 AM
For meniscus, see http://www.ncbi.nlm.nih.gov/pubmed/18786777

We can treat multiple lesions, although this is on a case by case basis (extent of damage).  We have a good success rate with more severe OA, but the mechanism is unlikely to be fixing all the lesions, it may just be improving the stem cell turnover in the local environment (meaning we have stem cell maintainence of the joint that happens everyday, we may just be placing more soldiers on the ground).  For a better understanding of these types of issues and a more comprehensive look at what can go wrong with joints (stability, joint issues, neurologic issues, alignment), see the small book at http://www.regenexx.com/2010/09/dr-centenos-new-book-on-regenerative-orthopedics/

Title: Re: Regenexx injections - Stem Cells
Post by: gb on September 09, 2010, 01:20:36 PM
Dr. Centeno,

Just to be clear, or for my own benefit, is stating that Regenexx treatment is capable of "treating multiple meniscus lesions" different than stating it can grow back a meniscus to its original state prior to partial meniscectomy (from say 60% to 100%) ?

I ask because I had a partial meniscectomy of my lateral meniscus during reconstructive ligament surgery of my PCL and ACL, and I've always wondered if Regenexx could give me back that part of my meniscus the doctors took away :(
Title: Re: Regenexx injections - Stem Cells
Post by: WestPoint on September 10, 2010, 07:44:54 AM
Dr. Centeno and other stem cell oriented doctors work is probably the future of medicine, but what scares me is the idea of going for treatment and being, for example, 70% cured of a meniscus tear. I would think that if 30% is still in need of healing - at least in the case of meniscal tears - you haven't really solved the problem; unless of course the solution is to go back for a second round of treatment (i.e. pay twice or three times until you are cured). Still, it's all very exciting and we should encourage research into this type of treatment.
Title: Re: Regenexx injections - Stem Cells
Post by: Saverio on September 10, 2010, 12:43:35 PM
Hi Everyone,

I haven't posted for awhile but have followed the board.  Brief recap...I was scheduled for 2 TKR's back in Jan 2008 (bone on bone) until I saw a video on regenexx.  Dr. Centeno did my left knee in Mar 2008 and my right knee in Sept 2008.  Pre regenexx, I had clicking and pain in both knees and could only play doubles tennis.  The clicking has gone away and 95% of pain has gone.  I am able to do more and more strengthing exercises which have helped me to play singles tennis in consecutive days if I choose to.  But, I do allow myself a days rest.  I think at age 59 it is prudent to do so.  I have also found that my knees get stronger month to month.  Don't know if stem cells are still producing or if it's the benefits of the exercise.  Maybe Dr. Centeno can answer?  I do want to get more regenexx treatments but only after the FDA come to it's senses.  Hope this helps.
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on September 10, 2010, 06:56:31 PM
Saverio

That is great news to hear. I hope your knees continue to improve. Oh that we all had a sensible government /FDA here in the USA!!
Title: Re: Regenexx injections - Stem Cells
Post by: WestPoint on September 11, 2010, 01:10:22 PM
That's terrific progress, Saverio. Very inspiring.

Would you say that you fit into the multiple lesion category Dr. Centeno was speaking about above, or did you have a couple of focal/large lesions?
Title: Re: Regenexx injections - Stem Cells
Post by: Saverio on September 12, 2010, 12:24:25 PM
Large lesions in both lateral compartments.  There was also damage around my kneecaps.  I was in bad shape.
Title: Re: Regenexx injections - Stem Cells
Post by: poke on January 06, 2011, 09:38:53 PM
Hello Lottie,
 Did you have the stem cell treatment ? If so how did you go?
  Regards Ian H
John,

Thanks very much for taking the time to reply. I've followed your responses to Regenexx with interest. I'm guessing the results are still going well for you?

I've been in touch with both X-Cell and Regenexx and am far more impressed with the latter. X-Cell are extremely keen to "sell" their product, and whilst I'm sure they do excellent work I feel more comfortable with the information, analysis, procedure and general approach that Regenexx seems to have. As you say, they use different methods that seem more firmly anchored in medicine and I like the conitnual improvement approach they advocate. Very early days with a lot to explore but I'm going to send my MRI and notes to Regenexx for their views. Its less money than 20 minutes with a scalpel happy UK surgeon! Given the current state of the pound, the treatment in the US works out at a very affordable rate (less than a private arthroscopy at the moment!!!) and even with flights to Denver its well within reach. I'm due a delayed honeymoon so perhaps Colarado might be in the offing in 2010!

Thanks again.

Lottie  :D
Quote
Title: Re: Regenexx injections - Stem Cells
Post by: men-at-arms on February 27, 2011, 02:29:36 AM
I've been researching alternatives to TKR for over an year now and have spoken or contacted OS's in USA, Taiwan, Hong Kong, Malaysia, and China. The prevailing view is that there are technologies in development right now that are superior to MSC injections only. In particular, there is an on-going clinical trial being conducted by Taiwan University Hospital that combines stem cells and scaffolding then the cartilage is grown then transplanted into the knee. You can read the following article on cartilage repair, towards the end Taiwan University's work is mentioned:

http://www.orthosupersite.com/view.aspx?rid=1622

It seems where most OS's I spoke with who are naysayers over MSC injection only approach cite that the lack of scaffolding will NOT result in total regenerated cartilage to replace damaged area where osteoarthritis condition exist. In my case, the tradition orthopedic advise has been that I wait 10 years or more for TKR (I'm 48 currently). I have had PRP injections to treat my knees, and so far that has yield enough "regeneration" where prior to PRP I could not ascend and descend staircases without pain and holding on to railings, whereas now I ascend and descend staircases without pain and without railings. I'm still taking a wait and see approach while tissue engineering work is on-going world-wide. I'm pretty confident that within 10 years, there will be a totally new approach that is widely accepted and approved such that for some cases of osteoarthritis TKR would be obsolete. But I believe Regenexx's work in MSC is the cutting edge and work like this needs to be done to prove MSC does regenerate worn cartilage. But without scaffolding implants, my conclusion is that MSC injection alone will not regenerate cartilage that has been completely worn away or surgically cut away. Furthermore, the ultimate goal is not just to regenerate cartilage but to yield the soft hyaline tissue to replace the natural tissue that has been damaged or worn away, and there seems to be questions herein as to what type of cartilage tissue is being regenerated -- is it the harder non-elastic scarring tissue versus the native slimy but firm and elastic hyaline tissue.

Title: Re: Regenexx injections - Stem Cells
Post by: Dr. Centeno on February 28, 2011, 03:40:18 PM
This is Dr. Centeno. A few points to make on the injection vs. surgery dilemma rasied here in these posts. First, if you're lucky enough to have PRP work well to help maintain the cartilage in your knee, then if it were me I would stick with that approach. I've always been a big believer in the basic tenant of "if it aint broken, don't fix it". On the stem cell scaffolding side, the technology you're referring to is similar to MACI, in that stem cells are grown on a matrix. ACI has been compared to stem cells in at least one clinical trial already: http://www.regenexx.com/2010/04/stem-cells-better-than-knee-autologous-chondrocyte-implantation-aci/. The stem cells worked better than chondrocytes.
On the use of scaffolding for injections issue, I think the OS's you're talking to should refer to this study http://www.regenexx.com/2010/12/the-regenexx-difference-taking-and-placing-stem-cells-with-accuracy/. Note the picture at the top of the page. When the stem cells were blindly injected into the joint, there wasn't much cartilage repair. However, when the cells were dripped on a cartilage lesion (without a scaffold), there was good cartilage repair. This is because MSC's work via attachment, i.e. once they attach to a lesion they will stay there and work at that spot. So this study shows that while a scaffold may help in some instances, it isn't necessary for repair. In fact, we've now developed a device for our own use that allows us to maximize this effect.
In the next 10 years, many different scaffolds for stem cells and cellular therapy will hit the market. We've already looked at one or two. I'm sure some will be revolutionary and improve the results of injection based and surgical re-implantation of cells. Also in the future, expect cells to be delivered into knees using injection and surgical methods, with each of these approaches having positives and negatives based on what the doctor is trying to accomplish. In some cases injections will beat surgery (like this story of injecting stem cells into fractures from last week's AAOS meeting where the injection of stem cells beat the traditional surgery-see http://www.regenexx.com/2011/02/injecting-stem-cells-help-heal-fractures-faster-than-traditional-surgery/) and there will be times that that surgery is the best way to get the job done. I wouldn’t look at these two delivery methods as competitive, as more options are always better for patients. The same transition from 100% invasive surgeries to a mix of needle based and surgical procedures has already happened in cardiovascular surgery. When I was in medical school, every middle age male had a huge sternum scar from his open heart CABG surgery. These days, many of those surgeries have been replaced by interventional cardiologists placing stents through needles. While there are still medical problems that need to be handled with the big cardiovascular surgeries, many patients have benefitted from having less invasive ways to get the job done.  :)
Title: Re: Regenexx injections - Stem Cells
Post by: men-at-arms on March 01, 2011, 04:27:57 AM
Dr. Centeno,

Thanks for your reply, opinion, insight, and info. Much appreciated.

I am very happy so far with my two injections of PRP w/o HGH and prolotherapy and what these injections did to improve my osteroarthitic knees (left knee condition 3, right knee condition 4 and requires high tibial osteotomy to correct the deformed alignment bowing inwards slightly due to tibial crook after right ACL rupture and miles and miles of running). I plan to get at least 4 more sets of injections to both knees to improve the knees with PRP as much as possible as I view these treatments as non-permanent solutions but buying more time. My HTO will be done within this year, though I am NOT looking forwards to the recovery then the removal of the wedge plate and recovery which understand will cost me 1 year of pain and suffering. However, compared to TKR, all the OS's I've spoken to (those who are familiar to regenerative medicine and not the traditional view doctors) seem to think these alternative treatments are worth the pain and may help me to avoid TKR altogether.

But I should point out for the other board members (although you made the distinction already with chondrocytes and stems), that the National Taiwan University Hospital clinical trial is a stem cell treatment where stems are extracted then expanded then grown in vitro then transplanted into injured site and not ACI/MACI (which I have been told are outdated procedures). The proof of concept was done in 2006 using a Vietnamese miniature pig, and it was noted that the cartilage regenerated is like native hyaline soft firm and slimy tissue. Also, since the whole cartilage was regenerated via the matrix the thickness is as non-injured natural cartilage full thickness. I don't know pig anatomy, but I believe I read in Chinese articles that the cartilage was meniscus cartilage, which are my injured cartilages in my knees. I also don't know what other technologies are involved to improve the patient's acceptance of implants, whether that involves further MSC injections after the transplants are in place to help "binding" ? But being that I currently live and work and live in Hong Kong and originally from Taiwan and moving back to Taipei this coming July, I am following National Taiwan University's on-going clinical trial with a high personal interest.

Personally, I believe I have time to take a wait-and-see approach while MSC, MSC combine with matrices mature more. But that's just my evaluation of my own case. I liken my situation similar to people waiting for any technological improvements whether it is say cosumer electronics or automotive. Medical technology likewise always improve over time. So, for me Regenxx may be version 1.1 beta of cartilage regeneration; I estimate I probably have time, given the improvements I felt after simple PRP injections to wait for version 3.0 or 4.0 full release. However, for other cases where patients can't wait, I have personally have no doubt the work your clinic is doing now certainly seems to provide a ready solution/alternative for osteoarthritic knee pain sufferers.
Title: Re: Regenexx injections - Stem Cells
Post by: Dr. Centeno on March 01, 2011, 05:14:29 PM
I would agree the Taiwain study sounds promising, just like microfracture with cells is better than micro fracture alone (at least in an equine model-see http://www.regenexx.com/2011/01/micro-fracture-plus-stem-cells-better-than-micro-fracture-alone/), I'm sure MAI with stem cells is better than MACI with chondrocytes. HTO may be a great option as well, as some recent research shows it does take pressure off the degenerated side (see http://www.regenexx.com/2011/02/high-tibial-osteotomy-of-the-knee-helps-cartilage-in-mri-study/). Since the PRP is buying time, I wish you all the best in finding the most appropriate interventions! You're 100% correct that all of these biologic interventions will continue to improve with time.
Title: Re: Regenexx injections - Stem Cells
Post by: Jules2424 on March 25, 2011, 03:39:14 AM
I decided to look up Dr. Centeno's company after reading this post and ran across something that very much disturbs me. The FDA recently sent his company a notification that he is in violation of their regulations and that they may seek legal action against him if he doesn't comply. "

I read this also, but considering the fact that the FDA doesn't have the best track record, it doesn't concern me. What I like about Regenexx is that they're very specific about their procedures. They're strictly ortho & do not make wild statements such as curing everyone or every disease under the sun. And after all, they're not injecting any foreign substance into your body. It's like a blood transfusion, using your own blood. We now take this for granted.  They are also very upfront about the possibility that the procedure may not work for everybody & tell you after evaluating you whether you're a fair, good or a poor candidate.  Believe me, I don't trust doctors easily.  But I'd rather try my own stem cells than getting cut open w/all of the risks that entails.  I'll probably go & get my knee injected with them even if I'm a poor candidate. Why? Because I think this is the wave of the future & I'd rather have my own stem cells injected than get cut open only to have the pain return, which is what happens too often with an arthroscopy.  I just wish my knee had lasted 5 more years-- when using your own stem cells will be better known. However, it makes perfect sense to me that our bodies have the capacity to heal themselves.  So it feels very natural to me.  We'll see. Maybe it's just wishful thinking on my part. I hope not.
Title: Re: Regenexx injections - Stem Cells
Post by: markld on March 25, 2011, 08:25:11 PM
Plantgeek and mayme,

I totally agree with both of your postings. There was a [edited by KG] guy named scooter posting on here last week claiming that he is [an] authority because he has a background in science, however I can see that plantgeek does as well.

Keep it up, I believe Regenexx is a shady outfit.....


[Some words edited out by KNEEguru as unnecessarily abrasive and against the registration rules]
Title: Re: Regenexx injections - Stem Cells
Post by: jamesofsuburbia on March 28, 2011, 10:33:32 AM
Hello everyone,

This has been a thoroughly fascinating thread to read, I have read it start to finish in the past hour or so and absorbed so much valuable information in my quest to fix my knee. I am 25, a year ago had a soccer injury to my right knee which was treated incorrectly by a surgeon who did a lateral meniscus trim only when my ACL was partially torn but functionally failing and then was given an incorrect rehab plan which led to a weight bearing lateral femoral chondral defect. As a result I have been only swimming and cycling since october or so last year. I am due for a bone patellar bone ACL reconstruction in the next few months.

I have been offered MACI here in Australia but since I have almost no pain unless I try to run I have declined the long rehab and open knee surgery. Regenexx sounds like it might work for my situation. Does anyone know if this procedure or something equivalent is being used in Australia? I mentioned stem cell therapy to my original surgeon once I had an MRI and found out I had a defect and he literally laughed at me (a defence mechanism for his ignorance).

In something similar to what is on this thread read 'supramolecular design of self-assembling nanofibers for cartilage regeneration' Ramille Shah et al. They have developed a molecular matrix to deploy MSC's to defects but as far as i can tell it requires open knee surgery. The results they have had on rabbits is great.

If nobody does a Regenexx type procedure in Australia I may email Dr Centeno directly and if need be, make the trip to the USA. 

Best of luck to everyone with their knees

James
Title: Re: Regenexx injections - Stem Cells
Post by: Scooter72 on March 28, 2011, 05:36:19 PM
James, I don't know if a similar procedure is offered in Australia.  However, just for your information, I will be treated by The Centeno-Schultz clinic from April 28th-May3rd, and be posting my experienes in this forum (in a separate thread).

-Scott
Title: Re: Regenexx injections - Stem Cells
Post by: markld on March 28, 2011, 09:42:24 PM
Evidently the rules of a free and open society, that being freedom of speech, regardless of how harsh it is, don't apply here to this bulletin.
What is the point of having a bulletin as this, if one can't express themselves in a free maner, even if they are abrasive at times????

To edit ones words is no different than what is practiced in China, Iran, or any other comunistic country, and I find it appalling.
Title: Re: Regenexx injections - Stem Cells
Post by: jonhark on March 28, 2011, 11:45:14 PM
Keep up the good fight Markld!! The FDA agrees with you that Regennex is a shady outfit!! Couldn't agree more about free speech. Maybe if this forum was headquartered in the US, it would be a little bit more amenable to promoting free speech. As they in New Hampshire....live free or die!!!
Title: Re: Regenexx injections - Stem Cells
Post by: The KNEEguru on March 29, 2011, 12:24:30 AM
Hi
 ;D This site and bulletin board is not really likely to have headquarters, as it is run by one retired woman on a meagre budget just for the benefit of people suffering from knee problems.

I understand about freedom of speech, but I care more about people here finding a sense of community and a safe venue for discussion. If I choose to edit comments to protect people from hurtful comments it is because I recognise that many of the people here have had bad experiences in the medical world and I do not want to make things worse for them.

Of course there will be differences of opinion, and expertise and experience - and people are free to express these - but not free to cause distress.

KNEEguru
Title: Re: Regenexx injections - Stem Cells
Post by: crumpet on March 29, 2011, 05:44:03 AM
KneeGuru:

Thanks for all you do...

~Crumpet ;)
Title: Re: Regenexx injections - Stem Cells
Post by: jamesofsuburbia on March 29, 2011, 02:12:38 PM
Thanks Scott will keep an eye out for that. Best of luck with your procedure I hope it is fruitful for you.

That speech should be free regardless of how harsh that speech is is certainly not conducive to a free society. If you really believe that how the USA is run then you are living in a dream world. Go stand on a street corner and shout 'death to america' and see what kind of response you get. Go stand there and say 'bring back the slaves' and see what happens. Don't be so ridiculous to think the moderators of this board have a right to regulate how off topic or abrasive the speech here gets, this isn't a microcosm of your flawed idea of society, its a forum about knee injuries. Deal with it.
Title: Re: Regenexx injections - Stem Cells
Post by: jonhark on March 29, 2011, 04:42:21 PM
James Buddy--Being from Australia, I wouldn't expect you to have the facts straight about free speech in America. Death to America? Bring back the Slaves? Would never advocate either in the best country the world has ever seen, or will ever, for that matter. What I do advocate is the following: When someone on this forum is an obvious imposter and liar (not naming names), they should be harshly rebuked and exposed for their fraudulent statements.  This should be a community of knee patients and not a forum for marketing and advertising of modern day snake oil.  I wish you luck with your Regennex injections, but think your money would be better spent on a lifetimes supply of Foster's.
Title: Re: Regenexx injections - Stem Cells
Post by: Lottiefox on March 29, 2011, 05:04:00 PM
Thank you Knee Guru for once again trying to bring some balance to the situation.  :)

I have been pretty disgusted by the blatant bullying of Scooter on a previous thread, and whilst everyone is entitled to their opinion, of Regenexx, Fosters or whether the world is flat, then bullying someone who has a different view and launching personal attacks as was done before just isn't helpful. To anyone.

Many many medical techniques cause controversy or scepticism. Indeed, a large scale research study showed that "proper medical intervention" aka an arthrscopy to wash out and clean up arthritic knees was no better than a sham scope blindly given to a control group. Has there ben a revolution against scopes for cleaning out knees? No. They are still widely practiced. So, Regenexx courts controversy - it doesn't appeal to everyone. Neither does microfracture, or many other attempts to repair cartilage. If an individual wants to try something that is their right.

James - good luck with your search. I would email Dr Centeno and ask if he knows of anything in Australia. There is a stem cell company in Australia - Mesoblast I think, but I am not sure if they are doing similar work or ACI work supplemented by stem cells. I have seen three OSs here in the UK. The most pioneering one is currently using stem cells in combination with a collagen paste to create a cartilage fix. (Cartifill). He strongly believes that work such as Regenexx is the future, and has similar results but so far only on sheep. I have seen that data for myself. Unfortunately, not being a sheep we cannot access similar here in the UK.....yet.

Good luck,

Lottie
Title: Re: Regenexx injections - Stem Cells
Post by: markld on March 29, 2011, 05:05:32 PM
Harsh speech not being conductive to a free society and freedom of speech are two totally different things pal.
In America, freedom of speech is just that "freedom of speech". What part of it don't you understand? If one wanted to, they could and would be free to stand on a street corner and shout "death to America" and there isn't a thing anyone could do within the law to stop them from doing such.
I wouldn't agree with them saying that, however they have a "RIGHT" to do that if they choose so. Obviously you don't have a good comprehension of the U.S constitution.

 Look at the most recent cases decided by the US Supreme court, ie; Snyder v.s. Westboro Baptist Church. The ruling from the supreme court was 8-1 siding with Westboro Baptist Church. If that isn't harsh speech that the court is condoning then I don't know what is.....

You obviously don't know the difference between ones rights under the constitution pertaining to freedom of speech and being socially indecorous......
Title: Re: Regenexx injections - Stem Cells
Post by: The KNEEguru on March 29, 2011, 05:17:52 PM
 :)
Title: Re: Regenexx injections - Stem Cells
Post by: jonhark on March 29, 2011, 08:04:40 PM
Oops, I apologize for my last post to James. What I meant to write was: Injecting Foster's into the knee has a better chance of producing cartilage than stem cells. It is a helluva lot cheaper as well.
Title: Re: Regenexx injections - Stem Cells
Post by: jamesofsuburbia on March 31, 2011, 02:32:51 AM

Thanks for the advice fellas, you have obviously missed my most salient point, that this board is fortunately not free to the kind of hateful speech the Westboro Church engages in! And I will try out that foster's as soon as it's published in a peer reviewed journal :) If it worked it would be a money saver. If you are unsure about the ability of stem cells to produce cartilage I recommend you access some scientific journals and scour them thoroughly, you will be pleasantly surprised at the success had so far.

Lottiefox - You are correct in saying Mesoblast is conducting trials in Australia, but at the moment they are using allogenic cells, and from what I can find are treating those with a recent ACL reconstruction and injecting generally into the knee, not in the more directed fashion Dr Centeno does.

I will look into Cartifill, did you read the paper I mentioned in my previous post? They are doing something similar to what you described, using cells contained within self arranging peptide amphiphiles which provide a nano scaled surface to the subchondral surface. The results they have had are just fantastic, the histology of the cartilage which has been repaired is almost indistinguishable from healthy cartilage. Although just like your lucky sheep, they have done it on rabbits. I am not so keen on allogenic, I would prefer an autogenic transfer, that is one of the concerns I have with the Australian trials. I have emailed a doctor I found here who is conducting one of the trials, and will find out exactly what they are doing.

Do you know of any research papers which describe the cartifill process? I will try my own searches now, thanks for your help.
Title: Re: Regenexx injections - Stem Cells
Post by: Kaputt_Knee on March 31, 2011, 07:16:49 AM
jamesofsuburbia nice one!  :D :D :D :D :D
Title: Re: Regenexx injections - Stem Cells
Post by: jamesofsuburbia on April 05, 2011, 03:00:23 AM
Thanks Kaputt! I am starting to suspect there is a representation of the religious right on this board? anti stem cells, pro Westboro? hmmm...I could be totally wrong, but perhaps not.

Back to more relevant matters, I have heard back from a promising trial in Australia but I am ineligible for the treatment they are conducting. Upon consultation with another surgeon with whom I am happy I am going in for a patellar ACL reconstruction and microfracture this week.

I wish everyone all the best with their knees, my best advice is do your research! Cheers and wish me luck.

Title: Re: Regenexx injections - Stem Cells
Post by: jonhark on April 06, 2011, 02:23:28 AM
It is painfully obvious from your post that you haven't DONE YOUR RESEARCH. Are you aware subsequent MACI after microfracture has a 5 X greater chance of failure? Why would you opt for a surgery which damages the subchondral bone for a MAYBE 50% chance of growing fibrocartilage? Why blindly inject stem cells into a defect when you can have a chondrocyte surgically glued or implanted into the defect? How does that stem cell know how to become a chondroctye and create a cartilage matrix? The dumbest thing you can do at your age is to get a microfracture. The second dumbest thing is to believe in a pipe dream fantasy that stem cells (in the current surgeries offered) are ever going to give you a long-term solution. 

Why would an advocate of free speech be considered part of the religious right? Seems you might be mixing up politics in two distinctively different countries. By the way, you don't seem a bit like most Australians I've met. You sure you aren't a KIWI?
Title: Re: Regenexx injections - Stem Cells
Post by: Scooter72 on April 06, 2011, 04:12:14 AM
How does that stem cell know how to become a chondroctye and create a cartilage matrix? The dumbest thing you can do at your age is to get a microfracture. The second dumbest thing is to believe in a pipe dream fantasy that stem cells (in the current surgeries offered) are ever going to give you a long-term solution. 

To all that are viewing this thread.. know that jon asks questions that are easily answered with a little research.  I would point out the other threads where trolling by jon and his friend, mark, have mindlessly (<-- emphasis) attacked any reasonable attempt at scientific discourse concerning similar topics.  Nevertheless, these are decent questions, that I don't mind shedding light on.  Prolo and MSC therapy go together because, in short, the prolo intiates an inflammatory response that allows for a better healing response.  The MSCs are "told" to differentiate into the proper collagen cells via certain types of cytokine signaling pathways.  I will quote from the following website which is one of many that can help explain (http://wehelpwhathurts.homestead.com/prolotherapy.html):

"Repair is the process by which lost or destroyed cells are replaced by new, living cells. The tissue defect is initially filled up with highly vascularized connective tissue called granulation tissue. It consists of newly formed small blood cells embedded in loose ground substance containing fibroblasts and inflammatory cells. Fibroblasts migrate into the wound bed under the influence of chemotactic factor (11,12).

As granulation tissue matures, inflammatory cells decrease in number, fibroblasts lay down collagen, and the capillaries become less prominent. A relatively acellular, avascular tissue with inactive spindle-shaped fibroblasts tucked in between collagen fibers emerges. The collagen fibers then aggregate into mature fibrils. The acquisition of tensile strength follows a sigmoid curve (12). The orderly movement and proliferation of cells within a healing wound is influenced by both cell signals and extracellular matrix (e.g., fibronectin and growth-stimulating factors). Thus, a wound-healing cascade is present. The growth associated with repair is regulated and ceases when healing is completed (12).

Proliferants are substances that cause a localized tissue reaction leading to an inflammatory response. The wound - healing cascade is thus triggered resulting in fibroplasia and collagen deposition. The healing cascade begins with granulocyte infiltration followed by monocyte/macrophage invasion. Growth factors are released and thus activated fibroblasts are recruited to the site to secrete new matrix. This new matrix includes collagen fibrils (2,6,7,13). "

Now, with this information, I want you all to read the following abstract from a paper released recently (http://www.ncbi.nlm.nih.gov/pubmed/21451545):
Tumor Necrosis Factor-α-Activated Human Adipose Tissue-Derived Mesenchymal Stem Cells Accelerate Cutaneous Wound Healing through Paracrine Mechanisms.
Heo SC, Jeon ES, Lee IH, Kim HS, Kim MB, Kim JH.

1] Medical Research Center for Ischemic Tissue Regeneration, The Medical Research Institute, School of Medicine, Pusan National University, Gyeongsangnam-do, Republic of Korea [2] Department of Physiology, School of Medicine, Pusan National University, Gyeongsangnam-do, Republic of Korea.

Abstract
Human adipose tissue-derived mesenchymal stem cells (ASCs) stimulate regeneration of injured tissues by secretion of various cytokines and chemokines. Wound healing is mediated by multiple steps including inflammation, epithelialization, neoangiogenesis, and proliferation. To explore the paracrine functions of ASCs on regeneration of injured tissues, cells were treated with tumor necrosis factor-α (TNF-α), a key inflammatory cytokine, and the effects of TNF-α-conditioned medium (CM) on tissue regeneration were determined using a rat excisional wound model. We demonstrated that TNF-α CM accelerated wound closure, angiogenesis, proliferation, and infiltration of immune cells into the cutaneous wound in vivo. To assess the role of proinflammatory cytokines IL-6 and IL-8, which are included in TNF-α CM, IL-6 and IL-8 were depleted from TNF-α CM using immunoprecipitation. Depletion of IL-6 or IL-8 largely attenuated TNF-α CM-stimulated wound closure, angiogenesis, proliferation, and infiltration of immune cells. These results suggest that TNF-α-activated ASCs accelerate cutaneous wound healing through paracrine mechanisms involving IL-6 and IL-8.
Journal of Investigative Dermatology advance online publication, 31 March 2011; doi:10.1038/jid.2011.64.

The point here is that TNF-alpha, and interleukins 6&8, which are all upregulated and secreted as part of a general inflammatory response, actually accelerated tissue healing.  This is only one paper, and one example of the effect of a microenvironment including a multitude of cytokines that enhance MSC proliferation (towards the site of injury/inflammation) and repair.


Title: Re: Regenexx injections - Stem Cells
Post by: The KNEEguru on April 06, 2011, 12:06:05 PM
It is a shame this thread continues being a sparring match instead of a discussion.
Title: Re: Regenexx injections - Stem Cells
Post by: jonhark on April 06, 2011, 01:19:43 PM
prolotherapy is more witchcraft. I had it done on a loose shoulder about five years ago in the hopes of it tightening my ligaments. Low and behold, it had absolutely NO EFFECT. Guess what did work? Surgical Capsular Shift. Prolotherapy is a great concept in theory, but just doesn't seems to be more placebo effect than anything else. Anyways, this is my last attempt to persuade anyone about cartilage repair. Don't take my word for it or even Scooter's. Go and interview the top five cartilage repair physicians in the country. Who, by the way, are innnovativew and work with numerous different technologies and companies. You know what they will tell you? Chondroctyes are the building blocks of cartilage and there is no substitute for them in the knee....In fact, neo chondroctyes are showing HUGE promise in initiial studies. They won't mention or recommend stem cells yet as the technology is too infant and hasn't been perfected. Save your money folks and DEFINITELY don't choose a microfracture. It has a great chance of causing subchondral osteophytes and cysts and hijacking your future cartilage repairs.
Title: Re: Regenexx injections - Stem Cells
Post by: Scooter72 on April 06, 2011, 02:55:21 PM
Jon, you are either purposely, or unintentionally misdirecting.  Prolo on its own is not what is being recommended!  It is in conjunction with stem cell therapy, that the effectiveness becomes synergistic.  As I said in the previous post, the point is to create a microenvironment (i.e. inflammation) that will cause the MSCs to migrate and repair the injured site. 

Also, there seems to be a disconnect here between Jon's support for his opinion, and my own.  Jon is tellling us that " the top five cartilage repair physicians in the country" would demean prolo and/or stem cell therapy in it's current state.  Can someone please tell me who those top 5 might be, and in what interview/journal they said such a thing?  Furthermore, I would like to know what basic science research they might have?  How many stem cell therapy treatments have they given to patients, that are as sophisticated as what is done at Regenexx?  Keep in mind, folks, that these people actually SORT out a specific kind of stem cell, among many many different kinds of cells that are drawn; this isn't your typical bedside draw with simple concentrating and re-injection.

Another problem there is with Jon and Mark's opinions, is that they casually dismiss real people, who have put up video testimonies, and are easily found, that have had incredible success with the Regenexx treatment.   I'll give you all one example: JARVIS GREEN.  Go look him up.  He's a New England Patriot.

Another fact I'd like to highlight to everyone here: In general, MDs are simply not the foundation of innovative medical research, from which new modalities of treatment spring.  Yes, there are plenty of exceptions, and to a certain degree this is changing.  However, if you, the public, wants to know what is on the forefront of medical research, understand that it is the research techs, MSs., BSs and of course PhDs who do hardcore research in labs at academic institutions and corporations, that are discovering those modalities you will one days see in the clinic.  That's not a knock against MDs; it's simply the truth.  MDs can empirically/anecdotally make observations based on their years of experience, but they hardly have time to conduct basic science research.

So, the bottom line is that if you want to know what is going on with some area of interest with respect to a disease or treatment, go to pubmed.com and do a search. See what those who are building the foundation of knowledge from which the public benefits, are discovering. Don't go to people who are not researchers, and might not have the training to even understand why something new (e.g. MSC w/prolo) might work.   
Title: Re: Regenexx injections - Stem Cells
Post by: rob wilson on April 06, 2011, 09:22:54 PM
Wow. I don't know a lot about the science or the politics. I only know that according to my MRI pre and post Regenexx (5 injections) that there was about 50% cartilage growth in my defect. As far as prolotherapy being withchraft I can only say it has been a God send for me and has enabled me to remain active. I have used it for many different body parts with fantastic results. It is a process not usually a 1 shot miracle.
Title: Re: Regenexx injections - Stem Cells
Post by: jonhark on April 06, 2011, 10:29:28 PM
So Scoots, what is your kickback on each Regennex procedure referrred by Knee Guru. You are doing a helluva job representing something you've never experienced, yet......
Title: Re: Regenexx injections - Stem Cells
Post by: Jules2424 on April 07, 2011, 01:52:56 AM
RE: The beginning of this thread.

The stem cell discussion really shouldn't be turned into a chest thumping competition. We're all here to learn. And on that note I found a great article that intelligently probes into this topic:

http://repairstemcells.org/Resources/Featured-Articles/Shopping-for-bones-a-future-possibility.aspx

This article discusses the possible future of stem cells for bones. If you really want to know about stem cell research, it's a good idea to read up on anything you can find.  That way we can explore this theme together w/out taking sides.  Are there  snake oil salesmen? Of course.  Are there money hungry, negligent doctors? You bet. Should we make sweeping generalizations?  Of course not.

Let's remember that nothing in this universe is black & white.  There's a whole spectrum of colors & much more that is a total mystery to all of us.. Medicine, after all, is part science, part art & a lot of luck.  Aren't we here because we need to look at all aspects? I am. And so very grateful that we have this forum to explore all issues that might  help us heal.
Jules
EGADS! My knee hurts!


Title: Re: Regenexx injections - Stem Cells
Post by: Scooter72 on April 07, 2011, 02:02:11 AM
Nice Jules.  I am glad you agree that intelligent discourse should be the norm, and not the exception.  Nice article you posted, albeit it deals with bone regeneration, and not cartilage (although there is significant crossover in the stem cell populations that will regenerate both).

Title: Re: Regenexx injections - Stem Cells
Post by: Jules2424 on April 08, 2011, 02:13:05 AM
Scooter & All interested in unbiased opinions about Regenexx:  I found this website that gives people free info on stem cell clinics, both here and abroad. They seem pretty legit since they aren't selling any specific place. They seem to want to help people find credible stem cell clinics. I filled out the form for free & they responded in one day. This is their email:


<<"Thank you for your application. Since Regenexx is not one of the Institute's recommended treatment center, we cannot provide you with detailed information on their treatments.  We do think they are dependable.
The treatment center we recommend for knees (and the best we have seen) is in Maryland, costs about $10,000 and requires one full outpatient day for treatment.
Sincerely,         
David, RSCI Coordinator         
Repair Stem Cell Institute LLC         

www.RepairStemCells.org <http://www.repairstemcells.org>
         
The Voice of Stem Cell Science ">>

They didn't give me Maryland clinic's  email or web address & I couldn't find it online so they're obviously not trying to push or advertise it.  I can write them back & ask, but Maryland is a long trek from California. However, I'd like to see what they're offering in terms of knee regeneration w/stem cells & compare their method to Regenexx's.  What I like best about their email is that they state that Regenexx is "dependable."  Regenexx is not one of their recommended clinics (yet), but a reason might be because Regenexx is strictly ortho & they research clinics that offer all types of disease treatments, such as cancer, rheumatoid arthritis, etc. Their list of diseases is vast. My take on this site is that they weed out the frauds, thus help people make informed choices & save themselves a lot of heartache not to mention possible dangers. Anyway, this is my take on this site & I am open to anyone else's interpretation. Plus, now we have one unbiased opinion that does not come from Regenexx.

Jules
Oh, dear Universe...please heal my knee w/out surgery  :-*
Title: Re: Regenexx injections - Stem Cells
Post by: jamesofsuburbia on May 09, 2011, 12:47:50 PM
G'day mates

Thanks Scooter for taking some of the questions that were flung at me, I have been hard at rehab and relaxation the last 4 weeks since my surgery.

The microfracture is feeling great, turns out I had an ACL tear to deal with too, which has been repaired also. Im being really careful on it, and I have a great surgeon and physiotherapist helping me along.

Lets hope for the best re stem cells in the future, I remain fascinated and optimistic in its capabilities.
Title: Re: Regenexx injections - Stem Cells
Post by: sbstritt on May 12, 2011, 07:51:38 AM
I have had 30% of my medial meniscus removed. I have had continual discomfort after two meniscectomies. I got some relief from Synvisco and PRP injections to my knee joint. I am wondering what people think about Regennex for this type of scenario. I know that they use a xray fluroscope to guide the injections. Can they actually hit the part of the meniscus where it was removed with the injection needle for the stem cells? Has anyone had this type of scenario (or worse) and did they have a positive outcome? I am 49 yo male still in very good shape with little arthritis in the knee and good joint spacing. I am trying to decide between stem cell treatment and menaflex implant? Thoughts people!
Title: Re: Regenexx injections - Stem Cells
Post by: sbstritt on May 13, 2011, 04:08:05 AM
point of clarification on my previous post, i had two previous partial meniscectomies- both small tears (total of 30% of meniscus removed)
Title: Re: Regenexx injections - Stem Cells
Post by: Scooter72 on May 15, 2011, 10:30:19 PM
I have had 30% of my medial meniscus removed. I have had continual discomfort after two meniscectomies. I got some relief from Synvisco and PRP injections to my knee joint. I am wondering what people think about Regennex for this type of scenario. I know that they use a xray fluroscope to guide the injections. Can they actually hit the part of the meniscus where it was removed with the injection needle for the stem cells? Has anyone had this type of scenario (or worse) and did they have a positive outcome? I am 49 yo male still in very good shape with little arthritis in the knee and good joint spacing. I am trying to decide between stem cell treatment and menaflex implant? Thoughts people!

I know that people with meniscotomy have been treated at the Centeno-Schultz clinic.  However, I can hardly speak as to the efficacy of their treatment in your particular case.  I will however say with good confidence that yes, they can "hit the part of the meniscus where it was removed".  From personal experience, I can tell you they are experts at guiding the injections directly into the troubled areas.
Title: Re: Regenexx injections - Stem Cells
Post by: Maite Velasco on May 27, 2011, 09:13:04 AM
Hello!

I would like to know if there are any other clinics whith treatments with stem cells apart from this in Denver. I am from Spain and it is a little far from home.

Has anybody had a stem cells operation? I don´t know if it is invasive, how much time do the operation last and the time of rehabilitation. And also the cost.

Thank you for your help.
Maite.
Title: Re: Regenexx injections - Stem Cells
Post by: Happy Knee on June 16, 2011, 10:39:56 PM
Hi - new here...thank a lot for all this wonderful information! I've been checking the Regenexx group out, also the Stem Cell Orthopedic in FL - will give them a call once I'm enough informed to ask the right questions...

To Jules2424 - the suggestion for the http://www.repairstemcells.org link is a good one - sent them a request. BUT then I discovered the following...

the only thing is that it seems a bit presumptuous to only recommend 10 out of 500 centers worldwide - I am sure there are quite a few more good ones out there. Looking through how they work, it turns out they just give you a recommendation from this tiny pool of 10 centers - and give the name to you only after you've gone through with their consultaions the whole way. In short, they essentially funnel you to these 10 centers...thus it looks like they are a sleek marketing and sales tool, probably funded by these 10 centers that they recommend (or at least, they are in exceptionally good personal terms with them...). I am not sure they are really objective thus...

Or am I reading this wrongly? Dont think so though...

it seems like there's really a jungle out there - the more I research, the more it get's dense...

What makes it so insiduous is that even though I've got a solid scientific background and am repeatedly shocked at how sloppy the medical and research community often operate (beginning with cleverly massaged statistics to carefully selected omissions of data/information), continuous pain can drive one to desperation - which tends to make one want to believe in cures that with a clear, detached head one would otherwise be weary of...

In any case - I think that stem cell therapy - if it works (some day) - is still better than surgery. And I will keep on researching them - until I may just take the jump...for I hate having gone from active athlete to complete couch potato these past two years...

keep posting and tx.

cheers, Mr. Happy Knee  :)

Title: Re: Regenexx injections - Stem Cells
Post by: selfridge23 on July 12, 2011, 02:05:08 AM
Hi Happy Knee and all others with knee problems who are trying to figure things out!
I agree, it is a "jungle out there". I am a 58 year old female who is fit and active in swimming and golf. I now have supposedly developed chondromalacia (degeneration of cartilage under my knee cap), a free-floating fragment, as well as a bone spur, and my knee cap is not tracking the way it should. I have been to FIVE different surgeons, and I was given five different opinions of what to do. Solutions were from one end of the spectrum (do nothing) to the other end (get a knee replacement) and everything in between (therapy, injections, arthroscopy to take bone fragment out and do a lateral release). I have mild to moderate arthritis, and I have never had surgery. I am concerned about numerous things that come with surgery, in particular, scar tissue. And, I am not thrilled with the idea of getting a lateral release, because I've heard so many horror stories and low success rates attached to that procedure.
So, the Regenexx treatments really interested me. I'm curious if anyone out there has had Regenexx injections for a knee similar to mine, and if so, how are you doing? And also, I'm curious about the stem cell draw itself...does anyone know if taking stem cells out of the hip bone weakens the hip in anyway? The last thing I would want is to trade one problem for another one down line. I'd appreciate any help that's floating around out there in Kneegeek Land. Thanks. Mary
Title: Re: Regenexx injections - Stem Cells
Post by: prpgk1 on July 12, 2011, 06:55:20 PM
I've considered the Regnexx procdure but I have my doubts about how useful it would be . It looke likely to cost 10,000.00 if you include flying out to Denver and staying there for a couple of days at least. I'm bothered by the lack of studies that Regenexx has done. After being in business for over five years now they've yet to publish a comprehensive peer reviewed double blind study. This is the only acceptable study  that is accepted by the Scientific community.

I'm also bothered by the posts I see here. Hard for me to imagine that Scooter72 is not either Dr. Cenetnio or Dr. Schultz. Also has anyone else noticed a trend here . Someone posts that they've had a consult with Regenexx, they plan on going through the procedure. Then they suddenly disappear . Very strange behavior. According to Regenexx they have performed well over 450 of these operations. Yet I've seen very few people on any of these sites come here or anywhere and announce hos successful the procedure has been. If that had been me I'd be all over the place telling everyone how great this has been. So until I get some good data I plan on staying away from Regenexx.

Title: Re: Regenexx injections - Stem Cells
Post by: WestPoint on July 12, 2011, 08:40:06 PM
I believe that would only be to your own loss.

As for anecdotes all over the Internet about Regenexx success stories, I don't know where you've been. Ask yourself this though: If what you are saying is true, wouldn't the Internet be full of stories of people who got absolutely nothing out of this treatment?

Personally, I find it a bit pathetic that you figure that Scooter could be Dr. Centeno or Dr. Schultz. While you're at it, you could get the secretary's name, too, and include that in your list. I think they're a little busy for that, don't you? Be fair.

Don't get me wrong. I have no problem with you or anyone not wanting to use Dr. Centeno's service and technology or even critiquing it fairly if need be. But polluting the Internet in this manner with highly speculative and even slanderous insinuations is another issue.

Please, keep your criticisms evidence oriented, as you have spoken about evidence oriented scholarship (studies) in your post. We wouldn't want you to be espousing double standards...

 
Title: Re: Regenexx injections - Stem Cells
Post by: Dr. Centeno on July 12, 2011, 09:11:07 PM
Dear all,

Neither Dr. Schultz nor I are Scooter nor any other name. My only login for this site is my name. David G is a very nice man that feels passionately about adult stem cells, but David is a pay for blogger. He approached us about whether we would compensate him to blog on our behalf, we said no. I suspect this is why were dependable but not reccomended. We charge approximately less than half of the Maryland group for the same procedure that we believe is better because we don't use a bedside centrifuge/kit, but our own process with real people handling the cells rather than a machine.

We have published our work and continue to publish. We have a study in medical journal review now on the outcomes of 250 knee/hip patients that has a provisional acceptance pending a revision. This will go back into the editor this week or next, hopefully it will be published this fall. This same data (a smaller and less analyzed data set) was already presented at the Orthopedic Research Society, see http://www.regenexx.com/2010/09/centeno-schultz-clinic-abstract-accepted-by-orthopedic-research-society/ . We have a safety paper published in the National Library of Medicine located at http://www.ncbi.nlm.nih.gov/pubmed/19951252. We have a larger n=339 safety paper that was just accepted for publication. Finally, our early knee data set has already been published at http://www.jpands.org/vol16no2/centeno.pdf.

Regarding the comments RE: double blind, randomized trials, this is not the standard in orthopedics or musculoskeletal medicine, but a great aspirational goal. Almost none of the knee procedures being discussed on this board have passed this test. This includes micro fracture, ACI, MACI, high tibial osteotomy, you name it. So if this is the standard, then almost all orthopedic surgical procedures fail out of the gate.

We have many, many happy patients, to read their stories see http://www.regenexx.com/global-navigation/regenexx-blog/ . Having said that, we have a medical procedure with a success and failure rate, like any other procedure. This board is filled with patients that love one procedure or don't like it for various reasons. We are a viable knee surgery alternative option that as of the publication of the two papers in review (above), will have as much published data about our procedure as any other procedure considered on this board (level II evidence).
Title: Re: Regenexx injections - Stem Cells
Post by: Scooter72 on July 13, 2011, 01:37:49 AM
Thanks to West Point and Dr. Centeno for their recent replies, although I am sure that the naysayers will continue to come here and make such implications.  It's ironic, because of the three doctors, Dr. Centeno is the one I did not get to see or meet, since he was away at a conference when I was at the clinic.

I don't know what else to do here.. I can only relay my experience, and explain the theory behind why MSCs give positive results for certain orthopedic maladies.  (see my post on pg 18)  It's not as if there isn't any hardcore molecular research to back all this up; as I've said a few times, all one has to do is go to pubmed and type in any combination of words dealing with MSCs, cartilage, bone etc.. into the search engine.

For me, it's somewhat amusing having random people come into these threads, and post their conspiracies.  Most are similar.  Not one has been willing (or able?) to debate the merits of MSCs as being used by the Centeno-Schultz clinic, on a scientific ground. 
Title: Re: Regenexx injections - Stem Cells
Post by: azawakh on July 24, 2011, 01:27:17 AM
Regarding Centeno-Schultz:
     I had a consultation with Dr. Hansen from their clinic in May of 2011.  I had a left knee with stage four osteoarthritis and seventeen degrees of valgus in the tibia.
     Dr. Hansen informed me of the procedure that he would use for the cartilage repair - adipose graft and then stem cell injections.  He also informed me that in his opinion I was a poor to fair candidate for the success of the graft and stem cell injections. Additionally, he did point out my valgus and indicated that even with the clinic's procedures I would need a tibial osteotomy to correct the valgus.
     As a result of this consultation I can certainly say that I was disappointed with the low probability of success and I was impressed with Dr. Hansen's honesty about the need to correct the valgus. Because of his honesty I had a TKR on June 20, 2011 performed by Dr. Stephan Kreuzer in Houston, Texas.  It is not what I wanted but my discussion with Dr. Hansen made me realize the appropriate choice for me.
     As such, my impression regarding Centeno-Schultz is that they are honest, have the ability to properly diagnose a condition and obviously are not so greedy that they would tell me that I would be an excellent candidate.

 
Title: Re: Regenexx injections - Stem Cells
Post by: WestPoint on July 26, 2011, 07:45:47 AM
Question: When going for a second round of injections, do you have to limit your actions to walking and bicycling in the same way as the first injection, or can you continue doing higher impact activities?

Also, would love to hear any more updates from old or new patients.

Title: Re: Regenexx injections - Stem Cells
Post by: telemarkerSteve on July 26, 2011, 05:32:03 PM
So since people having Regenexx and then not posting is somehow alleged to be evidence against these guys  - don't follow this by the way apparently they are being accused of making up lots of fake logins, posting they are going to have the procedure, then forgetting to make fake posts about how it worked for them?? - I felt compelled to post about my Regenexx SD results.

Going in I had two symptomatic issues:
 - perpetual inflammation
 - catching sensations in the knee
plus an MRI showing fissures in my trochlear groove and a full thickness defect in the lateal tibial condyle.

The knee in question has had a lot of work done since a traumatic injury in 2007 (ACL replaced, osteochondral allograft to fill in hole left by Obi bone plug which failed after being put in by famous ass-clown knee surgeon, etc).  The catching sensation and the inflammation both date from that osteochondral allograft surgery in the fall of 2009.  At that time neither the tibial defect nor the fissures were present, so it's entirely clear  how connected they are to those MRI detected issues.  The are probably related to the inflammation, but I am less sure about the catching which might be more of a proprioreceptive issue, rather than related to cartilage damage (my OS says that my patellar tracking was normal at the time of the surgery when I was anesthetized).  I had little to no pain.

I decided to try out Regenexx-SD in Feb.  My knee got huge from variety of injections and so it was difficult to compare before and after for about 6 weeks when the swelling was mostly gone again.  BTW during those 6 weeks, I rode my bike trainer 20 - 40 mins every morning and evening, so I didn't really feel like it was that hard maintain some decent leg strength or cardio fitness. 

At 6 weeks I went back to groomer skiing and by 10 weeks, I was back to pretty much full on backcountry skiing and pretty agressive inbounds skiing.  I was still using an unloader brace for all athletic activities and at that point was super-optimistic because with the brace I had no catching and little inflammation, but since I wasn't wearing the brace before it was hard/unfair to compare.   When biking season rolled around, I finally started exercising with no brace and I found the catching issues similar to before the procedure, but the inflammation greatly reduced. 

I saw my operating OS for the allograft for a follow-up and talked him into a follow-up MRI about 10 weeks post Regenexx.  There was no real evidence of cartilage regrowth on the MRI but he did say it looked "slightly better" than a year ago in terms of graft integration and cartilage irritation.  Frankly, I was happy to be the same or slightly better since the previous 3 years, every MRI I had showed a fresh problem that wasn't there "last time". 

Based on the "slightly improved MRI" and much improved inflammation, I opted to have a second round Regenexx-SD in late June.  I am now 5 weeks post procedure, the knee swelling is down to it's all-time low since the original injury, I still have the catching and I am biking moderately hard but otherwise only walking in the brace and swimming.


Bottom lines:
 - no negatives
 - only positive I regard as clear is substantially reduced inflammation
 - some positive MRI news but no meaningful cartilage regrowth (of course that's < 3 mos post 1st SD injection, not 6 mos post last C injection, which is the scenario for which they make some claims)
 - no pain before, no pain after, so same there (which is better than I can say for any surgery I've had)
 
So no miracle, but I'm happy enough.

BTW i think it's worth pointing out that
 - the Regenexx guys have published more clinical stem cell stuff than anyone else
 - their effectiveness study route kind of got rudely interupted when the government decided to try to classify the C procedure as a drug, so they couldn't collect any more data that was comparable to their old data - hard to blame them for that
 - no one is publishing controlled double blind studies showing stem cell effectiveness period
 - in so far as people are publishing such studies for "standard" orthopedic procedures like meniscectomies, it's fairly recent that they are doing so and they aren't producing clear cut effectiveness results



Title: Re: Regenexx injections - Stem Cells
Post by: WestPoint on July 26, 2011, 09:01:46 PM
Thanks Steve,

Sounds good. People seem to react differently, and as long as there is some improvement, that's a good sign.

Since I will be going for my second injection, could you inform me as to whether we need to stick to the walking and bicycling only for one month for the second injection too, or whether that is only for the first injection. That is, can I continue to do other high impact activities after the second injection, or do I need to stick to the original walking and biking for one month program?

Thanks...

 
Title: Re: Regenexx injections - Stem Cells
Post by: telemarkerSteve on August 01, 2011, 10:58:38 PM
I got the same advice for the second injection as the first:

 - for a few days:  do as little as possible (even limiting walking with unloader brace - some stationary biking OK)
 - from then to about two weeks:  walk up to 1 hr per day with unloader brace; biking, swimming and elliptical (last with brace) are OK
 - from 2-6 weeks:  unlimited walking with brace but still no impact sports; ok to up intensity some on biking/swimming/elliptical
 - 6 weeks+ : ease back into everything but wear brace for all impact activities (no longer need to wear for walking + elliptical)

I definitely got the impression that this is "best practice" but by no means known to be exactly correct.  For example, if you are getting noticeable inflammation you would want to back off from whatever was causing that, even if above says it is allowed.  If you have no inflammation and discomfort, you could definitely consider being more aggressive in consultation with your doc.   I tried skiing groomers in my 4th week.  Didn't like how it felt and stopped, but did start up again in week 5 when that felt comfortable and didn't cause noticeable inflammation.

For the easing back, they suggest adding about 20% intensity per week for 5 weeks, so back to full on around 11 weeks.

YMMV
Title: Re: Regenexx injections - Stem Cells
Post by: WestPoint on August 03, 2011, 01:07:31 PM
Thanks Steve for the information.

How are you feeling now?
Title: Re: Regenexx injections - Stem Cells
Post by: telemarkerSteve on August 13, 2011, 09:06:49 PM
The knee is feeling really good. 

I had pretty minor symptoms so it's hard to say how much improvement but inflammation is definitely down and the knee feels good.  The catching issues are also a lot better since I started swimming 3x a week.  I think that has affected the proprioreceptive issues rather than "real" things like muscle development or joint structure, but better is better.

For the summer I decided to go with road biking as my main sport, since it's supposedly so knee friendly and that is going well.  The knee definitely isn't holding me back, even on the steep climbs that call for a fair amount of power.

I am too busy this fall to squeeze in 2 Cayman islands visits, so I am holding off on a third round until I either have travel time or can get Regenexx C here in the US again.
Title: Re: Regenexx injections - Stem Cells
Post by: sbstritt on August 18, 2011, 06:34:11 PM
i just returned to this thread and wanted to say thanks to Scooter (btw not Dr Centeno and nice guy) and another gentleman who told me about their experience with regenexx. I'm off to Denver on Monday and will post my experience.
Title: Re: Regenexx injections - Stem Cells
Post by: telemarkerSteve on September 14, 2011, 03:43:24 AM
Apparently as a micro-geek I can't PM or even reply to PM's, so I am posting here a response to a question someone PM-ed me about Regenexx and biking during rehab:

In my case, I was told to wear the brace for elliptical or while biking IF I was going to stand up in the peddles.  That was for 6 weeks post op.  Since I found the brace too irritating for biking, I rode without it but avoided hills that might require me to stand on the pedals.  After 6 weeks I eased back into riding things that made more demands.

As usual, YMMV

Title: Re: Regenexx injections - Stem Cells
Post by: Sturge08 on September 23, 2011, 05:36:23 PM
Hi, I too have just come back from the Regenexx clinic in the usa. I was under the care of Dr Ron hnason, he treated my ankle for OA. I know this the kneeguru website but, trust me their isn't many websites which call for post injection results for stem cell ankle joint injections. I came away with a fairly positive outlook. I have found it odd that I was allowed to walk out of the clinic and bear weight so soon after both injections, I also have had no further contact from the clinic since. I guess its a case now of wait and see. It's a week since the injection and so far joint swelling and pain levels are just the same as pre injection. I will update my progress as the months pass.
Title: Re: Regenexx injections - Stem Cells
Post by: slyguy1 on September 27, 2011, 02:44:44 PM
At the beginning i was just as curious as anyone else out there about stem cell research.....but after reading about other people's experience and talking to an OS who is a family friend....i think i'll hold onto my dollars on this one. Microfracture also uses stem cells but forms a matrix.....people heal differently due to genetics....if stem cells actually generated new cartlige formation....every doctor on the planet would be doing it. Don't know if anyone watched  minutes segment on stem cell scams where vulnarable quadrupeligic spent life savings after doctor promised he would walk out of hospital.....felt so bad for that poor patient....watch for those scamming doctors
Title: Re: Regenexx injections - Stem Cells
Post by: Sturge08 on September 28, 2011, 09:52:51 AM
Microfracture does use stem cells but not as many as Regenexx procedures. Microfracture releases stem cells into the joint by drilling through the sub bone into the bone marrow in the already damaged joint. The Regenexx option is less invasive. As a former patient of Regenexx-sd I can say they aren't scam doctors, I went into an agreement to have the procedure knowing full well it may not work, I was not promised it would work. However I do wish they showed me more confidence rather than sitting on the fence so much. I feel there is room for improvement regarding their -sd procedure, perhaps some kind of 3d matrix to support cartilage regeneration. I would love for them to release more pre and post mri scans showing cartilage growth from patients. They claim they are treating approx 30 patients a month, surely with these numbers we could see on their blog a follow up patient with images once a month.
Title: Re: Regenexx injections - Stem Cells
Post by: ashok_guru on September 29, 2011, 10:02:10 PM
I thought this is the time for me to share my Regenexx-SD experiences here.

Regarding my Injury :

I had a cartilage damage due to intense sports activity in my right knee during July 2009. Since then I had two surgeries

         1. Partial Meniscetomy - Dec 2009 - 20-30% of medial mensicus was removed
         2. Cartilage debridement - Mar 2010 - 2X2 CM of cartilage in medial femoral condyle region of right knee was shaved off due to cartilage delamination.

I did not find any relief after the surgery, infact surgery made things worse. I was asked to use single crutch while walking since weight-bearing on the right knee became very difficult. As a result I've been using this crutches for the last 2 years.
Crutch usage made things to worsen more, my other joints were impacted as well because of this crutch, My hip, left shoulder, left knee, left hand wrist started to pain. Before my knee injury and surgery I was perfectly healthy and no other complaints

After long hard thought, decided not to undergo any further surgery and definitely don’t want to end up in getting a knee replacement surgery, so was looking for other alternate treatments for joint conditions and for regeneration of cartilage also ways to preserve the health of remaining medial meniscus.

To manage pain, I started with Acupunture, Acupressure for some time but that did not help with pain/swelling much.
In the knee Geeks forum, I was following the thread posted by GB and Irentat about Prolotherapy, PRP, HGH Injections http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=46074.0

At this point I wanted to thank Irentat for sharing his experiences about IAGH injections that helped to regenerate cartilage in his ankle and also for answering all my questions and thanks to GB for sharing his experiences about prolotherapy and prolozone injections.

So I thought I would give that Prolo+PRP a try, after reviewing many prolotherapy doctors I chose Dr. Ross Hauser from Chicago he had good record and had treated many patients for many ortho conditions. So I decided to have my first prolotherapy by July 2010. I was advised by fellow knee geeks friends that I should try atleast 10-12 prolo injections on the joints to see some improvements. I live in New Jersey and was travelling to Chicago every month for this Prolotherapy injections.

Initially Dr. Hauser treated with regular prolotherapy with Dextrose solution and 2 I.U of HGH solutions, after 3 injections I did not see even 1-2% of improvement in my knee. So I  have requested him to do "Hackett-Hemwall Prolotherapy"
http://www.caringmedical.com/therapies/hackett_hemwall_prolotherapy.asp Which is nothing but Prolotherapy + PRP injections into the joints. I had 3 of those treatment for the next three months where the doctor injected PRP + HGH + Dextrose + Magnesium + Other Prolo solutions into my joints. Still did not find any improvements but decided to continue with the treatment, in subsequent injections doctor also added testosterone. So I had mixture of many solutions into my joints but no real improvements. That's when Dr. Hauser started treating patients with Bone Marrow Prolotherapy. I decided to try that so I had Bone Marrow drawn from my tibia bone and got injected into the damaged knee along with regular prolo injections, I had two of those Bone Marrow prolotherapy injections.

http://bonemarrowprolotherapy.com/video_direct_bone_marrow_aspiration_prolotherapy.html


Hmmm… Yes….Totally I think I had almost 10 Prolo + 4 PRP + 2 Bone Marrow prolotherapy Injections from Dr. Hauser. And also had three PRP injections from a local doctor [Dr.Sammy Masiri] in NJ but to be frank there was no real improvement in the last one year of trying all this. I forgot to mention I also tried Prolozone injection from a doctor  [Dr. Andrew Lipton] in PA. I  had almost 8 Prolozone Injections where they inject Ozone into the joints which is suppose to give pain relief.

In my last visit to chicago Dr. Hauser requested me to undergo the following tests

   1. Electrolyte panel
   2. Food sensitivity test
   3. Vitamin D Panel [25-OH vitamin D]
   4. Hormone Panel

He wanted to understand my body condition whether it is in anabolic state or pro-healing mode for natural healing with prolotherapy injections.

http://www.caringmedical.com/media_blog/Vitamin_D_and_Chronic_Pain.htm

The reports came out showing that I have low levels of Magnesium, very low levels of vitamin D and moderate levels of some hormones. He advised me to avoid certain foods for sometime, asked me to take some supplements and requested to apply Testosterone topical cream. As per Dr. Hauser advise am following very strict diet

1. Low GI diet for the past 4 months
2. Also avoiding foods containing wheat, soy, egg, gluten, sugar, processed foods, high fat contents, caffeine, carbonated drinks etc
3. Taking Mutlivitamins/MultiMinerals/Phyto Nutrients.
4. Maintaining body PH balance between 6.5 and 7.
5. Regularly doing Stationary bike twice for 25-40 minutes.
6. Stopped using ICE for swelling after prolotherapy and stated using INFRA-RED heating unit and TDP Light therapy lamp.

http://www.activeforever.com/p-1701-thermotex-infrared-heating-pad-platinum.aspx
http://www.amazon.com/gp/product/B000NCWW6U


These are the supplements list that am taking regularly.

While I was doing all these, Parallely had set up a telephonic consulting with Regenexx. I spoke to Dr. Ron Hanson, sent all my medical reports/MRI and everything. Dr. Hanson rated me as a Good Candidate for the treatment.
But am not really convinced and comfortable to go ahead with regenexx treatment after telephone consulation so decided to have a in person consulation with Dr. Hanson, I travelled to Denver, met Dr. Hanson and he evaluated me thoroughly, answered all questions and suggested the following.

1. SFMA [Selective Functional Movement Accessment Technique] Evaluation, to understand the mobility of my joints
2. IMS [Intra muscular stimulation] for the joints
3. Regenexx-PL
4. Regenexx-SD
5. Regenexx-SCP.

After in person consulation I decided to go ahead with Regenexx Stem cell injections and had scheduled during August 2011.

I went to Denver and stayed in Broomfield for almost 10 days to complete the treatment. I really liked Dr. Ron Hanson, he was a very caring doctor answered all my questions during in person consulation and also all my email queries were promptly answered. Even small doubts/clarifications was prompty answered through email  despite his busy schedule. He took good care during bone marrow draw, Pre and Post Injections. In fact I passed out after bone marrow draw, and was unconscious for almost an hour. Am not writing this to scare anyone...bone marrow draw was totally painless, only the pressure of needly piercing the bone will be felt and nothing else. I passed out after bone marrow draw completion and when I tried to get up from the procedure table. Proper hydration of your body before the procedure will help, I did hydrated myself well by drinking enough fluids but still I passed out  ;D. May be I was weak after all those Low GI diet. ;)

After 10 days of my treatment I returned back to NJ and strictly followed the Post-Op instructions that was provided. I was advised to continue with the LOW GI diet.
4 weeks after Injections I was advised by Dr.Hanson to start PT using SFMA technique, and I have started PT since last week. Am into my 5th week now.

Result of the treatment :

After trying hard all these I haven't yet seen any marked improvement though am not sure if its bit early to decide on the efficacy of the treatment but there is little bit of improvement with weight bearing part thought am still walking with a crutch and also wearing the knee brace so I cannot be affirmative on this one.

But knee stiffness has gone down a bit though not completely, I had considerable swelling on my knee after the injections on top of the original swelling I had due to injury. Now after 5 weeks swelling due to injections was very much reduced but original swelling still persists. I think I have to wait some more time to make sure am on the right path to recovery. Due to last 2 years of crutch usage there are lots of stiffness on my hip, ankle and back and also considerable wastage of muscles in my quad, hamstring, hip region that inhibits my mobility.  My PT is working hard on these, I think I still have long way to go to regain my full strength back on these muscles and to walk normally

I also wanted to thank Scooter72 on this forum, who has offered some good advices by sharing his experiences and also for answering all my queries that helped me a lot and to remain confident during these tough times.

Quick Question :

Recently read somewhere, if you have lost chunk of meniscus on your knee due to meniscetomy surgery that is not good for Baby Cartilage or the newly regenerated cartilage. Also your knee will be in inflammed condition for the rest of our life reminding that our knee is not 100% alright. Is that true ?

Title: Re: Regenexx injections - Stem Cells
Post by: slyguy1 on September 30, 2011, 02:09:04 AM
interesting post.....again every person heals differently due to genetics.....i also have part of meniscus removed and i can tell you that the stability is at least 50 percent gone...not to scare you but those of us who have had such procedures are guranteed to have arthritis forever.....there is no cure for arthritis which is inflammatory in nature. Question came to mind as i replied here.....if stem cell injection is the answer....why are the professional athletes with knee problems galore opt to do that instead of microfraction or Aci? People with money in my opinion would not hesitate for a sec to get it if that was a sure thing.....
Title: Re: Regenexx injections - Stem Cells
Post by: rob wilson on September 30, 2011, 03:56:14 PM
I had to have 3-5 Regenexx C injections to get significant improvement in my arthritic knee. I was able to get at least 6 Regenexx C injections from 1 bone marrow extraction. Now that the Regenexx C is not allowed that many Regenexx SD injections would mean the same number of extractions. That could be difficult and expensive. 

Maybe you should just continue to inject as much regenerative stuff (HGH, PRP, testerone, stem cells) into that knee and hope. If you can afford it?
Title: Re: Regenexx injections - Stem Cells
Post by: Scooter72 on September 30, 2011, 07:47:09 PM
interesting post.....again every person heals differently due to genetics.....i also have part of meniscus removed and i can tell you that the stability is at least 50 percent gone...not to scare you but those of us who have had such procedures are guranteed to have arthritis forever.....there is no cure for arthritis which is inflammatory in nature. Question came to mind as i replied here.....if stem cell injection is the answer....why are the professional athletes with knee problems galore opt to do that instead of microfraction or Aci? People with money in my opinion would not hesitate for a sec to get it if that was a sure thing.....

Slyguy1, your question is a bit disingenuous for a couple of reasons:

1) Stem cell therapy for ortho conditions is relatively "new".  Exactly how many clinics around  the country do you see performing to the standards of Regenexx?  Answer: none (that I know of, at least).  Seriously man.. the FDA is still making Regenexx's existence a bit of hell, as they do for any novel therapy that has yet to pass into the mainstream.  That being said, there are many athletes that are catching on, and getting such treatment.  Of course, someone has to bring it to their attention first; it is not as if Regenexx nationally known, and barring awareness, these athletes will be funneled towards the "tried&true" modalities.

2) Relating to #1: There are MANY professional athletes who have been treated with one of the various Regenexx protocols.  I know this because I have been there, and seen the many autographed photos, and also asked (Drs. Hanson and Schultz). I would also guess there are many amateur athletes (myself included) who have been treated there as well. 

Just an FYI: My knee is still kicking, and I would do this procedure again if needed.  No question.  It beats mfx by 100 miles (speaking from personal experience).

Also, thanks for the kudos from people here with whom I conversed.  I really do want to help as I can.   Specifically to Ashok and Sturge08: I understand your frustrations over not feeling better at this point in your respective recoveries, but given what I know of your maladies, it is way too early to make any judgements, and in fact as I have stated prior, your diligence to rehab is as critical to a good result as the procedure itself.  I know it is difficult, but try to remain positive and focused.

Take care.
Title: Re: Regenexx injections - Stem Cells
Post by: WestPoint on October 01, 2011, 02:04:05 PM
Thanks Scooter and Ashok for your posts.

You have both brought up the issue of physiotherapy. Since I have so much muscle wastage myself, that 4 week waiting period where we can only walk or ride a stationary bike makes me lose even more muscle mass. That adds a lot of pressure on my joint after I've been through that four week period.

Since I pursued the Regenexx technology outside of the Regenexx clinic in Colorado, I have not had the chance to be exposed to Dr. Centeno's and Schultz's instructions in these regards. Is there nothing that we can do in the way of exercises during this four week period to keep up the muscle mass, such as leg raises at least?
Title: Re: Regenexx injections - Stem Cells
Post by: rob wilson on October 01, 2011, 06:23:05 PM
Stem cells love motion. If we don't move they will actually die. I believe the only thing you shouldn't do is deep flexion especially with load. That should allow you to be able to bike with some load and of course leg raises are no issue.
Title: Re: Regenexx injections - Stem Cells
Post by: WestPoint on October 01, 2011, 10:19:24 PM
Thanks Rob,

Apart from leg raises and bicycling, are there any other low impact physiotherapy exercises we can do during that initial 4 week period?
Title: Re: Regenexx injections - Stem Cells
Post by: rob wilson on October 03, 2011, 06:27:48 PM
I can't think of anything. Sorry.
Title: Re: Regenexx injections - Stem Cells
Post by: ashok_guru on October 08, 2011, 04:03:11 PM
My PT is giving me some aggressive exercises for the last 2 weeks, Dr.Hanson is also fine with that.
After Physical therapy for sometime am feeling better, my legs are feeling normal but it lasts only for 15-20 minutes then all my stiffness, swelling comes back. Swelling kind of increases a bit and subsides after a day.  Is this normal ? I am into my 7th week after Regenexx-SD injection.
Title: Re: Regenexx injections - Stem Cells
Post by: ashok_guru on October 08, 2011, 04:33:27 PM
When we can take MRI after these stem cell injections ? Is there a time frame that we should wait...
Title: Re: Regenexx injections - Stem Cells
Post by: Sturge08 on October 11, 2011, 07:11:17 AM
Hi ashok_guru, My symptoms are similar to yours, in the morning my ankle swelling and pain levels are low. By the afternoon they reach an all time high, so much so I have to take my shoes and socks off to relieve me of my pain. By bedtime, the swelling seems to of subsided. I am 4 weeks post regenexx-sd and I was told I was a good candidate for the procedure. I wish i could believe it. Fingers crossed my ankle responds and starts to improve before christmas.
Title: Re: Regenexx injections - Stem Cells
Post by: Nature Lover on October 11, 2011, 03:15:43 PM
I had my first Regenexx SD procedure on August 19th 2011 at the Centeno/Schultz clinic. My quality of life has improved so much. My right ankle was treated due to a three year hx of degenerative arthritis. I now have a 60% reduction of pain and an increase of my level of functioning. Both Dr. Hanson and Dr. Schultz are awesome doctors who care very much for their patients. My treatment results are far beyond of what I expected. I even can wear boots and heals again. I use to dread waking up in the morning and wondering how much pain I was going to have while walking. Now, I can't wait to get out of bed and start my new day.

Still waiting to see how I'm going to feel this winter. If needed I will make another trip to CO because I now have hope and Regenexx has worked wonders for me.
Title: Re: Regenexx injections - Stem Cells
Post by: Nature Lover on October 11, 2011, 03:24:06 PM
Hi ashok_guru, My symptoms are similar to yours, in the morning my ankle swelling and pain levels are low. By the afternoon they reach an all time high, so much so I have to take my shoes and socks off to relieve me of my pain. By bedtime, the swelling seems to of subsided. I am 4 weeks post regenexx-sd and I was told I was a good candidate for the procedure. I wish i could believe it. Fingers crossed my ankle responds and starts to improve before christmas.
(I will keep my fingers crossed for you. I'm so thankful that Regenexx has taken away so much of my pain and I have hope. Keep me updated.
Title: Re: Regenexx injections - Stem Cells
Post by: Nature Lover on October 11, 2011, 03:28:06 PM
Hi ashok_guru, My symptoms are similar to yours, in the morning my ankle swelling and pain levels are low. By the afternoon they reach an all time high, so much so I have to take my shoes and socks off to relieve me of my pain. By bedtime, the swelling seems to of subsided. I am 4 weeks post regenexx-sd and I was told I was a good candidate for the procedure. I wish i could believe it. Fingers crossed my ankle responds and starts to improve before christmas.
Regenexx has worked wonders for me. Please keep me informed. I will keep my fingers crossed for you.
Title: Re: Regenexx injections - Stem Cells
Post by: Sturge08 on October 11, 2011, 04:31:18 PM
Hi Nature Lover

I have a 2 year history of OA pain in my right ankle. I am so jealous of your improvement, sorry if that sounds rude, but I want to be pain free too.

Sounds like you are a month ahead of me. So maybe in a months time I too will be able to sing the praises of Regenexx, but for now I'll just hobble around in pain.
Title: Re: Regenexx injections - Stem Cells
Post by: CPKnees on October 14, 2011, 07:41:41 AM
Hi everyone,

I've read all the thread (all 21 pages!), and I must say I'm amazed with the amount of info here! I greatly appreciate the time everyone have contributed to this thread, especially the ones who have tried the Regenexx procedures and have updated everyone on the results they got. I also was surprised that Dr. Centeno and Dr. Schultz even took time to post on this forum and answer questions.

Quick topo on myself:

- 30 y/old female
- I started having knee problems about a year ago, it started in the left knee (ACL repair in 1998 which was successful). The right knee followed about 5 months later. It's chondromalacia in both knees (patellas and femurs are apparently not happy to cohabit with each other anymore it seems...)
- Pain is mostly a constant burning. I've had to limit my activities to the max to manage.
- Range of motion is not limited however (yet!)

I am interested with the Regenexx procedure, the main problem being the cost (well, that's obvious!). Even though this is a problem, I'm considering it because I'm very young, and I know what's ahead of me if I don't do anything (viscosupleance, cortisone shots, PFR and TKR).

For the moment, my doctor has suggested Euflexxa. He's an open-minded doctor who believe stem cells are the future of joint treatment. However, he feels the technology is still too experimental, and was of opinion that now may not be the best time to try it, maybe waiting a few years would be preferable (5-10 years minimum). He's offered me PRP instead or in addition to Euflexxa for the moment. But from what I've read on this forum considering cartilage regrowth, prolotherapy/PRP seem to have low results.

But thing is, I've come to understand that my knees will continue to wear out with Euflexxa (unless someone else has other information on the subject?). So if I wait to try stem cells later, my knees will be more damaged when I decide to try it later, so it will be more complicated.

For the moment, Euflexxa would allow me to get back to physical therapy, as I also have serious back problems.

Does anyone here know something about the following:

- Can products like Euflexxa (or Synvisc, Orthovisc or anything else) affect Regenexx procedures? Even standard prolotherapy or PRP?
- On the Regenexx website, they state that Regenexx will be available in other states at the beginning of 2012. Anyone has heard what those states (cities) are?

Thanks!
Title: Re: Regenexx injections - Stem Cells
Post by: Dizzy on October 16, 2011, 05:59:52 AM
Hi - I actually had Euflexxa not long before my treatment and was told no big deal. In fact, they do hyaluronic acid injections at their clinic.  In general, I think hyaluronic acid is thought of as being no biggie as its very similar to what your body already has in it.

No idea about what cities might have it.

Just one thing, I noted that you mention back problems - another good reason to see the folks at Regenexx as they are keenly aware that back problems can cause pain in the knees (nerves can be very sneaky). I don't know if you have fully explored the connection already but you might want to make sure that the pain isn't somehow related to your back.
Title: Re: Regenexx injections - Stem Cells
Post by: WestPoint on October 16, 2011, 02:55:22 PM
Thanks to Rob.

Dizzy, how is your treatment going? We'd love to hear about your experience.

BTW, I'd be interested to know if anyone can inform us as to how much healing we can expect once the first effects have been felt 4 to 6 weeks post injection. We all know that you can often really feel a difference at about a 4 to 6 week period, and we also know that healing can take place even around a year later. My question is: To what degree can we expect there to be healing after the first month and a half. Are we talking about a very small, almost unnoticeable amount, or does it just keep on getting noticeably better month after month.
Title: Re: Regenexx injections - Stem Cells
Post by: CPKnees on October 17, 2011, 02:36:22 AM
Hi,

To Dizzy: the knees are very "crunchy" when squatting... Especially the right one. Can't do that with nerves problems...

Noted for hyaluronic acid and prolo. Not very enthusiastic about it though, since it's not a permanent fix and it's injecting weird stuff in your body with a risk of bad reaction....





Title: Re: Regenexx injections - Stem Cells
Post by: ashok_guru on October 17, 2011, 05:39:47 PM
WestPoint, What was the time gap between your first and second Regenexx injections ? Am wondering whether to go for second injections or to wait for some more time to see some improvement in my knee condition. As Rob mentioned we would need 3-4 Regenexx injections, if that is the case each time we need to have a bone marrow extraction which would be more painful and also bit expensive. am yet to decide on the second round of injections.

Am also considering Dr. Allan Dunn's Iagh [http://www.iagh.com] treatment. I think Irentat and Rob had success with Dunn's approach. I already had a telephone conservation with Dr.Dunn but yet to decide on whether to go with Dr.Dunn or with Regenexx. Its been two month since I had Regenexx-SD, I dont see any considerable improvement....not sure if I have to wait for some more time. Meanwhile continuing with Physical therapy.
Title: Re: Regenexx injections - Stem Cells
Post by: WestPoint on October 17, 2011, 07:02:58 PM
I have not tried the SD treatment, so I'm not in a position to talk about the treatment that you are presently receiving. However, I am receiving the original Regenexx C version in a foreign country. Although I am not receiving Dr. Centeno's holistic approach to treating knee problems, I can say that the technology does work. I am reserving judgement beyond that generalization as I have just today received my third and perhaps last set of injections. So, I need a bit of time to really judge the whole thing, but I can say that the Regenexx technology being offered is amazing (I have seen signs of that), and from what I can read in Dr. Centeno's blogs, his holistic approach to medicine is also quite something.

Not to knock the other doctor you have mentioned, but his site does not document cases in the way that Dr. Centeno does.

Have you thought about going to their Cayman Islands clinic? I believe that you would be getting the same type of treatment you would in Colorado, as it is run by them. This would grant you exposure to the Regenexx C version.

Title: Re: Regenexx injections - Stem Cells
Post by: MS_Enigma on October 19, 2011, 02:52:54 PM
Hey All
There is Dr Thomas Einhorn, chief of Boston University surg Ortho
THey use the BMAC. A german publlication advocates BMAC, they indicated good results. I will also be talking with California Stem Cell TReatment center in their new offices in Beverly Hills (Dr. Tom Grogan). I will be on the webinar for Regenexx today. what ot do what to do?!
Title: Re: Regenexx injections - Stem Cells
Post by: ashok_guru on October 21, 2011, 06:51:49 PM
PT seems to be helping my case, am slowly regaining strength on my knee, hip etc.
Yesterday tried to walk with full weight bearing without crutch, the pain seems to be not there.
From next week I have to practice walking without crutches, I have been using them for more than 2 years so forgot how to walk normally  ;D. am bit excited...may be I have to wait few more weeks to see if this holds good. Will update my progress here in my next post.
Title: Re: Regenexx injections - Stem Cells
Post by: SW71 on October 22, 2011, 12:07:27 PM
Hi everyone,

I know the topic of this thread is Regenexx, but I just wanted to make readers aware of alternatives to just stem cells alone. Dr Saw in Malaysia has been combining stem cells with microfracture and hyaluronic acid and has been achieving hyaline cartilage generation in at least some of the 300+ patients he has treated. See the post

http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=56883.0

plus also

http://www.klsmc.com/in-the-news/insights/98-articular-cartilage-regeneration-with-autologous-peripheral-blood-progenitor-cells-and-hyaluronic-acid-after-arthroscopic-subchondral-drilling-a-report-of-5-cases-with-histology

Note the assessment of cartilage quality is done on only a handful of patients because it has been assessed by second look arthroscopy so doesn't happen that often. By his own acknowledgement at the end of his paper, the study is small (tiny) and uncontrolled, but it looks promising. One thing I do like about the study is that the inclusion criteria includes grade III/ IV defects of any size and number and including patients with maltracking or ligamentous instability - I like this because many studies suggesting something works are often done with half the population or more excluded from participating.

Don't get me wrong, I've done plenty of reading on stem cells and as far as I'm concerned the science is sound and well studied in academia and there's now a decent amount of clinical evidence that it works as well. So if I had to choose a first step I'd probably still choose stem cells alone because it just easier on the patient (us). However, it makes some sense that a surgical + stem cell approach could work better than stem cells alone, so I thought I'd post this here in case others hadn't read the post I refer to above. Actually I'd be interested in any doctors' opinions - any takers?
Title: Re: Regenexx injections - Stem Cells
Post by: bananzaboy on October 24, 2011, 08:43:05 PM
Hi SW17

It all depends. If someone has a small defect or tear in the cartilage then stem cells on their own may do the job OK. However I have grade IV bone on bone in the medial compartment and cystic changes. Basically I'm virtually at TKR stage but am only 31.
  I think my arthritis is too far advanced for Regenexx to help but Dr Saw's method looks as if it could buy me time. if I'm going to spend a lot of money, with time off work, travel & rehab then I'm going to give myself the best chance i.e. go for the best that's out there.

I have met Dr Saw & he isn't in it for money- he genuinely wants to help people & make a difference to their lives. He is quite passionate about it & is rightly proud of his work. Interestingly the Regenexx website has a link to an article showing stem cells + micro fracture is better than micro fracture alone albeit it is in horses http://www.regenexx.com/2011/01/micro-fracture-plus-stem-cells-better-than-micro-fracture-alone/.

A lot of Drs would say that data on stem cell therapy are not robust enough yet. However I have no doubt that it's the future & will probably be used everywhere in about ten years. I don't have time to wait on good quality trial data to be published. For me it's potential benefit v potential risk & for me the see-saw is weighed heavily in one direction.

Title: Re: Regenexx injections - Stem Cells
Post by: SW71 on October 25, 2011, 03:24:16 AM
I agree with your assessment Bananzaboy re stem cells alone vs stem cells plus surgery. There won't be a universal single treatment that works best every time, so often stem cells alone will suffice but for some a combined (or altogether alternative) approach will be more appropriate.

I also agree that most doctors current believe there is not enough evidence that stems cells is effective and safe. However, in my personal opinion this view held by many doctors is mostly because they have not been well enough informed.

Here in Australia there is very little choice when it comes to stem cells. I've seen a few posts in the past from Australia on this topic, so for those in Australia looking for this sort of treatment, the only ones that I know of are

http://www.lakesidesmc.com.au/specialty-services/osteoarthritis/ - Dr Bates
http://203.45.23.64/msc/DiseasesTreated.aspx - Dr Bright
http://www.southsydneysportsmedicine.com.au/ - Dr Gibbs.

My understanding is that Dr Bates is the most experienced at the stem cells procedure. I am currently seeing Dr Gibbs for PRP injections. Hope this helps anyone in Australia.

The PRP is going ok. Actually I didn't expect anything from it, but was just prepared to try this before surgery. It has certainly helped the pain and ROM, but I wouldn't call it great either. However, it was a better response that I expected so it gives me hope that stem cells might help for me, I will probably go to see Dr Bates.

If stem cells doesn't work then I am seriously considering going to Malaysia to see Dr Saw, because like you I am pretty young (40). While I am not in considerable pain, my view is that if I really want to avoid TKR plus continue some reasonable degree of physical activity then I need to make sure it doesn't progress much more than what it is today.

Title: Re: Regenexx injections - Stem Cells
Post by: Stonie on November 07, 2011, 08:35:10 PM
Hi all,
I posted a new thread for the first time this morning, but was referred over here. I’ve read all the posts and greatly appreciate all the helpful information.  In early December, I’m going to travel to Denver to have the Regenexx AD procedure on my left knee.  I’d love to hear from some of you that have had either the Regenexx AD or SD.  It sounds like the Regenexx C is not offered in the US for now….so I’d like to compare with others getting the same or similar treatment to mine.  Can you please share:
What procedure did you have done?
How long ago?
Would you do it again?
What type of improvement did you experience or not?
Did it hurt?
What sort of things brought relief?
Did the infrared heating pad device help?
Anything else you think I should know?

I will be happy to experience even a 25% to 50% improvement in daily living as a result of the procedure.   Two years ago I experienced a bucket handle tear of the left lateral meniscus.  My surgeon removed most of my left meniscus during the surgery, even so it was repairable, telling me that at age 50, I’d need a knee replacement anyway.  Terrific guy, huh. I do have stage 3 to 4 chondromalacia or osteo arthritis.    After two rounds of PT and 2.5 years, I still have almost daily pain of some sort.  Synvex does help for about 4 months at a time. I can walk but not run.  I’d really appreciate hearing about your experience.  I’m three weeks away and feeling a little scared. 

Title: Re: Regenexx injections - Stem Cells
Post by: Sturge08 on November 08, 2011, 09:08:20 AM
Hi Stonie

I had a regenexx-sd injection 8 weeks ago into my sub talar and ankle joint. Sadly I haven't experienced any pain relief from the procedure. My bone marrow draw and ligament, tendon injections hurt me the most. I have stopped using the infrared device now, I remember it was comfortable when using it. A week after you'll experience pain from injection sites but this will all gradually go. Good luck and report back in the new year with your progress.
Title: Re: Regenexx injections - Stem Cells
Post by: kneeguy on November 08, 2011, 12:25:44 PM
Hi Stonie,

After almost a year of going back and forth and reading this blog I had the AD procedure October 4, on my left knee.  Prior to that I had 3 surgeries to "clean out" my knee.  After the first two I was still unable to run but could do most everything else.  I hooked up with a reahb doc who got me running and back to triathlons and everything was going well until last fall (2010) and I ended up with another "clean out" November 2010.  Things have been going well since but in an effort to get me back to regular activities and hopefully avoid a 4th surgery in the future I decided to try this.

The exam and procedure was a lot more then I expeceted...they were very thorough.  There is a lot of good information here but some deatils I did not know of until I met with Dr. Shultz.  It took 6 marrow draws to get the required cells.  I thought it would be 2, so when he told me 6, I started to sweat it a bit.  The draws is what I thought would hurt most but I really didnt feel anything just the pressure of him pressing down.  The most painful part was the re-injection of fat aspiration to push my meniscus back in place.  Other then that it was realtively painless....I expected and was anticipating a lot more.  The first niht after I was pretty sore and swollen but flew back home the next evening with no problems.  I had a limp and was swollen for a couple days to a week or so. 

I think the heating pad is to help the cells grow not to keep the pain down...as far as that goes I am not sure just yet if it has worked since I am less then 4 weeks out.  My activity level is pretty good now, I am swimming and riding my bike 40 mins or so.  I have been taking it slow out of being cautious...I could probably go more on both.  I am also walking fine now.  Another thing I did not know about was the brace.  I guess not eveyone needs it.  I had to wear it 24, 7 the first 2 weeks and it was difficult sleeping.  The 2nd 2 weeks I only wear during the day then after that I wear it 3 months for weight bearing activities.  The supplements they recommend are pricey but when you pay for the procedure you  might as well go all the way.  Pick them up while you are there...I didnt since I was on what the recommended already.   

I can't say if I have improved yet since I am still wearing the brace and limiting my activities.  However, my knee would sometimes be locked up sort of when I woke or sat for a while.  That problem seems to have subsided or is less frequent then it used to be.  I feel pretty good walking most of the time (before the procedure I was doing well and almost put it off) so I am not sure if thats a real improvement. 

I cannot start running until after 6 weeks from the procedure which will be around November 25.  Before the procedure you need to refrain from all NSAIDS, steroid meds and all sorts of other things for several weeks.  So you will need to work that into your schedule if you are on them.

Thats about all I got for now...good luck. 
Title: Re: Regenexx injections - Stem Cells
Post by: Stonie on November 09, 2011, 02:07:42 AM
Sturge08 and kneeguy,

Thank you very much for your reply and comments.  I so appreciate your taking the time to share your recent experiences.  I asked Centeno for two references and neither one ever got back to me.  Sort of got me spooked a bit.  I wonder what I should read into their silence.

Kneeguy, they did tell me that the fat graft would be the most painful part.  Good to hear the marrow draw wasn’t so bad, as that part gives me the most trepidation.  I know what you mean about almost cancelling because sometimes my knee isn’t so bad.  But then a bad day keeps me determined to move forward.  As long as no harm is done, the only thing to lose is money (not to minimize the cost).  If I don’t try Regenexx, I will always wonder.  With a knee replacement, there is no running, lunging, squatting or kneeling and no going back.  My hope is that Regenexx will allow me to get back into yoga….to ski again would just be divine.  Now that I’m sending up my wishes, walking up and down stairs without pain and a lumbering gait would be great, too!  I was encouraged after reading an earlier post by the guy who is back to playing singles tennis.   

Sturge08 and kneeguy, I wish you both successful recoveries.  Now that I’ve found this board, I will repay your kindness someday and hope that I have a good experience to share.  Take Care  Oh, one more quick question….about the brace….did it fit comfortably under dress pant legs….how about jeans? 
Title: Re: Regenexx injections - Stem Cells
Post by: Sturge08 on November 09, 2011, 09:01:20 AM
My brace was very uncomfortable, i just couldn't wait to not have to wear it. My brace was worn around my ankle, I can't speak regarding the knee braces.

I was given a reference of someone to contact by Regenexx, and their reference person didn't respond to my emails either. Don't let this put you off.

Regenexx are the guys to trust, go for it. If they don't help you this time around, they continue to develop their techniques so eventually one day they will. That's what I keep telling myself. Avoid the knee replacement as best you can and good luck. I know the money is a worry, I flew over from the UK for the treatment, so I had to pay for international flights and none of the pre evaluations were paid for by my insurance. I think you've got it cheaper compared to me.
Title: Re: Regenexx injections - Stem Cells
Post by: kneeguy on November 09, 2011, 12:23:36 PM
Yes the brace does fit fine under jeans and dress pants.  I will be happy to get rid of it too.  I forgot to mention the cost of it...they said it would be $1200-2000 dollars if my insurance did not cover it.  Luckily it did....its custom fit and they had to have it flown in over night for me.  As far as the rest of the cost, I guess I was lucky because I really only paid for the stem cell procedure out of pocket, my insurance picked up the office visits, consult and all the regular doc stuff.  My surgeon from last year and another doctor also said....I had nothing to loose but the money so I might as well try it.  Easy for them to say, but as with you if I did not try it I would be wondering.  My knee, they told me, was not as bad as most they see and I am a bit younger...so hopefully that will equate to improved chances of success.

I was bruised on my back a bit from the draw and it was sore like a bruise for 2-3 weeks.  It was bearable and in the begining only hurt when I first sat down but went away after the initial pain.  After the first 5 days or so I only noticed it occasionally.
Title: Re: Regenexx injections - Stem Cells
Post by: prefersdosequis on December 07, 2011, 06:06:15 PM
This is my first post in this thread. I am very pleased to have found this discussion as I have learned so much regarding the work being done with stem cells. I too am in the process of evaluating Regenexx to help my troubled left knee. Should I go through with the procedure I will be sure to post all of the details on this forum. I am currently in the process of accumulating my complete medical file and latest MRI to send off to Regenexx for an initial evaluation to see whether I am a candidate. I thought I would post the details of my condition here in advance of that to see if someone with a similar problem might be able to offer me any confirmation that Regenexx will work for me.

Almost two years ago (4/2/2010) I had a skiing accident where my ski did not release when I fell. I bent the ski in the process and unfortunately all the torque went directly through my knee. My initial self diagnosis was that I had a medial meniscus tear. Having had a previous labral tear in my hip fixed by an arthroscopic procedure, I wasn't too worried about the long term outlook of returning to sport (specifically long distance running). However, my MRI did not reveal any damage to the medial meniscus even though this was the location of all my pain. After three months of physical therapy and no results I decided to return to the OS for an investigatory arthroscope (7/6/2010) believing that the MRI must have missed the tear. In surgery the OS found a lateral tear (even though there was no pain on the lateral side) and a medial plica. After four months of PT I was still unable to return to running as I had hoped. I could run short distances of 3-5 miles at a 10 minute pace with tenderness in my medial meniscus and little to no pain in the days that immediately followed. However, where I really noticed a problem is when I would string four of these 3 mile runs together over a two week period. After running this way for two weeks my medial meniscus would hurt terribly all the time. The pain would grow sharper if I sat the wrong way, and walking or standing for long periods of time exacerbated the pain. Long periods of inactivity is the only thing that brought relief to my knee.

I sought a second MRI, this time a 3.0 tesla MRI with contrast. The MRI revealed a faint intrameniscal signal in the posterior horn of the medial meniscus. Overall impression was an intrasubstance tear and/or myxoid-type degeneration in the medial meniscus. After googling these terms I concluded that, while the external shape and appearance of the medial meniscus was normal, the internal structure was not sound. I visited multiple OS's in the Los Angeles area with this new information, but none of them considered me a candidate for a meniscectomy. The next thing I tried was a PRP injection into my medial meniscus (2/9/2011). I did not notice a marked improvement from this procedure.

After sometime passed and no relief in sight I decided to reach out to the Steadman Hawkins Clinic in Vail. I went out there this past September for an evaluation with the possibility of a next day surgery. In Vail I had another MRI (1.5 tesla) which revealed minimal mucinous degeneration within the body segment and posterior horn of the medial meniscus, without evidence of a discrete linear meniscal tear. While not mentioned in the MRI, the OS did also see a tear in the posterior portion of the medial meniscus. As I was having sharper pain in the posterior portion we agreed that I was a candidate for a menisectomy to remove this tear. Surgery was preformed (9/22/2011) and the posterior portion of the meniscus was trimmed, while leaving the bulk of the meniscus intact.

It is now two and half months out from my last surgery and I have slowly returned to activity through PT. While I agree that it may be too early to tell, I am still having a great degree of pain in my medial meniscus. The pain seems mostly unchanged, with severe pain coming after a series of four short runs in consecutive weeks. The pain does not subside for at least three to five weeks of inactivity.

Okay so that is the blow by blow on my condition. I apologize if that was too much detail. After reading this blog and seeing how many folks have had their meniscus's shaved away without providing much relief I am seriously not wanting any more arthroscopic work done on my knee. What I am hoping for is that I might be a good candidate for the Regenexx procedure considering that I have a large portion of my medial meniscus intact, albeit very damaged internally. Additionally, from reading the Regenexx literature it appears the stem cell injection will introduce the much needed "general contractors" of healing, which will rebuild the damaged portion of my meniscus.

If anyone has any insight after reading what I have said I would greatly appreciate to hear from them. Also, I would also like to hear from Saverio and mccartjt. I know that both of you have had some success from the procedure, and we haven't had an update from either of you two in a while as to how your recovery has progressed.

Well, thanks again to everyone who has posted to this forum. And thank you for taking the time to read my post.
Sincerely,
Travis
Title: Re: Regenexx injections - Stem Cells
Post by: andyhart on December 07, 2011, 10:24:47 PM
Travis,

Who did your surgery in Vail? If you had surgery there (one of the top places in the world) and you're having problems you should go back there for their advice FIRST. It's very difficult to be your own doctor.

I have the opposite story. I tried to be own doctor, underwent several Regenexx SD procedures and am now scheduled to have surgery next month performed by Dr. Steadman. I have a lot of reflections about the Centeno-Schultz clinic. The main relevant point here is that I had the sense that I was mostly looked at as a data point for the study of the use of Regenexx SD on meniscus tears. I strongly suspect that their cultured procedure may actually help heal certain kinds of tears (but certainly not all types), but that the SD just may not be effective in a lot of cases. Above all things they are a small business enterprise and won't often turn away a customer. The fact that Dr. Centeno himself trolls this BBS in order to defend the clinic or make clarifications should tell you a few things. I went and saw Dr. Stone in San Francisco as well. He also has a lot of slick marketing like Centeno-Schultz. The Steadman Clinic doesn't need to do this kind of stuff and it would unthinkable to find any doctor from there on these forums trying to protect their reputation or drum up new business.

I'm not trashing Centeno-Schultz because certain other procedures they did may have helped me in other areas. However, they are learning their craft. If you want to be part of the experiment it's only your money and time that might be wasted. Just try and have a realistic view of things and don't be caught up in marketing hype.
Title: Re: Regenexx injections - Stem Cells
Post by: prefersdosequis on December 07, 2011, 11:03:05 PM
Hello Andyhart,

Thank you for your response. I am definitely interested in hearing more testimonies from people who have had the procedure done. Sure I am personally hoping that all the cases are positive, but I also want to hear the negative ones as I don't want to throw my money away. In Vail I saw Dr. Sterett who just recently switched from the Steadman clinic to Vail Summit Orthopedic. He still preforms his surgeries at the Steadman Clinic, and I have to say he was outstanding. I have nothing negative or critical to say about my experience at the hands of Dr. Sterett and would strongly recommend him.

Can you speak further about your condition? Did you have meniscal degeneration? Or did you have a meniscal tear? I am interested in finding other people who have also had instrasubstance damage to their meniscus and found an answer to their pain. Thank you very much for your response!

Travis
Title: Re: Regenexx injections - Stem Cells
Post by: prefersdosequis on December 07, 2011, 11:05:56 PM
One other thing, I am still in touch with the folks at the Steadman clinic. I am aware that they also have a doctor doing Stem Cell work. Before I decide on anything I will likely explore that option as well.
Title: Re: Regenexx injections - Stem Cells
Post by: andyhart on December 08, 2011, 01:24:15 AM
One other thing, I am still in touch with the folks at the Steadman clinic. I am aware that they also have a doctor doing Stem Cell work. Before I decide on anything I will likely explore that option as well.

Do you mean Dr. Karli? I thought he was just doing PRP.
Title: Re: Regenexx injections - Stem Cells
Post by: prefersdosequis on December 08, 2011, 02:17:00 AM
That's a good question. When I spoke with Dr. Sterett's assistant at the Steadman Clinic he did not give me the name of the doctor who they refer to for Stem Cell work he only said they have someone in house. I was asking him if they had sent or received any patients from the Regenexx clinic. However, while he knew about Regenexx he did not have any experience with any of their patients.
Thanks,
Travis
Title: Re: Regenexx injections - Stem Cells
Post by: andyhart on December 08, 2011, 03:16:10 AM
Dr. Steadman told me he thought that the stem cell injections had done absolutely nothing for my meniscus tear, which I may be inclined to believe. It's hard to say because while the pain is a lot better than a year ago, I have had to really lay off a lot of activities. If I start up with them, the pain and dysfunction come back. Needless to say Steadman was very unbelieving of stem cells for meniscus. He did think that the CMI would again be available in the US in 4 or 5 years (Dr. Stone thought it would come back as well). Keep in mind, Travis,when you are educating yourself that you understand the difference between the regenexx Sd treatment and the cultured treatment, which is only available in the Cayman Islands.
Title: Re: Regenexx injections - Stem Cells
Post by: prefersdosequis on December 08, 2011, 04:31:12 AM
Hello Andyhart,
Wow. Great information! No I do not yet know the difference between the Regenexx SD and the cultured treatment. (I am clearly still too new here.) I am also not familiar with the term CMI, though I suspect it has something to do the cultured cell treatment you speak of. 

Give me a second here while I google around...

Ok so looking around on Regenexx's site I noticed that they offer four different procedures. SD, AD, SCP, and C. From their explanation it seems like the Regenexx-C procedure is the one you are talking about which has the best results (I noticed their literature also supports this). Is this the cultured stem cell treatment you are referring to? And is this treatment not currently available in the US? Are you saying that I can only get the Regenexx-C treatment in their Cayman Islands clinic? And if my budget wasn't blown already. Crap.

Thank you so much for sharing this information with me.
Travis
Title: Re: Regenexx injections - Stem Cells
Post by: prefersdosequis on December 08, 2011, 04:42:31 AM
One other question. Is there a reason why CMI (whatever it stands for) isn't available in the states at this time? Is it waiting approval by the FDA? Also, your statement that it would be again available in the US, gives me the impression that it was once available here. If that's the case, I am sure it's not a short answer as to why, but I'd appreciate any info you can give me on it.
Thanks again.
Travis
Title: Re: Regenexx injections - Stem Cells
Post by: andyhart on December 08, 2011, 11:27:47 AM
One other question. Is there a reason why CMI (whatever it stands for) isn't available in the states at this time? Is it waiting approval by the FDA? Also, your statement that it would be again available in the US, gives me the impression that it was once available here. If that's the case, I am sure it's not a short answer as to why, but I'd appreciate any info you can give me on it.
Thanks again.
Travis

CMI is a collagen meniscus implant. It was actually pulled off the market by the FDA for reasons I don't totally understand. It's available in Europe. From what I understand, Steadman and Stone had a lot to do with it.
Title: Re: Regenexx injections - Stem Cells
Post by: andyhart on December 08, 2011, 11:31:24 AM
Hello Andyhart,
Wow. Great information! No I do not yet know the difference between the Regenexx SD and the cultured treatment. (I am clearly still too new here.) I am also not familiar with the term CMI, though I suspect it has something to do the cultured cell treatment you speak of. 

Give me a second here while I google around...

Ok so looking around on Regenexx's site I noticed that they offer four different procedures. SD, AD, SCP, and C. From their explanation it seems like the Regenexx-C procedure is the one you are talking about which has the best results (I noticed their literature also supports this). Is this the cultured stem cell treatment you are referring to? And is this treatment not currently available in the US? Are you saying that I can only get the Regenexx-C treatment in their Cayman Islands clinic? And if my budget wasn't blown already. Crap.

Thank you so much for sharing this information with me.
Travis

The C is only available in the Cayman Islands. They're in the midst of a lawsuit with the FDA over this, could prove to be landmark. The cost per treatment is well over 10k and depending on things they might recommend 3 treatments, however, for meniscus this is so experimental you'd have to be pretty well off to consider trying it.
Title: Re: Regenexx injections - Stem Cells
Post by: prefersdosequis on December 08, 2011, 10:08:46 PM
Well sad news for sure. But I greatly appreciate both the information you have shared about these procedures as well as your own personal experience with the Regenexx injections. I sure hope that Steadman will be able to work his magic on your knee. I too, like you, can quit exercise and have my knee pain almost disappear. But it's the active lifestyle I am trying to hold onto. Thanks again. I wish you the best.
Travis
Title: Re: Regenexx injections - Stem Cells
Post by: prefersdosequis on December 09, 2011, 05:29:04 PM
For all interested parties I just called Regenexx to inquire about the cost of the C procedure in the Caymans. The cost for one knee is $15000, which would require two trips to the Islands. I also asked how long the procedure had been banned by the FDA in the US and was told that their last C procedure done in Colorado was preformed last summer (I think she meant the summer of 2010 though I could have got that wrong). I asked her if they had a time frame for being able to once again do the C procedure in the US, and she said that they were hoping for sometime between 6 and 18 months. I was sort of pleasantly surprised to hear this positive outlook, and so I further inquired whether they believed they were going to win the case with the FDA and she responded that they were hopeful. I then asked her whether the procedure would likely be cheaper if it were preformed in the US, at which she replied, "absolutely!" She couldn't give me a definite figure though she said the previous price for one knee done in Denver was $7000.
Travis
Title: Re: Regenexx injections - Stem Cells
Post by: Fastrider on December 16, 2011, 06:17:30 AM
Thanks for the update Travis. I'm new on the forum but am seriously looking into the Regenexx procedure. I'm just getting ready to send them my MRI report and medical history form, then consult with them and go from there. I'm anticipating my situation (sever meniscal degeneration, left knee) might require the cultured procedure and have been saving up for it; the ability to have it done in CO instead of the Cayman Islands would be a big help in terms of procedural cost and travel expenses. 

 
Title: Re: Regenexx injections - Stem Cells
Post by: prefersdosequis on December 17, 2011, 07:52:37 PM
Hey Fastrider, it is nice to meet someone who shares my degenerative meniscus misery. I too am planning on having the initial consult with them soon. I am currently waiting to get another MRI done on my knee. And like you, I desire the cultured procedure; especially after what Andyhart has shared. Please keep me updated on how things go for you. Thanks, Travis.
Title: Re: Regenexx injections - Stem Cells
Post by: Sturge08 on December 20, 2011, 04:59:19 PM
I'm just over 3 months post -SD injection. My right ankle was treated due to OA. I regretfully have to inform that it has provided no pain relief at all. I will review the situation in 3 months time with my dr to see what the best next course of action will be. As you can imagine my confidence in a repeated similar injection working is low. Perhaps I may wait until a far more developed approach is available. Good luck to all who are due to have the procedure done, I hope you respond better than me.
Title: Re: Regenexx injections - Stem Cells
Post by: prefersdosequis on December 20, 2011, 07:14:59 PM
Hello Sturge08, I am sorry to hear about your experience. Having myself gone through procedures which don't provide any relief I know how disappointing this must feel for you. I do appreciate the update on your condition. Out of curiosity, what response have your received from Regenexx? Have they suggested more procedures? Or different procedures? Did they say the C procedure would have been more helpful? Thanks, Travis.
Title: Re: Regenexx injections - Stem Cells
Post by: rob wilson on December 20, 2011, 08:52:54 PM
Sturge08,

I am sorry to hear that you received no improvement. I know Regenexx SD is not very efficient versus the old Regenexx C that has been shut down by FDA. By efficient I mean that with 1 bone marrow extraction for Regenexx C, I received 8 separate stem cell injections. I can tell you that I needed them all to get the results I got for 2 body parts. Unfortunately this would mean 8 separate bone marrow extractions with the SD approach. Hopefully the FDA will come around. I still have cells in storage that I cannot get to.
Title: Re: Regenexx injections - Stem Cells
Post by: Sturge08 on December 21, 2011, 11:54:17 AM
Hi Travis

The response from Regenexx was to wait a further 3 months, which I am doing. The options which I was given were to return for another similar -SD injection but this time have the stem cells injected using a new ankle injection device which ensures they get to the right place even better, or try a -C procedure. As Regenexx-C is way to expensive for me I only have -SD to choose from. I would like to see some released -SD data before I decide to return, so I can compare how other patients are doing – its been promised for some time now. And also I'd like to see a development of their current -SD procedure. If the cost of treatment wasn't a barrier I'd certainly give it another go without hestitation.
Title: Re: Regenexx injections - Stem Cells
Post by: ashok_guru on December 21, 2011, 12:49:37 PM
Its been just over 4 months after my first SD Injection for  my cartilage defect after a knee injury. I have to say my condition still persists. With physical therapy I thought this is working but unfortunately whatever relief that I got were just temporary. I still have swelling, pain and stiffness. May be I will have to wait till Regenexx-C becomes available in US. May be I will have to wait few more months and see if its working.
Title: Re: Regenexx injections - Stem Cells
Post by: NickCat11 on December 21, 2011, 09:37:09 PM
Ashok,

Just curious, but did you undergo any surgeries prior to your Regenexx procedure?
Title: Re: Regenexx injections - Stem Cells
Post by: ashok_guru on December 21, 2011, 10:46:10 PM
Hi Nick,

Please check my posting in the same thread, yes I had two surgeries prior to regenexx injection one for partial meniscetomy and other one for cartilage debridement.

http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=40048.msg556563#msg556563
Title: Re: Regenexx injections - Stem Cells
Post by: Ivy973 on January 03, 2012, 11:26:52 PM

I am very excited to learn that Regenxx clincs have opened up on the east and west coasts (CA and NYC).  But I have fond that even the same day procedure is more expensive than other practioners.  I would understand this if Regenexx results and safety standards were at higher levels than all others.  But it doesn't seem like this is the case...?  This statement does not say that Regenexx has the best results or effectiveness or health/safety criteria: 

Centeno-Schultz Clinic, the original stem cell based musculoskeletal practice in the U.S. and founders of the Regenexx Procedures. Their stem cell orthopedics experience is unrivaled and they are physician leaders in stem cell therapy for orthopedic injuries in terms of research presentations, publications, and academic achievements.

Curious -- has anyone tried prp or stem cell therapy at Regenexx as well as elsewhere and have you noticed a difference...? 

Title: Re: Regenexx injections - Stem Cells
Post by: prefersdosequis on January 04, 2012, 07:35:38 PM
Ashok, thank you for posting again. I re-read your detailed post regarding all the knee procedures you have had done, and find your experiences very informative. I am grieved to hear that you have not found any answers for your knee, and it does dampen my own outlook.

After hearing these less than stellar reviews for the SD procedure, I sure would like to hear from folks who were able to have the C procedure done and are a years removed from it. I know there were a couple of folks on this forum who had the C procedure done and were reporting positive results. It would be nice to get an update from them.
Title: Re: Regenexx injections - Stem Cells
Post by: NickCat11 on January 06, 2012, 02:31:43 AM
Prefersdosequis,

 I wouldn't let other individual cases where a certain procedure didn't work dampen your outlook. As you know every procedure has its share of failures depending on a number of factors. I also believe a high percentage of people who have success with stem cells and other procedures don't bother posting their results in forums, they just get back to their normal life like it was before injury. After extensive research for my own injury, I truly believe the next 5-10 years are going to be revolutionary for regenerative medicines and I truly hope guys like yourself, Ashok, and others can benefit because no one deserves to be struggling they way you are. Good luck to you...
Title: Re: Regenexx injections - Stem Cells
Post by: ashok_guru on January 06, 2012, 05:23:12 PM
Yes true, we have seen patients getting success with Regenexx-C, we haven't seen anybody people getting results with Regenexx-SD.
Spoke to few people who had Regenexx-SD whom I met at the clinic during my visit none of them had any relief.

As Rob mentioned

"I had to have 3-5 Regenexx C injections to get significant improvement in my arthritic knee. I was able to get at least 6 Regenexx C injections from 1 bone marrow extraction. Now that the Regenexx C is not allowed that many Regenexx SD injections would mean the same number of extractions. That could be difficult and expensive. 

Maybe you should just continue to inject as much regenerative stuff (HGH, PRP, testerone, stem cells) into that knee and hope. If you can afford it?"

"By efficient I mean that with 1 bone marrow extraction for Regenexx C, I received 8 separate stem cell injections. I can tell you that I needed them all to get the results I got for 2 body parts. Unfortunately this would mean 8 separate bone marrow extractions with the SD approach."
Title: Re: Regenexx injections - Stem Cells
Post by: slyguy1 on January 11, 2012, 01:40:44 AM
Sorry to jump in here but did anyone see the segment on the 60 minutes show this past week about phony stem cell scams....believe several people were arrested after scamming 1.5 million dollars. It really makes you think after seeing stuff like that
Title: Re: Regenexx injections - Stem Cells
Post by: NickCat11 on January 11, 2012, 01:08:22 PM
I think like in any new and upcoming field there are going to be frauds like this looking to take advantage of desperate people. Based on the current published research with stem cells in orthopedics, I really have no concern. It's a viable solution worth trying if your condition sees fit. It's a shame though because these frauds give a negative perception of stem cells which is publicized nationwide on the news, overlooking the fact that they do have a positive role in orthopedics if used correctly.
Title: Re: Regenexx injections - Stem Cells
Post by: catglass on January 11, 2012, 08:45:35 PM
I, too, have been trying to get objective information on the Regenexx therapies being done in Colorado. If anyone has more information on any new studies that have been done, or why the FDA has (evidently) stopped them from doing some procedures, it would be appreciated.

I had a TKR about 18 months ago that has almost healed up now. My PT refers to me being on the "wrong end of the bell curve", but many of the problems I experienced could have been avoided with very simple precautions. If you are scheduled for a TKR, here are some ideas for your consideration:

1. Make sure that your body will accept dissolving stitches. Mine rejected them. Have a doctor give you a dissolving stitch beforehand to see  what happens. You will know within a few days if they don't agree with you.
2. Have a MRSA test done before going into surgery. This is a simple nasal swab that I thought was required for all surgery patients. And ask if there have been any recent MRSA outbreaks at your hospital.
3. Be prepared for when that nerve block wears off after surgery. Unless you have extremely high pain tolerance, call for more pain medication at the first twinge you feel.
I'm pretty sure the results were worth the sugery, but I won't be doing it again.
Title: Re: Regenexx injections - Stem Cells
Post by: slyguy1 on January 12, 2012, 03:11:45 AM
hi catglass............just curious as to where you are in your progress.....are you pain free with the TKR? Are you limited in any way of doing certain activities? Thanks for sharing:)
Title: Re: Regenexx injections - Stem Cells
Post by: ashok_guru on January 16, 2012, 04:08:46 PM
I sent an email to Dr. Hanson updating my status and requesting his advice on what I should I do further with my knee he replied me stating the below

"Usually multiple SD will add onto one another, if you didn't get a lot of relief for SD, C is a better consideration. "

Now I dont know whether to go ahead for another SD injection or wait for Regenexx-C once it is available in US or go ahead and inject all the regenerative stuff  into my knee[PRP, Prolotherapy, Prolozone, Testosterone, HGH etc]  ???  ???
Title: Re: Regenexx injections - Stem Cells
Post by: rob wilson on January 16, 2012, 05:55:36 PM
IMHO

The Regenexx C is superior to the SD. However, I am a firm beliver that any regenerative injections are good and cumulative. If I could afford it, I would inject anything and everything that could assist in the regeneration. Definitely try the HGH after the Regenexx.  Keep up the regenerative injections. Prolo, PRP, stem cells, ozone, HGH, etc. No cortisone. BE PERSISTENT AND CONSISTENT.
Title: Re: Regenexx injections - Stem Cells
Post by: ashok_guru on January 16, 2012, 09:06:21 PM
Thanks Rob.

I am planning to meet Dr. Allan Dunn for IAGH Injections, am in the process of scheduling an appointment. Already sent all my documents and had 3 rounds of consultation over phone.
Title: Re: Regenexx injections - Stem Cells
Post by: Saverio on January 23, 2012, 11:01:46 AM
To All,

Regenexx was on ESPN's Outside the Lines on 1/22/2012.  Here's a link  http://search.espn.go.com/outside-the-lines/videos/6

Saverio
 
Title: Re: Regenexx injections - Stem Cells
Post by: manville on January 26, 2012, 03:02:54 AM
I would like to speak about my regenexx experience.

I have an injury which I needed to get fixed, and I was pursing regenexx as I believe they were one of the leaders in the field.  I decided to pay the 200 dollar fee for one of their doctors to examine my chart in a sister office.  I was told the procedure would cost around 4k for stem cells prior to paying the 200 dollars.  I was not informed of any other fees.  After paying the 200 dollars I proceeded to make an appointment.  At this time, the price suddenly jumped up 1400 additional dollars for administrative fees.  I also was informed I needed to pay a 150 fee to the imsc society(or something like that) for registry purposes.  In the paperwork, there are also other fees that "could" result.  I felt this was a bait and switch, but regardless of this, I was still interested.

I then spoke with another doctor who talked about some of the things that he was doing and regenexx were doing.  I gave it another week to sit on it and here are my thoughts.  First off, regenexx doctors are not orthopedic surgeons.  I thought this was odd.  Second, there is a lot of heavy marketing by this company, and a lot of things unsaid when it comes to fees.  There are also a lot of "studies" that they put out there, without any real medical credibility, other then in a blog and some things they say. (minus the two studies regarding safety).  There are also some issues with culturing cells, as shown by outside the lines, and the ability for those sells to grow out of control.  The doctor I talked to said this was a big problem, and thats why the FDA shut this down.  Success comes at what price?  Then there is the fact that Regenexx gets its accreditation and promotes this fact, from the ICMS.  The ICMS was basically started by the owners of Regenexx.  Conflict?  I would think so. 

It seems like a very great marketing engine they have developed here.  My thoughts are, if they were so interested in helping patients out, they wouldnt be on TV shows like the doctors promoting, but instead they would be so busy from referrals like many of the other doctors, they wouldnt need to be on those shows.

Im not saying regenexx is good or bad, but I want everyone to understand some facts and I want my experience to be put out there.  Three is a great blog out there somewhere between the doctor at this clinic and a blog poster disputing a number of good facts.  Search is your friend.
Title: Re: Regenexx injections - Stem Cells
Post by: NickCat11 on January 26, 2012, 01:09:37 PM
Like any new product that hits the market it needs to be advertised so the general public knows it's out there, correct? How many Viagra commercials did you see when their product hit the market? I'm not looking to get into a debate here, those are just some of the questions that pop into my mind when you bash them for advertising. As far as the fees, if what you said is true, then that's not right and you should argue your case.

As a side note, I was doing some more research and came across a product that just got released to the public in South Korea. Cartistem is the name. I couldn't find to much info but it does look promising. Something to keep an eye on at least.

Another good read is this...http://www.journalofprolotherapy.com/free_issue_11/issue_11_03_stem_cell_regenerative_medicine/issue_11_stem_cell_regenerative_medicine_01.php
Title: Re: Regenexx injections - Stem Cells
Post by: Saverio on January 26, 2012, 01:38:47 PM
Manville,

Why did you think that The Centeno clinic has no Ortho Surgeons to be odd?  They are a Pain Management clinic and the regenexx procedure is not surgery.  It is strictly withdrawl and injections with needles.

Title: Re: Regenexx injections - Stem Cells
Post by: manville on January 26, 2012, 06:13:33 PM
Manville,

Why did you think that The Centeno clinic has no Ortho Surgeons to be odd?  They are a Pain Management clinic and the regenexx procedure is not surgery.  It is strictly withdrawl and injections with needles.



Its odd because the procedures they are preforming are orthopedic based, not pain management based by default.  Orthopedic doctors know through doing thousand of these operations, and have turned to different techniques and cutting edge alternatives.  So I feel that the knowledge of an orthopedic surgeon sticking a needle in me and understanding the function of the movements, the muscles, the nerves in the area, and an overall history of the practice is something that must be considered.

Also to be fair, I also looked into the regenerative clinic in mexico.  I have a phone call with Dr. Jesus who, apparently is a scheduler but has some mysterious DR. degree.  He stated that all the places in the US were doing this illegally, and I should never consider any place other then the regenerative clinic in mexico.  Obviously this is false.  I asked him how many procedures he did on my body part, and he said none.  But he was very confident in there ability to heal, for 8k.  I had a bit of a laugh.  That place is a joke.  I think they are charging something like 20k for procedures which they had one once or twice.
Title: Re: Regenexx injections - Stem Cells
Post by: manville on January 26, 2012, 06:28:51 PM
Like any new product that hits the market it needs to be advertised so the general public knows it's out there, correct? How many Viagra commercials did you see when their product hit the market? I'm not looking to get into a debate here, those are just some of the questions that pop into my mind when you bash them for advertising. As far as the fees, if what you said is true, then that's not right and you should argue your case.

As a side note, I was doing some more research and came across a product that just got released to the public in South Korea. Cartistem is the name. I couldn't find to much info but it does look promising. Something to keep an eye on at least.

Another good read is this...http://www.journalofprolotherapy.com/free_issue_11/issue_11_03_stem_cell_regenerative_medicine/issue_11_stem_cell_regenerative_medicine_01.php

Also to be fair, yes, this pricing issue is what started to make my water boil.  Its very shady of a company to bait you in and then switch you like that.  But being someone who studied marketing and has a full understanding of being a CEO in a company, I started to see all the signs of this marketing beast they have created.  The doctor which i have found, is the opposite of this clinic, and has seems to be less involved in making money and more involved in helping people.  I believe if the results are there, the marketing is not needed.  This procedure is so revolutionary, if it works, that the marketing will do itself. 

So when it comes to regenexx, it leads me to believe that they dont have a good formula yet for this procedure, and they are marketing so heavily to get "clinical Trialists" to pay them to increase their testing and improve their results.  By contrast, the doctor I have found(which I dont want to name until later) has 6 years of proven track record of this procedure as well as 30 years as a board certified orthopedic surgeon.  But yet, you dont hear much about this guy, because he said hes not in it for the money and he gets most of his patients through sports and doctor referrrals due to his success rate.  He also does things that regenexx doesn't do, and doesnt believe some of the things that regenexx does are actually worth the money, such as PRP before the procedure.  He believe they are just guessing that PRP pre procedure does anything, and as he says, PRP actaully comes out of the stem cell procedure, so why do it before.  Its not activating anything because the fun doesnt begin until you start with the actual stem cells, and PRP after is what they shoot for.  Anyways....just some thoughts after 5 months of self research.
Title: Re: Regenexx injections - Stem Cells
Post by: Affliction79 on January 26, 2012, 07:22:07 PM
Hi Manville,
thanks for your info on regenexx. I am very interested in finding out who is doing stem cell therapy for you now. This is my first post, so I can't figure out how to pm you. Would you be able to send me some info on this doctor of yours. That would be awesome! Thank you
Title: Re: Regenexx injections - Stem Cells
Post by: The KNEEguru on January 26, 2012, 08:03:28 PM
Hi
PM has been inactivated for new users, until they have 20 posts. This is to avoid harassment via PM by spam bots. Feel free to go to the 'games' section and pay a few of the very easy word games, and you will soon have your 20 posts and be able to use PM.
KNEEguru
Title: Re: Regenexx injections - Stem Cells
Post by: slyguy1 on January 26, 2012, 10:47:03 PM
Manville.....thanks for sharing your experience. I pointed out the 60 minutes piece on stem cell scams that aired several weeks ago awhile back. The more the info that is now coming out the more skeptical i am about the whole stem cell procedure....reality dictates that it sounds promising but scientists are at least 10 years away from proving anything (this is coming from a research scientist i've spoken to). The FDA doesn't shut them down for no apparent reason. I hope you did not pay all that money that you say they asked for....the hidden fees:) If money is no object like the professional baseball player A-rod i would go to Germany .
Title: Re: Regenexx injections - Stem Cells
Post by: Sturge08 on January 26, 2012, 11:37:44 PM
I must admit, I wasn't expecting in my telephone consultation with a Regenexx doctor, finding out that on top of the -sd injection I would need to pay for prelim PRP injections and a recommended -scp injection after. Not to mention paying for IMS injections, an ankle brace, registry to ICMS, infared gadget and daily supplements. Perhaps all these likely costs should be outlined in Regenexx's procedures explained page. It certainly would of cushioned the blow when I found out these costs during my telephone consultation. I hope this helps anyone planning a phone call.
Title: Re: Regenexx injections - Stem Cells
Post by: manville on January 27, 2012, 01:20:21 AM
I must admit, I wasn't expecting in my telephone consultation with a Regenexx doctor, finding out that on top of the -sd injection I would need to pay for prelim PRP injections and a recommended -scp injection after. Not to mention paying for IMS injections, an ankle brace, registry to ICMS, infared gadget and daily supplements. Perhaps all these likely costs should be outlined in Regenexx's procedures explained page. It certainly would of cushioned the blow when I found out these costs during my telephone consultation. I hope this helps anyone planning a phone call.

Im happy to see that I was not the only one who felt this way.  It was very snake oil salesmenish. And for the other poster, If my procedure goes well, ill post the doctor and information so that everyone can read and make a decision for themselves in the very near future.  Id give it 3-4 weeks time.  I dont feel right promoting a doctor, while I might think it is all gravy, might end up not working in the first place.

Also Id like to point out the fact that with regenexx, I had my initial consult with one of their outside providers.  When I decided to go to the Colorado location for speed of procedure, I asked them several time to speak with their doctors so they could confirm my diagnoses their partners confirmed, as well as a few other questions.  They blindly refused to allow me to talk to any doctors, and consistently called my via a business manager who wanted me to pay another 500 dollar deposit for the bone marrow collection.  He specifically knew I requested to talk to the doctor, but yet he blindly ignored the fact and told me he was the contact on this.  I hope this thread spreads so that people are fully aware of what they are getting themselves into with this clinic and there are no surprises.
Title: Re: Regenexx injections - Stem Cells
Post by: mccartjt on January 27, 2012, 04:25:52 AM
I have just read the recent posts and I've recently had messages from Saverio one of Dr Centeno's early patients & he is doing well from three years ago. I had issues that were beyond Dr Centeno's ability to fix. Some one gave me a "Hashish brownie" and there went my $20k + the time flights hotel stays car rentals etc.

Here's a couple of facts I was doing good with Regenexx C before the brownie. Since my procedure I am only slightly worse than I was but that may be due to 2-3 years of aging and the "Brownie".
 1)  Dr Saw, in Kuala Lumpur has second look arthroscopy results of his style of this procedure showing it works. He does a modified microfracture + peripheral blood stem cells injections.
 2)Dr Centeno gives you lidocaine injection to rough up inside the knee and make it sticky (injection microfracture?) +  bone marrow derived stem cells.

Dr Saw and Dr Centeno each have their way of trying to do the same thing. Both too have a way of qualifying their results. Dr Saw can look inside the knee. Dr Centeno goes by the follow up registry that tells him whether his patients are improving over time.

There may yet be another methodolgy soon derived from Dr Heber-Katz and what she's working on. http://healthjournalclub.com/the-mice-that-regrow-toes/ On a personal note I've found Dr Centeno and his clinic to honest and fair. I have had no experience of Dr Saw. I hope that this helps..

One final thing. Dr Saw's work has shown that it takes a long time to grow back the cartiliage into a knee. Realistically over a year to get full thickness from a grade IIII lesion to perfect from what I've read..
Title: Re: Regenexx injections - Stem Cells
Post by: NickCat11 on January 27, 2012, 02:33:24 PM
Hey manville,

I'd like to ask you some questions off topic. If you don't mind, shoot me an email. No problem if you choose not to. Thanks.
Title: Re: Regenexx injections - Stem Cells
Post by: bananzaboy on January 27, 2012, 08:56:54 PM
Hi Guys

I have met Dr Saw & he is a gent. He thinks he can help me but told me straight up that it would take £20K+ & a 6wk stay in KL. I know he isn't in it for the money, there was absolutely no pressure on me. The results from his study should be published by the end of 2012.

I have only had minimal contact with Regenexx so I can't comment that much. However I don't think I'll go that route. That's just my opinion- they could be the greatest thing since sliced bread, I can't say. We have to understand that it is a business after all but the "hidden charges " thing is just wrong.

At the end of the day stem cell therapy is still very experimental. Even if it definitely works, no one can tell if there could be problems down the line - it is just too new. We can't blame the FDA for being cautious. Can you imagine if they turned a blind eye & there was an issue down the line? They would get absolutely crucified! They are there to protect public health & that's what they're doing. It is easy for us to become frustrated with this because we are all very desperate to get relief.

The data on stem cell therapy are not robust enough..........yet. Eventually they will be but some of us obviously can't wait. I need a TKR very soon unless I try something else so it may be worth giving it a go. Trials like Dr Saw's will obviously help.

I am also aware that Dr Kevin Lee in Singapore is currently conducting a trial. His protocol is similar to Dr Saw's (Dr Lee actually pioneered it) but he uses MSCs as opposed to PBCs.

Keep sharing experiences & info guys, we're all in the same boat!
Title: Re: Regenexx injections - Stem Cells
Post by: SW71 on January 28, 2012, 10:45:03 AM
Hi Bananzaboy,

Do you mind if I ask how you got in contact with Dr Saw? Did you visit him at his clinic in KL? If so did you have any pre-visit phone or email conversations discussing your history to make the trip more likely to be useful. I am quite interested in Dr Saw's procedure (and now Dr Lee, thanks I wasn't aware there was anyone else in Asia doing this. I'm in Australia so going to Asia is much better for me than to US or Europe). But I don't want to waste money on a trip over and just get a "sorry, can't help you". I'd rather be able to send some MRIs and give a history so if there's a fair chance of not being able to help then at least I'm reducing my chances of wasting my money on the initial trip. I could go on a holiday I suppose....

Anyway, any info on how you initially got in contact with Dr Saw would help. Thanks.

Agree we are all helping each other out here. FWIW I have an appointment with a doc in Australia who is doing stem cell trials. But it's hard to get in so I'm can't get in until April. After I visit this doc I'll finally be able to contribute something useful to this site rather than just read everyone else's posts...



Title: Re: Regenexx injections - Stem Cells
Post by: Dr. Centeno on January 28, 2012, 03:10:29 PM
I would like to speak about my regenexx experience.

I have an injury which I needed to get fixed, and I was pursing regenexx as I believe they were one of the leaders in the field.  I decided to pay the 200 dollar fee for one of their doctors to examine my chart in a sister office.  I was told the procedure would cost around 4k for stem cells prior to paying the 200 dollars.  I was not informed of any other fees.  After paying the 200 dollars I proceeded to make an appointment.  At this time, the price suddenly jumped up 1400 additional dollars for administrative fees.  I also was informed I needed to pay a 150 fee to the imsc society(or something like that) for registry purposes.  In the paperwork, there are also other fees that "could" result.  I felt this was a bait and switch, but regardless of this, I was still interested.
-----------------------

This is Dr. Centeno, inventor of the Regenexx procedure. We want any patient who isn't local to our clinic or one of our network doctors to get on the phone to look at candidacy. We do this because we think the most ethical way to approach a new procedure is to make sure the patient knows where he/she stands before spending money on travel. Alternatively any patient is free just to have an in office evaluation with the physician.

The fact that we and our network docs aren't orthopedic surgeons is the whole point behind Regenexx. Our goal as a group of doctors is nothing less than to create an entire new field of medicine we call interventional orthopedics-or allowing physicians to do through a needle what used to be done surgically. Regrettably your thinking that surgeons know how best to drive needles is not accurate. As an example I just spent several days in the OR with surgeons teaching them these new skills.

We did begin ICMS, but at this point have dropped off all boards and that organization is pursuing it's own path without our input. If you read our book orthopedics 2.0 I think you'll get a good idea of why we want to reinvent the status quo of orthopedic care. For example the concept that the average surgeon spends much time thinking about how your muscles, nerves, and ligaments might be playing into your problem isn't something I've experienced.

Regrettably the OTL piece failed in it's gatekeeper function. The media has the responsibility to make sure that the experts they put out there really know the area in which they're commenting. The tumor issue with stem cells is a good example. Embryonic Stem Cells have a known tumor problem, adult mesenchymal stem cells do not. The difference is that MSCs are contact inhibited, meaning once they cover a surface and the cells touch, they stop growing. Our procedure was also put through extensive safety studies with our practice paying for more than 200 research grade MRI's to make sure nothing like that was happening. We have published many papers in this area and continue to do so. Our cultured procedure is now at the data quality of most common orthopedic procedures being offered.

On the FDA issue, we sued the agency several times over whether culturing your cells could make them a drug. We finally mutually agreed with the agency that we would stop culturing in the US until a competent court answered this question. Our case against the FDA on whether body parts can be drugs is now a landmark case that will decide how physicians use your stem cells (see http://www.regenexx.com/2011/09/are-the-stem-cells-in-your-body-drugs-an-update-on-our-battle-to-protect-physician-patient-rights/). In the meantime we sought and received the approval of the Cayman government and moved our culture operations there. Based on our published safety data we are the only advanced stem cell treatment currently approved.in the Caymans. Nothing about this battle over cultured stem cells takes from the fact that the FDA reviewed our same day procedures performed in the US and decided not to assert regulatory authority. However, you may be interested to know that they are now calling the same day fat stem cell treatments being performed in the US for orthopedic injuries the production of a drug, based on several letters sent from the tissue reference group.

In summary, we work hard to do the right thing. Quality isn't inexpensive, i.e. at our Colorado and/or Cayman sites we have a state of the art clean room lab facilities, a full time lab Ph.D. working on constantly improving what we do, a full time bioengineering expert to help us create new tools to make cell therapy better, a full-time clinical research staff to make sure it really is better, and a staff of dedicated cell biologists.
Title: Re: Regenexx injections - Stem Cells
Post by: manville on January 29, 2012, 09:18:46 AM
I dont have time to fully reply now, but you glaringly and blatantly ignored and overlooked all of your potential patients concerns and complains in your rely, to yet again only promote your product.

I would like to speak about my regenexx experience.

I have an injury which I needed to get fixed, and I was pursing regenexx as I believe they were one of the leaders in the field.  I decided to pay the 200 dollar fee for one of their doctors to examine my chart in a sister office.  I was told the procedure would cost around 4k for stem cells prior to paying the 200 dollars.  I was not informed of any other fees.  After paying the 200 dollars I proceeded to make an appointment.  At this time, the price suddenly jumped up 1400 additional dollars for administrative fees.  I also was informed I needed to pay a 150 fee to the imsc society(or something like that) for registry purposes.  In the paperwork, there are also other fees that "could" result.  I felt this was a bait and switch, but regardless of this, I was still interested.
-----------------------

This is Dr. Centeno, inventor of the Regenexx procedure. We want any patient who isn't local to our clinic or one of our network doctors to get on the phone to look at candidacy. We do this because we think the most ethical way to approach a new procedure is to make sure the patient knows where he/she stands before spending money on travel. Alternatively any patient is free just to have an in office evaluation with the physician.

The fact that we and our network docs aren't orthopedic surgeons is the whole point behind Regenexx. Our goal as a group of doctors is nothing less than to create an entire new field of medicine we call interventional orthopedics-or allowing physicians to do through a needle what used to be done surgically. Regrettably your thinking that surgeons know how best to drive needles is not accurate. As an example I just spent several days in the OR with surgeons teaching them these new skills.

We did begin ICMS, but at this point have dropped off all boards and that organization is pursuing it's own path without our input. If you read our book orthopedics 2.0 I think you'll get a good idea of why we want to reinvent the status quo of orthopedic care. For example the concept that the average surgeon spends much time thinking about how your muscles, nerves, and ligaments might be playing into your problem isn't something I've experienced.

Regrettably the OTL piece failed in it's gatekeeper function. The media has the responsibility to make sure that the experts they put out there really know the area in which they're commenting. The tumor issue with stem cells is a good example. Embryonic Stem Cells have a known tumor problem, adult mesenchymal stem cells do not. The difference is that MSCs are contact inhibited, meaning once they cover a surface and the cells touch, they stop growing. Our procedure was also put through extensive safety studies with our practice paying for more than 200 research grade MRI's to make sure nothing like that was happening. We have published many papers in this area and continue to do so. Our cultured procedure is now at the data quality of most common orthopedic procedures being offered.

On the FDA issue, we sued the agency several times over whether culturing your cells could make them a drug. We finally mutually agreed with the agency that we would stop culturing in the US until a competent court answered this question. Our case against the FDA on whether body parts can be drugs is now a landmark case that will decide how physicians use your stem cells (see http://www.regenexx.com/2011/09/are-the-stem-cells-in-your-body-drugs-an-update-on-our-battle-to-protect-physician-patient-rights/). In the meantime we sought and received the approval of the Cayman government and moved our culture operations there. Based on our published safety data we are the only advanced stem cell treatment currently approved.in the Caymans. Nothing about this battle over cultured stem cells takes from the fact that the FDA reviewed our same day procedures performed in the US and decided not to assert regulatory authority. However, you may be interested to know that they are now calling the same day fat stem cell treatments being performed in the US for orthopedic injuries the production of a drug, based on several letters sent from the tissue reference group.

In summary, we work hard to do the right thing. Quality isn't inexpensive, i.e. at our Colorado and/or Cayman sites we have a state of the art clean room lab facilities, a full time lab Ph.D. working on constantly improving what we do, a full time bioengineering expert to help us create new tools to make cell therapy better, a full-time clinical research staff to make sure it really is better, and a staff of dedicated cell biologists.
Title: Re: Regenexx injections - Stem Cells
Post by: The KNEEguru on January 29, 2012, 11:05:14 AM
Hi everyone
I have allowed this thread to run and run. I have let the arguments swing this way and that. I have let all parties have their say.

Now I think it is time for the interested parties to take their discussions onto a new venue, rather than letting the KNEEguru bulletin board be the main venue for direct matters which should be taken up privately between patients, potential patients and the doctors of the relevant clinics.

I am closing this thread now.

KNEEguru