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Author Topic: Regenexx injections - Stem Cells  (Read 224787 times)

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Offline Dr. Centeno

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Re: Regenexx injections - Stem Cells
« Reply #45 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 / Regenexx procedure, please don't hesitate to write me at [email protected]

Chris Centeno, M.D.

Offline Saverio

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Re: Regenexx injections - Stem Cells
« Reply #46 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

Offline 60schld

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Re: Regenexx injections - Stem Cells
« Reply #47 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)
TKR  finally done!!!  9/9/13     Whew!!

Offline joew

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Re: Regenexx injections - Stem Cells
« Reply #48 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
7/02: ACL and medial meniscus tear playing basketball
9/02: ACLR; meniscus repair (local OS)
2003-2005: Patella grinding and pain after surgery.
12/05: Scope. Patella and trochlear groove debridement (kissing lesion).  Partial medial meniscectomy. (local OS)
5/07:  LOA/AIR, plica removal (Vail)

Offline Kaputt_Knee

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Re: Regenexx injections - Stem Cells
« Reply #49 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
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline Saverio

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Re: Regenexx injections - Stem Cells
« Reply #50 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


Offline Kaputt_Knee

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Re: Regenexx injections - Stem Cells
« Reply #51 on: September 28, 2008, 02:38:40 PM »
Good luck Saverio - I look forward to reading your posts afterwards.
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline Kaputt_Knee

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Re: Regenexx injections - Stem Cells
« Reply #52 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
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline slyguy1

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Re: Regenexx injections - Stem Cells
« Reply #53 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

Offline lizsherr

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Re: Regenexx injections - Stem Cells
« Reply #54 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

Offline Saverio

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Re: Regenexx injections - Stem Cells
« Reply #55 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

Offline 60schld

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Re: Regenexx injections - Stem Cells
« Reply #56 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!!!
TKR  finally done!!!  9/9/13     Whew!!

Offline Kaputt_Knee

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Re: Regenexx injections - Stem Cells
« Reply #57 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
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline MrPotatoKnee

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Re: Regenexx injections - Stem Cells
« Reply #58 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)
« Last Edit: October 12, 2008, 07:27:02 PM by MrPotatoKnee »
1978 (6 y.o.): R knee. Removed debris, bone chip. Synovitis diagnosed
1987 (14 y.o.): R knee. Arthroscopy. Haemangioma diagnosed. Corrective surgery discouraged
1997 (25 y.o.): R knee. Miniscus trimmed, debris cleared. Early OA diagnosed
2008 (36 y.o.): R knee. Wash out. Chronic OA diagnosed

Offline mccartjt

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Re: Regenexx injections - Stem Cells
« Reply #59 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