Regenexx injections - Stem Cells

[mccartjt]

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

[mccartjt]

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

[NikkiE]

PLease please please open a  clinic in Australia!!

[rob8647932]

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

[mccartjt]

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

[rob8647932]

Can you call me on my cell.

330-212-4101

[sp7]

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

[mccartjt]

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

[sp7]

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

[Dr. Centeno]

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 . 

[mccartjt]

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

[sp7]

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.

[rob8647932]

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.

[sp7]

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.

[BearsCubs]

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.