Advertisement - Hide this advert





Author Topic: Any recent stem cell experience for cartilage damage?  (Read 216 times)

0 Members and 1 Guest are viewing this topic.

Offline mang0954

  • MICROgeek (<20 posts)
  • *
  • Posts: 12
  • Liked: 0
Any recent stem cell experience for cartilage damage?
« on: July 09, 2020, 04:14:55 AM »
Hi,
I have grade 3 chondromalacia on medial facet and apex of patella, grade 3 chondromalacia on trochlea of femur, and grade 1 on chondromalacia on medial and lateral tibiofemoral joint spaces.

Just had an appointment with Dr. Joseph Purita, here is the summary of what he said:

1) Given my situation, the best option is to do just one injection of bone marrow+fat aspirate+PRP (with about 3 follow-up laser or patch treatments), it will change chemistry of knee (like laying a new interface) to make symptom free. He claimed that 85% of his patients have 70+% improvement. Considering that I am 37, he does not think I need second PRP. The goal is to buy me 10 years of time till higher concentration of stem cell available

2) He doesn't think lipogems is cost efficient and had stopped doing it though he is the first guy who used it. The "fat" he does will do the same job.

3) No surgery is suitable for me including Dr. Saw's procedure (drilling+stem cell for cartilage regeneration) as Dr. Saw's drilling is in femur or tibia but NOT for patella cartilage (He said he met Dr. Saw several times and know his procedure)

Can any guru here kindly provide some comment? Thank you!

=========================== Update on 7/20/2020 ===========================
Just finished a meeting with Dr Adam Anz, the doctor who brought Dr. Saw's procedure to U.S. and just finished a 5-year clinical trials in U.S. He said result of cartilage regeneration is very good, and he expects FDA to approve it so he can perform the procedure in U.S. again. Here is the summary

-- 70% of patients in his trail (or Dr Saw's procedure) are for patellofemoral join issue, thus Dr Purita's statement of Dr. Saw's procedure is only for tibiofemoral joint is wrong

-- If I need this procedure now, I can go to Malaysia, not sure how long we have to wait in U.S., may be a few years

-- The peripheral stem cell (higher cell count) used in the trail and by Dr. Saw is not available U.S.

-- They tested or someone just published (I didn't catch it very well) bone marrow v.s. PRP and fat aspirate v.s. PRP, it turns out that neither bone marrow nor fat aspirate has any difference than PRP alone, it is just doctors that want to make money including cytokines. He commends doing 3 PRP injections in 3 consecutive weeks which has study to prove better result over single injection.
May be this https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7029538/

-- He said there is no publication to prove that debridement leads to early osteoarthritis. He recommends me to do 3 PRP and debridement. Any existing cartilage restoration surgery or osteotomy are all big operations and should be last option. If Dr. Saw's procedure is approved here, he would choose this procedure over any other procedures for my injury.

And has anyone done 3 PRP in 3 weeks? I only found one study that is for patellar tendinopathy not for cartilage
https://pubmed.ncbi.nlm.nih.gov/24519184/
How do you guys think about 3 PRP vs BMCA+fat+PRP?
« Last Edit: July 26, 2020, 07:34:22 PM by mang0954 »

Offline diesiel

  • MINIgeek (20-50 posts)
  • **
  • Posts: 22
  • Liked: 2
Re: Any recent stem cell experience for cartilage regeneration?
« Reply #1 on: July 14, 2020, 11:56:56 PM »
Did he mention anything about post-therapy rehab?  Don't you have to limit motion (especially shearing forces) in the knee to prevent wear on the kneecap? at least while the stem cells are doing their job  Something to ponder....


Also, he mentioned "symptom free", so he is not in fact claiming any regeneration?  Just reduced inflammation and hopefully slowing down the progression

Offline mang0954

  • MICROgeek (<20 posts)
  • *
  • Posts: 12
  • Liked: 0
Re: Any recent stem cell experience for cartilage regeneration?
« Reply #2 on: July 15, 2020, 03:14:26 AM »
Did he mention anything about post-therapy rehab?  Don't you have to limit motion (especially shearing forces) in the knee to prevent wear on the kneecap? at least while the stem cells are doing their job  Something to ponder....


Also, he mentioned "symptom free", so he is not in fact claiming any regeneration?  Just reduced inflammation and hopefully slowing down the progression

Doctor implies that cartilage regeneration is minimum.

No doctor did not mentioned about limited motion on post-therapy. He said I can drive home myself (injection is on my right knee) and recommend starting physical therapy immediately after injection

Offline db1984

  • MINIgeek (20-50 posts)
  • **
  • Posts: 33
  • Liked: 2
  • Knee OA, going all out with cultured MSCs!
Re: Any recent stem cell experience for cartilage damage?
« Reply #3 on: July 23, 2020, 08:39:35 AM »
If you're going the PRP and bone marrow concentrate route you should look into having your subchondral bone injected. There have been several studies in the last few years showing that injecting subchondral bone has a more potent effect than just injecting the joint. Ideally both the bone and joint space should be injected:

https://www.tandfonline.com/doi/abs/10.1517/14712598.2016.1157162
https://link.springer.com/article/10.1007/s10067-018-3985-6
https://journals.sagepub.com/doi/abs/10.1177/1947603518756462
https://link.springer.com/article/10.1007/s00264-020-04687-7
https://link.springer.com/article/10.1007%2Fs00264-020-04546-5
https://www.hindawi.com/journals/sci/2016/1247950/
https://link.springer.com/article/10.1007/s00264-018-3916-9

Subchondral bone is critical in OA. The idea is that by treating the subchondral bone the arthritis progression is slowed down significantly and with much greater pain relief. In OA there's also increased crosstalk between cartilage and bone, so injecting the bone can potentially treat the deep cartilage layers as well.

Next month I'm having an arthroscopy to remove some loose bodies from my knee, but after my knee has been drained I'll be having PRP injected into both the joint and the subchondral bone (trochlea), where I have a small cartilage defect but also a bone marrow lesion that was spotted on an MRI a few months ago.
Jun 16: Patellofemoral OA, Lumbar DDD
Aug 16: Regenexx-SD left knee, PRP right knee
Mar 17: Bone marrow aspiration for cell culture
Apr 17: Regenexx-C both knees, lumbar spine, left shoulder
Jun 17: PRP both Achilles, right hip, both knees
Jan 18: Knees and back MUCH better, planning 2nd treatment

Offline mang0954

  • MICROgeek (<20 posts)
  • *
  • Posts: 12
  • Liked: 0
Re: Any recent stem cell experience for cartilage damage?
« Reply #4 on: July 26, 2020, 07:45:42 PM »
If you're going the PRP and bone marrow concentrate route you should look into having your subchondral bone injected. There have been several studies in the last few years showing that injecting subchondral bone has a more potent effect than just injecting the joint. Ideally both the bone and joint space should be injected:

https://www.tandfonline.com/doi/abs/10.1517/14712598.2016.1157162
https://link.springer.com/article/10.1007/s10067-018-3985-6
https://journals.sagepub.com/doi/abs/10.1177/1947603518756462
https://link.springer.com/article/10.1007/s00264-020-04687-7
https://link.springer.com/article/10.1007%2Fs00264-020-04546-5
https://www.hindawi.com/journals/sci/2016/1247950/
https://link.springer.com/article/10.1007/s00264-018-3916-9

Subchondral bone is critical in OA. The idea is that by treating the subchondral bone the arthritis progression is slowed down significantly and with much greater pain relief. In OA there's also increased crosstalk between cartilage and bone, so injecting the bone can potentially treat the deep cartilage layers as well.

Next month I'm having an arthroscopy to remove some loose bodies from my knee, but after my knee has been drained I'll be having PRP injected into both the joint and the subchondral bone (trochlea), where I have a small cartilage defect but also a bone marrow lesion that was spotted on an MRI a few months ago.


Hi db1984,

I hope your arthroscopy debriment operation goes well!
Thank you for your suggestion, this definetly helps, but I am not sure if doctors here who never combine subchondral bone and joint injection will be willing to inject in subchondral bone as well. I'll have to ask them.

And I was asking you in the culltured cell post if you can share the devices that you purchsed. I'll copy&paste the comment here below as my reply there is kind of off topic:

Do you mind sharing the electrical stimulator device and ultrasound device that you purchased and the vibrational resonance frequency that you mentioned?

And thank you for sharing your experience and information your gathered, I learn a lot after reading through all your posts. I am about the same age as you (1983 here), I too developed moderate cartilage damage due to running and powerlifting. I feel we are exactily the same that once we see some improvement we jump into weight room to lift heavy again.... After injecting PRP, pentosan polysulfate and some peptides, I recently get a little better and kind of figure out what movement pattens that bothers my knee -- lowbar squats is safe, but deadlift and lunge are big no-no, even RDL gets my knee swelling for 2 days, and mild swelling after using elliptical machine as well. So the difference is knee pointing to the side versus pointing to the front.

if cultured stem cell can get most of my cartiliage back, I'll be all in without hesitation. But after reading your posts, it seems no where near fully restore. Someone lately told me that Korea has a clinical trial using umbilical cord blood stem cell which has the most cell count for knee cartilage regeneration. If this trial is successful, I will fly there to recevie treatment (I live in south Florida).

Also I am not sure if Dr Saw's multi injections of peripheral stem cell without surgery will work or not. If it works, I am willing to stay in Malaysia for several weeks to receive treatment


========================= Update 7/28/2020 =========================
Dr. Purite replied that no sub chondral injection as "articles indicate some deficienies in protocals with limited results/benefits" :(
« Last Edit: July 28, 2020, 04:24:45 PM by mang0954 »

Offline db1984

  • MINIgeek (20-50 posts)
  • **
  • Posts: 33
  • Liked: 2
  • Knee OA, going all out with cultured MSCs!
Re: Any recent stem cell experience for cartilage damage?
« Reply #5 on: July 29, 2020, 10:16:37 AM »
Hi mang0954,

I just replied to your questions in the cultured cell thread. I agree that if a doctor doesn't normally do bone injection then they shouldn't do it. It's more complicated and requires fluoroscopic needle guidance. The data on bone injection looks pretty good though. I'm not sure how certain you are with pursuing treatment with Dr. Purita but I recommend giving Regenexx a call, at least for a consultation. They do subchondral injections all the time. I think if you're trying to maximize your outcome with bone marrow concentrate and PRP you should at least take a serious look at it.
Jun 16: Patellofemoral OA, Lumbar DDD
Aug 16: Regenexx-SD left knee, PRP right knee
Mar 17: Bone marrow aspiration for cell culture
Apr 17: Regenexx-C both knees, lumbar spine, left shoulder
Jun 17: PRP both Achilles, right hip, both knees
Jan 18: Knees and back MUCH better, planning 2nd treatment

Offline mang0954

  • MICROgeek (<20 posts)
  • *
  • Posts: 12
  • Liked: 0
Re: Any recent stem cell experience for cartilage damage?
« Reply #6 on: July 29, 2020, 11:13:28 PM »
Hi db1984,

Thanks for your reply. I ordered another model of the same maker that you purchased:
https://www.amazon.com/dp/B0777SVFDZ/ref=emc_b_5_t?th=1
Bottom of the page has comparison of their different models

No I am not locked to any doctor, I'll ask 2 other PRP doctors in my local area if they do subchondral injections, I'll go for them for 3 PRP instead of Dr Purita if they do subchondral but I doubt it.

I was reading other posts in this board about Regenexx-c and I don't feel the result is convincing (they are good at markting though), and you yourself don't get much improvement in your cartiliage, no where near returning to sports. Considering the price of Regenexx-c is 4 times as much as Dr. Purita's and I am only 30-minute drive away from Dr. Purite package, I am hesitated to arrange international travels to grand cayman. If Regenexx-c is just to make me symptom free, then I know 2 tennis professional who received same day bone marrow or fat + PRP from doctors in Miami for their back/spine and got symptom free almost immediately. I feel that all stem cells doctors are eager to sell you the treatment including Dr. Purite, but if I throw a few grands to receve injectins locally and see no result, I won't be upset as I don't waste much time. Right now I am symptom free when I low bar squats a few sets of sub 300 lbs and single leg extention using 40 lbs weight on th machine. So unless regenexx-c has evidence that at least 50% of their knee patients get their hyaline cartilaige nearly 100% back, I'll rather wait for Dr. Adam Aanz till FDA approves the procedure. I'll read more about Regenexx-c though to find out more.
(https://www.kneeguru.co.uk/KNEEtalk/index.php?topic=63739.30
Did you see Dr. Centeno's last comment in this post says "While the cultured procedure outperforms for hips and hand joints, for most knee patients, we now recommend the same day procedure"? Does this mean cultured stem cell is not superior than same day bone marrow?)

I did not inject aynthing in past 3 weeks, but my knee swellinig after exercise is much improved, I don't know if it is because PRP from mid of May or peptides that I injected last month. What I did in past few weeks is to apply Thai green herbal cream to my knee. I have a bottle of it at home as it is a miracle drug to heal burned skin, skin infection and insect bites, one day I happened to see the label on the bottle that it can be used to treat osteoarthritis so I gave it a try. The cream gives cool and burning sensation in skin causing a little swelling, but after 5-10 hours the swelling is gone and futher reduces the fulid in knee prior to using it. My understanding is that healthy swelling promote healing similar to PRP. On top of that I use infrared light knee warp in past few months as it promotes blood circulation. Similar to TENS and unltrasound, the research publication of infrared light is limited. I kind of believe that every little things matter a little bit like what you said.

Hi mang0954,

I just replied to your questions in the cultured cell thread. I agree that if a doctor doesn't normally do bone injection then they shouldn't do it. It's more complicated and requires fluoroscopic needle guidance. The data on bone injection looks pretty good though. I'm not sure how certain you are with pursuing treatment with Dr. Purita but I recommend giving Regenexx a call, at least for a consultation. They do subchondral injections all the time. I think if you're trying to maximize your outcome with bone marrow concentrate and PRP you should at least take a serious look at it.
« Last Edit: July 30, 2020, 03:33:01 PM by mang0954 »

Offline mang0954

  • MICROgeek (<20 posts)
  • *
  • Posts: 12
  • Liked: 0
Re: Any recent stem cell experience for cartilage damage?
« Reply #7 on: August 03, 2020, 10:40:40 PM »
Hi db1984

I called Regenexx Cayman today. They said that Regenexx-C is not necessarily to grow cartiliage but to treat the whole join to strengthen it and that grow cartiliage is not the focus. So my understanding is that goal/result is the same as regular stem cell offered in the U.S., to change chemistry/lay down a new interface to make it asymptomatic.

As for cost, apart from the first treament price $19500 of Regenexx-C, each addtional injection costs $9000 (as long as you still have cell in their bank), with $9000 I can do two BMAC+fat+PRP locally. So if you instead spend that money to receive constant regular stem cell and PRP, you may get the same result, just like what MADL in this sub did. Regenexx Cayman on the phone did say that the advantage of C and why it is so costly is because it is able to treat multiple joins with only one bone marrow withdraw and if there are still cells left in the bank they can be used for future injection and that for single join single injection Regenexx-SD may work the same as Regenexx-C (They didn' mention higher cell number per injection on the phone).















support