Where to get cultured stem cell procedure?

[db1984]

Anyone has tried, or knows someone who tried, a cultured cell treatment to an articulation?

Teknon and MedXCell seem quite interesting. I tried googling and searching the forum for testimonials but found none. MedXCell claims that over 700 patients have been treated and would really be interesting to know how it turned out for them.

dex,

I think you'll have a hard time finding testimonials for a couple reasons:

-Cultured cells are only available at a few clinics around the world
-Treatment is very expensive, $15k - $20k (US dollars) for an injection

That being said, the Teknon Barcelona doctors have run two randomized controlled trials showing MRI evidence of cartilage regeneration. They've also run a non-randomized study on a larger group of patients with long term follow-up (4 years) also showing MRI evidence of regeneration. I posted links to these studies earlier in this thread.

I'm 5 months post-op for cultured cell injections at Regenexx Cayman. I've noticed some improvement but still have a long way to go in terms of recovery. I'll see if I can get an MRI in a few months.

[db1984]

I forgot to mention, before 2010, when Regenexx was still doing culture expansion in the US, there was a thread on this forum of patients who had the procedure done and they were getting good results. I don't have the link on hand but if you search for it you should be able to find it.

[db1984]

Quick update on my post Regenexx-C status. I had 8 month post-op MRI's of both knees, as well as x-rays of my lumbar spine.

I'll start with the spine:

Previously I had lumbar instability, basically the vertebrae slip sideways a few mm instead of staying in alignment throughout the range of motion. This was most noticeable on extension, and is easily seen on x-ray. I also had early degenerative disc disease on the bottom 2 discs, L5-S1 and L4-L5, which shows up as mild disc narrowing on x-ray. Symptomatically my low back was tight but not super painful. 8 month post-op x-rays show good alignment of the vertebrae and normal disc space... basically no spine abnormalities! I was quite surprised by the results on the lumbar discs, as I haven't found any research indicating disc height can be restored with these procedures. It might be due to the fact that the sloppy vertebrae movement has been corrected, putting less stress on the discs, and that we caught it early. Symptom wise my low back is greatly improved with occasional soreness that might just be a posture or muscle issue. Been doing lots of planks and other core exercises, the back feels strong.

Now the knees:

I have moderate cartilage wear in the trochlear groove of the left knee, and mild damage on the left patella. No cartilage damage in the right knee. Bilateral patellar tendinosis with some partial tearing on the right side. I also had bone marrow lesions (BML's) in the trochlear grooves and patellas of both knees. If you don't know what a BML is, look it up. It's basically arthritic bone degeneration and abnormal remodeling of bone. They cause knee pain and accelerated OA progression.

My 8 month post-op MRI shows ZERO bone marrow lesions in both knees! That was by far the best part. My cartilage wear doesn't look like it's changed much and I still have patellar crepitus, which I'm somewhat disappointed by, but not heartbroken. Patellar tendinosis doesn't seem to have changed much either, which I am surprised by, was expecting more improvement in that area. Symptom wise my pain levels are significantly improved with much less frequent flare-ups. I'm not back to working out hard, but I can squat down comfortably and jog up and down the stairs, although not as fast as I used to.

Overall I would say I'm extremely satisfied with my low back results and partially satisfied with the knees, the most encouraging part being the complete healing of the BMLs. We're all dreaming of cartilage regeneration, but subchondral bone integrity is an extremely important part of OA, so the fact that they healed means the treatment is having a serious impact structurally. I have a follow-up appointment at the Centeno-Schultz clinic next month to discuss next steps. I would like to see how much improvement they would expect with a second injection of cultured cells in the left knee and if they think I would have a reasonable chance of getting some cartilage growth. Also need to get a price quote, these treatments aren't cheap! Also... maybe I just need to give it more time. If I like what I hear I might go back for a second treatment. If not... then I have a lot of thinking to do.

[Brandon123]

Many thanks for the info, please keep us updated on how everything develops!

[db1984]

I previously stated that my knee results from Regenexx-C were moderately good. I need to correct that, the positive results have been nothing short of amazing. I previously based my opinion on the report of the radiologists reading my MRI's, but now that I've taken the effort to line up matched slices back to back, I can see that the results are truly dramatic and that the radiologist was probably too lazy to do a thorough comparison. I've had not only significant healing of bone marrow lesions, but also a substantial amount of cartilage regeneration as well as greatly improved inflammation levels. I just attached a before and after comparison of a sagittal image of my left knee. I have many more, but I'll just include this one for now. Very exciting stuff!

[Brandon123]

Thanks for the update, db1984.

I follow your journey with interest as I also suffer from patellofemoral OA (approx. the same age as well). You seem to have gotten really good results with Regenexx-C! Can I ask if your previous PRP shots did anything for your knees? Also, PRP and injections in general only last a 6-12 months or so, but what about stem cells such as Regenexx-C? Of course, if cartilage healing occurs that is hopefully permanent, but do such stem cell treatments also have anti-inflammatory effects that wear off after a while?

[db1984]

Hi Brandon,

My right knee had some improvement from the PRP injections, but that knee has intact cartilage, so the damage was less severe. Left knee, not so much. My Achilles tendons as well as some tendons in my right hip responded very well to PRP and are much better than before. The stem cells definitely have an anti-inflammatory effect, but it takes a few months to kick in. Before the procedure I had frequent flare ups, but as time progressed after the injections the frequency and intensity of flare ups gradually decreased. I didn't see much improvement until the 3 month mark, then had a bigger boost at 6 months. Now at 9 months I've improved significantly, although I still have some issues. I definitely recommend this, it's just a very big commitment in terms of time and money. I tried the Regenexx-SD procedure before this, but the difference between same day stem cells and cultured cells is like night and day... at least for me! I can't say for sure how long the improvements will last but my research suggests that it should be at least a few years, possibly longer, unless of course I mess up my knees again. If so I can always get more injections.

[Brandon123]

Ok, thanks for the info! Yup, from what I have understood PRP seems to work best for tendons and other soft tissue issues.

Is Regenexx-C the only cultured cells treatment out there?

[db1984]

Ok, thanks for the info! Yup, from what I have understood PRP seems to work best for tendons and other soft tissue issues.

Is Regenexx-C the only cultured cells treatment out there?

No, there are others, it was discussed earlier in this thread. There's the Teknon Medical Center in Barcelona and MedXcell in Switzerland, both run by the same doctors. They've published very good data on their procedures, but I can't say to what extent they're comparable to Regenexx Cayman. To my knowledge the main similarity is that they both use autologous cultured bone marrow MSCs and deliver the cells via injection. At Regenexx Cayman, they use customized blood platelet solutions to optimize cell growth based on lab data collected during the expansion phase, as well as a little dexamethasone to stimulate cartilage growth, so you're getting an optimized injection. I don't know if the Teknon doctors have any techniques to optimize growth. At Regenexx Cayman they also do a full biomechanical assessment and customize the treatment plan to address your specific issues, so it's a bit more involved than just squirting cells into the knee. For example, they do tendon and ligament injections to address instability, as well bone augmentations, platelet lysate injections around nerves to address neuromuscular problems, etc. I'm not sure how a biomechanical evaluation and treatment would look at Teknon or MedXcell. I do know they treat lumbar discs in addition to knees, but I can't say much more than that. There's also Clinica Las Condes in Santiago, Chile, they've published data on using cultured cells to treat hip OA. Depending on what country you're from and whether or not you need a visa, there's the Royan Institute in Iran. They're using cultured cell injections for knees and have published a lot of good data too.

[diesiel]

Theres also : https://www.cellmedicine.com/

he was on the joe rogan podcast recently, apparently the umbilical cord stem cells are extremely potent as well...

[db1984]

Theres also : https://www.cellmedicine.com/

he was on the joe rogan podcast recently, apparently the umbilical cord stem cells are extremely potent as well...

diesiel,

I looked up the Joe Rogan podcast with Dr. Riordian, watched it on YouTube. Very interesting stuff, sounds like Dr. Riordian is getting great results treating a lot of different conditions. My main concern is that I couldn't find any publications on his website specifically addressing umbilical MSCs and OA, although in the podcast he did mention good results treating RA and other joint issues. (Maybe the data is there but I just didn't find it) By comparison, there's a lot of data on the use of cultured bone marrow MSCs to treat OA. Not saying it wouldn't work, just that given the enormous investment one makes to undertake one of these procedures, it should be done with as much supporting evidence as possible. I definitely would NOT have paid as much as I did for cultured BM-MSCs without first seeing some controlled trial data and MRIs of treated joints. I think we've passed that threshold of evidence for cultured BM-MSCs, not sure if the same is true for umbilical MSCs (but I could be wrong). If you know of any publications by all means don't hesitate to post the link. I'll do more research on this myself. If I see some pre and post op MRIs of arthritic joints treated with umbilical MSCs showing regeneration I'll be convinced.

[Brandon123]

Ok, thanks for the info! Yup, from what I have understood PRP seems to work best for tendons and other soft tissue issues.

Is Regenexx-C the only cultured cells treatment out there?

No, there are others, it was discussed earlier in this thread. There's the Teknon Medical Center in Barcelona and MedXcell in Switzerland, both run by the same doctors. They've published very good data on their procedures, but I can't say to what extent they're comparable to Regenexx Cayman. To my knowledge the main similarity is that they both use autologous cultured bone marrow MSCs and deliver the cells via injection. At Regenexx Cayman, they use customized blood platelet solutions to optimize cell growth based on lab data collected during the expansion phase, as well as a little dexamethasone to stimulate cartilage growth, so you're getting an optimized injection. I don't know if the Teknon doctors have any techniques to optimize growth. At Regenexx Cayman they also do a full biomechanical assessment and customize the treatment plan to address your specific issues, so it's a bit more involved than just squirting cells into the knee. For example, they do tendon and ligament injections to address instability, as well bone augmentations, platelet lysate injections around nerves to address neuromuscular problems, etc. I'm not sure how a biomechanical evaluation and treatment would look at Teknon or MedXcell. I do know they treat lumbar discs in addition to knees, but I can't say much more than that. There's also Clinica Las Condes in Santiago, Chile, they've published data on using cultured cells to treat hip OA. Depending on what country you're from and whether or not you need a visa, there's the Royan Institute in Iran. They're using cultured cell injections for knees and have published a lot of good data too.

Thanks for the info!

[db1984]

It's been a while, so time for an update. I'm now over 12 months post-op for Regenexx-C and I'm actually heading back to Grand Cayman this month for a second treatment. It's not because I've declined, but because I want an extra boost to see how far I can take this. I also have a few issues which haven't improved to my satisfaction, in particular my patellar tendons need more work, so that will be a big focus on this trip. I have cells in cryostorage, so no need to do a bone marrow harvest. Currently I have 3 million MSCs in storage, which they'll culture a little more to get a therapeutic dose, but it will most likely be a smaller dose than my first treatment. This treatment will likely use up the rest of my remaining cells, so if I want more after this I have to start the whole process over again. Hopefully that won't be necessary... at least for a while, I'm not getting any younger! They'll likely give me some more platelet lysate injections in my low back while I'm down there. Back is still doing well but I get some occasional stiffness and right leg symptoms that seem like nerve irritation. That might require more maintenance going forward.

Overall I've continued to improve, despite my stubborn patellar tendons. For the last month I've been jogging up and down the stairs at a park near my apartment. It's 188 steps to the top and right now I'm doing 5 laps up and down, which I'm increasing as my fitness improves. It feels great to get an actual workout again. Before the procedure my knees would have been in agony after a workout like that, but lately exercise seems to make them feel better... how it should be. I get a little stiffness in the evenings if I work at my desk for too long, and I do get some occasional pain from the tendons if I'm rising from a squat position, but overall my pain levels are much lower.

I should mention that my Achilles tendons are starting to get stiff again too. The PRP injections gave me big improvements for about 9 months before they started to decline, which isn't bad I think. I've been doing eccentric exercises, which I was very consistent about until I was distracted by traveling last month. Been doing eccentrics for the patellar tendons as well. I will most likely get more PRP for the Achilles sometime this summer, as well as some PRP in my right hip which has some tendinopathy. These areas might need long term maintenance.

Hopefully this 2nd treatment boosts my knees further so that I'm sufficiently satisfied with them. This treatment is going to be $10k for both knees, plus an additional $4k if we do the platelet lysate injections in my low back. If I had to do the whole cycle over again my finances couldn't handle it, so this will be the last cultured cell treatment for a while, unless something crazy happened like one of my hips started to go out, in which case I would scrounge up the money somehow. Fingers crossed that won't happen.

[exrunner1]

It's been a while, so time for an update. I'm now over 12 months post-op for Regenexx-C and I'm actually heading back to Grand Cayman this month for a second treatment. It's not because I've declined, but because I want an extra boost to see how far I can take this. I also have a few issues which haven't improved to my satisfaction, in particular my patellar tendons need more work, so that will be a big focus on this trip. I have cells in cryostorage, so no need to do a bone marrow harvest. Currently I have 3 million MSCs in storage, which they'll culture a little more to get a therapeutic dose, but it will most likely be a smaller dose than my first treatment. This treatment will likely use up the rest of my remaining cells, so if I want more after this I have to start the whole process over again. Hopefully that won't be necessary... at least for a while, I'm not getting any younger! They'll likely give me some more platelet lysate injections in my low back while I'm down there. Back is still doing well but I get some occasional stiffness and right leg symptoms that seem like nerve irritation. That might require more maintenance going forward.

Overall I've continued to improve, despite my stubborn patellar tendons. For the last month I've been jogging up and down the stairs at a park near my apartment. It's 188 steps to the top and right now I'm doing 5 laps up and down, which I'm increasing as my fitness improves. It feels great to get an actual workout again. Before the procedure my knees would have been in agony after a workout like that, but lately exercise seems to make them feel better... how it should be. I get a little stiffness in the evenings if I work at my desk for too long, and I do get some occasional pain from the tendons if I'm rising from a squat position, but overall my pain levels are much lower.

I should mention that my Achilles tendons are starting to get stiff again too. The PRP injections gave me big improvements for about 9 months before they started to decline, which isn't bad I think. I've been doing eccentric exercises, which I was very consistent about until I was distracted by traveling last month. Been doing eccentrics for the patellar tendons as well. I will most likely get more PRP for the Achilles sometime this summer, as well as some PRP in my right hip which has some tendinopathy. These areas might need long term maintenance.

Hopefully this 2nd treatment boosts my knees further so that I'm sufficiently satisfied with them. This treatment is going to be $10k for both knees, plus an additional $4k if we do the platelet lysate injections in my low back. If I had to do the whole cycle over again my finances couldn't handle it, so this will be the last cultured cell treatment for a while, unless something crazy happened like one of my hips started to go out, in which case I would scrounge up the money somehow. Fingers crossed that won't happen.

Good luck with your second treatment. Have to say a big thank you to you for sharing your experience and other information. Also, I think you should start a separate page about your experience. What you are doing is a inspiration for a lot of people like me.I am also looking at stem cells and may get it done in a few months.

Questions: Knee is a water tight joint. So any stem cells injected into the knee might not impact any other joint. Back muscles are not. Considering that, how do they make sure stem cells injected for the back do not impact other parts of the body.

Why did you choose Regenexx-C over SD. Any other reason apart from increased stem cell count and substantially larger impact.

Also, what about side affects from Regenexx-C. Did you do any research on them?

My knee situation is similar to yours. So eagerly following your development.

[db1984]

exrunner1:

Thanks, I'm hoping it goes well too. I guess I could have a separate page, but since this is the cultured cell thread and I'm apparently the only one here who has actually tried it, I think it's appropriate to share my experience here. If anybody else has tried cultured cells they're welcome to share their experience as well! I know they're out there, just not on this little corner of the internet.

I'm not sure if cells injected into the back impact other body parts. If they did somehow migrate out (which is possible but seems unlikely) I don't think they would be harmful. Regenexx tracks their patients in a registry and has published safety data, so if harmful effects were occurring I think that would have come to light by now (after 13 years doing these procedures). When I was in Cayman my next door neighbor at the hotel was also a patient and was getting some discs in his back injected. He was in A LOT of pain afterwards, my recovery was a cake-walk in comparison. I didn't have any discs injected, just muscles, ligaments, facet joints and epidurals.

I actually did try Regenexx-SD first for my left knee and experienced no improvement in my condition. I improved significantly with Regenexx-C, I mean a night and day difference! With culture expansion you get 100-1000 times more stem cells. In addition to that it's a "pure" stem cell injection, as opposed to a bone marrow concentrate injection (ie. SD) which is really many types of cells mixed together, a small percentage of which are stem cells. Many people do improve with SD though, and Regenexx has registry data showing that. The biggest difficulty with C is the cost, 3 times as expensive as an SD procedure. However in my case, I would have actually saved money if I skipped the SD and went straight for C.

Having researched as much as I can, my opinion is that there is more evidence of efficacy for cultured cells, which is consistent with my experience. Most of the studies on cultured cell injections include MRIs that show repair of cartilage and subchondral bone. My own MRIs show dramatic improvements. In addition cultured cell injections have now been tested in at least 7 randomized controlled trials (just for bone marrow, not adipose). I've searched extensively for similar data on bone marrow concentrate injections and haven't found anything comparable. The studies that do show cartilage repair combine BMC with surgery, ie. Dr. Broyles, etc.

Also, cultured cell injections aren't a panacea. Last year I met a fellow patient who was getting his arthritic hip treated. It didn't work... he ended up getting it resurfaced. My own knee, while significantly improved, is definitely not "brand new". I still have damaged cartilage which I'm hoping will further improve with my second treatment.

Before the FDA cracked down and Regenexx was still doing cultured cells in the US (pre-2010) there was a thread with a lot of patients sharing their experiences. A very interesting read. See the link below:

http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=40048.0