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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
Hi Vanderbilt1,This is somewhat subjective but I do think the crepitus has improved. What's interesting is that when I bend the knee unloaded it sounds about the same, but when I put a load on it and bend I can hear a difference. At it's worst it sounded like a wet paper bag, now it's more like hard clicks. Seems like the cartilage still isn't perfectly smooth but has firmed up. Take that with a grain of salt of course. My 8 month post-injection MRI showed what looked like improvements in the cartilage on the T2 sequence. Most significant improvement on MRI was that the bone marrow lesions disappeared.Functionally my knees have improved significantly, but still aren't perfect. I'm doing stair climbing workouts and recently started doing squats and lunges just with my bodyweight, but with very low reps, just to see how they feel. I even did a little jogging a few weeks ago, but am by no means attempting long distance runs or sprints yet.They still flare up a little if I push them too hard, but not nearly as bad as they did before the injections. I have patellar tendinopathy that I've been rehabbing with single leg eccentric decline squats on a slant board. That seems to be my primary knee issue at the moment.
exrunner1,Yes, I've been doing the stair workouts for a while, but as of last week decided I'm taking a break for a while to focus more on patellar tendon rehab. The tendinopathy has been much more stubborn than I expected. It's fine once I warm them up but the first few minutes of activity are painful.People who get this procedure are very few and far between, and I don't really know anybody other than myself who has done it, so I can't comment on people getting back to distance running. I did some running on the beach this summer, but it was only a couple minutes at a time and not something I did regularly.As for my activity level, I'm noticeably improved but not back to the level I was at before all my injuries. I think this is due to numerous factors, such as the complex nature of my injuries. I think it's likely I'll pursue more treatment at some point in the future, but I can't say exactly when. Might be a few years down the road or maybe sooner depending on my circumstances.I'm 18 months out from my first cell injections and 5 months out from the second. I would like to get another MRI at some point to see if there have been any more structural changes in my knees. It's definitely not perfectly cartilage repair as I still have crepitus in my left knee, I just want to make sure it's still heading in the right direction.ankle_boneonbone,I'm a little leary of the Teknon clinic at this point. I've received three cost estimates from them ranging from 15,000 euros to over 60,000. If you decide to pursue them for treatment make sure you get a straight answer from them regarding price. I would look into the Regenexx Cayman clinic. Just be sure to ask a lot of questions and make sure you get a comprehensive estimate. Also understand this has a good chance of helping your ankle but it won't make it perfect or brand new, especially if it's bone on bone like your name suggests.-Dane
db1984 - thanks a lot for the very informative post. I am 3 years older than you and have had similar issues with my knee, though perhaps not as bad. That pre and post MNRI scans are really something! There is no denying the it - you aren't just in some placebo effect post-op bliss.When I had stem cells 3 years ago for chrondomalicia under my left patella, we used SVF (fat adispose). I was told at the time it has 100x more stem cells than bone marrow. Do you know Regenexx uses BMAC when SVF is much less invasive?Suggest you read a blog called "Healing my knees". Low impact, high rep, consistent exercise helped that fellow heal OA knees, without any procedures. It may change your thinking on how you work out, because it sounds like you are putting a lot of pressure and strain on your knees with all those stair exercises. Just food for thought.All the best!
Quote from: ChrondoCanuck on March 04, 2019, 06:15:34 PMdb1984 - thanks a lot for the very informative post. I am 3 years older than you and have had similar issues with my knee, though perhaps not as bad. That pre and post MNRI scans are really something! There is no denying the it - you aren't just in some placebo effect post-op bliss.When I had stem cells 3 years ago for chrondomalicia under my left patella, we used SVF (fat adispose). I was told at the time it has 100x more stem cells than bone marrow. Do you know Regenexx uses BMAC when SVF is much less invasive?Suggest you read a blog called "Healing my knees". Low impact, high rep, consistent exercise helped that fellow heal OA knees, without any procedures. It may change your thinking on how you work out, because it sounds like you are putting a lot of pressure and strain on your knees with all those stair exercises. Just food for thought.All the best!Can you please provide the link to that blog?
Thought I'd give a quick update. The Regenexx Cayman clinic is closed until at least November 2020, possibly longer, and last I heard scheduling priority will be given to patients who had to cancel their procedures due to Covid-19. So I anticipate that it will be at least until spring 2021 until I have the opportunity to get another cultured cell treatment, but that's not confirmed.In the meantime I've been taking it easy on my knee and doing a lot of research. My first course of action is a minor knee surgery with Dr. Ethan Kellum in Tennessee. He's a Regenexx doctor who is also an orthopedic surgeon. He's going to do an arthroscopy to remove some loose bone fragments from my left knee, which are leftover from my patella dislocation 20 years ago. After that he'll inject PRP into my knee both intra-articular, as well as intra-osseous to treat the bone marrow lesion. I'm actually pretty interested to see how my knee responds to this. Since my knee will be completely flushed out in the arthroscopy, there won't be any fluid in my knee to dilute the PRP, so it will be super concentrated. As for the intra-osseous injection, there have been several studies showing that injecting both the joint and the bone makes PRP a lot more effective than the usual method of just injecting the joint. I'm feeling pretty optimistic about this overall. I might get another PRP injection a couple months after that.I've taken a renewed interest in methods to stimulate cartilage non-invasively. I bought a CPM machine after I read a lot of studies showing it enhances cartilage repair. I know all the surgeons use it in their patients but Regenexx doesn't. I decided I would rather have one available to use after my next procedure.I've also been doing a lot of research on the use of ultrasound to stimulate cartilage. I don't think I've mentioned this before but I'm an engineer at a company that makes medical ultrasound scanners, so I have a lot of background in this. I found a bunch of studies by a research group at the University of Nebraska that have done simulations to model the way cartilage cells and MSCs vibrate in response to ultrasound. They've found that there's a vibrational resonance frequency that maximizes the gene expression of the cells to enhance cartilage repair. I studied their ultrasound setup and am going to replicate it myself. I ordered some ultrasound probes on eBay and they're en route. This could be a way to enhance cartilage repair non-invasively and I'm pretty excited about it. The nice thing about the trochlea is that with the knee in full extension the cartilage is only covered by soft tissue, which makes it easy to access with ultrasound. I know because I've used the ultrasound scanners at my job to visualize my cartilage and it makes a very clear image.On top of all this I ordered an electrical stimulator to target my VMO, which should be arriving sometime next week. My left VMO has always been a little weaker than my right, so I'm going to try correcting that to improve my patellar tracking. I've read a lot of physical therapy blogs about how isolating the VMO with exercise is a waste of time but that electrical stimulation works pretty well. I found a few studies to back that up so I'm excited to get started with it.Basically I've decided that I'm still on board with the Regenexx approach but I think there are a lot of parameters that can be better optimized in my recovery to get a better cartilage repair response. In the short term I'll manage with PRP, but sometime next year I anticipate I'll get another injection of cultured cells, then apply my modified recovery plan to see how much more improvement I get.
