Looking to treat severe knee medial compartment OA

[silver_maple]

Ubercool,

Prompt and fulsome response by Dr Goodwin earns respect. Good to learn osteoporosis does not result in complications with bone marrow harvest.

The two So Korean products that are winding through trials are JointStem by Nature Cell/Rbio and the temporarily named SMUP-IA-01 by Medipost.

JointStem is autologous adipose based with an element of culturing but no genetic enhancement. Akin to what Dr Centeno has been doing in the Caymans for ~ 10 years. JointStem appears to have progressed very far with the Korean FDA and trials are underway in the U.S. To the best of my knowledge Dr Centeno has not initiated cultured trials in the U.S. This is just a news release:
https://www.einnews.com/pr_news/541453843/the-success-of-jointstem-phase-3-clinical-trial-world-s-first-stem-cell-treatment-for-osteoarthritis-of-the-knee

SMUP-IA-01 has been billed as "2nd generation" by Medipost after the first generation Cartistem failed to sell well for a number of reasons. SMUP-IA-01 is injectable, Cartistem is not. SMUP-IA-01 is allogeneic cord blood-derived.

https://www.medi-post.com/stem-cell-therapeutic/2021/12/36934/

I am just monitoring, I endorse neither of these treatments and in fact am skeptical of both. I don't believe we are anywhere near to restoring native hyaline cartilage in all its four zonal variations via stem injections. But we've got to keep trying. Biotech has realized the demand will only grow. I am slightly more hopeful re gene therapy but there are many problems there currently, including safety. It's going to take time, possibly a long time. There is no way to do a 5 year follow up in 2 months.

There is lots of activity in the OA space, apparently 80+ companies pursue various therapies. A free high-level summary of a 60-page 2021 OA drug-focused pipeline report is available here. JointStem is listed - culturing triggers classification into a drug.
https://www.researchandmarkets.com/reports/4989227/osteoarthritis-pipeline-insight-2021?utm_source=GNOM&utm_medium=PressRelease&utm_code=cz5n93&utm_campaign=1638340+-+Global+Osteoarthritis+Market+Pipeline+Analysis%2c+2021+Featuring+Insights+on+Emerging+Drugs+Ampion+and+Lorecivivint+(SM04690)&utm_exec=joca220prd

Best.

[ubercool]

Great info, silver_maple, very useful and all bookmarked.

Thought I would provide an update. Today, I was told by Chad Hanson’s Desert Orthopedic clinic that they will no longer accept my insurance, so I guess I’m out of luck there. I had already substituted him in the meantime for Dr. Steven Nishiyama at the same clinic because he specializes in robot knee-replacement surgeries.

Oh well, that means that my mind has been made up for me. I’m scheduled for Regenexx prolotherapy on April 11, BMAC extraction on April 13, and PRP injections on April 21.

Wish me luck.

[silver_maple]

Thanks for the update, ubercool. What you've decided to do has no meaningful downside so from a risk perspective you should be ok. The upside in your case of severe KOA is debatable, esp. the prolo part.

Things have been rather quiet in terms of stem cell experience reports over the past year or two. I am sure people are having stems, they are just not reporting on this board.

Personally I am coming close to the annual PRP refresh my doc recommends and I intend to do (last PRP I did was on Jun 15, 2021 - bilateral). Haven't booked anything yet but getting PRP on short notice is easy in my jurisdiction. PRP has been discussed at length here so won't get into it. Generally, less potent than stems but helps somewhat with the skewed homeostasis of arthritic knees.

Trust you will report post-op. The admin could guide whether to continue this thread or start a new one in a different section (e.g. post-op diaries or injections into the joint).

Best.

[ubercool]

Yea, well prolo is bundled in the price, so might as well try it.

BTW, your doctor, Thomas Vangsness, is now on Centeno’s s..t list:

https://regenexx.com/blog/doctors-misconstruing-orthobiologic-regulations/

 

Thanks for the update, ubercool. What you've decided to do has no meaningful downside so from a risk perspective you should be ok. The upside in your case of severe KOA is debatable, esp. the prolo part.

Things have been rather quiet in terms of stem cell experience reports over the past year or two. I am sure people are having stems, they are just not reporting on this board.

Personally I am coming close to the annual PRP refresh my doc recommends and I intend to do (last PRP I did was on Jun 15, 2021 - bilateral). Haven't booked anything yet but getting PRP on short notice is easy in my jurisdiction. PRP has been discussed at length here so won't get into it. Generally, less potent than stems but helps somewhat with the skewed homeostasis of arthritic knees.

Trust you will report post-op. The admin could guide whether to continue this thread or start a new one in a different section (e.g. post-op diaries or injections into the joint).

Best.

[silver_maple]

Thanks for this tidbit of info, ubercool, wasn't aware. This is a regulatory debate that I am not qualified to comment on. I could not get the full article in AJSM that is in Dr Centeno's crosshairs. I have read a fair bit of hardcore FDA regulations and in his analysis Dr Centeno does use the key relevant terminology (i.e. homologous use, minimal manipulation, same procedure, HCT/P, etc) and appears to have a point. Extensively annotated as well. Further, he certainly has done battle with the FDA and I would think among the bruises he has taken (e.g. having to move cultured offshore) he is highly likely to know the bounds of what is acceptable practice in the U.S.

Good luck with the procedure! I trust you will report post-op.

[ubercool]

Good luck with the procedure! I trust you will report post-op.

Thanks, I will be posting my experience in the Post-op diaries. Tomorrow I will be getting my Regenexx stem-cell procedure. I ended up skipping the prolotherapy, due to a car issue. Given your feedback that it does little anyway, I guess that’s OK.

Thanks again for the wishes.

[ubercool]

I don't know if anyone is reading my post in my post-op thread, so I thought I would post a two-week out report here:

On April 13, I had a BMAC treatment at the Las Vegas Regenexx clinic run by Dr. Josh Goodwin. Here are some general observations.

I have had pain in my knee only once since the BMAC injection, although it can feel a bit sore after walking a lot. Before my procedure, I had recurring pain after going up or down the stairs, etc. I can’t begin biking until late May, so that will be the real test.

BTW, I have a True Innovations DPS 3D Insight Gaming Chair and I was able to sit in it for six hours, so the lumbar PRP appears to be working.