Had Regenexx Stem cell procedure done on Left knee

[skishikes]

I recently read ubercool's thread on his Regenexx procedure ( https://www.kneeguru.co.uk/KNEEtalk/index.php?topic=79711.msg735256#msg735256) and thought I add my experience. 

I found very little information from people who had actually done this procedure, so I thought I would add my experience for people who are contemplating pursuing this option.

attached is my MRI report on the condition of my left knee, (severe osteoarthritis, macerated lateral meniscus, torn medial meniscus, bakers cyst)

The procedures recommended to me by my Regenexx affiliated doctor was:
Left knee aspiration, then prolotherapy to the Left intra-articular knee joint, Popliteal cyst, other areas pending ultrasound exam;  Bone marrow aspiration from bilateral iliac crest; bone marrow concentrate injection to left intra-articular knee joint, medial compartment, lateral meniscus body.  Regenexx PRP injection to left knee, MCL, pes anserine, popliteal cyst.

The procedures were done over three days,
5/19 : removed fluid from the bakers cyst and other areas of the knee, and then injected prolotherapy solution.
The fluid removal and following prolotherapy was slightly uncomfortable.

5/21:  removed stem cell from hip in the morning, returned in the afternoon to have them reinjected
I felt very little discomfort during the bone marrow aspiration, the injection into the various areas was a bit more uncomfortable.  I did take xanax and phenergan prior to the procedure, so I'm sure they helped lessen the pain/discomfort.

5/26:  had blood drawn in the morning for the PRP.  The PRP was injected in the afternoon.  The blood draw was a non-event, the discomfort with the PRP injection was similar to the bone marrow injections.  I did not take anything to lessen discomfort or pain on this day.

The most swelling and pain, post procedure was after the PRP injections.  The knee was slightly swollen and pretty painful for two days after the PRP injections.  I had to take tramadol, for the pain, to allow me to sleep. After the second day post PRP, the knee felt much better.

So as of today 6/16, I am just shy a month from the start of the procedures.  I am primarily doing water walking in a pool for exercise, and just started to doing short walks on flat ground.  .5 to .75 miles. 

[skishikes]

To add a little background.  This is a description of my baseline knee function, discomfort level prior to the regenexx procedures:

I have had no previous injections, or procedures of any kind on this knee.  I have not had any specific injury to this knee, other than wear and tear from the stresses and strains put it on it from hiking, backpacking and skiing.

For the most part have full range of motion with no pain when moving the knee.  If I move the knee in certain ways, I will sometimes experience a catching, which causes a significant momentary twinge of pain.

I can walk on flat ground, for 3+ miles, pretty much pain free, but will occasionally feel minor pain that comes and goes, but nothing at the level that makes me want to stop walking.

If I walk on ground that is on slope, I can go up the slope without pain, but coming down hill, the steeper the slope, the more pain in the knee.  I have to go down steep slopes very slowly, and avoid them when possible.

the knee is painful whenever I put weight on it, in a forward bending motion; ie going up steps, with left leg leading, cannot do more than a 1/4 single leg lunge without pain with the left leg, cannot do squats without pain.
cannot ski without pain.

when the knee has been in the same position for awhile, like when I have been asleep for awhile, and then wake and try to extend the knee, I have to extend it very slowly due to tightness and pain.  Once I get the knee moving, it feels fine.

So in summary, for normal day to day activities, the knee pretty much pain free.  I avoid using the left leg to lead up steps, and avoid walking down hill.  When I do activities that aggravate the knee, like hiking on rough, steep trails, or skiing the knee will get swollen and painful.

I consider trying Regenexx a "hail mary" pass kinda thing.  I am pretty skeptical of the whole stem cell thing, but there really is nothing else to try, and my situation is not bad enough for a TKR...nor do I want to go that route.
I chose a Regenexx affiliated doctor, because they have a well documented approach.  The Regenexx doctor went over my MRI with me in a very detailed manner.  When he did my ultrasound evaluation, he had a large screen for the patient to see what he was looking at, and explained what he was looking at during the ultrasound, pointing out the ACL, MCL, etc.  When he did the injections, I also could see the needle being inserted and the injections being done.  He explained where he was injecting, and I could see each injection.  He was very thourough and professional.  I went to one other "stem cell" doctor, who I know did not even look at my MRI, and did not give me the feeling of really being concerned about my situation, other than the money he could make from it. 

My ultimate reason for trying it:  It is a low risk procedure, worse outcome, is that it doesn't work and I'm out the money.   If it does work, it will have been worth every penny.  The cost for my treatment was $8450. Pretty expensive, but if I can't ski anymore, I figured the thousands I will no longer be able to spend on ski vacations, might as well go to trying something that might allow me to continue doing it. 

[gaoshanfelix]

8450USD is more than what I paid (without any insurance co-payment) in Europe for a full minced cartilage (arthrex autocart) surgery including aftercare and 3 MRI plus some other stuff.
I would not trust Regenexx much based on their study results.
Rather give the full stack of food additives for osteoarthritis a go - first and foremost:
UC-2 collagen (2 years supply cost you around 120USD in the US - this is the most expensive item by far on this list)
Take 20-30g of normal collagen protein per day (about twice the price of milk protein)
Glucosamin (that stuff is very cheap if you get it as powder in a big amount - like 20USD for a year)
Chondroitin (as powder medium priced - 50USD for a year)
Vitamin D3 & K2 (like 4000IU per day without sun)
Hyauluron (maybe 20USD for a year)
Omega 3 (it's anti inflammatory - cheap)

There are stacks that kinda include all of the above -but they are way overpriced vs the single ingredients. Glucosamine/Chondroitin as pills is way more expensive than as powder - but you avoid the disgusting taste - and year really badly disgusting. If it's combined they often save on chondroitin. The recommend dosage is 1.6g glucosamine per day, 1.2g chondroitin.

Try to eat a lot of actual cartilage - e.g. cook your own soup from bones or I think best - try to eat a lot of chicken cartilage. I would guess this is actually the best if you can manage 5-10g of it per day (but that's hard to manage - you would be eating chicken legs every day to achieve it). Some people say the collagen breaks down when heated above 60° - but then I think this does not apply to bone soup (especially lamb bones) or chicken cartilage... Cannot eat it cold anyhow.

Skip sugar and other inflammatory foods - especially with no nutritional value.

All have proven some positives in study - UC2 I would say even better scientific basis than Regenexx. Non harms you.
Then you could still go for Arthrex Autocart or ACI in last resort before TKR. Autocart surgery in US will surely be more expensive vs Europe - but it's a single surgery no more difficult than say an ACL implantation - and could 30-48h stay in hospital. Of course rehab is way more than from Regenexx - but the success is also way bigger. And Autocart is a single surgery not double like ACI/MACI and so on. Forget microfracture/nanofracture - that is a dead end.


Bromelain I am quite split about. Showed some good results in studies - but then if they do animal studies they use exactly that - bromelain in high dosage injected into the knee/cartilage - to remove the cartilage. Maybe it softens your cartilage a tiny bit - and that way on small impact (not big impact) allows it to regrow/regenerate a bit? This one is a really tough one so I would rather stay away from it. Stay away from NSAID too except if you have a sudden big swelling.
Same for MSM - also often recommended but I am afraid it could also be actually negative.

Basically 3 months after Autocart surgery I was better of than you right now. But yeah the first 8-10 weeks were hell - especially the first 5.5 before I could get on a trainer bike.

[vickster]

8450USD is more than what I paid (without any insurance co-payment) in Europe for a full minced cartilage (arthrex autocart) surgery including aftercare and 3 MRI plus some other stuff.
I would not trust Regenexx much based on their study results.
Rather give the full stack of food additives for osteoarthritis a go - first and foremost:
UC-2 collagen (2 years supply cost you around 120USD in the US - this is the most expensive item by far on this list)
Take 20-30g of normal collagen protein per day (about twice the price of milk protein)
Glucosamin (that stuff is very cheap if you get it as powder in a big amount - like 20USD for a year)
Chondroitin (as powder medium priced - 50USD for a year)
Vitamin D3 & K2 (like 4000IU per day without sun)
Hyauluron (maybe 20USD for a year)
Omega 3 (it's anti inflammatory - cheap)

There are stacks that kinda include all of the above -but they are way overpriced vs the single ingredients. Glucosamine/Chondroitin as pills is way more expensive than as powder - but you avoid the disgusting taste - and year really badly disgusting. If it's combined they often save on chondroitin. The recommend dosage is 1.6g glucosamine per day, 1.2g chondroitin.

Try to eat a lot of actual cartilage - e.g. cook your own soup from bones or I think best - try to eat a lot of chicken cartilage. I would guess this is actually the best if you can manage 5-10g of it per day (but that's hard to manage - you would be eating chicken legs every day to achieve it). Some people say the collagen breaks down when heated above 60° - but then I think this does not apply to bone soup (especially lamb bones) or chicken cartilage... Cannot eat it cold anyhow.

Skip sugar and other inflammatory foods - especially with no nutritional value.

All have proven some positives in study - UC2 I would say even better scientific basis than Regenexx. Non harms you.
Then you could still go for Arthrex Autocart or ACI in last resort before TKR. Autocart surgery in US will surely be more expensive vs Europe - but it's a single surgery no more difficult than say an ACL implantation - and could 30-48h stay in hospital. Of course rehab is way more than from Regenexx - but the success is also way bigger. And Autocart is a single surgery not double like ACI/MACI and so on. Forget microfracture/nanofracture - that is a dead end.


Bromelain I am quite split about. Showed some good results in studies - but then if they do animal studies they use exactly that - bromelain in high dosage injected into the knee/cartilage - to remove the cartilage. Maybe it softens your cartilage a tiny bit - and that way on small impact (not big impact) allows it to regrow/regenerate a bit? This one is a really tough one so I would rather stay away from it. Stay away from NSAID too except if you have a sudden big swelling.
Same for MSM - also often recommended but I am afraid it could also be actually negative.

Basically 3 months after Autocart surgery I was better of than you right now. But yeah the first 8-10 weeks were hell - especially the first 5.5 before I could get on a trainer bike.

How old are you out of interest?

[Dave33]

I'll only say this, and move on, as I don't want to make it seem like I have any sort of expertise in the medical field, but it's very clear to me that some of the companies mentioned in these stem cell products have all the hallmarks of snake oil salesmen.

The marketing of the treatment, both pre, during and post IS clearly the product, the result or which is largely based upon the placebo effect of the process. Promotional materials at the level of luxury car glossies. Networked doctors that are essentially franchisees, trained to take the patient through a sales process. Slick websites quoting 1st hand reviews of dubious origin - ie: "I could barely move, and now I'm training for marathons" etc, are extremely powerful motivators, especially for people that have had their quality of life reduced, and are looking for any avenue to recovery. "Studies" conducted and controlled by companies with vested interests in the outcome, or connected to such.

The motivator here is clearly money, and little else, and this unfortunately is common in countries with privatized medicine.

Be cautious, skeptical, and read the fine print.

[gaoshanfelix]

How old are you out of interest?

38


Oh yeah - and you an likely get a full Autocart surgery plus 2 day hospital stay in Germany for 3300€ - that's the rate the public insurance will pay for a patient. If you pay 6000€ like me - that's because you chose a private hospital and a famous surgeon (well and as arthrex autocart last year in Austria was still very scarcely available, but getting more and more now) and that in Austria if you private pay for public hopsital you pay twice the rate insured people do. This is not the case in Germany (but I have no free place to live in Germany / didn't want to bother my sister living on crutches for 3-4 weeks there - and you cannot drive a long distance/fly/whatever the first weeks after surgery - so paying a bit more for it was the best thing to do.

To me those stem cell companies also sound a lot like snake oil. I think the main reason it helps - is that people will for some weeks take weight of, then do a rehab and in that way resolve their bone bruises. 1-2 year later if they go back to previous level activity they are back to square one.

The science on food supplements isn't too good either (but actually better than on stem cells). However some of these supplements may help you to not further degenerate - while others may help you to get rid of pain. They are not expensive but have no known side effects (if you are not allergic to them - which may well be the case for some of them). If they help you to not degenerate further - and get rid of the pain - it's a good enough solution. Clearly it will only work for grade 1-3 cartilage damage just like the stem cell promise to do.
Quite a few small scale but higher quality studies have shown that food supplements slow/stop your cartilage breaking down further. While NSAID in the long run are the best way to destroy your cartilage (so if there are studies comparing supplements with NSAID like Ibuprofen or Voltaren take the control group with a big doubt). NSAID have their place - if they stop inflammation quickly which is not chronic.

My surgeon said, the most important thing for cartilage is 15-20 minutes of cycling/walking or knee friendly sports each day (and yes not accumulated but in one bit). Everything else comes secondary. The cartilage needs to be loaded - but not too much. If you get sedentary - that's the quickest way to kill your cartilage. The second thing is living healthy so your cartilage gets its nutrition and maybe support it with dietary supplements.

[skishikes]

Update #1: One month post stem cell/prp procedure.

Prior to my update, here is some additional background information.  I am a 64 year female, who has always been active.  My orthopedic surgeon told me, that due to my age, the extensive osteoarthritis, and damage to my cartilage, that I am not a good candidate for any type of repair procedures. He said I will probably need a TKR in the future.  Told me, that until I reach that point, I should take NSAIDs and avoid activities that aggravate the knee.

I am not on any prescription medicines.

I have taken the following supplements, daily since 2006:
        Glucosamine, Chondroitin, Hyaluronic Acid (Schiff Move Free joint Health)
        Fish Oil
        Vitamin D3
Apparently, they did not prevent my joint from deteriorating, but maybe it would be worse if I hadn't take them.  There is no way to know

In the past 5 months, I started taking the following on daily basis:
         Turmeric/Curcumin
         Vitamin K-2 (MK-7)
I have stopped taking all NSAID pain relievers.  I have been using the Turmeric as an anti-inflammatory, and it seems to work for me.

A couple months prior to proceeding with the Stem Cell procedure, I improved my dietary nutrition.  I started to eat low glycemic foods, more vegetables and fruits, less red meat and processed foods and refined carbohydrates.  Decreased sweets and dairy.  This has helped me lose about 8 pounds.

Update, Month 1:   I will update, by contrasting my baseline knee function/pain, described in my second post, with my current situation.

-For the most part have full range of motion with no pain when moving the knee.  If I move the knee in certain ways, I will sometimes experience a catching, which causes a significant momentary twinge of pain.

update 6/22: No Change. I have full range of motion with no pain when moving the knee.  The knee still occasionally catches, with the same momentary twinge of pain.

-I can walk on flat ground, for 3+ miles, pretty much pain free, but will occasionally feel minor pain that comes and goes, but nothing at the level that makes me want to stop walking.

update 6/22:  No Change. I can walk for 3+ miles, very minor discomfort, every now an then.

-If I walk on ground that is on slope, I can go up the slope without pain, but coming down hill, the steeper the slope, the more pain in the knee.  I have to go down steep slopes very slowly, and avoid them when possible.

update  6/22:  I have not re-introduced this yet, so will include in next update.

-the knee is painful whenever I put weight on it, in a forward bending motion; ie going up steps, with left leg leading, cannot do more than a 1/4 single leg lunge without pain with the left leg, cannot do squats without pain.

update 6/22:  Improvement. I favor the left leg less.  When going up and down steps there is less discomfort. I can support more weight on left leg,  less pain and discomfort.  I have not tried squats or lunges yet, so will include in the next update.

-cannot ski without pain.

update 6/22:  :  I have not re-introduced this yet.  Can't be updated till this upcoming winter.

-when the knee has been in the same position for awhile, like when I have been asleep for awhile, and then wake and try to extend the knee, I have to extend it very slowly due to tightness and pain.  Once I get the knee moving, it feels fine.

update 6/22:  Improvement. This issue of tightness and pain has completely gone away, and is the most noticeable/significant improvement thus far.  Not sure if this can be attributed to the stem cell or prp, or maybe it was improved by the left knee aspiration, when he removed all the inflammatory fluid.

update summary: I am starting to use the left leg to lead up steps, and favor it less.  The issue of tightness and pain, seems to have completely resolved.  My activities this first month, have been swimming and water walking twice a week, and walking approx. 2 miles twice a week.  I plan to re-introduce activities that aggravate the knee, like hiking on steep terrain, next month.

[gaoshanfelix]

Glucosamine, Chondroitin, Hyaluronic Acid (Schiff Move Free joint Health)

That one has the common problem of mixtures - very low on Chondroitin, super low on HA. You pay a lot more than for single ingredients - and they skip on the expensive ones vs the dosages used in studies... So basically you only get 1/6 of the chondroitin vs the studies, and the HA is less than 1/100 of some high dose pills (500mg per pill/day vs 3.3mg). So basically you only took Glucosamine here.

[ubercool]

@skishikes ignore Felix, you're doing just fine. Supplements have a marginal effect at best. The most important element of stem cell therapy is choosing the right clinic and Regenexx is by and large the best, based on my extensive research.

And those comparisons with European practitioners are not useful either. Our market baskets are totally different.

[gaoshanfelix]

@skishikes ignore Felix, you're doing just fine. Supplements have a marginal effect at best. The most important element of stem cell therapy is choosing the right clinic and Regenexx is by and large the best, based on my extensive research.

And those comparisons with European practitioners are not useful either. Our market baskets are totally different.

The only thing that Regenexx has proven well - is that it's safe (no adverse reactions). The studies supporting that it works in treating cartilage damage are very low quality/less effect than UC2 collagen (which is the food additive with the highest quality positive research).

In order to prove that Regenexx works - there would need to be a double blind study comparing it to another proven treatment (like ACI). Regenexx charges so high prices that they could easily afford such a study. The fact that such a study doesn't exist is quite telling (instead they did a big study proving that it is safe).
Alone the process of taking a longer break, then doing rehab - likely has a bigger impact then those stem cells they inject.
There are 2 things I really don't get over Regenexx - a) price b) that it kinda has a rehab that isn't much shorter than from ACI.
So why get Regenexx if you could get some proven treatment like ACI with the same rehab. If it's about price then go for minced cartilage surgery which will be about the same price as Regenexx but with small scale studies so far showing actual great effectiveness (for long term studies need to wait another 4-5 years until the 5 year studies will be published).


For grade 2-3 osteoarthritis I think getting full muscle back for example with a high quality BFR cuff would show way more promise. Making sure that your diet is not junk food/no sugar, no muscle disbalances - and you are on a better track.

So far there is not much track record for stem cells solving any kind of bigger problems in real life (be it cancer, arthritis or other problems where stem cell advocates thought a simple injection may cure it). ACI/MACI is not stem cell treatment but specialised cells.

[Robert Lloyd]

I agree with  gaoshanfelix.

Dr. Centeno acknowledges that stem cells will NOT regrow cartilage in bone on bone arthritis.

https://regenexx.com/blog/will-stem-cells-regrow-new-cartilage-none/

Very few technologies will regrow cartilage in bone on bone arthritis.
ACI (your own cartilage cells) is one of them:

https://www.verywellhealth.com/aci-autologous-chondrocyte-implantation-2549483

The MACI procedure by Vericel is a $60,000 plus cartilage treatment, but most insurances will pay for it because it actually DOES regrow cartilage in bone on bone arthritis.

https://www.maci.com/patients/

Recovery from ACI/MACI is definitely long and challenging.  Athletes have been sidelined for a year before being able to run again.

If Regenexx or any stem cell/prp injection strengthens your tendons and ligaments by even 5% then you should consider it a successful outcome for stem cell/PRP (assuming you ignore the high out of pocket cost).
Regenexx might strengthen and protect healthy cartilage from decay, but we simply don't have enough data on just how effective Regenexx actually is.

[ubercool]

So, Felix complained about Regenexx costing too much but if Vericel charges $60,000 that makes Regenexx charges, ~$8K, look like chump change.

Also, the MACI site says to stay off your knee for eight weeks! I had trouble enough staying off mine for three days! So, add another $10K for a rehab facility.

I was willing to take the risk to learn first-hand whether stem cells work. So far, the jury is out of course, but Dr. Carlo Tremolada of LIPOGEMS told me it could take as long as nine months before you see real results.

I agree with  gaoshanfelix.

Dr. Centeno acknowledges that stem cells will NOT regrow cartilage in bone on bone arthritis.

https://regenexx.com/blog/will-stem-cells-regrow-new-cartilage-none/

Very few technologies will regrow cartilage in bone on bone arthritis.
ACI (your own cartilage cells) is one of them:

https://www.verywellhealth.com/aci-autologous-chondrocyte-implantation-2549483

The MACI procedure by Vericel is a $60,000 plus cartilage treatment, but most insurances will pay for it because it actually DOES regrow cartilage in bone on bone arthritis.

https://www.maci.com/patients/

Recovery from ACI/MACI is definitely long and challenging.  Athletes have been sidelined for a year before being able to run again.

If Regenexx or any stem cell/prp injection strengthens your tendons and ligaments by even 5% then you should consider it a successful outcome for stem cell/PRP (assuming you ignore the high out of pocket cost).
Regenexx might strengthen and protect healthy cartilage from decay, but we simply don't have enough data on just how effective Regenexx actually is.

[gaoshanfelix]

So, Felix complained about Regenexx costing too much but if Vericel charges $60,000 that makes Regenexx charges, ~$8K, look like chump change.

Also, the MACI site says to stay off your knee for eight weeks! I had trouble enough staying off mine for three days! So, add another $10K for a rehab facility.

I was willing to take the risk to learn first-hand whether stem cells work. So far, the jury is out of course, but Dr. Carlo Tremolada of LIPOGEMS told me it could take as long as nine months before you see real results.

In Europe for 8K you can easily get Autocart without any insurance. However from what I would gather about those stem cell injections - I guess if you cannot reduce your weight bearing for 2-3 weeks - there is no chance for the cells to grow (not too likely they grow into anything useful even if you don't do any weight bearing for that time).
With Autocart you are kinda in for a really tough 4-5 weeks (the bigger your difficulties pre surgery - the harder those weeks) - you have 25% weight bearing two weeks, then 50% in the third week - and from the 4. week it's 75% or even 100% depending on the doctor and what your pain level allows you. If you only have grade 3 damage you most likely can be off crutches in the 5. week already.

From week 5 you can be back on a trainer bicycle. Week 6 back on a real bike and if possible no more crutches. Maci is the same most surgeons really shortened those guidelines.
Yes - the first 8 weeks will be much harder - the 3. and 4. month still a bit harder - but the effect will be much bigger and it's proven success. And those times are from severe grade 4 damage - if it's grade 3-4 it will be much faster. For grade 2 cartilage damage you don't need any surgery - build muscle - loose weight - should be your main priority. I was painfree for at least 6 years with grade 4 damage - because of good muscles and enough sport. Should have had surgery earlier but then good I didn't because MACI would not have been covered by my insurance - while NFX/MFX likely only would have caused bigger damage. I do think with some advances in MACI (like the new liquid scaffolds which seem superior in blind studies vs older scaffolds) MACI is on par with Autocart concerning success, maybe even superior (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9137299/ - those numbers are really great in this study!)? But then it's  surgeries instead of a single one and it's way more expensive.

The biggest change you realized in your other thread - do sports every day! But don't do sports that hurt your knee. That's the best way to keep your knee working. Cartilage needs to be nurtured - but not stressed. That's why very early return to swimming / cycling is great. Return to hiking as soon as possible. Walk up and down stairs every day for 20 floors if it doesn't cause you pain. And grow back your muscles as quickly as possible - BFR training is a way to achieve that even if kinda everything causes you pain. Usually after surgeries proprioception is more important than muscle mass/power - with cartilage damage and the ability to do BFR training I think this approach should be changed. First get back the muscle mass then the proprioception. Usually if you first grow back mass the danger is you will do damage while other structures aren't back yet. If you are still in pain that's not a worry - so BFR to get back muscle to really high levels - then this will allow you to add proprioception quicker too.

MACi is around 25K in Europe vs 60K in US , but that's mainly due to lab costs which are prohibitive. Autocart should be possible to find for 8K in US - it would be the same price as ACL surgery because it's about the same difficulty (and yes ACL surgeries can be found for 8K USD - even if some clinics will charge way more and rip you of in US). And  it can be done with ligament surgeries together in the same surgery (Same for Maci of course). If you have grown up - there simply seems no way to actually regrow cartilage without surgery. Without surgery the best that can be achieved is stopping degradation - which is good enough IF you are not down to the bone yet (or only small area). And anyhow most insurances will pay for it - unlike Regenexx.


Actually I would be very sceptical about Regenexx taking stem cells and same day reimplantation. That sounds like snake oil if ACI/MACI needs 3-4 weeks for lab growth of the cells. Most of Regenexx is nothing else than PRP really overpriced. The fact that they make secrets over what they are doing is typical for snake oil procedures.

[Robert Lloyd]

So, Felix complained about Regenexx costing too much but if Vericel charges $60,000 that makes Regenexx charges, ~$8K, look like chump change.

Not a fair comparison.  If your insurance covers 100% of MACI and zero percent of Regenexx then MACI is the far better deal.
Insurance will cover MACI because it had an FDA trial and MACI actually grows real cartilage in bone on bone arthritis.

Also, the MACI site says to stay off your knee for eight weeks! I had trouble enough staying off mine for three days! So, add another $10K for a rehab facility.

Good argument.  MACI recovery is brutal, but it does actually regrow cartilage for bone on bone arthritis and Regenexx does not.
Dr. Dunn had me on crutches for many months following IAGH and it didn't regrow any cartilage.  He claimed it did, but MRIs and follow up scopes showed otherwise.  I wasted all this time on crutches for a worthless IAGH procedure.  Eight weeks on crutches is rough, but doable.
Dr. Centeno has regularly stated that there is no evidence IAGH regrows cartilage.

I was willing to take the risk to learn first-hand whether stem cells work. So far, the jury is out of course, but Dr. Carlo Tremolada of LIPOGEMS told me it could take as long as nine months before you see real results.

What is your definition of "works"?  Stem cells won't regrow cartilage in bone on bone arthritis.  Perhaps stem cells will strengthen existing cartilage and tendons.

[Robert Lloyd]

Actually I would be very sceptical about Regenexx taking stem cells and same day reimplantation. That sounds like snake oil if ACI/MACI needs 3-4 weeks for lab growth of the cells. Most of Regenexx is nothing else than PRP really overpriced. The fact that they make secrets over what they are doing is typical for snake oil procedures.

I can explain this and same day stem cells isn't anything to be skeptical about.  MACI is a two part procedure.  The first arthroscopy removes a tic tac size piece of cartilage from your knee.  This cartilage sample is used to create millions of cartilage cells on a matrix.  That matrix is glued with fibrin into the defect with a second surgery (usually an arthrotomy).

Regenexx stem cells are obtained from your hip.  They are mesenchymal stem cells.  They are spun in a centrifuge and injected into your joint.  There is no need to make millions more of them because your knees can only take so many at once.  If you want your stem cells multiplied to use them later you can go to Regenexx Cayman Islands.

The two procedures are quite different.  Regenexx isn't capable of regrowing cartilage in bone on bone arthritis because no one has figured out how to make stem cells do that yet.