General FAQs

While some clinics intravenously inject MSCs in the mistaken belief that stem cells will go where they are needed, this claim has not been proven and is likely an FDA violation to inject them this way. They should be injected directly into the damaged tissue.

Studies have shown that MSCs don’t travel throughout the body. The theory behind this is that they usually don’t circulate in the bloodstream the way other adult stem cell types do. In fact, MSCs mainly live in the tissues they assist. For this reason, we are careful to inject MSCs precisely into the affected tissue to optimize the tissue’s healing process.

Adult stem cells tend to stop growing on their own, unlike embryonic stem cells. Even when we grow a patient’s stem cells in a lab over a few weeks’ time, they reach a point when they no longer propagate. Plus, your body gives off signals to these cells to stop growing once a fracture or ligament tear has been healed.

MSCs stop themselves from growing when they come into contact with each other. This is called confluence in cell culture jargon. When growing these cells in a lab setting, technicians know when the MSCs will no longer proliferate. Another reason these repair cells stop growing is that they have completely covered the injured area. We have not seen evidence of overgrowth in patients whose treatment plan includes ongoing MRI views of the implant sites.

We generally use an MRI to help diagnose and assess the condition of the injured area. An x-ray only shows bones and not soft tissue. Sometimes, a Regenxx physician will also do a diagnostic ultrasound, if the area in question is not in the spinal region. For patients who can’t have an MRI, we might conduct a CT arthrogram.

Please note that your Regenexx doctor needs your most recent MRI, and it must be less than one year old and without contrast. It should also be after any surgery or scope you may have had.

Do you use embryonic or adult stem cells?

Regenexx procedures only use a patient’s own adult stem cells, not embryonic cells.

Are amniotic, umbilical cord and placenta stem cells more effective than adult stem cells?

Current research is too limited to determine whether stem cells isolated from the placenta, umbilical cord or amniotic membrane can be effectively used to treat orthopedic conditions. We do know that the safest stem cells for any patient are those taken from the patient’s own body. In addition, in the United States, the use of umbilical cord stem cells for orthopedic treatments is prohibited by the FDA. Any birth tissue produces sold in the United States don’t have any living stem cells. 

Can stem cells taken from adipose (fat) tissue be effective?

While fat tissue does contain many MSCs, they aren’t as effective for orthopedic treatments as those derived from a patient’s bone marrow. Plus, the FDA has not approved the use of true fat-derived stem cell procedures for orthopedic treatments because the process of obtaining those cells “more than minimally manipulates” the tissue. Per the FDA, this makes the extracted fat tissue cells a drug that would require special approval. Any U.S. physicians who perform treatments with fat cells are either violating the FDA’s rules or not processing the fat in a way that extracts its stem cells.

What are the various types of MSCs?

Two main types of MSCs are used in orthopedic treatments: ones derived from fat and ones derived from bone marrow. The adipose or fat MSCs often come from liposuction. The bone marrow MSCs are extracted with an aspiration that patients report as being a comfortable procedure. The fat-derived MSCs consistently and significantly pale in comparison to bone marrow-derived cells in orthopedic applications. Because bone marrow-derived MSCs naturally repair cartilage, bones and soft tissue, it stands to reason that these cells would outperform their fat-derived counterparts. 
VIDEO: Bone Marrow Extraction with Regenexx Tampa Bay and Sarasota's James Leiber, DO
But I’ve heard adipose (fat) tissue has more stem cells than bone marrow does, so why do you use bone marrow-derived MSCs? Often, adipose stem cell clinics overstate the stem cell count produced by their processed fat. In fact, some of these supposed stem cells are actually fat tissue. Also, the Regenexx method of isolating stem cells greatly expands the amount of these cells that were taken from a patient’s bone marrow. Lastly, the MSCs from fat cells simply aren’t as effective in orthopedic applications as bone marrow MSCs. That being said, the Regenexx-AD knee stem cell procedure uses MSCs derived from both fat and bone marrow.

We began doing clinical trials in 2005. These lasted until 2007, and they were the first orthopedic stem cell procedures done in the United States. Since then, Regenexx has conducted more of these procedures than our peers – either at clinics or medical groups. In 2010, we developed our same-day procedure protocol and we continue to refine it.

It depends on the severity of your anemia. If your hemoglobin is under 10 or your hematocrit is under 30, you may not be eligible for a stem cell procedure. If your hemoglobin is under 12 or your hematocrit is between 30 and 36, we may be able to make adjustments, such as limiting the IV blood or marrow draw amounts, and we will suggest you visit your primary doctor after your procedure.