What you need to know about Cell Therapies! Three important questions to get answers to before you go for it. What is the origin of cells you are getting? Who is performing the procedure? Is fluoroscopy or ultrasound guidance used for the injection procedure?
All of the above questions are very very important and you definitely need to get the answers to these questions before you take the plunge. Many vendors are peddling fake products, many unqualified practitioners with no interventional training are performing cell therapy, and in some cases the cells are not being deposited in the correct spot because they are using no guidance. Lets look at the issues.
Interventional Orthobiologic Medicine.
It is a new brach of medicine that is very new and very promising as far as it use for musculoskeletal conditions, orthopedic conditions and spine conditions.
These procedures are not cure all procedures and are not magical! They are very promising however. But remember there are failures like in anything else in medicine!
Up to this moment, cell therapies were only being used for bone marrow transplant in patients with leukemia or other blood borne malignacies. However thanks to the pioneering work in Denver Colorado of Chris Centeno MD, Gerard Malanga MD in New Jersey, Don Buford MD from Dallas Texas, and many others, great advances have been made in the use of Cell Therapy for many other conditions.
Only a select group of physicians have dedicated themselves to the study of this new field and they usually belong to select societies and attend seminars from very reputable organizations dedicated to the study and advancement of this new field of medicine. These societies and organizations include the Interventional Orthobiologic Foundation and The Orthobiologic Institute.
Lets now address what you need to know so you don't waste your money or run major risks.
1. What is the origin of cells you are getting?
This is a crucial question. Many vendors out there are peddling fake product that not only have been proven not to have viable live cells but also some of these products can transmit disease!
At the present moment there is only one kind of Cell Therapy procedure that is worth considering for musculo- skeletal conditions, and is the one in which you actually get Live Cell. I am refering to one where the Cells are obtained from you own bone marrow and then imediately injectected into the area that needs to be treated. These procedures are called Autologous Cell Therapy procedure. You are both the donnor and the recepient so there is no chance of disease transmision.
Products Advertized as “Amniotic Fluid Stem Cells” that come in a vial or “Umbilical Cord Products such as Warton Jelly”, have been proven to contain no live cells by Dr. Chris Centeno MD, the pionneer of modern day cell therapy procedures and also by the Cornell lab. Additionally some of these products have been proven to be contaminated with bacteria. So besides inefective they are also very dangerous.
This is also extremely important. There are many good docs out there but not all have the skills to preform precision guided injections under fluoroscopy or ultrasound guidance. These are not injections that just anyone that can stick a needle can do. It requires a level of expertice that that takes year to acquire.
Because of the novelty of the technique and the financial gains, there has been a flood of minimally trained physicians and midlevel providers such as nurse practitioners and physician assitants offering these Cell Therapy procedures. They do not even have the most basic training on these types of interventional procedures, making them both dangerous and ineffective. Chiropractors are the ones hiring nurse practitioners or physician assistants to perform the injections simply because a chiropractors license does not allow them to perform injections.
3. How is the injection being done and what equipment is needed ?
This third question is very important! You want to give the injection the best chance of working. For this, the live cells being injected have to be deposited in the correct place! With a blind injections without fluoroscopy or ultrasound for guidance so you can see where the tip of the needle is going, you simply have no idea where it is going to end up at.
Some very specialized equipment is mandatory to do Cell therapy procedure properly and safely. A properly equipped procedure room includes a fluoroscopy table, a C-Arm fluoroscopy equipment, an Ultrasound machine, centrifuge, adequate monitoring and emergency resuscitation equipment, oxygen, intubation equipment etc. in a “clean” room specialy dedicated to carry out these procedures safely. Only properly trained physicians that know how to handle the above equipment should be performing cell therapy procedures.
4. What are the most common cell therapy procedures?
Basically the two most common types of cell therapy procedures are Platelet Rich Plasma (PRP) procedures and Bone Marrow Concentrate BMC/MSC procedures which is basically;;y the gold standard of cell therapy procedures. They are basically used in our office for musculoskeletal conditions, orthopedic conditions and sport injuries. These are very advanced procedures that require a degree of knowledge that not everyone has or is equipped to perform.
a) Platelet Rich Plasma.This is the simplest of the two. The patients undergoing the procedure need to meet certain criteria. The procedure basically entails a venipuncture to draw 60 ml of the patient's own blood. This blood is anticoagulated and then placed in a centrifuge at a certain speed and for a certain amount of time. The goal is to separate and isolate the portion of the plasma rich in platelets (therefore the name of Platelet Rich Plasma). This plasma rich in platelets is injected in the area to be treated under either fluoroscopic or ultrasound guidance. Usually one or two procedures, sometime three need to be done six to eight weeks apart.
b) Bone Marrow Concentrate BMC/MSC. This is a much more involved and sophisticated procedure which requires knowledge of advanced techniques such as how to perform a bone marrow puncture and more sophisticated equipment. Here the goal is to obtain and isolate as many as possible inmature undifferentiated cells which are then injected in the area treated to repair the damage.
5.Warning, Warning! Magical Procedures to avoid!.
We are living in what the pioneer of Stem Cell therapy procedures Dr. Chris Centeno calls the “Wild Wild West”. We live in an era where a multitude of magical claims are being made concerning the benfits of unproven procedures for the sole purpuse of making money. Here are some:
a) Exosome therapy. First of all they are illegal and second they can transmit disease. These exosomes are basically minute vesicles given off by cells in their culture media, bottled without FDA approval for sale. Since they do not come from from your own cells, they can transmite disease. For more info on them visit the following link : https://regenexx.com/blog/what-are-exosomes-are-they-legal/
b)Cell therapy procedures to treat Erectile dysfunction. None have been proven to work so far.