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Stem Cell Therapy Users Update


Rednucleus
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I have been curious about stem cell therapy for a few years now. Reviewed all the BOS posts I could find. Recently went to one of the "sales seminars" too. As a veterinarian I have some understanding of the theory and science involved, and my training has me leaning more to the "too good to be true" conclusion. So, there are quite a few threads on here that date back a few years. I would be especially interested in Ballers reports that are more than a year out from their procedures, and where their cells came from (fat, marrow etc) and what areas you had treated. Also any physicians & therapists comments appreciated.

Thanks!

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Dave, I have had two recent patients who have underwent Stem Cell coupled with PRP injections, one for a knee, and one for Neck, Shoulder, and Knee. The last patient is also coupled withwacupuncture as well.

Both individuals are having very favorable results. Both have gone with umbilical cell.

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Last Thursday I had my foot rebuilt. They re-attached the ATFL ligament on the outside of the foot that I'd torn 25 years ago when I smarted off to a University of Texas football player at a party and he beat me like a drum. LOL. And because of bad genetics, I had no space in the metatarsal joint and it had worn 75% of the cartilage away, causing pain every step for the last 18 months. So they did a v-Cut in my toe bone, realigned the head, pinned it back together. Essentially, it was a radical bunion surgery for someone without a bunion. Then they also did biologic augmented microdrilling where they drilled 65 holes in the bone head and injected Amniotic stem cells in both the site of the ligament repair and in the toe repair. We'll see how things progress over the next 60/90/180 days. My doctor says from his perspective, the people who he can also do the stem cell therapy in conjunction with the corrective surgery are back to walking with less pain sooner. And since my insurance is silly good and covers everything known to man, we did it.
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5-years ago my friend's wife had a hip replaced and one was stem celled. It gave her 5-years but she just had that hip replaced as well.

 

Was at my Ortho last week. My right hip is headed down the path and I asked about stem cell and he said "It isn't where it needs to be yet" and recommended not bothering at this time.

 

I have a messed up left shoulder and a messed up right hip and would love for there to be some magical injection!

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@A_B: "it isn't where it needs to be yet " - meaning the current technology? If stem is going to work for you, getting it done earlier on give the cells better tissue to regenerate - so if stem cell therapy is the real deal, now is the time to explore options. It's not realistic to expect it to help an end stage arthritic joint.
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I had an excellent hip Dr. tell me that “it isn’t where it needs to be yet” meaning that my joint wasn’t bad enough yet to warrant replacement. Same Dr. referred to stem cell therapy as “money transfer “ from patients to providing clinics. He wasn’t a believer was the feeling I took away.
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@RichardDoane I had that discussion with my doctor. I did a lot of research on foot doctors and decided on one who was on the cutting edge from what I could find. What he said was that the studies he's been involved in are showing is that the application method for stem cells is more important than even the type of stem cells themselves. That just using stem cells in a procedure doesn't show any verifiable increased growth in cartilage or bone. And that the problem as he has seen it over the last years is that it has become this boutique thing.....let's throw some stem cells in there for good measure while we're repairing X". He also said this is why he also doesn't do microfracture any longer. That if you are going to use stem cells it has to be in a very targeted manner and bone has to be prepared in a very specific manner.
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PRP is a lot cheaper and has worked very well for me 14 out of 16 times. The two times it didn't work were hail Mary's trying to avoid surgery. The MRI showed that the rotator cuff was completely detached, but tried prp just in case there was some attachment that didn't show up in the mri.
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What I usually say is find a doctor you trust and trust your doctor. If you trust the doctor and they recommend PRP go for it, if they recommend it and you don't trust the recommendation you need a different doctor.

 

Important to separate PRP and Stem Cell - PRP is largely coming up as placebo effect -

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6214820/

 

Bear in mind as @BoneHead states - PRP could actually be beneficial just like Stem Cell could actually be beneficial - but when it is a service that's being tacked on to the visit or when it is on the website as a way to lure clients into the practice you are going to get a lot of hype.

 

I would further comment, just because an Athlete/Celebrity is pitching a product doesn't mean it works - Ortho's are of the conclusion that generally PRP works because it is expensive, it isn't expensive because it works (People want new/trendy stuff that costs money to work)

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Ok, I'm getting in on this thread as well. I have a knee that really just ain't right and I want to see what people have to say here.

 

This is so difficult for me because I see so many similarities between orthopedic surgeons and the mechanical engineers I call on day to day. Sometimes engineers really are warning their clients of a new "technology" that has come out that really truly isn't what it's claimed by all of the people selling it to be and really truly isn't good. Sometimes, however, they think it's not good just because they don't know how to use it yet or they tried (the wrong way) to use it and it backfired. And sometimes, they are just old dinosaurs scared of anything new.

 

Knowing that they, as human doctors, are certainly subject to the same possible errors as these human engineers makes it really tough to just trust them completely on a topic such as this.

 

Edit: For the record, I'm in the camp of folks who has asked my orthopedic surgeon for his opinion on stem cell and his opinion of it was overall negative. However, I'm not ready to take that for anything more than it is: One Opinion from one guy.

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@escmanaze - a good bit of the similarity is that engineers and doctors are both the decision makers for the health and safety of the public, and they are both held to a HIGH degree of accountability for their actions.

 

Searching for current research - "In conclusion, MSC treatment improves knee pain, physical function, and cartilage quality, without any severe adverse events. However, evidence for these outcomes that are considered critical for clinical decision making was “very low” to “low” according to the GRADE system because of the poor study design, high risk of bias, large heterogeneity, and wide 95% CI of the effects estimate. These GRADE ratings were similar even if only high quality RCTs were included in the meta-analysis. Detail information about rehabilitation is lacking; therefore, the role of rehabilitation in MSC treatment in patients with knee OA is unclear. However, rehabilitation was a significant effect modifier of better MSC treatment on self-reported physical function, supporting a concept of the newly born field, regenerative rehabilitation. Integration of rehabilitation into MSC-based therapy may be beneficial at least in improving physical function. These findings would help researchers and clinicians in designing future high quality clinical trials."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6141619/

 

Which would say the studies seem to say there's nothing harmful about it - but also that the studies that conclude that can't definitively say there is nothing harmful...

 

What I've been seeing is that Ortho practices of a decent size often have a physiatrist, or a non-operative/sports med ortho doc who will provide more of these sorts of procedures along with rehab. Often the procedures are cash, and people are doing travel medicine to get some of these procedures performed.

 

A few years we should get a better idea.

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@Rednucleus Here is my story, short version. I'm 65, I have had ostearthritis in my shoulder for some 35 years now. Last year it got so bad that I could not raise my arm past my waist without severe pain. My very good friend, who is a well respected orthopedic surgeon specializing in everything from the shoulder to the fingers and has put me back together longer than I can remember, was my firt stop. Over the last 20 years he has cared for my shoulder with various surgeries and lubricating injections. When I went to him last winter he told me I needed it replaced. Had xrays and MRI's and the radiologist told me she has never seen such a trashed out shoulder, no cartilage, 75% torn supraspinitus, no spacing, etc.. I asked my friend about stem cells and he said "it wasn't there yet, and anyways you are so trashed I doubt it be of benefit. Even though he was my friend I went for a second and a third opinion and they said same thing, replace it. The third guy was the top shoulder guy in Chicago, and he said he would do the stem cell if I really wanted to but it was probably a waste of money. Regardless, I booked an appointment.

 

Then chance would have it I met another Dr., this guy was sports medicine, not a surgeon, and he is totally committed to this avenue as the future of Orthopedic medicine. Although he also said my shoulder was totally trashed, worse he's seen, and there was no research that would indicate it would be of benefit. But he was so knowledgeable, and refreshing to talk to that I booked the appointment with him, even though he was twice the cost, and cancelled the "expert".

 

As I said, for me it was a miracle. It is not an instant cure, and not a cure for the arthritis at all. I'm really not sure what it does,but it worked for me. Over a six month period it got stronger and stronger. At six months you get to full benefit. So now I have a shoulder that still does not have full range of motion, but the range I do have is pain free and strong. I can live with that. I can ski, I can lift weights, I can throw a ball, etc. He used my own bone marrow stem cells and my own fat stem cells.

 

I do not know if it is a permanent fix, and if the symptons come back I will do it again. But for me it was an easy decision, shoulder replacement or try the stem cells. If it doesn't work then I'm out a couple thousand bucks, kind of like buying a ski you wish you didn't. But it worked. My buddy the surgeon was shocked, and told me he didn't think I would have gotten any more function with a replacement. He was very surprised at the result but happy for me.

So that's it, oh yeah, I took a lot of PT afterwards from some very well trained therapists.

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@Rednucleus for what it is worth, personally I would never have had it done at one of the sales seminar places. They may be great, don’t know, but not for me. I was lucky to find the guy I did. Don’t know where you are located but if you pm me I’ll share the info.
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SC Rx will eventually have it's place, but at present is a bit out of control; profit driven, lacking prospective studies, and oversight regulation (FDA). As promising as it can be made to appear, I'd be cautious in having it applied lacking sound studies, a reputable clinic with a proven track record (many hundreds of successful rx's), and possibly FDA approval (although that often is mfg - $$$ politic derived).

 

from the NYT...

12 People Hospitalized With Infections From Stem Cell Shots

Dr. Scott Gottlieb, the F.D.A. commissioner. Federal regulators are cracking down on clinics offering stem cell injections, warning that the treatments can be unsafe. Credit Aaron Bernstein/Reuters

By Denise Grady

• Dec. 20, 2018

• Twelve patients became seriously ill after receiving injections that supposedly contained stem cells from umbilical cord blood, according to the Food and Drug Administration, which issued a warning to the California company, Genetech, that made the blood product they were given.

(The company has no connection with Genentech [TPa - alteplase], the biotechnology corporation.)

The F.D.A. said on Thursday that it had also written to 20 clinics that offer unapproved stem cell treatments, warning them that such products are generally regulated by the agency and encouraging the clinics to contact federal regulators before November 2020, when enforcement will tighten. The names of the clinics have not been released.

“We’re going to be going in and inspecting more stem cell operators this year,” Dr. Scott Gottlieb, the agency’s commissioner, said in an email. “We’re focused on outfits that may be engaging in unsafe practices and haven’t been working with F.D.A. to come into compliance with the laws they’re subject to. Unfortunately, there are too many firms that fit this description.”

Hundreds of clinics have sprung up around the country, offering treatments supposedly containing stem cells, to treat a wide variety of ailments, including arthritis, eye disorders, Parkinson’s disease and lung problems. The treatments are marketed as having curative or healing properties, but there is no proof that they work or are safe.

Clinics offering the treatments claim they are not drugs and therefore do not need F.D.A. approval, but in some cases the agency disagrees. In November 2017, it gave the clinics three years to come into compliance, and said during that period it would use “enforcement discretion”— giving the industry some leeway but cracking down on clinics that harmed patients.

In May, the F.D.A. sought permanent injunctions against two stem cell clinics. One, U.S. Stem Cell Clinic L.L.C. of Sunrise, Fla. had treated three patients who lost their sight after stem cells were injected into their eyes. The other, the California Stem Cell Treatment Center, with locations in Rancho Mirage and Beverly Hills, had been administering a combination of smallpox vaccine and stem cells to cancer patients.

The people who became ill after receiving the Genetech products had been given injections into their knees, shoulders or spines to treat painful conditions like arthritis or injuries. They contracted infections in their bloodstreams or joints, and all were hospitalized.

One patient spent 58 days in the hospital with a bloodstream infection, a spinal abscess and other spinal problems. Another, with an infected knee, was hospitalized for 30 days. The shortest stay was four days; others lasted 12, 15 or 35 days.

Tests of unopened vials of the cord-blood products taken from clinics giving the shots found the same types of microbes that had infected the patients, which included E. coli and other fecal bacteria.

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As a jumper for well over 20 years, my lower back is crap. I did go to a stem cell presentation, and it looked promising. But expensive. No help from Medicare or Medicaid. A single treatment was quoted as $3,200. Comments, ideas? Sure would be nice to feel and move "normally" again, and maybe even re-start skiing, of sorts.
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My thinking is there is very little risk in using cells harvested from your own bone marrow and fat. I personally would not have had the procedure with cells harvested from umbilical or any other foreign source, and as previously stated I would not have gone to a “sales” oriented clinic, especially one that advocated using umbilical sources, which by the way was not offered by the group I went to.

I was lucky to have found the guy I did, and was able to have further comfort in that he is part of the same hospital orthopedic group that I have used for over 25 years, which includes a very close friend who has surgically put me back together many times. It may not be for everybody, but it also is a legitimate procedure. You just have to find the right people. I paid 3,500, and compared to a shoulder replacement it was a bargain.

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It's been three years since I had my shoulder done, still going strong with no problems. I went and had my knee done with the same results. My knee was trashed, torn acl, torn lcl, bone on bone arthritis, no cartilage. Got same advise as shoulder, "replacement is only alternative". Going on 2 years knee is feeling very good.
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@tjm your results on both shoulder & knee are remarkable, especially at 2+ years. From where were your cells harvested? One procedure or a few return visits? Anything else done besides stem cells? Cost for knee? AND does your doc have a buddy here in WA??
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@lpskier for me it took all of 4-6 months before I started noticing. PT all the way through. After 6 months the strength and comfort kept getting better and better. PT is very important though, for me.
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