Stem Cell Injections
Stem cell therapy is a form of regenerative medicine that utilizes the body's natural healing mechanism to treat various conditions.
Stem cells are being used in regenerative medicine to renew and repair diseased or damaged tissues, and have shown promising results in treatments of various orthopedic, cardiovascular, neuromuscular and autoimmune conditions.
Stem cells are present in all of us acting like a repair system for the body. However, with increased age sometimes the optimum amount of stem cells are not delivered to the injured area. The goal of Stem Cell therapy is to amplify the natural repair system of the patient's body.
Types of Stem Cells
There are two major types of stem cells embryonic stem cells and adult stem cells. Embryonic stem cells (ESCs) are stem cells derived from human embryos. They are pluripotent, which means they have the ability to develop into almost any of the various cell types of the body.
As the embryo develops and forms a baby, stem cells are distributed throughout the body where they reside in specific pockets of each tissue, such as the bone marrow and blood. As we age, these cells function to renew old and worn out tissue cells. These are called adult stem cells or somatic stem cells. Like embryonic stem cells, adult stem cells can also replicate into more than one cell type, but their replication is restricted to a limited number of cell types.
Use of Stem Cells in Orthopedics
The unique self-regeneration and differentiating ability of embryonic stem cells can be used in regenerative medicine. These stem cells can be derived from eggs collected during IVF procedures with informed consent from the patient. However, many questions have been raised on the ethics of destroying a potential human life for the treatment of another.
Adult stem cells are most commonly obtained from the bone marrow, specifically the mesenchymal stem cells, which have the ability to replicate into cells that form the musculoskeletal system such as tendons, ligaments, and articular cartilage. They can be obtained from the iliac crest of the pelvic bone by inserting a needle and extracting the stem cells from the bone marrow.
Currently, stem cell therapy is used to treat various degenerative conditions of the shoulder, knees, hips, and spine. They are also being used in the treatment of various soft tissue (muscle, ligaments and tendons) as well as bone-related injuries.
Bone Marrow Concentrate (BMC) Stem Cell Treatment
What is Bone Marrow Concentrate (BMC)?
BMC is a biologic treatment that is derived from your own bone marrow. It contains a variety of bioactive cells, including multipotent stem cells, in addition to many growth factors, anti-inflammatory cytokines, and many other proteins that can promote healing and also provide significant anti-inflammatory relief. It can be used to stimulate healing for soft tissue injuries involving tendons, ligaments and muscles. It can also be used for joint injuries including labrum and meniscus tears as well as for degenerative joint diseases such as arthritis and chondromalacia.
How do I prepare for a BMC injection?
Discontinue any anti-inflammatory medications or supplements five days prior to your procedure. An option to take an anti-anxiety medication is available for the procedure. If you choose to use this medication, bring this to your appointment and take it one hour before the procedure. If you take this medication, you will also need a driver to bring you home.
What can I expect on the day of the procedure?
Expect to be in clinic for around one and a half hours. Paperwork will need to be completed prior to your injection. The procedure will take place in the clinic. A local anesthetic will be administered at the site to numb the area and after the bone marrow aspiration is performed, a bandage will be applied. The bone marrow will be processed immediately afterwards. The BMC will be administered via injection to the affected area using ultrasound guidance in the clinic. Depending on your injury, a brace may be administered followed by any prescriptions including physical therapy. A follow-up appointment will be made at this time as well.
What can I expect after my procedure?
BMC can stimulate a healing response and the first phase of healing inflammation. As a result, BMC may initially cause stiffness and mild swelling that can potentially last for several days. Anti-inflammatory medications are discouraged for up to two weeks after the procedure to allow for an adequate natural inflammatory response. Ice, acetaminophen (Tylenol), and pain medications can be used if necessary. Excessive high exertion activity involving the injured body part is discouraged during the first week. Physical therapy is typically recommended to begin one week after the injection. The bone marrow aspiration site may feel like a bruise for several days and will need 10 days for complete healing. Avoid pools, hot tubs and baths during this time period. Showers are allowed with a tegaderm dressing which will be provided to you on the day of the procedure.
How long does it take to see any results?
BMC injections may begin relieving pain as early as several weeks after the injection but typically it may take up to six to eight weeks before there is a noticeable effect Depending on your injury, complete healing may take several months after the procedure. A decrease in pain does not necessarily mean the injury is completely healed as BMC has a strong anti-inflammatory effect It is recommended that you adhere to the rehabilitation protocol as prescribed.
Will I need repeat injections?
This depends on your injury. Typically, BMC is administered as a single treatment for soft tissue injuries combined with physical therapy. If the healing effects plateau, then a supplemental platelet rich plasma (PRP) injection may be recommended. For degenerative conditions such as osteoarthritis and chondromalacia of the joints, repeat injections of BMC, platelet rich plasma (PRP) or autologous conditioned plasma (ACS) may be needed again in the future as this is a degenerative condition.
Is BMC covered by my insurance?
Since medical insurance policies do not reimburse for BMC, this is not billed to your insurance and a cash payment will be necessary prior to your procedure. Billing documents can be provided for health flexible spending accounts.