Growing demand for regenerative treatments like platelet rich plasma (PRP) and stem cell injections has lead to an explosion of clinics offering regenerative therapies in Colorado. Despite the wide variety of clinics to choose from, a 2018 paper highlighted alarming variances in treatment strategy between stem cell clinics in the United States. Experts are concerned that many clinics offering regenerative therapies may be profiteering from the high-dollar, out-of-pocket price of injections, while lacking consistent quality control and best practices.
We will discuss six tips to help you avoid bad clinics and find reputable clinics that will give you the greatest chance of a successful outcome. While doing your research, you'll need to figure out the following:
Currently, there is minimal regulation regarding who can and cannot perform stem cell injections nor is there a standard training program that physicians must attend prior to offering stem cell treatment. For the above reasons, there are a wide variety of doctors of different skill levels offering these treatments, such as orthopedic surgeons, interventional radiologists, physiatrists, plastic surgeons, anesthesiologists, and family practitioners. As with most medical procedures, the injection of stem cells into a joint or ligament requires careful understanding of human anatomy and medical imaging. If you are considering stem cell treatment, it is crucial to ensure the doctor you choose has the knowledge and skillset to deliver safe and successful results. Questions to assess your doctor's skill Here are a few questions you can ask to get a better sense of your doctor's skill level with injection procedures:
When evaluating which patients are likely to benefit from regenerative therapy, it is important to ensure any clinic is stratifying patients into categories based on the likelihood of procedural success. With almost any medical procedure, there are patients who are good candidates, fair candidates, and poor candidates for the procedure; regenerative treatments are no different. Questions to assess if a clinic is grading candidacy Asking the following questions to your regenerative medicine doctor to determine if they are grading your candidacy for a procedure.
Depending on the stem cell clinic, there are a wide variety of materials that could be injected into your body. For instance, bone marrow derived stem cells have the most data supporting their ability to regrow orthopedic tissue when compared to other stem cell types derived from amniotic, umbilical, or adipose (fat) tissues. It is also important to note that the safest type of cell to use is an autologous stem cell, i.e., a stem cell from your own body. There is an increased risk for a negative immunologic reaction when using cells from someone else. Questions to assess what cells a clinic is using Ask the following questions to understand what cell types your doctor will be using:
Cells must be processed and concentrated prior to injecting them back into your body. Differing processes can factor into procedural success. For example, recent literature suggests that higher concentrations of platelets in platelet rich plasma (one of the major components of a stem cell injection) can lead to increased stem cell activation, especially in older patients. Certain commercial stem cell "kits" are unable to concentrate platelet rich plasma enough to initiate meaningful stem cell activation. Questions to assess how a clinic is processing cells Ask the following questions to get a better sense for how platelet rich plasma (PRP) or bone marrow-derived stem cells are being processed:
Platelet rich plasma (PRP) falls into three categories:
Image-guided procedures are procedures where the doctor uses real-time imaging to ensure the proper placement of an injection into injured tissue. If the injection is inappropriately targeted, there is a lower chance of success. Examples of real-time imaging include ultrasound (the machine used to evaluate fetal progression during pregnancy) and fluoroscopy (which displays a continuous x-ray image). Questions to assess if the clinic is using image guidance Ask the following questions to make sure the clinic you choose is using image guidance:
While regenerative therapies are rapidly advancing, the field is still relatively young. As such, clinics have a responsibility to measure and track functional improvement after a procedure to inform future patients about the benefits, risks, and expected outcomes of regenerative therapies. Outcomes tracking, or systematically following up with patients at predefined intervals after their procedure, allows clinics to improve their techniques over time. Questions to assess if a clinic is tracking outcomes Ask the following question about outcomes tracking to your regenerative medicine doctor: