Autologous Stem Cell Grafts

Stem cells offer a more powerful treatment than PRP and is often necessary in the more severe cases.


Where Are Stem Cells Obtained

The stem cells we use come from two primary sources, the bone marrow or fat derived stem cells.

We obtain bone marrow stem cells, also known as mesenchymal stem cells thru a simple process by doing an almost painless bone marrow aspiration in the hip area of about 60ml. The marrow is placed in a special centrifuge and we end up with about 9cc’s of stem cells and other progenerator cells which can be used for the treatment.

Fat derived stem cells are usually taken from the fat around the abdomen using a suction process. The stem cells are than filtered out. Fat also can act as a scaffold to fill in larger gaps and defects in tissue that the stem cells attach to help form new tissue.


How Is The Treatment Performed

The injured tendon, muscle, ligament, or joint is identified thru careful examination and image guidance with Ultrasound or X-ray fluoroscopy. MRI or CT knowledge aids in placing the STEM CELLS in the correct location. The region to be treated is cleaned with an asceptic technique and a local anesthetic is applied to make the procedure comfortable. Using “realtime” image guidance the STEM CELLS are transplanted and grafted to the injured site. We than may add thrombin and calcium to turn the stem cells into a gel so it activates and sticks to the injury site. It usually takes 3 to 7 treatments 4-6 weeks apart to eliminate the pain depending on the severity of the case.


What Am I To Expect Afterwards

Since the STEM CELLS cause a healing inflammatory response there is usually some pain and swelling later that day. It can usually be controlled with rest, ice, and sometimes a mild pain medication is helpful. By the next day light exercise is encouraged to prevent stiffness. Sometimes splinting is necessary to promote healing. Discomfort usually goes away in 3-5 days. Anti-inflammatories and steroids are discouraged. Returning back to your sport is dependent on the extent of the injury and tissue damaged. The pain from your original injury may start to diminish as early as 1-2 weeks, but frequently it takes a few months to know if it worked for you. The treatment may continue until healing is complete and the pain is gone.


What Are The Risks Of The Procedure?

There are very few risks of using STEM CELLS since you are using your own blood also known as Autologous. Embryonic STEM CELLS on the other hand carry very significant risk and are still experimental. Infection is possible but very remote. There is more of a risk from the needle if you go to a physician who is inexperienced or just starting out with this procedure without extensive training. Since our physicians have years of experience, and use copious sterile technique and image guidance the risk is minimized.


Who Is The Candidate For A Stem Cell Graft Treatment?

The following are only some of the conditions treated with STEM CELL GRAFTS

  • Arthritis of any joint including shoulder, elbow, wrist, fingers, hip, knee, ankle, fingers, toes and TMJ joint.  Joints with Osteochondral defects (chunks missing) in the cartilage.
  • Larger Rotator Cuff or tendon and muscle tears which need a more powerful treatment than PRP.
  • Cartilage, meniscus, or labral tears in the shoulder, wrist, hip, and knee, or ankle.
  • Spinal defects, and disc degeneration or herniation.

What Is Prolotherapy

Prolotherapy(Prolo) also known as Regeneration Injection Therapy (RIT) has been around for over 75 years. Years ago it was an accepted treatment for hernia repairs and esophageal varices. Drs. Hackett and Hemwal, two surgeons, discovered that when injecting a mildly inflammatory substance they could create a healing response that within a few treatments would regenerate the tissue that was injected.

Hundreds of thousands of patients have been treated successfully thru the years with this treatment with all types of Orthopedic problems. This treatment was considered alternative by some people because the science at the time could not explain how it worked and it seemed too good to be true. Since it fixed the problem and surgery often was not necessary there was considerable political pressure to make it main stream.

We now know it works the same way as a Laser Peel or Chemical Peel used in Dermatology by creating a slight local inflammation at the site injected which attracts Platelets or the PRP to come into the area which carries growth factors and attracts stem cells to the area to differentiate into new collagen. In the face it takes away the wrinkles with the collagen, and makes new skin. When we inject it into joints it makes cartilage, or into tendons and ligaments it strengthens and repairs them.


How Is The Treatment Performed?

The injured tendon, muscle, ligament, or joint is identified thru careful examination and image guidance with Ultrasound or X-ray fluoroscopy. MRI or CT knowledge aids in placing the Prolotherapy solutions in the correct location. The region to be treated is cleaned with an asceptic technique and a local anesthetic is applied to make the procedure comfortable. Using “realtime” image guidance the medication is injected at the injured site. It usually takes 3 to 7 treatments 4-6 weeks apart to eliminate the pain depending on the severity of the case. Some of the medications used are dextrose, saline, glycerin, phenol, Sarapin, Sodium Morrhuate which are all FDA approved.


What Am I To Expect Afterwards?

Since the Prolotherapy causes a healing inflammatory response there is usually some pain and swelling later that day. It can usually be controlled with rest, ice, and sometimes a mild pain medication is helpful. By the next day light exercise is encouraged to prevent stiffness. Sometimes splinting is necessary to promote healing. Discomfort usually goes away in 3-5 days. Anti-inflammatories and steroids are discouraged. Returning back to your sport is dependent on the extent of the injury and tissue damaged. The pain from your original injury may start to diminish as early as 1-2 weeks, but frequently it takes 3-4 treatments to know if it will work for you. The treatment may continue until healing is complete and the pain is gone.


What Are The Risks Of The Procedure?

There are very few risks in performing Prolotherapy. Infection is possible but very remote. There is more of a risk from the needle going into a blood vessel or nerve if you go to a physician who is inexperienced or just starting out with this procedure without extensive training. Since our physicians have many years of experience, and use copious sterile technique and image guidance the risk is minimized.


Who Is A Candidate For Prolotherapy Treatment?

The following are only some of the conditions treated with Prolotherapy also known as Regeneration Injection Therapy.

  • Arthritis of any joint including shoulder, elbow, wrist, fingers, hip, knee, ankle, fingers, toes and TMJ joint
  • Tendonitis or tearing of any tendon including the rotator cuff, biceps, tennis or golfers elbow, tendinitis in the wrist and hand, hip tendinitis, patellar and Achilles tendinitis, and plantar fasciitis in the foot.
  • Cartilage, meniscus, or labral tears in the shoulder, wrist, hip, and knee.
  • Trigger points at muscle and tendon attachments and spinal injuries or pain to the neck, mid, low back or sacral iliac joints.

When Would You use Prolotherapy vs. PRP?

Prolotherapy is slightly less expensive since there are fewer equipment costs. Also, you can treat much larger areas so there is no limit on the amount of medication available unlike the 3-9cc’s of PRP available. When stability is an issue Prolotherapy may work better. PRP however is better at healing cartilage, tendon, meniscus and labral tears. PRP also carries less risk around blood vessels and nerves when working in delicate areas. Your doctor will be able to advise you which of the treatments or combinations of treatments would be best for solving your problem.

Conditions Treated:

  • Shoulder Arthritis
  • Rotator Cuff Tears
  • Rotator Cuff Tendinitis
  • Shoulder Labral Tears
  • Shoulder Instability, Sprains
  • Shoulder Dislocation
  • Biceps Tendinitis
  • AC Joint Instability
  • SC Joint Instability
  • Tennis Elbow
  • Golfers Elbow
  • Elbow Instability
  • Elbow Arthritis
  • Wrist Sprains/Arthritis
  • TFCC Cartilage Tears
  • Wrist Tendinitis
  • Thumb Sprain/Arthritis
  • Dequervains Tendinitis
  • Finger Sprains/Arthritis
  • Trigger Finger/Flexor Tendinitis
  • Hip Sprains/ Arthritis
  • Hip Labral Tears
  • Hip Osteochondral Defects