Which is better, PRP or Stem Cells?

We don’t have this answer. Research has shown that both procedures are generally effective regarding accelerated tendon healing and joint pain control.

How many injections are required?

This is the subject of ongoing study. Most stem cell studies report on a single injection. Many PRP studies report on several injections separated by weeks, though the evidence has not demonstrated that multiple injections are clearly superior to a single injection.

If I have stem cells injected into my arthritic knee, will it grow new cartilage?

Studies have shown that focal areas of cartilage damage heal with improved characteristics when supplemented with stem cells. However, the effect of biologic injections is thought to be more of a pain control mechanism than a cartilage re-growth mechanism. In a degenerative knee, biologic therapy is a potential “bridge” between biologic knee restoration and total knee replacement. . One may, however, achieve significant pain control for a period of time. If you have a bone-on-bone joint, it is very unlikely that a stem cell injection will re-establish a new layer of cartilage.

How fast do these injections start to work?

This is variable according to the degree of tissue or joint damage. Although the cells may well go to work immediately, the effects may take a period of time to be appreciated. The effects of an injection in an acutely injured muscle may be in days. Whereas most clinicians believe that a degenerative joint may take 1 to 2 months before one can expect to appreciate clinical improvement.

How long will the effects of the biologic injection last?

his is a variable according to the degree of tissue or joint damage. Studies have shown that the pain-controlling effects of a stem cell injection may last for 1or 2 years or longer.

Which stem cell preparation is preferable; BMAC, Adipose or Amniotic?

Mesenchymal Stem Cells (MSC’s) are located in many parts of the body. Wherever there are blood vessels there are MSC’s surrounding and sitting on them, able to rush to areas of injury and inflammation quickly. In the United States NO CLINIC can truly inject “Stem Cells”. These would have to be grown in culture in the lab to be STEM cells and this is illegal in the United States. Clinics in the USA are injecting solutions filled with growth factors, other anti-inflammatory Proteins, and some stem cells as a mixture. The actual number of cells is not known in each injection. We don’t even know if the cells are most important or if the materials they secrete are doing the job. We do know PRP has very effective growth factors, cytokines and proteins and few if any Stem cells. Fat and Bone Marrow have more stem cells with Adipose perhaps having the most per milliliter however we are not yet sure if more means more clinical effect. These questions and many others are the subject of ongoing investigation. 

What does the research show?

Stem cells are a hot button concept in medicine these days. Stem cell products are being used in orthopedics with regularity, despite the fact that we do not fully understand their definition or efficacy. However, in the literature shows good pain relief in arthritic conditions, and some tendinopathies plus quicker healing of tendon injury with PRP and some MSC products.  It could be years before we have all the answers.

Are biologic injections covered by insurance, and how much does it cost?

At the present time, most insurance policies do not cover biologic injections. They are considered investigational. Speak to your physician’s office regarding the price profile, which varies according to the product and procedure used. Consult your health savings account advisor to see if these qualify.

Do I make an appointment for PRP or stem cell injections?

A screening appointment is necessary to first determine if you are a candidate for a biologic injection. This may involve Xrays and possibly an MRI. It can then be determined if biologic therapy is appropriate for you. A separate appointment for the procedure is arranged.