The risks and possible complications associated with blind injections include failure, increased pain and injury and have been previously discussed.
At the Centeno-Schultz Clinic knee injections are performed under x-ray or MSK ultrasound guidance to ensure accurate placement of the PRP, Regenexx SCP or other platelet derived or bone marrow derived therapies.
Unfortunately when guidance is not used complications can occur. SG is a case in point.
SG is an athletic 45y/o patient who sustained a meniscus injury and declined traditional surgery where a portion of the tear would be cut out. Removal of a injured meniscus places increased force on the remaining knee structure and is associated with acceleration of the degeneration process.(blog).
SG acknowledged stem cell therapy as an alternative to knee surgery and opted to proceed with Regenexx SD. He had undergone multiple therapies which included physical therapy, chiropractic adjustments and injection of Synvisc, a medically approved DW40. MSK ultrasound was not used. SG reported that not only was the injection painful since the provider stuck him three times but after the injection the top portion of his knee cap was red, painful to the touch and movement of the knee was difficult. It remained painful for weeks thereafter.
Diagnostic knee ultrasound at the Centeno-Schultz Clinic demonstrated inflammation and partial tear of the distal quadriceps tendon. The previous knee injection most likely injured the tendon. Complications such as these can be avoided with the use of MSK ultrasound guidance.
At the Centeno-Schultz Clinic we acknowledge the regenerative potential of stem cell therapy for common orthopedic conditions. Stem cell treatment utilizing Regenexx C and Regenexx SD has been used successfully as an alternative to
knee surgery and joint replacement
Peer reviewed studies have demonstrated its safety.
Regenexx utilizes a patient’s own stem cells which are referred to as autologous.
Stem cells can also come from donors and are referred to as allogeneic.
Is there a difference?
Yes as discussed in Dr. Centeno’s recent chapter on Stem Cell Therapy.
Autologous stem cell cells do not have the same communicable disease transmission risk as donor cells since they are the patient’s own cells.
Donor stem cells have the following concerns.
Gene transmission: Stem cells transplanted from the bone marrow of mice bred to have osteoporosis were able to induce osteoporosis in healthy mice.
Immunosuppressive potential is reduced in mismatched settings.
At Centeno-Schultz Clinic we acknowledge the regenerative potential of stems cells in treating common orthopedic injuries. Dr. Centeno authored a chapter on stem cell use in orthopedic injury.
Regenexx C & Regenexx SD are alternatives to knee surgeries.
How do stem cells work?
Three principal ways: differentiation, paracrine affect and regulation of inflammation.
Mesenchymal stem cells are multipotent and can differentiate into cartilage, tendon, bone and ligament.
Paracrine means that mesenchymal stem cells release certain growth factors to assist in tissue repair. Mesenchymal stem cells can be viewed as construction managers as they recruit other cells to the local area and coordinate the repair of damaged tissue. The growth factors include TGF-beta, VEGF and FGF.
Finally MSC’s have been demonstrated to regulate inflammation. Inflammation is not all bad and is the first step in healing.