Rehabilitation Medicine Physicians
10340 Spotsylvania Avenue, Suite 101
(540) 374-3164 Fax (540) 899-1342
Stem Cells are undifferentiated cells that have the potential to become other, more specialized types of cells.
Adult Mesenchymal stem cells (MSCs), are multipotent stem cells that can differentiate into a variety of cell types,
including: osteoblasts (bone cells), chondrocytes (cartilage cells and tendons) and adipocytes (fat cells). MSCs are
obtained from the bone marrow, most commonly from the back of the iliac crest (or "hip bone”).
How are stem cells obtained?
Harvesting MSCs for injection therapy is done right in the office. First, the skin is numbed with lidocaine. Then, the hip
bone is numbed so that the stem cells can be extracted from the bone without pain. A special needle is then passed through
the cortex of the bone into the marrow cavity. This is a painless procedure in most cases. The liquid marrow is then
slowly drawn into a syringe. Once an adequate amount of liquid marrow is obtained, the needle is removed and a bandage
applied. The syringe containing the liquid marrow is then placed in a special centrifuge. After the marrow is spun, the
highly concentrated stem cells are then passed into a new syringe, from which the injection is given. The entire procedure
takes about one hour and is minimally uncomfortable.
How are stem cell injections given?
All of our stem cell injections are given under direct ultrasound guidance, meaning an ultrasound machine is used to guide
the needle to the precise location in which the stem cells will be injected. The use of ultrasound guidance insures that
injections are both accurate and safe.
Stem cells are usually not injected by themselves. We create a healing "cocktail" by using a special centrifuge to separate
the platelet-rich plasma (PRP), stem cells, and growth factors from the red blood cells. The stem cells work together with
the PRP to regenerate new cartilage and bone. Sometimes a PRP injection is recommended 4-6 weeks after the stem cell
injection to optimize the healing process.
Following the injection, the area needs to be immobilized for the next 18-24 hours to allow the stem cells to "set up" and
adhere to the damaged sites. Crutches, slings, splints or braces may be used to facilitate this.
How often are injections given?
After the initial treatment, a follow up visit is scheduled within 2 weeks to check on the healing progress. Some patients
respond very well to just one treatment however, 2-3 treatments may be needed in very severe cases.
What conditions might benefit from stem cell injections?
Stem cell injections are most commonly used for the treatment of conditions that have failed or responded incompletely to
other more conservative treatments. Conditions include, but are not limited to osteoarthritis, muscle tears (partial rotator
cuff tears), tendon tears (achilles tendon tears, tennis elbow, or quadriceps tendon tears), and cartilage breakdown or tears
(meniscus tears or chondromalacia patella in the knee).
Stem cell injections allow you an alternative to surgery, with no down time, no missed work days, less cost than surgery,
and without scar tissue, which is commonly associated with surgery.
Are There Risks Associated With Stem Cell Treatment?
Any injection is potentially at-risk for causing infection, bleeding, or nerve damage. Risks will also vary depending on the
structure(s) being injected. Because we are using your own cells, you cannot be allergic to the treatment! Also, because
the injections are done under ultrasound guidance, the risks of damaging surrounding structures, or of injecting the wrong
location, are almost completely eliminated. The procedure is done using a sterile environment with sterile instruments to
reduce chances of infection. Your doctor will review the complete risks of the treatment with you. Nonetheless, the risks
of treatment are extremely low.
Are Stem Cell Treatments Covered by Insurance?
You are responsible for the kit to harvest the stem cells from the bone marrow. We will bill your insurance for part of the
procedure. Coverage will vary according to your plan.