What are stem cells?
Mesenchymal Stem Cells (MSCs) are the basic building blocks of adult human tissue and have the ability to repair, rebuild, and rejuvenate tissues in the body. Stem cells respond to specific signals and facilitate cell differentiation required for the body’s repair and healing process.
MSCs are tissue-based stem cells and found throughout the body in all or most vascular tissues. They do not circulate through the bloodstream but are attached to the blood vessels (known as pericytes). When an injury or trauma occurs, MSCs either mechanically detach because of the trauma or receive chemical signaling from the microenvironment to go off and respond to an injury.
Activated MSCs naturally works to reduce inflammation, prevent cell death, prevent infection, and generate new blood vessels. For more info, click here.
Is there any scientific evidence behind this treatment?
Although there haven’t been any large randomized control trials (due in large part to the nature of medical patents), there are several small clinical trials that have shown the effects of stem cell injections. Please visit our section on research for more details. For a more complete listing of all published works, please visit the US National Library of Medicine.
Do most people have successful treatment with stem cell injections?
The vast majority of the patients in the clinical trials for stem cell injections have experienced positive results, although the sample sizes of these studies are small. Anecdotally, our colleagues in the United States that have also been doing these procedures have stated that over 80-90% of patients had a successful outcome from their stem cell injections. Our colleagues defined success as a 50% or greater reduction in pain.
Is it guaranteed to work for me?
Despite the best efforts of physicians, researchers and other health professionals, nothing in medicine is ever guaranteed. However, clinical research and anecdotal accounts have been very promising, with as high as 80-90% of patients experiencing positive results, decreased pain and improved function.
Is this a cure for osteoarthritis?
Unfortunately, a true cure for osteoarthritis does not yet exist. Stem cell injections have been shown in clinical trials to be able to regenerate some cartilage, which is a large step in the right direction but we are not at a point yet when any treatment can claim to be a cure for osteoarthritis.
Other than taking out fat cells, are there other ways to get stem cells?
Stem cells can also be taken from a bone marrow aspirate concentrate (BMAC). We primarily use adipose-derived stem cells (ADSCs) as the procedure at this time is less invasive and better tolerated than a bone marrow harvest. However, in some cases, bone marrow aspirate concentrate (BMAC) may be preferable; your doctor can discuss this with you.
Please note that there is currently NO approved or known way to isolate stem cells from blood alone in sufficient numbers, practically or theoretically. Please be wary of anyone claiming to be delivering “stem cell” therapy by only taking blood – at this time, the only ways to obtain adult mesenchymal stem cells for orthopedic indications are through adipose tissue or bone marrow.
Are there any side effects?
The side effects of the adipose tissue lipo-aspirate procedure are minimal and may include: minor swelling, bruising and redness at the procedure site and/or tenderness at the procedure site. These side effects typically resolve after 4-5 days. Occasionally, some patients will have sensitivity to the lidocaine and may experience headache or nausea. No long-term negative side effects or risks have been reported.
The side effects of the ADSC injection itself are also minimal and may include: localized joint pain and swelling, difficulty walking or limited range of motion. However, these side effects typically resolve after a few days and no long-term negative side effects or risks have been reported.
It is important to note that anytime the skin is broken during a medical procedure, there is a risk of bleeding or infection but this occurs less than 1% of the time.
When will this treatment start working?
Everyone is a little bit different but typically, you will start to feel some of the positive effects after 2-3 months but it can take 6-9 months before most of the benefits are realized.
How long does it work for?
Because stem cell injections are a relatively new technology, having only been approved in Canada for roughly two years, long-term data is not yet available. However, the vast majority of patients who have received a stem cell injection have not required a second injection within that two-year time frame. This is also consistent with our US colleagues who have similarly not had to give patients a second treatment for at least two years.
Are any enzymes used to process the stem cells?
In accordance with Health Canada regulations, no enzymes are used to process the adipose tissue or stem cells. The isolation and concentration of stem cells is done entirely through mechanical separation with the centrifuge.
What is the pre-procedure care like?
Prior to your stem cell procedure, please do not take any NSAIDs or anti-inflammatory medications (Advil, ibuprofen, naproxen, Aleve, Celebrex, etc) for 5 days leading up to the procedure. These medications can affect platelets, and possibly stem cells, and we want these to be in as natural a state as possible to maximize their regenerative potential.
What is the post-procedure care like?
After your stem cell procedure is completed, the area where the stem cells were taken from and the area they were injected into may be sore. We recommend you plan to rest for the remainder of the day. Please do not take any NSAIDs or anti-inflammatory medications (Advil, ibuprofen, naproxen, Aleve, Celebrex, etc) for 7 days after the procedure. These medications will work against the platelet and stem cell treatment.
Use ice pack or heating pads as necessary after the procedure and experiment with which method provides you the most relief. Unless otherwise indicated, Tylenol can be taken once every 4-6 hours for the discomfort. Please monitor both the incision site and the injection site for signs of infection (fever, increased pain or redness, new painful swelling, discoloured or malodorous discharge).
Soreness and discomfort typically resolves within a week after the procedure.
Does government or private insurance cover stem cell therapy and how much does it cost?
Unfortunately, most (if not all) private insurance and government insurance do not currently cover stem cell therapies and therefore patients must pay for this procedure out of pocket. However, the cost of the procedure is typically tax-deductible.
A recent study in the United States found that average cost for a bone marrow stem cell injection is $4000 USD (*data from MedRebels), with adipose-derived injections typically costing more.
Our current pricing for most adipose-derived stem cell injections, which includes the combination PRP injection, is $3500 CAD per injection site; with discounts given for multiple injection sites.
We understand that the price will be a deterrent for many patients but we don’t want cost to prevent patients who wish to have stem cell treatment from getting care. We have partnered with Medicard Finance as a financing option for patients who want to spread their payments out over time. Please let us know if this is something you are interested in.