Stem Cell Therapy
Stem Cell Therapy
Stem cell therapy, also known as bone marrow aspirate, is a procedure where we use a specialized harvesting technique to remove bone marrow stem cells (mesenchymal stem cells) from the patient’s hip bone. The bone marrow is filtered, then concentrated in an FDA-approved device, and finally injected into the patient’s area of damage with ultrasound guidance for precise placement. This treatment uses the body’s own repair mechanisms and growth factors to promote healing. These cells are capable of transforming into a wide variety of tissues including tendons, ligaments and cartilage. Generally speaking, this treatment appears to be more effective for more advanced joint or tendon degeneration and is a good next step if platelet rich plasma therapy (PRP) is not successful.
This minimally invasive procedure is done under local anesthesia. The bone marrow harvesting may result in a dull aching pain for several days. Because of the potential for infection within the bone, this procedure is done in a clean environment in our office procedure room. The entire process will take a little over an hour and most patients will have minimal restrictions following the procedure.
Not all patients are candidates for stem cell injection therapy. Schedule a consultation today to find out whether you are a candidate.
Stem Cell FAQs
Where do these stem cells come from?
Bone marrow is the source of stem cells that Dr. Lehman uses. She harvests the bone marrow stem cells (called BMAC) from the posterior iliac crest (the back of the hip).
What is the benefit of Bone Marrow Stem Cell treatment?
Dr. Lehman uses BMAC injections primarily for painful joints and severely damaged tendons. These injections provide a non-surgical treatment option to provide long-lasting relief from chronic joint pain. The injections are performed under ultrasound guidance, as needed, to ensure proper placement of the stem cells.
What do published studies say about BMAC?
So far, we do not have robust clinical studies that have shown regrowth of damaged tissue, therefore, Dr. Lehman will not make that claim. Published data, however, demonstrate that many thousands of patients treated with this procedure have had pain relief and functional improvement. Those patients have also shown that this is a safe procedure with no increased risk of cancer. It appears that for knee arthritis, for example, it provides longer lasting relief than our other injection options that may serve to postpone the need for a joint replacement in some. Small published cases have shown healing of knee meniscus tears and shoulder rotator cuff tears.
Who is a candidate for this treatment?
In general, Stem Cell injections are performed for moderate osteoarthritis in joints where there is not complete collapse of the joint space and not “bone on bone” changes. Partial thickness rotator cuff and other tendon tears are also reasonableThere are some medical issues (like lymphoma and leukemia) that will preclude you from having a stem cell procedure done.
Studies and experience are showing that the knee and shoulder are joints that respond best to this treatment.
What is the cost?
The cost can vary depending on treatment area. Stem Cell therapy is not covered by your insurance company. This is an out of pocket expense. Starting at $4000.
Who is not a candidate for this treatment?
- Patient with cancer history (such as prostate cancer or breast cancer), not in remission for at least 5 years
- Certain other malignancies or blood borne diseases that you are being treated for
- Patient with any current infection
- Patients on anticoagulation
- General procedural contraindication
- Patients with multiple medical issues may not be good candidates (low testosterone, low vitamin D, hypothyroidism, diabetes, smoker). This a partial list; there are other conditions that may limit your stem cell candidacy.
Which joints/body parts can stem cells be applied to?
Most often to the larger joints, such as hips and knees, but also shoulders, ankles and thumbs. Stem cell therapy is also an option for chronic tendon issues that have been resistant to other treatment (usually including PRP).
Dr. Lehman does not treat neck or back conditions with stem cells or PRP.
Will this procedure regenerate cartilage in my joint?
There is some limited data suggesting an ability to regenerate cartilage in joints, but it also appears that whether or not the cartilage regenerates has little correlation with relief of pain. If there is significant spurring and significant loss of the joint space, there is little chance of cartilage regeneration. We see that the internal environment of your joint or damaged tendon becomes healthy again often producing significant pain relief in itself.
What is the success rate of Bone Marrow Stem Cell injections?
While this is still an investigational treatment, we have seen that most patients will have significant relief of pain around 1-2 months post injection. This will often continue to improve for the first 3-6 months after the stem cell procedure. Studies have shown relief lasting 1-3 years. As with most medical procedure, individual results will vary.
Does the treatment consist of one injection or multiple injections?
In some conditions, one stem cell injection followed up 6-8 weeks later with a platelet rich plasma injection in the office. The protocol is continually evolving, so this is ultimately decided on a case-by-case basis.
Can I fly/drive home that day?
If you are flying (and you are not the pilot), you may fly home the same day, but there will be increased pain/discomfort after the procedure. If you are driving, you should have a driver, as there can be some mild to moderate discomfort in the first few hours following the procedure.
Where is this treatment offered?
This procedure is done in a clean environment in our office procedure room.
What should I do if I think I am a candidate?
Schedule a consultation with Dr. Lehman for an appointment to review your radiology films (x-rays), conduct a physical exam, and determine if you are a good candidate or not.
What about amniotic or umbilical cord stem cells?
These products contain growth factors that may play a role in lowering inflammation, acting as a tissue matrix and providing pain relief, but unfortunately do not contain functional stem cells. For the right patient, Dr. Lehman may consider using this product to treat a large tear of a tendon in combination with PRP or BMAC, for ex. In a situation where a patient's own bone marrow or platelets are not able to be used, this product may be considered.
18 Medical Park Drive
Asheville, North Carolina 28803