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10 Questions to Ask Your Doctor About Stem Cells

Stem cell therapy augments your body’s natural healing capacity to reduce pain and improve function after a tendon, joint, disc or ligament injury.  Stem cell therapy may also reduce the pain from inflammation of osteoarthritis.

At San Diego Orthobiologics Medical Group, we use the latest in cellular biology and orthopedic clinical research to optimize your care.  We use advanced technology to harvest, process and administer stem cells to maximize your results.  Because we use your own cells to stimulate healing, each treatment is unique and must be customized to your personal situation.

QUESTIONS FOR YOUR DOCTOR

Regenerative Medicine is an exciting new field that will forever change the way we treat orthopedic injuries.  Many physicians are excited to leap into this field with varying levels of knowledge and experience.

So how do you, the patient, decide if you are a good candidate for this therapy.  And who should you decide to use as your treating physician?  We suggest that you ask your doctor the following questions to help you understand your care.

How much experience do you have treating musculoskeletal injuries?

Musculoskeletal injuries are best managed by specialists in the field of sports medicine.  These include board certified physical medicine and rehabilitation physicians (physiatrists), orthopedic surgeons, and fellowship trained sports medicine physicians.  It takes years to gain the experience and knowledge necessary to appropriately treat these kinds of injuries.

Accurate diagnosis is essential to successful treatment.  And, in many cases, it is necessary to exhaust all conventional forms of treatment before even considering PRP therapy.

Dr. Rogers graduated as chief resident of the University of Texas, Health Science Center in San Antonio, Texas Physical Medicine, and Rehabilitation program in 1997.  He completed a nonsurgical interventional spine fellowship in 1998 before joining the University of California, San Diego Orthopedic Surgery Department as an assistant clinical professor.  He has practiced nonsurgical musculoskeletal medicine in private practice since 2000 and has treated more than 80,000 people just like you.

How much experience do you have with Stem Cell Therapy?

Stem cell therapy is a relatively new technology to orthopedics and our field is learning more about it all the time.  Dr. Rogers was the first physician in San Diego to use an FDA compliant adipose stem cell transplant technique for his patient with knee osteoarthritis.  The protocols and algorithms that he uses have been shaped by his experience and the current medical literature to produce the best results possible.  Dr. Rogers has been teaching stem cell therapy to physicians at the Regenerative Medicine Therapy Institute, the BREG musculoskeletal ultrasound course and The Orthobiologic Institute (TOBI) courses since 2014.

It is not a bad idea to ask your doctor how he or she stays up to date on Regenerative Medicine.  As this is a new field, most physicians did not receive any specialized training in medical school. Doctors advance their knowledge by participation in continuing medical education, reading medical journal articles or attending Regenerative Medicine conferences.  This discussion will give you an idea of the commitment your doctor has made in this emerging field.  Dr. Rogers has attended more than two dozen Regenerative Medicine conferences and met with physicians from all over the world.

How much experience do you have with diagnostic musculoskeletal ultrasound and fluoroscopic (digital x-ray) guidance?

Administration of stem cell therapy with high precision and comfort leads to better outcomes and reduces the likelihood of additional expensive or risky procedures.  Diagnostic ultrasound has radically changed the practice of orthopedic medicine allowing for better diagnostics and improved comfort with office based treatments.

For more than a decade, Dr. Rogers has trained his fellow physicians in the proper use of diagnostic musculoskeletal ultrasound.  Dr. Rogers currently teaches musculoskeletal ultrasound at the BREG ultrasound courses, the American Academy of Physical Medicine and Rehabilitation workshops, and the OrthoBiologic Institute (TOBI) courses.  He utilizes the most advanced diagnostic ultrasound equipment for his patient care.

All stem cell therapy of the spine should be performed with fluoroscopic guidance (x-ray).  Dr. Rogers completed a fellowship in fluoroscopic guided spinal injections in 1997.  Since that time he has performed tens of thousands of spinal injections and trained physicians from all over the world.

What kind of stem cells will you use?

There are many methods used to harvest, process and deliver stem cell therapy.  The cost and clinical results of each method vary widely as well.  The healing response is largely determined by the concentration and quality of the cell harvested and the method used to deliver them to the injury site.  Improvements in your condition may be slower or faster depending upon the method used to process your cells.

At San Diego Orthobiologics Medical Group we only use cells from your own body.  The cells may be derived from your bone marrow or fat tissue.  Your stem cells will not be manipulated or altered with enzymes.  The cells are administered on the same day that they were removed.

We do NOT use cells obtained from a donor.  We do NOT use cells from embryos or fetal tissues.  Some physicians believe that donated amniotic fluid or fetal membranes contain living stem cells.  But, at the time of this writing, they do not.  When tissue obtained at the time of birth is sterilized with freezing or other techniques, any living stem cells do not survive the procedure.   Independent testing has demonstrated that no cells are contained in this fluid.

Nutritional status, hormonal status, exercise, medications, and supplements all influence the quality of your cells and your healing potential.  Prior to performing stem cell therapy, we will often need to assess and modify these factors to improve your results.

What system (s) do you use to harvest and process your stem cells?

There are several commercially available products that assist in the harvesting and processing of stem cells.  The cost of each system varies and more sophisticated systems are generally more expensive.  However, more sophisticated systems will allow your physician to customize your treatment and optimize the results.  At San Diego Orthobiologics Medical Group we use four different cell concentrating systems depending upon the goals of treatment.  We use closed systems which eliminate the risk of contamination from airborne particles.

Furthermore, we can measure the cell concentration which allows us to better understand why treatment results may vary from one person to the next.

Will you combine stem cell therapy with any other form of therapy?

Stem cell often functions very well as a stand-alone treatment.  However, many times additional forms of treatment need to be performed at the same time to maximize outcomes.  This may include physical therapy, bracing, nutrition, and supplements, or electromagnetic therapies.

How many treatments will I need?

More than 95% of our patients only require one treatment and will see results for years.  More challenging conditions may require repeat treatments or be combined with other cellular-based therapies.

Have you ever had a complication?

Stem cell is considered to be a very safe procedure.  It is certainly safer than most other orthopedic treatments and surgery.  Potential complications include pain, infection, fever, allergic reaction, swelling, tissue injury, and a failure to relieve symptoms.  At the San Diego Orthobiologic Medical Group, we have never had a significant complication with any procedure in more than 20 years.

Do I have any reason to not consider stem cell therapy?

Some people are just not a candidate for stem cell therapy.  Their condition may be too advanced and other more conventional therapy such as surgery may need to be considered.  Contraindications to stem cell therapy include active infection or cancer, pregnancy, very low platelet count, fever, anemia with symptoms, or use of certain medications.

Will you combine exercise or physical therapy with my stem cell therapy?

This important step is often overlooked by some medical clinics.  Exercise is crucial to expedite and maximize healing with stem cell therapy.  Stem cells simply address incomplete healing of specific tissues, whereas stretching and strengthening are necessary to restore function to the entire joint.  We have developed physical therapy protocols that you can do at home or with your therapist to allow the restoration of mobility, strength, and endurance.

How long will it take for my condition to improve after treatment with stem cells?

This depends on the severity of your injury and your ability to regenerative healthy tissue.  Some people heal very quickly and others more slowly.  However, on average most people feel some significant improvement within six to eight weeks.  Healing will continue for many more months after treatment.  Many studies have demonstrated continued healing for up to a year.

What are your clinical results?

Very few medical practices track clinical outcomes.  Although there are several clinical outcome studies in the medical literature, consensus regarding the exact types of therapy to use for a specific condition does not exist.  Therefore, it is critical that each physician tracks the results of their treatment and share this information with prospective patients.  At San Diego Orthobiologics Medical Group we have been tracking our results for years.