This time of year always brings with retrospection, reviews and prophecy, no matter what area of interest. As my area of professional concern is arthritis and assisting a patient avoid or at least delay a joint replacement, I thought it would be helpful to look at what Outcomes we recorded in our Data Base. Unlike the majority of Regenerative “experts” marketing themselves on the internet, I don’t cite the results of others or make unsupported claims, I document what I learn from having treated patients with Bone Marrow Aspirate Concentrate over two and a half years. Imagine if you would the complexity of having integrated patient care with clinical research using all the parameters I applied to development of new generations of total hip and total knee prosthetics during my almost 40 year joint replacement career. That’s why there are few if any involved in musculoskeletal care via Regenerative Medicine who are able to provide a patient the comprehensive experience I offer.

As of this morning, we have registered over 525 patients in our comprehensive Data Base with measurement pre and post Bone Marrow Aspirate Concentrate/Stem Cell intervention in 125 hips and almost 400 knees. Of the hips, three have gone on to a joint replacement; of the knees, two have gone on to a total knee replacement to the best of my knowledge. What I have defined from my experience is who will benefit from a BMAC intervention and who should undergo a joint replacement. Note the absence of reference to adipose derived stem cells. The explanation is simple; the FDA views such as a drug and hence does not approve the use of fat in the management of arthritis. I am also beginning to get a better understanding about how long the benefits of the intervention will maintain and how to best manage and extend those benefits. In the joint replacement world, the benchmark parameter is survivorship, how long until the prosthesis fails? In the stem cell world, I am interested in observing and prolonging the pain relief and functional improvement after the Bone Marrow Aspirate Concentrate Stem Cell procedure.

Evidence Based Medicine and Best Practices require maintenance of an outcomes data base; not an injection without ongoing follow-up. As I perused the internet this morning, other than Regenexx, I find a paucity of clinical data and a predominance of unsupported claims. In my lifetime of joint replacement surgery, there were many others performing large numbers of procedures around the country. We would meet periodically and present our own scientific outcomes and the evidence and learn from each other, all leading to the best possible clinical practices of total joint replacements. When it comes to the seductive claims from Stem Cell clinics found all over the Web, my challenge this year: Show Me Your Evidence

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