My clinical practice mission is to use autologous concentrated marrow-derived mononuclear cells for the care and treatment of a joint afflicted by degenerative arthritis so as to assist a patient in postponing, perhaps avoiding a joint replacement. I then follow the patient using osteoarthritis outcome scores to measure pain control, activity improvement, and quality of life impact. The knee society score, an orthopedic surgeon’s vehicle, (KSS) also demonstrates a significant improvement of on the symptoms subscale and function subscale in most patients who undergo a Bone Marrow Concentrate procedure in my office. What about Stem Cells? Please note at the end of the first sentence and the beginning of the second, my emphasis on autologous concentrated marrow-derived mononuclear cells; not “Stem Cells”. That bone marrow concentrate is made up of Platelets, Growth Factors, and Mononucleated cells. It has been estimated that somewhere between .0017% and .034% of the mononucleated cells are actually adult mesenchymal stem cells. My point is that when you see the ads for stem cells on the many web sites, in the print media and now on outdoor advertising signs as the one I noticed on Clinton and Monroe in Chicago this past Monday, you may fall victim to marketing and not science. Chiropractors, non-board certified physicians, family practitioners and the entire realm of camp followers have embraced the exploding discipline of Regenerative Medicine. Patient beware as I point out in the next paragraph using a recently published study from the Mayo Clinic.
Many patients come to Mayo Clinic for a second opinion or diagnosis confirmation before treatment for a complex condition. In a new study, Mayo Clinic reports that as many as 88 percent of those patients go home with a new or refined diagnosis – changing their care plan and potentially their lives. Conversely, only 12 percent receive confirmation that the original diagnosis was complete and correct. Given what I have seen evolving in the field of Regenerative Medicine, I am not surprised. Few practices offering “Stem Cells” have any idea what is involved and what is in the bone marrow concentrate. Many mislead the public with a stem cell presentation using amniotic fluid product wherein it has repeatedly demonstrated there is an absence of stem cells in amniotic fluid once processed, frozen and fast thawed. What about adipose derived stem cells? For one, to liberate the stem cell from the adipocyte, there has to be a cycle of enzymatic degradation. The latter violates FDA requirements. What about platelets and growth factors in adipose derived materials? Given the relative absence of blood supply in fat, I have yet to find a scientific publication suggesting there are growth factors in adipose tissue.
The cover story in the April 2017 AARP.ORG/Bulletin is titled “How to Stop Fraud, The Ultimate Guide to Protect Yourself from Scammers and Crooks” While not directed to Regenerative Medicine, the warning applies. As suggested by the Mayo Clinic referenced article above, the best protection is a second opinion.