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Petri Dish

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Stem Cell Therapy

When it comes to Regenerative Orthopedics, stem cells are a game changer. They make our regenerative injection techniques much more effective. Stem cell therapy is the strongest, fastest and most effective regenerative stimulus we have. Over the last several years, stem cell technology has made rapid advances and we have learned much about how to isolate and use a patients’ own stem cells (autologous) to regenerate joints, ligaments and tendons.

What kinds of cases do we use stem cells for? 

Stem cells are indicated when the joint has more serious damage. For example in bone-on-bone knee arthritis, we need to rebuild the cartilage. This will generally require a more powerful regenerative cocktail i.e. stem cells. In many cases, stem cell therapy might be the only reasonable alternative to surgical approaches and may in fact have a better result, with much less risk. Stem cells have an amazing capacity to heal even severe joint problems in a most elegant fashion. At times I am in awe when I see what stem cells can achieve.


Stem cells are also indicated if the patient wants to get better in the fastest time possible. For example if I treat a professional athlete or a busy executive, these people will often opt for stem cell therapy just because its faster and is often a single treatment versus three or four visits for PRP or five or six visits for regular Prolotherapy. For them time is crucial and they need to get back to full functioning asap. The stem cells are generally harvested from a patients’ own abdominal fat in a simple, gentle liposculpting procedure. This procedure is done in the office under local and takes about an hour. The stem cells are then isolated from the fat using special enzymatic processes. We then mix the stem cells with PRP (i.e. platelet rich plasma) from a patients own blood and we inject the stem cell/PRP combo as close as possible to the problem areas. The stem cells have the capacity to differentiate and become any tissue that is required. If a patient is a good candidate and assuming a skilled harvesting, lab processing and evaluation/injection process, the success rate of an orthopedic stem cell procedure should be at least 80%. There is about a 15% chance that the patient will not respond to the stem cells and fail to heal. Generally speaking, a single stem cell treatment is usually sufficient to solve a problem. Patients’ response to the stem cell therapy varies greatly and depends on their own healing response. We see everything from a fantastic response in the first week to six weeks before the patient notes any improvement. The healing path of an individual patient is impossible to predict. For patients who are slow responders we sometimes recommend a PRP booster after about 6 weeks to reignite and boost the healing process. Some patients will also benefit from booster Prolotherapy sessions to stabilize the joints in question. The stem cell procedure is very safe and the only real downside is the cost. Orthopedic stem cell therapy is done in a single four hour session and involves a minor outpatient surgery using local anesthesia. The cost of a treatment is approximately $7,000 to $10,000 per joint and/or region treated and will vary according to which joints and areas are being treated. For patients with multiple joint areas the cost goes down as we do more areas. Interested patients should contact us to arrange a personal consultation by phone or preferably in person so we can give them all the details and they can make an informed decision.

Our Stem Cell Science

One of the keys to an effective Orthopedic stem cell program is the quality of the stem cell isolation procedure that is done on site in the lab.

Our chief stem cell science consultant is Kristin Comella, who we consider as one of the top authorities in the world when it comes to designing effective office lab procedures to produce high-potency stem cell preparations. Ms. Comella has achieved international recognition for her work and has been ranked #24 in the world of most important people who influence stem cell science.

Kristin Comella has over 15 years of experience in regenerative medicine and was recently named number 24 according to Terrapin’s 2013 list of the Top 50 Global Stem Cell Influencers.

Dr. Walter and his lab staff have trained directly with Kristin and use her recommended equipment and protocols to insure the highest quality stem cell preparations.

Platelet Rich Plasma (PRP)

I have used PRP for joint regeneration for over five years. PRP is a stronger regenerative stimulus then Prolotherapy but of course, not as good as stem cells. The only advantage of PRP over stem cells is it is less expensive and does not require fat harvesting. The downside is it usually takes four or five sessions and there is a chance that if PRP fails, the patient may end up needing stem cells to finish the job properly. That being said, if the problem is not too severe and the patient is younger and healthier, PRP may be just the ticket to fix the problem. A PRP treatment costs in the region of $950. To $1200, depending again, on what areas are involved.

A PRP treatment costs in the region of $950. To $1200, depending again, on what areas are involved.   Where does Prolotherapy fit in?


Where does prolotherapy fit in?

In General we use the term Prolotherapy to refer to dextrose regenerative injections that have been used for over 50 years to tighten ligaments and tendons, but Prolo is actually the injection technique. We could correctly talk about Stem Cell Prolotherapy or PRP Prolotherapy for example (although thee terms are not commonly used!)

At the end of the day, I am a classically trained Prolotherapist that uses the same tried and true evaluation and injection techniques that we draw from Prolo and use them for stem cell therapy. I had the privilege of learning from some of the top Prolotherapy teachers in the world and have, over the last 15 years, used Prolo extensively to help heal and regenerate all kinds of issues. For me the Prolo methodology of evaluating and injecting patients is a huge advantage when it comes to getting the best results with stem cell injections.

In my opinion, the best regenerative orthopedic specialists will be Prolotherapists. It is also true that dextrose Prolotherapy still has its place in the regenerative orthopedic approach to a patient, even if you use stem cells. Prolo is particularly good when it comes to tighten the ligaments and tendons around a joint and can be quite synergistic with stem cells in the following manner. For example if I had a patient with a severly arthtitic knee i.e. a lot of cartilage loss who also had a loose joint I might want to do some Prolo treatments around the stem cell therapy to stabilize the joint and reduce the shear on the joint surface. This would better allow the stem cells to build up the cartilage without having the joint surface being constantly disrupted by too much play in the joint. I still have many previous patients who are staunch believers in Prolo and that’s all they want. If they have the time and Prolo does the job I am happy. If they have a session or two of regular Prolo and they get no better I will usually reevaluate and might recommend PRP or even stem cells if the situation calls for it.

Prolotherapy sessions are less expensive and vary between $800 – $1,000 depending on which joints or regions are injected.

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