Regenerative Orthopedics: Stem Cells & PRP Questions & Answers

1. How do BMC stem cell injections, platelet rich plasma (PRP) injections and amniotic fluid-derived allografts accelerate the healing process of orthopedic injuries?

Platelet rich plasma (PRP), BMC (bone marrow concentrate) stem cell injections and amniotic fluid-derived allografts (such as Orthoflo) all utilize the latest in medical technology when combined with the body’s natural healing abilities. When the body becomes injured, it initiates a healing response that includes rebuilding important tissue with the use of cells and growth factors.

Growth factors are characterized as small signaling proteins that help the body initiate and control the healing process. Mesenchymal stem cells (MSC) are specific cells to the musculoskeletal system, which are able to differentiate into different tissue types such as ligament, tendon, muscle and even bone. By providing these cells or growth factors to the injured site, Dr. Matthew Provencher may be able to help decrease inflammation, improve or accelerate healing and allow for pain relief and/or a quicker recovery.

2. Are BMC stem cell injections, platelet rich plasma (PRP) and allografts all considered regenerative therapies?

The simple answer is no. While PRP accelerates the body’s ability to heal itself through the aid of growth factors, it is not considered a regenerative therapy.

BMC and amniotic-fluid derived allografts on the other hand are considered regenerative therapies because they are believed to assist with both healing acceleration and tissue regeneration. The additional “pluripotent” adult stem cells withdrawn from the patient, typically from a patient’s own iliac pelvic bone, used for the BMC procedure are “undifferentiated,” meaning they are able to replicate themselves into (or regenerate) various types of tissue. Amniotic-fluid derived allografts contain cells and growth factors from donor tissue, specifically placenta and amniotic fluid.

3. Why is bone marrow concentrate (BMC) called a stem cell “like” therapy?

The term “stem cell therapy” is often associated with controversial treatments using embryonic or fetal stem cells collected from aborted fetal tissue. By using a patient’s own “pluripotent” adult stem cells or placental tissues, the BMC stem cell injections utilized by Dr. Provencher can replicate the same benefits of stem cell therapy without the ethical concerns of using embryonic/fetal stem cells.

4. Is there an age limit for BMC stem cell injections?

There is not an age limit for BMC stem cell injections, but certain factors should be considered in patients over the age of 60 years.

Patients up to the age of 60 can generally achieve tissue regeneration using their own “pluripotent” adult stem cells through BMC therapy.

Unfortunately, as the body ages, its ability to regenerate tissue from autologous (its own) stem cells diminishes. It is reported the body’s number of stem cells begins to decrease with age starting at about 40 years. After age 60, autologous BMC typically fails to provide regeneration because there are not enough stem cells in the bone marrow. Between the ages of 70 and 80 years, there are almost no stem cells in the bone marrow to use. After age 80, stem cells in the bone marrow are virtually non-existent.

Due to this decline in autologous stem cells, patients over 60 years of age generally achieve better results using a combination of a healing accelerator, such as PRP or an amniotic-fluid derived allograft, and allograft tissues derived from another source for regeneration.

5. Do all platelet rich plasma (PRP) and bone marrow concentrate (BMC) stem cell therapies provide the same healing and regeneration benefits?

The answer is no. It is very important patients considering PRP and BMC therapies understand the doctors who administer these treatments buy kits to concentrate and prepare the blood or bone marrow for the injections. As the regenerative orthopedic treatments continue to gain popularity throughout the country, there are more companies that sell these kits. It is important to note that only a small number of companies have received FDA approval for their treatments. This means that some physicians are using kits that are not FDA approved, or kits that provide significantly less concentrations of cells than the approved kits.

Research shows that the minimum level for the concentration of platelets necessary to achieve positive results from platelet rich plasma injections are 5-7 times that of the human blood platelet count. Studies conducted in head to head comparisons have repeatedly shown that inexpensive and inferior kits used by some physicians only produce 2-3 times the blood platelet concentration. It is very important that patients ask if the kits their physicians are using are FDA approved and if they are meeting the concentration levels necessary for a positive outcome.

The PRP kits used by Dr. Provencher and his orthopedic team are FDA approved and produce at least 7-9 times concentrate of platelets. The BMC kits are one of very few approved by the FDA and consistently produce higher counts of nucleated stem cells than the competitors’ kits in head to head studies.

6. Why doesn’t my insurance cover this treatment?

Since regenerative orthopedic treatments are still considered experimental, insurance does not cover them. Cash pay is required at this time.

To learn more about the affects of biologics in sports medicine, please visit the biologic research section of our website: Biologic Research.

Matthew Provencher, MD

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66 reviews

James Wilson

Oct 11, 2024

by James Wilson on Matthew Provencher, MD

Senior Electronics development engineer

Wow the Steadman clinic and Doctor Matthew Provencher now that;s a super combination of expertise, experience, empathy, skill and a cherry picked staff with truly outstanding nurses and professional support staff. I was scared of shoulder surgery until I read Dr. Provencher BIO and talked to him. If your considering shoulder replacement surgery this is the place. In three weeks out now and people are amazed at my ability of movement and flexibility I have now. I love the Steadman Clinic and Dr. Matthew Provencher, He's Superman

Anne Miller

Jun 18, 2024

by Anne Miller on Matthew Provencher, MD

Grateful to Dr Provencher and his team

I am a 75-year old, active, athletic woman. Over the last few years, both of my shoulders reached a point where severe arthritis was affecting even day to day tasks. It started with one shoulder in 2021 and recently the second reverse shoulder replacement – both with Dr Provencher. Before my first one, I had received various recommendations including adjusting my lifestyle. Dr Provencher looked at my MRI and x-ray and asked what I enjoy doing and was quick to let me know I could be back to my active lifestyle soon – and he was right. He reads images faster and more accurately than any doctor I have consulted. He has many options available and if you need surgery he is the one to do it. Surgery is quick and the recovery is much easier than I anticipated. I am 10 days out from my second reverse shoulder and have no pain and gaining mobility already! My case for both shoulders was a bit more complicated due to bone integrity, severe arthritis and bicep tears. Dr Provencher has dealt innovatively with both complications and makes it seem straightforward although I know it was not. He is not only one an extraordinary surgeon, but also, a caring human being who takes the time with his patients and makes himself available if questions arise. His team is second to none – Maddy, Madison, Sam, Scott, Jasmin and in pre-op, Layla and Kevin – in terms of commitment, competence, compassion and responsiveness. Both times I have felt cared for and that resolving my situation mattered to him. Wherever you live, Dr Provencher and his team are the ones to trust. There is no need to live a compromised life!

Gene reiling

Jul 21, 2023

by Gene reiling on Matthew Provencher, MD

Success

If you are planning to see Dr Provencher ,do not hesitate ,do it. In 2018 Dr Provencher replaced my LCL. I had no complications and very little pain. I did my physical therapy as prescribed. I was able to ski 30 plus days the winter of 2019-2020. Before seeing dr Provencher I had spent a years time trying to solve my problem locally. I saw a pain specialist, orthopedic urgent care and a orthopedic surgeon. All had access to an mri done locally. It was also read by local radiologist. Pain dr gave injections as did orthopedic urgent care. No relief from pain. Orthopedic surgeon told me about arthritis, meniscus needing cleaning up and general deterioration from age. Told me to take ibuprofen for pain. At that time I reached out to Steadman Clinic. By luck of the draw I was assigned Dr Provencher. I took with me the mri that had been done locally and viewed by 3 local Drs and 1 PA. It took Dr Provencher less than a minute to tell me my problem was my LCL after viewing my mri. He told me my options . I selected surgery as I wanted to continue an active life style. It was a complete success!!

Knee | Shoulder | Joint Preservation | Arthroplasty