Orthobiologics FAQ

Why can't I be on certain medications during regenerative procedures?
Certain types of medications will negatively impact the regenerative cells. In addition, we generally see that many prescription medications will reduce cellular repair.
Is a fat lipoaspirate safer than a bone marrow aspirate?
Both procedures have a very good risk profile, with the risk being less than 1:10,000. Each procedure is generally well tolerated and completed under local anesthetic.
What if I take Coumadin, Plavix, or other blood thinners?
We generally recommend that you stop these before the procedure. For example, if you take Coumadin, you need to have the OK of your family doctor or cardiologist to come off this drug and an INR (blood clotting test) that is in the normal range before pursuing this procedure. If you take other blood thinners such as Plavix, you should be off this drug for 72 hours prior to the procedure. Your family doctor or cardiologist may also need to be consulted to ensure that it’s safe to come off of this medication. If you take a daily baby aspirin, then you need to come off this one week before the procedure.
What if I have a blood clotting disorder?
If your clotting times are normalized by taking clotting factors, then there should be no problem performing the procedure.
What can I expect when I have my blood drawn?
Many patients ask why we need to draw blood and how much is taken. Blood is drawn from a vein in your arm and the amount drawn can vary significantly based on the type of procedure and your body weight. The growth factors that we use for your regenerative treatments and enhance your procedure are contained in your blood platelets. These same growth factors and blood platelets are used for our platelet rich plasma and platelet lysate procedures.
Can a second procedure be helpful?
Our analysis of patients who have had a second procedure shows that very often a second procedure can help continue and improve the success a patient has from our regenerative treatments.
What happens to my blood, adipose or bone marrow after you complete the harvesting procedure?
Your tissue is prepared in the on-site lab using a proprietary cleansing and concentrating techniques. The concentrated cells are then precisely injected into the area of injury the same day.
Can I get a phone review of my condition?
While we prefer to see someone in person to review their condition and evaluate whether they would be a good candidate for Regenexx, we do offer an initial phone review of your condition if it’s inconvenient for you to drive to our office. Dr. DeMers can look at your films, history, and speak to you on the phone about whether she believes this may help your problem. It’s important to note that this is not the formation of a traditional doctor-patient relationship until you actually visit the doctor. Rather, this is just an opportunity for Dr. DeMers to determine if you’re a reasonable candidate for the procedure and for you to ask additional questions. Dr. DeMers will require an MRI on CD / DVD or an uploaded version of your MRI in order to review your imaging.
What should I know about the bone marrow aspirate?
Patients often confuse a bone marrow aspirate with a more involved and more painful bone marrow biopsy. We only perform the less involved and much more comfortable bone marrow aspirate. This is a short (20 to 40 minute) in office procedure where the skin and tissues are numbed and a needle is used to withdraw marrow blood, which contains a complex mixture of reparative growth factors and signaling cells. One site on each side of the low back and pelvis will be numbed and three samples are taken from each site. Because the area is extensively numbed, 88% of our patients report that the procedure is very comfortable and would do it again. To better assess how our patients feel about this procedure, we ran questionnaires on 44 consecutive patients undergoing marrow draws, showing that 86% said they had no to mild discomfort. 88% said that the procedure was either less uncomfortable or about what they thought it would be. 88% also said they would do it again without hesitation. A properly performed marrow aspirate procedure should not be uncomfortable to the vast majority of patients.
When can I expect to feel better?
The results should become apparent over 1-3 months but sometimes can take as long as 6-9 months.
How painful is the regenerative procedure for returning the concentrated cells to my injury site?
About as painful as a typical shot in a doctor’s office. We may recommend a nerve block for some procedures on an individual basis
How long do I have to stay for the procedure?
There is virtually no down time with this outpatient procedure. The entire process will take anywhere from 2-6 hours depending on the doctor’s recommendation and time needed for harvesting, processing and re-injection. You can walk right out of the clinic the same day any procedure is completed. For all blood-derived procedures you will only need to come in for one day for treatment.
How do you know where to place the injections for my regenerative therapies?
We use real-time x-ray known as fluoroscopy or musculoskeletal ultrasound to precisely guide the needles for your regenerative therapies. Your X-ray and MRI images are used to help plan that injection.
Will I need a second procedure?
Some of our patients will require a second or even third procedure. Our usual protocol involves a single series and the majority of our patients get a single procedure.
When can I return to normal activity?
This depends on the type of procedure. However, all of our procedures are designed to promote as much early activity as possible. Here is a general guide: Bone healing procedure (for fracture non-union or avascular necrosis): You must be off the area on crutches until the pain from the procedure subsides. You can then move toward slowing increasing activities over the next few weeks. Total time off the area for most patients is 1-3 weeks with normal activities at about 6 weeks. The only exception is when there is an existing rod or plate stabilizing the fracture site, in these cases you will be allowed more activity more quickly. Joint procedure. If there is more minimal cartilage loss, low impact activities would be encouraged immediately after the procedure. Full high impact activities would be expected at 4-6 weeks. Partial tendon/ligament/muscle tear: Low impact activities would be encouraged immediately after the procedure. Full high impact activities would be expected at 4-6 weeks.
Do I need to have someone drive me?
All of our patients walk out of the clinic. However, having someone drive you for a medical procedure is never a bad idea. On occasion, a local nerve block may be used, which could impair your ability to drive safely, so you should consult with Dr. DeMers about your specific treatment and protocol to ensure that it will be safe for you to drive if you wish to do so.
How much does a Regenexx procedure cost?
Because the procedure protocol will vary from person to person and because each person will have a unique condition to be treated, the pricing of procedures can vary considerably from patient to patient. An evaluation will give you a better idea of condition, treatment, and costs specific to your condition. The chart below provides a general idea of the procedures and where they fall in terms of cost and severity of conditions treated. Platelet procedures cost considerably less than adipose or bone marrow procedures.
Should I take specific supplements after my procedure?
Yes, Regenexx has developed a supplement based on lab tests with human mesenchymal stem cells and their response to various nutritional supplements.
Is physical therapy needed after the procedure?
In general, we always try to look at more than one injured part. As a result, it’s very likely we will recommend other types of conservative care to restore normal biomechanics. This might include physical therapy, different types of myofascial release, or specific home exercises.

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