Recent news coverage about unqualified providers harming patients with risky, unproven procedures highlights the need for patients to ensure they are receiving care from reputable physicians before undergoing BMAC and PRP (platelet-rich plasma) treatments. The FDA has even stepped in to regulate rogue clinics and product manufacturers.
BMAC and PRP procedures are invasive medical procedures, so it is critical to do your research before selecting a clinic and physician for your treatment. We recommend that patients investigate the following factors before being treated by a regenerative medicine clinic.
Find a regenerative medicine physician with the necessary skill level and training.
You wouldn’t select a surgeon without doing your research about their patient outcomes and success rate. Selecting a regenerative medicine provider should be no different. To ensure that the doctor you are considering has extensive expertise in treating your condition, ask the following questions:
1. How many procedures of the type that I need have you performed? You want to make sure that the doctor you are selecting has treated your specific concern before with the type of procedure they are recommending (i.e. PRP vs. BMAC – take a peek at our FAQ to learn about the difference) before.
When receiving BMAC or PRP injections, it is critical to ask whether your doctor has training in performing guided injections under ultrasound or fluoroscopy, as you do not want to have these complex injections blindly performed.
2. What is your specialty? To ensure the best outcome for your treatment, you need a physician who specializes in BMAC or PRP injections. Why is specialization important? You want to be treated by an expert who has the specialized training necessary to help you achieve the best results by addressing your specific conditions and pain. If you needed brain surgery, you wouldn’t visit a dentist for the best results, right? Selecting a physician that specializes in BMAC and PRP injections helps to guarantee the best possible outcome for your treatment.
3. What training have you completed? Just as you want to be sure that your doctor has first-hand experience in treating your issue, it’s also important to find a physician who has the necessary background and education to be an expert in their field. You want to look for a board-certified physician in interventional radiology, orthopedic medicine, physical medicine, sports medicine, interventional radiology or interventional pain treatment.
Ensure that PRP or BMAC therapy is the right fit for you.
After selecting a knowledgeable doctor, it’s important to have a conversation about whether regenerative medicine is the right course of treatment for you. A reputable physician will conduct a full evaluation, asking you about your symptoms and pain, any injuries you may have suffered, the medications you take, your lifestyle, treatment goals and more. A reputable clinic will also use imaging such as an ultrasound or MRI to gain a full understanding of your condition. Then, the doctor will have a conversation with you about the likelihood that BMAC or PRP therapy will be successful in relieving your pain.
There is a risk of failure with any procedure and a physician who guarantees you that regenerative medicine injections will eliminate your pain, no questions asked, is not to be trusted. Instead, your doctor should have a conversation with you about all possible outcomes, including ones that don’t result in 100 percent pain relief, and share what their success rate is for the procedure you are considering.
Ask questions to identify a clinic that harvests cells from the right source.
When PRP treatment will not be effective, BMAC cells are used. The type of regenerative cells that are needed to treat knee, shoulder, hip, wrist and other musculoskeletal pain can be found in adipose tissue (the fat under our skin) or bone marrow (the tissue within our bones). If a clinic only harvests cells from adipose tissue, it may be an indicator that they lack the expertise, training and equipment to derive cells from bone marrow, and we would recommend looking elsewhere for treatment. Procuring bone marrow requires more experience from a physician and is a powerful treatment along with it’s adipose counterpart.
Some providers may try to sell you on cells derived from amniotic products like umbilical cords. These treatments, which do not contain live cells, are widely recognized as consumer fraud and should be avoided. Most importantly, we have very significant concerns on the sterility of these products, and we are now seeing nationwide issues of infections, injuries, and even death from these treatments.
Seek a regenerative medicine doctor who uses guided imaging for BMAC injections and PRP.
Getting stitches in the general area of a cut wouldn’t solve the problem if you were bleeding, right? The same concept applies when receiving BMAC or PRP injections. Targeting the injection using imaging is essential to ensure that the cells reach the right location to maximize the potential for healing.
If your physician is not using guided imaging (either ultrasound guidance or fluoroscopy), they are going in blind and are unlikely to successfully treat your pain. Learning how to accurately and precisely perform regenerative injections requires extensive training. Be sure to ask potential physicians about how they will perform injections (with or without guidance) and what training they have undergone to learn how to ensure injections reach the right area.
Be sure the clinic you select is processing your cells the correct way.
You wouldn’t want to eat at a restaurant that doesn’t follow the highest standards of cleanliness and food preparation safety, right? In the same vein, it’s important to make sure that the clinic you select is properly set up to handle your cells after they are extracted and prepared for injection.
Look for a clinic that uses a closed system to keep your cells in a sterile environment in order to avoid exposure to bacteria that can be found in an open system where your samples are exposed to open air.
You should also ask questions about how the clinic you select is counting the cell dose in the sample they retrieve and whether they have the necessary equipment to do so. Depending on age and other factors, some patients may not have enough cells to treat the areas where they have pain. In case this is the outcome for you, it is important to make sure that you work with a clinic that has the ability to process your sample, remove unnecessary tissues and concentrate the number of cells that are used for injection.
Less reputable clinics may use a centrifuge to extract the cells from your sample. These machines are inexpensive to obtain, meaning your costs may be lower, but they provide a lower concentration for injection. Seek a provider that uses either a closed in-office hood system where your sample is processed by hand (rather than a machine) or, the highest level of processing, an advanced lab run by dedicated cell biologists.
Regenerative medicine procedures like PRP and BMAC therapy are genuine medical procedures and selecting a physician to perform these procedures requires the same level of diligence as selecting any other medical provider. With many rogue clinics erroneously advertising expertise and procedure benefits, it’s important to do your research before paying for and undergoing any regenerative medicine procedures.
As you select a clinic, this guide of 10 questions you should ask the clinics you are evaluating from our friends at Regenexx is a great resource.
At RestorePDX we have a team of highly specialized, certified and expertly trained physicians who are dedicated to providing the highest level of patient care to ensure the best outcomes. We work with each patient to listen to their concerns, develop a customized treatment plan and carefully treat pain to allow patients to get back to living pain free. Give us a call at 503-535-8302 to schedule a consultation.