939 W. Market St., Suite 3, Lima, OH 45805 | 419-516-0515

Stem Cells for Regenerative Medicine

What are stem cells used for?

Dr. Kuhlman is using stem cells to treat a wide variety of orthopedic conditions, and also for cosmetics to give a more youthful appearance.  Stem cells are the body’s raw materials. They can turn into new cells to help the body repair itself. In orthopedic medicine, current research is most promising in treating arthritis of the knee, hip and shoulder joints, cartilage repair, chronic disc disease of the neck and low back, chronic tendon and ligament injury of the shoulder, hip, knee and ankle.

What are the different types/origins of stem cells?

In regenerative medicine to treat chronic arthritic conditions and cosmetic concerns, adult stem cells are typically used.  These are most commonly obtained from the patient’s bone marrow or abdominal fat or from donated umbilical cords. Adult stem cells are multipotent, which means they can turn into some, but not all, types of cells. We do not use stem cells that come from embryos.

What are the pros and cons of bone marrow derived stem cells?

Stem cells obtained from the patient’s own bone marrow has the most adult stem cell research showing benefit. They are very safe as they come from you. Bone marrow derived stem cells have been shown to help with arthritic joints and chronic tendon injuries. The entire procedure takes about an hour to harvest the stem cells from your hip bone, prepare it, and inject it back into the appropriate area. Major drawbacks are that withdrawing the bone marrow can be painful and bone marrow stem cells are not as good when we get older.

What are the pros and cons of adipose derived stem cells?

Recent research has shown adipose derived stem cells to be very effective in treating orthopedic conditions. Additionally, these stem cells appear to work well even when the patient is elderly. For this procedure, we numb the stomach and then a cannula is placed under the skin to remove a small amount of fat from the stomach region. The fat is then broken into smaller particles and then re-injected back into your body. The entire procedure takes about an hour. There is mild discomfort and you should limit vigorous physical activity for a week. Dr. Kuhlman uses adipose derived stem cells for orthopedic problems, especially knee arthritis, and for cosmetics to give a fuller youthful appearance.

What are the pros and cons of umbilical cord blood products?

Umbilical cord blood products are obtained from an umbilical cord when a mother donates it after she delivers a healthy full-term baby.  These are not embryonic stem cells. The primary benefit of umbilical cord injections is that the entire procedure is very quick and easy.  We do not have to harvest adult stem cells from you as we do with bone marrow and adipose derived stem cells. These cells are shipped to our office and stored at minus 80 degrees Celsius. We simply remove the vial from the liquid nitrogen container, let them thaw, then use an ultrasound machine to guide the injection into the appropriate joint or area. These injections are helpful for treating arthritic joint pain and chronic tendon and ligament injuries. Drawbacks are that there is currently less research compared to bone marrow and adipose derived stem cells and some people may be concerned that these products come from another person.

What are the pros and cons of Exosomes?

Exosomes come from amniotic fluid of a full-term mother. They do not contain stem cells, but do contain enormous amounts of growth factors that can aid in healing degenerative arthritic joints and tissues. Exosomes come to our office in a frozen vial that we store in a liquid nitrogen tank. We simply thaw the exosomes for a few minutes, then inject them into the appropriate area. Exosomes are significantly less expensive than stem cells, so they are a great option for a person who has more than one large joint that needs treated or a person with diffuse chronic neck or back pain that would be very expensive to treat with stem cells.

What are the pros and cons of using platelet rich plasma?

Platelet rich plasma (PRP) is an injection treatment that uses the patient’s own blood. PRP has been used for decades and there is significantly more research demonstrating safety and benefits with PRP than with stem cells. As a result, PRP is more likely to be paid by insurance than stem cells in the near future. PRP is very beneficial in treating a wide variety of arthritic joints, chronic tendinits/bursitis and for facial cosmetics. The procedure involves drawing 30-120 cc of blood, which is placed in a centrifuge to separate the platelet rich plasma and growth factors from the rest of the blood products. The PRP is then injected with ultrasound guidance into the involved joint or area to be treated. The entire process takes about 45 minutes. It is very safe as the PRP comes from you. There is minimal discomfort. It can take 1-2 months to see results and improvement can be seen for 1-2 years. PRP is probably (no research to verify) not as effective as stem cells, but the cost is significantly less.

Which regenerative medicine treatment is better - bone marrow stem cells, adipose stem cells, umbilical cord blood, exosomes or platelet rich plasma?

In 2019, we simply do not know which of these regenerative medicine products is best at treating orthopedic conditions. There has been extensive research on all of these products, all of which show promise in providing long-term (greater than a year) benefit to people with chronic arthritis and musculoskeletal pain. However, there are no good head-to head studies showing that one is better than another.

What is the cost for stem cells?

Stem cell treatments are not covered by insurance. It will probably be another 5-10 years before regenerative medicine procedures such as stem cells and PRP are covered by medicare and insurance companies. Dr. Kuhlman charges $3400 per large joint/area for adipose derived stem cell treatments and umbilical cord blood injections. Exosomes which can treat two large joints or a large area such as the neck or low back cost $2300. PRP injections for one joint/area is about $800 and two large joints are $1500. Our fees are almost 50% lower than the national average for the same service.