The failure or hang ups of surgery and rehabilitation has often led professional athletes to spend thousands for stem cell injections to repair damaged tissue. The procedure is turning mainstream, as sports medicine and orthopedic surgeons seek older patients who are up to spend similar amounts of cash for the promise of feeling youthful again.

Dr. Jesse Sally, of Rehabilitation Pain Specialists, gave a presentation to a group of Bethel Park residents on June 25, touting the benefits of the stem cell and platelet-rich plasma procedures he offers at his clinics through the Regenexx program. The newest location opened at 701 Boyce Road, Bridgeville, in March.

With an ACL tear, 90 percent of patients saw improvement ... with 50 percent improvement at six months, he said of nearly 16,000 patients in a nationwide database compiled since 2005. According to practice spokeswoman Mary Cvetan, Dr. Sally and other doctors have treated 250 local patients in the region since April 2013.

Insurance covers consultation, diagnostics, bracing and post-recovery, but the actual procedures ranging from $300-7,500 are not covered by insurance. The procedures get a technical pass from the Food and Drug Administration because they are same-day body modifications and arent considered a drug process like some other stem cell procedures. According to Dr. Sally, double-blind testing cannot be done with an authentic placebo, thus having anecdotal reports of patient success serve as the primary data set, which is not viable for insurance companies to write-off on.

The stem cell procedure pulls your own stem cells. Theres a little bit of pain, but we numb you up very well and draw the cells from the back of your pelvis hip bone, he said. Those cells are then reintroduced to an injured site, like a shoulder or knee, and the undifferentiated cells that can copy any type of cell in the body go to work by cloning themselves and adhering to tissue as if they were part of the original body mechanism. At least thats what doctors have said about the evidence behind the procedure still in its infancy. Since 2006, scientists have successfully been able to reprogram stem cells to act as other cells in a persons own body, but the success of their new roles relative to pain and movement still arent thoroughly documented.

You can have one (stem) cell be Obi Wan Kenobi, the other is Darth Vader, said University of Pittsburgh head athletics physician, Dr. Freddie Fu. Dr. Fu said he has refused to administer stem cells to patients despite their availability because of the unverifiable nature of reported success.

But even doctors who are skeptical acknowledge the underlying medical premise is sound: to have ones own body repair itself. Some of the Regenexx procedures that dont use stem cells, like platelet-rich plasma injections, purposefully antagonize an injured area, encouraging inflammation and spurring a repair response from the body.

As for future patients getting the procedures paid for, Dr. Sally said his and others practices have to develop an objective way to test for patient outcomes other than them simply reporting how they feel months after the procedure.

I think the insurance companies need to look at patient outcomes as they relate to a persons general health. But the companies look at hard data, so official numbers with statistical significance is not something we have right now. We have to design randomized trials and improve them so it works for insurance providers, he said, but otherwise, this is the least invasive way to deal with pain and movement issues when compared to surgery. Its a safe outcome with improved function.

David Singer

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