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Regenexx Procedure Traditional Surgery
Purpose Eliminate pain and increase joint function, reduce need for addictive pain medications while repairing and regenerating damaged tissue and degenerated joints. Improve pain and function. Remove and suture injured tissue. Remove natural tissue and joints.
How is it performed? Uses a needle to inject your natural healing cells (platelets and bone marrow Stem cells). Uses scapel, hardware, or artificial components to remove, suture or replace injured tissue.
Invasive Less Invasive More Invasive
Scarring No Scar Scar
Need for Hospitilization No Yes
Need for Pain Medications Week Months
Need for Bracing Possibly Possibly
Down Time/Activity Restrictions 6 Weeks 2-3 Months
Need for Physical Therapy Twice a Week for 6 Weeks Twice a Week for 3 to 4 Months
Lost Time from Work Less More
Risks/Complications Less Risk More Risk
Insurance Coverage No Yes
Out of Pocket Cost Yes Yes
Other options if the treatment Fails More Options Less Options

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154,007

More than 154,007 highly specific image-guided procedures using Regenexx injectates have been performed since Regenexx pioneered the field of interventional orthopedics, using your body's own cells to treat common orthopedic problems in 2005.

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Regenerative vs. Surgical Procedures Cost Comparison

Choose the chronic pain issue you’ve been experiencing and press submit to compare the cost of Regenerative Procedures and Surgery.

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CCI 101: Understanding Craniocervical Instability and the Road to Recovery

Dr. Centeno’s new book on Craniocervical Instability is now ready to go! This covers everything from conservative care to surgery to newer precise orthobiologic injection procedures like PICL that can help existing ligaments tighten down and stabilize the upper neck. This book is a must-read for anyone diagnosed with CCI.

This is version 2 of this book and while it has been read by several CCI patient advocates who made suggestions if you find things that require correction or have ideas for improvements, please send a quick email to the author at [email protected]!

Download Ebook

What is a procedure using Regenexx injectates?

These procedures are designed to treat common orthopedic conditions and help people avoid surgery using cells from their own body.

A physician in the licensed Regenexx network uses image guidance to inject customized concentrations of the patient’s own cells, from either blood or bone marrow concentrate, into the precise area(s) of injury.

Is a nonsurgical procedure using Regenexx lab processes right for me?

Deciding if a nonsurgical procedure is right for you starts with learning your candidacy for treatment.

Schedule a consultation with a physician in the licensed Regenexx network who will evaluate your condition or injury, explain your candidacy for a nonsurgical procedure, and answer your questions.

Some reasons patients choose to learn their candidacy for a procedure include:

  • Struggling with a condition that’s not improving
  • Unsure about a diagnosis or treatment plan from another doctor
  • Desire to avoid or put off orthopedic surgery, prefer a treatment that is less invasive than surgery
  • Desire to use their own cells for treatment and avoid implants, permanent hardware, grafts, and/or removal of tissue

Will my body be fully restored after a procedure using Regenexx lab processing?

Although we are able to provide you with results data for procedures and your specific candidacy for a procedure, no one can guarantee a full restoration of your body to the way it was prior to injury.

Like all medical procedures, procedures using Regenexx injectates have a success and failure rate. You can review what patients report for pain reduction and joint function improvement for up to six years post-procedure by exploring Patient Results.

Are procedures using Regenexx injectates safe?

Using the U.S. Department of Health and Human Services (HHS and OHRP) guidelines for complications reporting, complications to date have been in the mild to moderate category and rare.

  • Mild: requires no medical treatment. For example transient swelling.
  • Moderate: requires treatment. For example, opting for a treatment other than a procedure using Regenexx lab processes if it failed.

We have published an extensive safety and complications tracking study of bone marrow concentrate, which contains adult stem cells, in patients. This study did not show any serious procedure-related complications and it did not show that any patient developed a cancer related to bone marrow concentrate use. View our Safety Paper.

Is a procedure using Regenexx lab processes painful?

Procedures using Regenexx SCP and PL injectates start with a basic blood draw. Regenexx SD injectate, a bone marrow concentrate procedure, requires a bone marrow aspirate with local anesthetic. A bone marrow aspirate is significantly less invasive than a bone marrow biopsy. Some patients are given an oral sedative to help to ease anxiety and relax the muscles prior to the bone marrow draw.

Procedures are performed with comfort considerations for the patient. Local anesthesia is used to numb the area(s) of treatment. After a procedure, the joint and injection site(s) may feel sore. Your physician may prescribe pain medicine or recommend acetaminophen. You will be asked to keep the joint as still as possible for 30-60 minutes after the procedure and limit activity on the joint for the first day post-procedure. Your physician may also recommend a brace, wrap, or walking boot to support the area treated.

How soon after a nonsurgical procedure using Regenexx lab processing can I resume normal activities?

Generally, patients return to normal daily activities as tolerated. Most patients resume light activities after 5 to 7 days and return to sports at 6 to 8 weeks. Further improvement may continue over several months. Your physician will discuss what post-procedure may be like for you based on your specific condition or injury and the recommended procedure.

Can more than one body area be treated at the same time?

Some patients are able to have more than one area treated at the same time. This is on a case-by-case basis and determined by several factors including: evaluation and recommendation of the physician, the amount of blood or bone marrow that would need to be drawn and concentrated to treat multiple areas of injury, and the overall comfort of the patient.

What is the difference between procedures using Regenexx SCP injectate and Regenexx SD injectate?

A procedure using Regenexx SCP injectate is a blood based procedure. SCP means “Super Concentrated Platelets” and is a type of highly-concentrated platelet rich plasma (PRP) procedure.

A procedure using Regenexx SD injectate is a bone marrow concentrate (BMC) based procedure; bone marrow concentrate contains the patient’s own stem cells. SD means “Same Day” as the cells are harvested, highly-concentrated, and reinjected on the same day.

How do “stem cell therapy” or other “stem cell procedures” compare to a procedure that uses Regenexx SD injectate?

Regenexx does not call procedures using Regenexx SD injectate “stem cell procedures.” Unfortunately, that term has been co-opted by sellers of products which are manufactured from birth tissue (typically amniotic fluid or membrane), and then bottled, labeled as “stem cells”, and then shipped nationwide.

A procedure using Regenexx SD injectate is a bone marrow concentrate (BMC) based procedure; bone marrow concentrate contains the patient’s own stem cells. This procedure uses customized concentrations of the patient’s own cells for treatment and is specific to their individual condition or injury needs.

How long will a procedure using Regenexx injectates last?

You can review what patients report for pain reduction and joint function improvement for up to six years post-procedure by exploring our Patient Results.

There are many factors that contribute to the effects of a procedure over time including: specific condition or injury treated, severity of the condition or injury, candidacy for procedure, and the lifestyle and activity levels of the patient. A physician in the licensed Regenexx network will discuss what post-procedure may be like for you based on your specific condition or injury and the recommended procedure.

Is physical therapy needed after the procedure using Regenexx injectates?

Your physician may recommend additional types of conservative care to support your post procedure recovery. These care recommendations may include: physical therapy, myofascial release, home exercises, and bracing or taping.

How much do procedures using Regenexx lab processes cost?

These procedures are customized for each patient and their specific injury needs. The price and any insurance or benefits you may have are reviewed during your consultation appointment. Generally, platelet procedures using Regenexx SCP injectate cost considerably less than procedures using bone marrow concentrate (Regenexx SD injectate).

What do insurance plans cover or reimburse?

Medical insurance plans may cover evaluation appointments, diagnostic testing (if recommended), imaging (X-ray or MRI), physical therapy (if recommended) and bracing (if recommended). While other employer specific benefits typically cover the procedure using Regenexx lab processing.

Your plan paperwork or benefits documents can help verify any coverage or employer specific benefits you may have as well as in-network benefits for specialist services within your plan.

Do employers include or offer Regenexx Benefits?

Yes, some employers do include Regenexx Benefits for their employees. If your employer includes Regenexx Benefits you will find more details about your specific plan in your employee benefits documents. You may have received a Regenexx benefits card and/or welcome letter in the mail and your employer will have a Regenexx Benefits website link where you can access additional information about your specific Regenexx Benefits. You can also search to see if your employer or group offers Regenexx Benefits, here.

Do Medicare or Medicaid cover procedures using Regenexx injectates?

Unfortunately, neither Medicare nor Medicaid choose to cover regenerative procedures at this time.

Why do other clinics and providers charge less?

Other providers may offer their patient less costly methods of treatment requiring less time from the provider, basic medical equipment, and offering little to no customization.

Other clinics may also:

  • Restrict patient access to a board-certified physician.
  • Allow non-physician practitioners to handle evaluations and/or procedures.
  • Base recommendations solely on limited information, such as verbal details or imaging.
  • Use off-the-shelf pharmaceuticals or drugs instead of customized injectates.
  • Offer standardized approaches rather than customizing the dosage for individual injuries or conditions.
  • Use less concentrated injectates.
  • Perform injections without image guidance (blind injections).
  • Provide limited follow-up care or post-procedure support.

What are the side effects and risks with Regenexx nonsurgical procedures?

An injection-based procedure produces a micro injury. After a procedure, the joint and injection site(s) may feel sore.

Using the U.S. Department of Health and Human Services (HHS and OHRP) guidelines for complications reporting, complications to date have been in the mild to moderate category and rare.

  • Mild: requires no medical treatment. For example transient swelling.
  • Moderate: requires additional treatment. For example, opting for a treatment other than a procedure using Regenexx lab processing.

We have published an extensive safety and complications tracking study of bone marrow concentrate, which contains adult stem cells, in patients. This study did not show any serious BMC related complications. View our Safety Paper.

Where Are You Experiencing Pain?

Treatment Areas
ShoulderShoulderFoot & AnkleFoot & AnkleHand & WristHand & Wrist Knee Knee ElbowElbowHipHipLower SpineLower Spine

Select a Problem Area

If you have pain, we're here to help. Regenexx® Procedures are non-surgical injection treatments that are intended to help reduce pain and improve function for those who are suffering from pain due to common injuries, arthritis, and overuse conditions.

Click a problem area to discover what Regenexx can do for you.

Shoulder

Commonly Treated Conditions:

  • Rotator cuff tears
  • Arthritis of the shoulder joint
  • Thoracic outlet syndrome
  • Labral tears or degeneration
  • Rotator cuff tendonitis & tendonosis
  • AC Joint Separation
  • Recurrent shoulder dislocations

Foot & Ankle

Commonly Treated Conditions:

  • Arthritis
  • Ankle Instability
  • Plantar fasciitis
  • Peroneal tendon tear or split
  • Ligament sprain or tear
  • Sub-talar arthritis or instability
  • Tarsal tunnel syndrome
  • Bunions

Hand & Wrist

Commonly Treated Conditions:

  • Hand Arthritis
  • Basal Joint Arthritis or CMC / Carpometacarpal Arthritis
  • Instability
  • TFCC Tear
  • Carpal Tunnel Syndrome
  • Trigger Finger

Knee

Commonly Treated Conditions:

  • Arthritis
  • Meniscus Tears
  • Patellofemoral Syndrome/Chondomalacia
  • ACL Tears + PCL, LCL & MCL Tears & Sprains
  • Patellar Tendonitis
  • Pes anersine bursitis
  • Baker’s cyst
  • Instability
  • Hamstrings Tendinopathy & Biceps Femoris Insertional Tendinopathy

Elbow

Commonly Treated Conditions:

  • Arthritis
  • Instability
  • Tennis Elbow or Golfer’s Elbow
  • Nerve entrapment (ulnar nerve)

Hip

Commonly Treated Conditions:

  • Arthritis
  • Osteonecrosis
  • Bursitis
  • Tendinopathy
  • Labral / Labrum Tear

Lower Spine

Commonly Treated Conditions:

  • Lumbar Facet Injury
  • Degenerative Disc Disease
  • Herniated or Bulging Disc
  • Radiculopathy (pinched nerve)
  • SI Joint Syndrome
  • Many More Disc and Low Back Issues

Cervical Spine

Commonly Treated Conditions:

  • Cervical Instability
  • Cervical Facet Injury
  • Neck, Back or Rib Instability
  • Many More Disc and Cervical Issues Causing Pain
Adult Stem Cells

Stem cells found in the adult human body, as opposed to those removed from embryos. When applicable, procedures using Regenexx injectates exclusively involve adult stem cells, and none involve embryonic stem cells.

Allogeneic

From one human into another. Off-the-shelf “stem cell” products are allogeneic, as they are typically derived from donated birth tissue prior to being packaged, shipped to the doctors who use them, and then injected into patients. All allogeneic “stem cell” products are required to be approved by the FDA before being administered to patients in the United States.

Amniotic Fluid

The fluid which surrounds the fetus while in utero. Amniotic fluid is often processed, packaged, and sold as an injectable product in the United States, with claims that contains stem cells. However, in the absence of FDA approval, the FDA treats amniotic fluid products as adulterated and misbranded, and therefore unlawful. Regenexx does not use amniotic fluid in any of its procedures. Additionally, numerous studies have shown that amniotic fluid products contain no stem cells.

Autologous

The implantation, transplantation, infusion, or transfer of human cells or tissue back into the individual from whom the cells or tissue were recovered. See 21 C.F.R. § 1271.3(a). Procedures using Regenexx injectates exclusively involve the use of autologous (“your own”) cells and tissue, which reduces patient safety risks and supports regulatory compliance.

Blind Injection

An injection into the body without image guidance. When patients have mild orthopedic conditions, like carpal tunnel syndrome, a doctor may “blindly” inject the patient with cortisone (or similar injectables) within the standard of care. However, for more complex conditions, or when more complex areas of the body are involved, doctors should use image guidance tools like ultrasound and fluoroscopy. All procedures using Regenexx injectates involve image guidance for the most accurate administration of orthobiologics possible.

Bone Marrow Concentrate

Bone marrow concentrate (or “Concentrated Bone Marrow” or “Bone Marrow Aspirate Concentrate” or “BMAC”), is a concentrated form of autologous bone marrow. Bone marrow concentrate is the result of centrifuging bone marrow to obtain a smaller volume which is more highly concentrated with cells and growth factors and therefore more useful as an injectate.

Clinical Trial

A clinical trial, also known as a clinical investigation, is a research study in which people (“subjects”) volunteer to help find answers to specific health questions. Most often, the term “clinical trial” is associated with the development of new drugs and biological products in the United States, as the FDA typically requires product sponsors to test their products through multiple phases of clinical trials in order to establish safety and effectiveness. Clinical trials are a critical part of the drug development process, but by nature carry risks all potential “subjects” should understand. First, the new drugs and biological products being researched in clinical trials have not yet been proven safe and effective, as that “proof” will only be established once the clinical trial is complete. Second, in many clinical trials, product sponsors are required to establish that their new drug or biological product is superior to a placebo, so subjects might receive the placebo instead of the product being studied and not be told which they received. Third, product sellers often use the term “clinical trial” as sales jargon to induce patients to purchase their unapproved product, so it is important for potential subjects to participate only after they have a full understanding of the entire process and the risks that may be involved.

Concentrate

(verb) To increase the density of a substance, or (noun) the product which results from concentration. Physicians in the licensed Regenexx network “concentrate” blood and bone marrow to obtain smaller volumes that are denser with cells and growth factors, thereby making them (for instance, bone marrow concentrate) more useful as orthobiologic injections.

Cord Blood Stem Cells

Cord blood stem cells are collected from the umbilical cord and placenta after a baby is born, as cord and placental blood contain large numbers of blood-forming stem cells. In the United States, cord blood stem cells are often employed in the treatment of complex conditions, such as leukemia and lymphoma, within the standard of care. Those cord blood stem cell products are either approved by the FDA or being studied in an authorized clinical trial and manufactured and used in highly regulated environments. However, unscrupulous sellers also sell unapproved cord blood stem cell products as orthobiologic injectates, which has led to well-documented public health crises and FDA warnings and consumer alerts.

Culture Expanded

Culture expansion is the process of multiplying cells over the course of days or weeks by exposing them to natural growth factors in a laboratory. Culture expansion allows the treating physician to obtain a greater quantity of cells for injection into the patient, which can be useful when treating larger areas of the body, such as the hip, or more complex conditions, such as avascular necrosis. Procedures using Regenexx injectates involving culture expansion are not available in the United States but are available at the Regenexx clinic in the Cayman Islands.

Embryonic Stem Cells

Embryonic stem cells are stem cells from discarded embryos. Historically, embryonic stem cells have been associated with a wide range of safety and ethical concerns and are not available to patients in the United States. Procedures using Regenexx injectates do not use embryonic stem cells.

Exosomes

Exosomes are nanoparticles secreted by cells that contain nucleic acids, proteins and lipids. Products marketed as “exosomes” typically result from the chemical treatment of cells and are therefore treated as “more-than-minimally-manipulated” by the FDA and subject to FDA’s approval requirements. Regenexx does not use exosome products due to their unknown health risks and non-compliant regulatory status.

FDA

The United States Food & Drug Administration. For more information on how FDA’s regulations apply to Regenexx’s suite of orthobiologics procedures, please visit our FAQ page.

FDA-approved

Medical products which have been explicitly “approved” by FDA.

Fluoroscopy

Fluoroscopy is a type of medical imaging that shows a continuous X-ray image on a monitor, much like an X-ray movie. During a fluoroscopy procedure, an X-ray beam is passed through the body. The image is transmitted to a monitor so the movement of a body part or of an instrument or contrast agent (“X-ray dye”) through the body can be seen in detail. Fluoroscopy is one of the two types of image guidance used by physicians in the licensed Regenexx network to precisely administer autologous bone marrow and blood to patient injuries.

Growth Factors

Natural proteins which allow cells to multiply.

HCT/P

Human cells, tissues, or cellular or tissue-based products. See 21 C.F.R. § 1271.3(d). HCT/Ps include human cells and tissues that are used as medical products in human patients, whether autologous or allogeneic, but do not include autologous blood and bone marrow when used in procedures using Regenexx injectates.

Homologous Use

The repair, reconstruction, replacement, or supplementation of a recipient’s cells or tissues with an HCT/P that performs the same basic function or functions in the recipient as in the donor. See 21 CFR § 1271.3(c). In 2018, Regenexx’s founder, Dr. Christopher Centeno, and more than thirty other nationally recognized physicians collaborated on a published study concluding that bone marrow concentrate is “homologous” when used in orthopedics, as it behaves similarly to in vivo bone marrow which the body naturally releases when bones, joints or tendons are issued.

Image Guided

All procedures using Regenexx injectates involve “image guided” injections of concentrated blood and/or bone marrow. Image guidance leads to more precise injections, which are critical for the proper administration of orthobiologics. Fluoroscopy and Ultrasound are defined elsewhere in this glossary. For more information about Regenexx’s image guidance techniques, click here.

Interventional Orthobiologics

Interventional orthopedics is a growing medical specialty involving the image-guided injection of orthobiologics (defined below) as an alternative to orthopedic surgery. Regenexx’s Interventional Orthobiologic procedures exclusively involve concentrated blood and bone marrow because they are well understood and comply with state and federal law.

Interventional Orthopedics

Interventional orthopedics involves the injection of drugs, lubricants, and other injectates into injured areas of the body as an alternative to surgery. Commonly used injectates in interventional orthopedics include hyaluronic acid, epidurals, and steroids. More recently, the concept of interventional orthopedics has expanded to include interventional orthobiologics, which involves the injection of orthobiologics (defined below) to address musculoskeletal injuries.

Mesenchymal Stem Cells

Mesenchymal stem cells (or “MSCs”) are multipotent stem cells found in bone marrow that are important for making and repairing skeletal tissues, such as cartilage and bone. Mesenchymal stem cells can differentiate into a variety of cell types, including osteoblasts (bone cells), chondrocytes (cartilage cells), myocytes (muscle cells), and adipocytes (fat cells which give rise to marrow adipose tissue).

Minimal Manipulation

FDA regulations provide two meanings for “minimal manipulation” depending on the tissue involved. For structural tissue, such as bone or fat, minimal manipulation means “processing that does not alter the original relevant characteristics of the tissue relating to the tissue’s utility for reconstruction, repair, or replacement.” For non-structural tissue and cells, minimal manipulation means “processing that does not alter the relevant biological characteristics of cells or tissues.” See 21 CFR § 1271.3(d)(4). If an HCT/P is “more than minimally manipulated,” FDA requires that it be FDA approved.

Orthobiologics

Orthobiologics is a broad category of medical products and procedures involving the use of biological materials for the treatment of orthopedic conditions.

Platelets

Cell fragments that circulate in the blood and also contain exosomes and growth factors.

Platelet Lysate

Platelet lysate (PL) is a specialized derivative of platelet-rich plasma (PRP), which is subject to additional concentration that allows blood platelets to open and immediately release their natural growth factors at the area of injection. Normally, PRP isolates platelets from the blood which slowly release growth factors into the site of the injury over the course of roughly one week. In some cases, however, our research shows that a faster, more intense release of the blood’s factors creates a better healing response, making Platelet Lysate the preferred orthobiologic. Platelet Lysate is often recommended for back and spine treatments due to its fast release and reduced inflammation but is also available for treatments involving the knee, hip, shoulder, hand, wrist, foot, ankle, and elbow.

Platelet Rich Plasma ("PRP")

PRP is autologous blood which centrifuged to obtain a sample that is highly concentrated with the blood’s natural cell and growth factor populations. The smaller, denser portion of concentrated blood is better suited for orthobiologics’ procedures than blood in its original state, half of which is water. PRP injections can have a stimulating effect on the repair cells within the targeted area, making those cells work harder to perform their natural job of healing the body.

Prolotherapy

Prolotherapy involves the injection of saline or sucrose into the injured area of the patient’s body to promote natural healing. Generally, prolotherapy signals to the body that a particular tissue needs attention, which promotes the migration of immune cells and healing agents.

Regenexx SCP

A non-surgical procedure developed and used by Regenexx which involves autologous “super concentrated platelets,” otherwise called “highly concentrated PRP.” Regenexx’s proprietary lab processing removes nearly all white and red blood cells from the autologous blood sample, resulting in a greater opportunity for your body to improve in pain and function, with less inflammation and swelling. The difference between Regenexx SCP and other varieties of PRP is visible. While PRP is reddish in color because of its higher red blood cell count, Regenexx’s SCP is thicker and more amber in color due to its higher percentage of cells and growth factors. Click here for more information about the Regenexx SCP procedure.

Regenexx SD

A non-surgical procedure developed and used by Regenexx involving the “same day” concentration and administration of highly concentrated bone marrow (see, Bone Marrow Concentrate, above). Click here for more information about the Regenexx SD procedure. Regenexx SD treatments may also involve separate injections over the course of weeks or months, depending on the specific needs of the patient.

Regeneration

Repairing or growing new tissue.

Regenerative Medicine

The use of orthobiologics to trigger the body’s natural regeneration capabilities.

SANS

Stability, Articulation, Neurologic, Symmetry. This system was developed by Regenexx’s founder, Christiopher Centeno, M.D., and first introduced as a concept in the book “Orthopedics 2.0”. SANS is a method of treatment involving orthobiologics for musculoskeletal injures.

Stem Cell

Click here for Regenexx’s interpretation of the term “stem cells,” including how that term is used colloquially, how it has changed over time, and how actual stem cells are involved in procedures using Regenexx injectates.

Ultrasound

Diagnostic ultrasound, also called sonography or diagnostic medical sonography, is an imaging method that uses sound waves to produce images of structures within your body. Ultrasound is one of two types of image guidance used by physicians in the licensed Regenexx network to precisely administer blood and bone marrow to patient injuries.

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