You may be interested in stem cell therapy for arthritis but you are wondering “What do I have to do in this process?” “What can I expect?” or even “How much time and effort is involved on my part.?” Humans are natural planners. We plan for upcoming holidays. We plan for our retirements. We plan trips and we even plan other people’s lives such as an aging parent. So, asking these questions is a normal process of our lives. Thus, I am going to try to paint a picture of what is involved.
There are four phases of the treatment.
- Evaluation
- Preparation
- Cell Delivery
- Post Care
We will review each phase.
Evaluation Phase - Here you come in for a thorough evaluation by a board certified orthopedic surgeon. We discuss in depth your symptoms such as where they are located; quality and frequency of the pain; initiating and alleviating factors, your goals and desires as well as your social situation. A comprehensive physical exam of the range of motion of the joint, stability, nerves, circulation, skin and physical function of the joint is carried out. Most importantly , we look at the joints above and below to see how they affect your gait and overall function. We personally review your xrays or other studies and come up with a list of options for you. We help walk you through each option including surgical and non surgical treatments. This is a shared decision model of medicine. We provide you with an honest professional opinion of your condition and help you make the best decision for you. This is normally one and possibly two visits.
Preparation Phase - We provide you with a simple step by step instruction sheet to prepare for the process. This includes a simple 10-15 minute daily exercise program. Goal setting exercises; changing your shoes; improving your nutrition and encouraging a health weight all help with providing you a true holistic approach to your condition. You will need to stop medications which may interfere with the cells such as anti inflammatories for a few weeks prior. There is normally no need for pre-procedure clearances by another physician with some exceptions. This phase normally lasts about 1 month. ,
Cell Delivery Phase - This is where you start receiving the cells. Most (but not all) have one day where they come in with someone who will drive them home. You will arrive about 30 minutes prior to your treatment time. You will be asked to take some oral medication to make you drowsy, yet still awake. We will ask you to lay on an exam table on your stomach or on your side. We provide plenty of numbing injection medication such as lidocaine to properly reduce the discomfort of the harvesting of the cells. We place a sterile drape over the area and within about 5-10 minutes all the cells we need are extracted from your pelvis area near your buttock bone. We process the cells and get them ready within about 30 minutes or less. The joint is numbed up and we deliver the cells through a simple injection in about another 30 seconds. You can immediately weight bear on the joint and resume normal not stressful joint activities in 24-48 hrs. The dressing over the buttock area stays on for about 2-3 days and no other care is needed. Some patients with more severe disease may require a treatment in a outpatient surgical center and they will have separate instructions but almost all can resume normal non-stressful joint activities in about 7-10 days.
Post Care Phase - This is where we wait and nourish the cells for 3 months. The only activity restrictions are no running, stop and go sports, squats and lunges for 3 months. This prevents anything that may inflame the joint. We encourage you to continue on with the accomplishments of your goals in weight control, nutrition, shoe wear, bracing. Most patients (but not all) have a simple follow up platelet rich plasma (PRP) injection which is just a simple blood draw like when you go for a lab study. This provides vital growth factors just like a fertilizer to help with the overall recovery. Most patients need about 3 months before the damage in their joint starts to turn the corner and improve. Yet, patients normally notice continued improvement for over a year. Sometimes, you will return at 3 months, 6 months and one a year to ensure you are happy with your results. Some patients require a few touch up injections of PRP, but most do not require a repeat stem cell procedure.
So, there are 4 phases :
- Evaluation
- Preparation
- Cell Delivery
- Post
These 4 phases require about 4 to 8 office visits and about 3 to 5 months of your time.
If you are interested in a personal one-on one evaluation by Dr. Loniewski, please call 248-893-3200 for an appointment.