Ask Dr. Boettcher: What to Expect During Stem Cell Treatment
Learn how to prepare and what to expect during stem cell treatment.
Stem cell treatments are an emerging and promising orthopedic option for appropriate patients with arthritis and other joint conditions. However, the process of harvesting and reinjecting stem cells for a BMAC injection can seem intimidating. Dr. Brennan Boettcher walks you through each step of the process, explaining exactly what you can expect.
Preparation prior to a BMAC procedure
“When you elect to proceed with BMAC therapy, there are a number of steps we may take before the procedure,” says Dr. Boettcher.
- Walking aids. You may be fitted with crutches or provided with a cane, and asked to bring these with you on the day of your procedure.
- Abstain from alcohol and smoking. “Both alcohol and smoking are toxic to cells,” explains Dr. Boettcher. “We aren’t sticklers about this, but we encourage patients to avoid these substances for a few weeks before and after a BMAC procedure.”
- Avoid anti-inflammatories. “I ask patients not to take anti-inflammatories for one week prior to the procedure,” says Dr. Boettcher. “These medications interfere with the joint environment and could interact with the injected stem cells. After the procedure, I ask patients to continue to avoid anti-inflammatories for two more weeks.
- Pain prescriptions. “We might give a prescription for one or two tablets of oral medication such as valium, Xanax, or hydrocodone,” says Dr. Boettcher. “Taken in advance of the therapy, these medications ease procedural discomfort and anxiety.”
- Select a care advocate. Dr. Boettcher recommends that you bring a care advocate to accompany you for your procedure and drive you home afterward.
On the day of your stem cell treatment
“When you come in for your procedure, we’ll review the risks and benefits one more time,” explains Dr. Boettcher. “Then, we take you to the procedural room where your treatment takes place. You’ll be positioned, usually on your stomach, to harvest the bone marrow. Once we have you comfortably settled, medications and imaging guidance are set up.
- “We numb the skin and tissue at the hip bone site where we will be harvesting,” explains Dr. Boettcher.
- Bone marrow harvesting. “Once you are numb,” continues Dr. Boettcher, “I make a 3 mm incision to introduce the needle, using imaging guidance to precisely position the needle at the bone. There may be a slight feeling of pressure as the needle goes through the bone to reach the marrow. Usually, patients tolerate this well. Once the needle is seated in the bone marrow, we begin harvesting stem cells. I harvest cells with one needle penetration, but at multiple depths within the bone as the needle is withdrawn. This is because studies have shown that harvesting at multiple locations increases the stem cell yield.” During the harvesting, it’s not uncommon for people to have some achiness in the low back or legs. However, this discomfort only lasts for the five or six seconds as the cells are harvested.
There are a number of ways to harvest cells. Dr. Boettcher harvests them with two needle penetrations, one on each side of the hip. When the harvesting is complete and the needle is withdrawn, he holds pressure on your hip area to minimize bleeding. Then, the needle incisions are dressed, and treated with ice packs if the area is sore.
- Bone marrow processing. While you wait, harvested bone marrow is processed. Red blood cells and plasma are separated from the stem cells.
- Treatment with marrow stem cells. “Once the marrow is processed,” says Dr. Boettcher, “I inject the stem cells into the joint we are treating, under imaging guidance.”
- Home recuperation. The entire procedure, including cell harvesting and the stem cell injection, is completed in under two hours. Your care advocate takes you home, with the assistance of crutches or other support if a walking aid has been prescribed. “My patients don’t usually need pain medication following the procedure,” notes Dr. Boettcher. “If you do feel sore, we suggest using ice, Tylenol, or a pain medication other than an anti-inflammatory.”
Protocols following a BMAC procedure
“We tell patients not to take any baths or soak underwater for one week,” says Dr. Boettcher. “That’s because we want to give your low back incisions time to heal. However, showering during the first week following the procedure is fine.”
Allowing the treated joint to rest following the procedure is also important. “I recommend that you take it easy for several days following stem cell treatment,” says Dr. Boettcher. “Don’t do a lot of walking. Many patients take a few days off work, or schedule the procedure for a Wednesday or Thursday. This gives them one or two days of rest, plus the weekend to recuperate. Most patients are ready to resume their regular routine a week after stem cell therapy.”
Stem cell therapies are not covered by insurance
BMAC therapy does not require FDA approval since the process is considered to be minimally manipulated. As such, these stem cell treatments have not been traditionally covered by insurance companies. “The devices used during the procedures are FDA-approved and the techniques and procedures are FDA permissible,” notes Dr. Boettcher. “However, as long as we aren’t growing stem cells in a lab or combining them with other products, they are considered ‘minimally manipulated.’ The processing we do to centrifuge aspirated marrow or blood and filter out bone particles falls within the FDA’s minimally manipulated definition. As a result, the stem cells we use are FDA permitted. FDA standards may change in the future. In the meantime, we follow the existing guidelines.”
Expert care committed to safe, effective stem cell treatment
“At Summit, our team of experts provides FDA-permitted regenerative medicine therapies to trigger tissue repair and healing,” says Dr. Boettcher. “We carefully screen appropriate candidates, and talk frankly with you about the benefits you can expect. Guided by experience and the most current orthopedic stem cell research, we offer treatments that expand your options to address arthritic joint pain.
Summit Orthopedics offers regenerative medicine expertise
Summit’s team of experts provide innovative regenerative medicine therapies for those looking for an alternative to traditional treatments. They can treat arthritic joint pain, sports injuries, neck and back conditions—creating an environment to trigger tissue repair and healing.
Start your journey to better function and less pain. Visit our regenerative medicine services hub and find your expert, request an appointment online, or call us at (651) 968–5201 to schedule a consultation.
Summit has convenient locations across the Minneapolis-St. Paul metro area, serving Minnesota and western Wisconsin. We have state-of-the-art centers for comprehensive orthopedic care in Eagan, MN, Plymouth, MN, Vadnais Heights, MN, and Woodbury, MN, as well as additional community clinics throughout the metro and southern Minnesota.
More resources for you
“My goal is simple; getting you back to the activities you love. At Summit, we help you achieve your healthiest version of yourself by rehabilitating injuries, utilizing cutting-edge treatments such as minimally-invasive ultrasound guided procedures and regenerative medicine, and reserving surgery as a last resort.”
Research guides the use of knee stem cell therapy to manage arthritis pain.
Ask the Expert: Regenerative Medicine Video Series