Helping Your Body Heal Itself - Regenexx Kansas Cityregenexxkansascity.com/wp-content/uploads/2017/04/RegenexxKans… · Helping Your Body Heal Itself PATIENT PROCEDURES AND PREPARATION

REGENEXX KANSAS CITY PROCEDURES AND PREPARATION GUIDE

Help ing Your Body Heal Itsel f P A T I E N T P R O C E D U R E S A N D P R E P A R A T I O N

REGENEXX KANSAS CITY PROCEDURES AND PREPARATION GUIDE 2

TABLE OF CONTENTS

Page Number

I. Welcome To Regenexx Kansas City 3

II. Policies and Transportation Agreement 4

III. Clinic Contact and Directions 6

IV. What Is Regenexx 8 A. Regenexx versus Surgery B. Regenexx versus Other Stem Cell Solutions

V. Procedure Preparation 11

VI. SD+ Stem Cell Procedure 15 A. Pre-Procedure Instructions B. Office Evaluation C. Procedure Days and Visit Detail D. Post-Procedure Instructions-Activity-Follow-Up E. When Will I Notice Changes?

VII. Super Concentrated Platelet (SCP) and Platelet Lysate (PL) 24 A. Procedure Days and Visit Detail VIII. Platelet Lysate Disc (PL-Disc) and 26 Degenerative Disc Disease (DDD)

IX. Spine Procedures (SD+ and SD Disc) 28 A. Procedure Days and Visit Detail

X. Billing and Insurance 32 XI. Planning Your Trip to Kansas City 33 XII. Therapy Support 34 XII. Frequently Asked Questions 37 A. General B. Pre-Procedure C. Procedure D. Post Procedure


Welcome to Regenexx Kansas City. Our expertise is interventional orthopedics, which is the use

of sophisticated image guided injections that replace more invasive orthopedic surgery. Since

Regenexx pioneered Orthopedic Stem Cell treatments in 2005, tens of thousands of Regenexx

procedures have been performed to date.

We are part of the most advanced stem cell based musculoskeletal practice in the United States,

with more stem cell orthopedic experience and data published in research journals than

any other clinic worldwide. We have several board certified and fellowship trained medical doctors

available to treat patients and perform Regenexx procedures.

Our PhD led labs at Regenexx feature advanced, state-of-the-art equipment similar to any

university-based stem cell research facility. Specially trained blood processing technicians are on-

site and all patient cells are processed completely separate from the research lab.

The Interventional Orthopedic Foundations (IOF) was founded by Regenexx Headquarters and

runs the world’s oldest and largest interventional orthopedics patient database registry. More

information on the IOF and your participation in the Registry can be found toward the back of this

packet.

On behalf of our doctors and staff, thank you for choosing Regenexx Kansas City.

We look forward to having you and entrusting us with your care.

welcome


APPOINTMENT AND CANCELLATION POLICY

Our goal is to provide the highest quality medical care. We have implemented an appointment

cancellation policy which enables us to better utilize available appointments for our patients.

Schedule Appointments/Cancel Appointments

To schedule an appointment or cancel an appointment, please call (816)-897-1669.

Please know you will be asked to check in up to 30 minutes prior to your scheduled appointment

time. Inability to do so may result in the need to reschedule your appointment.

Cancellation of Office Appointments

Please be courteous and call Regenexx Kansas City promptly if you are unable to attend your

scheduled appointment. This time will be reallocated to someone who is in urgent need of treat-

ment.

If it is necessary to cancel your scheduled office appointment we require at least a 24 hour notice.

If you do not cancel your appointment with at least a 24 hour notice, you will be billed $35.00.

Your insurance will not cover this fee.

Procedure Appointments and Cancellations

At the time of scheduling your procedure you will be required to put a deposit down:

Same Day (SD+): $750 Super Concentrated Platelets (SCP/Spine): $500

If a procedure is cancelled, you will forfeit your deposit.

No Show Policy

A “no show” is a missed appointment without canceling it one working day in advance. Three

patient “no shows” within a six month period may result in the temporary suspension of service.

Prior Authorization/Pre-Approval

We do not bill your insurance for your procedure, therefore, Regenexx will not submit a prior au-

thorization or pre-approval to your insurance company. If requested, you will be provided with an

itemized statement with procedure codes after completion of your procedure for you to

independently submit.

policies


transportation

POST PROCEDURE DRIVER/TRANSPORTATION

We recommend a designated driver be available for your post-procedure care.

Epidurals and Spine Procedures: If you are going to have an injection in the neck or lumbar

spine, your arms and/or legs may be numb or weak for several hours. This can impair your ability

to walk or operate a vehicle safely. Until these areas are no longer numb or weak, you are at an

increased risk of falling or injury.

Extremity Procedures: When performing injections on any part of your extremities, numbing med-

ications and/or local nerve blocks are performed to reduce the pain associated with the procedure.

Numbing these areas can cause local numbness and weakness. This may cause the region to be

numb and weak for several hours and can impair the ability to use the extremity. This may impair

your ability to operate a vehicle and may put you at increased risk.

Sedation: Oral sedation is sometimes used for patients prior to a procedure to help decrease any

anxiety and/or pain associated with the procedure. These medications can cause sedation and im-

pair one’s cognition for many hours after taking the medication. It is important to avoid operating a

vehicle for up to 8 hours after taking these medications, and longer if continuing to feel sedated or

altered.

Because there is a chance for temporary impaired sensation/strength after a procedure as noted

above, we recommend having a driver after any procedure you have in clinic. A driver is

REQUIRED after any spine procedure or any procedure in which sedation is used.

If you do not have a driver in these circumstances, your procedure will be re -scheduled.

If you choose to drive after a procedure/sedation then you understand your risk of injury to yourself

and others is increased by operating a vehicle and that you take full responsibility for any injury that

may occur to yourself/anyone else.

_________________________________________________ ________________

Signature of patient or person acting on patient ’s behalf Date


ADDRESS AND CONTACT

INFORMATION Address: 1300E. 104th Street, Suite 150

Kansas City, MO 64131

Clinic: (816)-788-6981

Scheduling: (816)-897-1669

Website: www.regenexxkansascity.com

Dr. Paras Shah M.D., M.S., FABPMR

Parul Shah PA-C

Sarah Bracken Laboratory Technician

about us

MEET OUR CLINIC


DIRECTIONS TO THE CLINIC

From I-435 West Bound: Take the Holmes exit.

Make a left turn onto Holmes Road.

Take the first left onto 104th Street.

1300 E. 104th is the second building on the left (go past US Bank and St. Luke’s Building).

The clinic is located directly across from the cemetery.

Our entrance is located in the back of the building.

From I-435 East Bound: Take the Holmes exit and continue straight onto 104th Street.

1300 E. 104th is the second building on the left (go past US Bank and St. Luke’s Building)

The clinic is located directly across from the cemetery.

Our entrance is located in the back of the building.

about us


WHAT IS REGENEXX?

Regenexx uses the most sophisticated method worldwide to extract, process and re -inject stem

cells. This method is trademarked under the name Regenexx.

Regenexx is advanced interventional orthopedics. What does this mean to you? While other clinics

may offer simple blind or low sophistication level, ultrasound guided procedures, we offer advanced

ultrasound and fluoroscopy guided procedures using more sophisticated customized versions of the

stem cell and blood platelet commonly used. Our goal is to replace many of the more invasive ortho-

pedic surgical procedures with less invasive, precise injections. We help our patients return to an

improved lifestyle with advanced non-surgical comprehensive treatments for:

• Arthritis

• Alternative to knee/joint and hip replacement

• Neck, Upper Back, or Low Back Pain

• Sciatica or slipped discs

• Carpal Tunnel Syndrome

• Joint/Knee, Hip, Ankle Pain Injuries

• Leg/Arm Numbness & Weakness

• Muscular/Ligament Strains

These procedures utilize a patient’s own stem cells or blood platelets to help heal damaged or torn,

tendons, ligaments, cartilage, meniscus, spinal discs, or non-healing bone. Our patients experience

little to no down time and avoid the painful and lengthy rehab period that usually follows surgery to

restore joint strength and mobility.

Since 2005, Regenexx has helped people of all ages and lifestyles. We are part of the longest

running, most experienced, best published orthopedic stem cell therapy in the United States.

• Shoulder Rotator Cuff Injuries/Shoulder Pain

• Sacroiliac Joint Pain

• Tendonitis and Bursitis

• Tennis and Golfer’s Elbow

• Spinal Instability

• Achilles Tendon Tears

• Plantar Fasciitis

• Knee ACL, MCL, and Meniscus Tears

about us


The Regenexx® Difference

Versus Surgery

• Over 95% of our patients avoid the need for invasive surgical intervention

• Recovery time is reduced by more than 60% on average

• Needle injections are non-invasive significantly lowering the risks associated with orthopedic

surgery

• Less invasive therefore less painful

• Better post procedure function allowing the immediate implementation of physical therapy

• Physical therapy is recommended for weeks, not months

• We use localized numbing and occasionally mild sedatives, avoiding the risks of anesthesia

• No plastic, steel, or foreign materials for your body to accommodate or reject

• Nerves, blood vessels and lymphatics are uninterrupted

• No visible scars with injections

• Less need for pain medication

• Regenexx treatments repair and regenerate tissue naturally, resulting in increased function

and improved quality of life


The Regenexx® Difference

Versus Other Stem Cell Solutions

• We are the inventors of orthopedic stem cells in the United States and performed the first

orthopedic stem cell procedure in the U.S. now with more than a decade of experience.

• 100% focused on treating orthopedic conditions.

• The most researched stem cell procedure for orthopedic conditions with published patient

outcomes and safety data.

• Our flexible processing platform allows us to customize your stem cell therapy to your

needs.

• All injections and stem cell harvesting utilize advanced imaging guidance for precision.

• All doctors are musculoskeletal experts with extensive training in orthopedic injections. It

takes years to become a Regenexx physician.

• The ability to count cells and dose appropriately by condition.

• Dedicated lab research team for continuous procedure improvements.

• Proprietary multi-injection stem cell protocol for the best possible outcomes.

• 10 to 20 times more stem cells than similar procedures (per unit volume).

• Stem cells are evaluated and recorded for maximum viability.

Infinite Expertise


HOW TO PREPARE YOUR BODY

Our doctors and scientists have found several things that increase the chances

of success for your procedure. It is particularly important to pay attention to the medication

restrictions (Table 2), and review this entire section on ‘preparation.’

Table 1

Restrictions

Before Procedure 2—4 Weeks

6—8 Weeks

12 Weeks

After Procedure 2—4 Weeks

6—8 Weeks

12 Weeks

DO NOT

preparation


Table 2

Medication Restrictions Our goal is to help maximize your outcome from your stem cell procedure. Since this procedure involves the ability of your cells to repair t issue and the decade long Regenexx experience has seen that certain medications may interfere w ith your procedure, we have the follow ing recommendations:

Stop all prescription medications and supplements that can be stopped. We recognize that some medications may not be safe to abruptly discontinue, so you need to check w ith your Regenexx doctor. He or she may have you contact the prescribing physician. For the medications listed below we recommend stopping for at least 2 -4 w eeks before and 6 w eeks after your

procedure. For all other medications, stop if able 1 -2 w eeks before, and 1-2 w eeks after your procedure.

Exceptions for supplements (i.e. you can stay on these) include Glucosamine, Chondroit in, Collagen 2, Hyaluronic Acid, Fish

Oil (omega 3s, EPA, DHA), DHEA, Curcumin, Quercitin, Bitter Melon, L -Carnosine, Vitamin C, Vitamin D, and Resveratrol.

These medications have been shown to be particular problems in our clinical experience or are suspected to be issues based

on w hat is published in the medical research about their impacts on cells or stem cells.

DO NOT STOP ANY PRESCRIBED DRUG WITHOUT SPEAKING WITH A PHYSICIAN:

Acetaminophen (Tylenol) may be taken as needed to relieve pain. Take 500mg every 6 hours and no more than 3000mg in one day. Opioids (Vicodin,

OxyContin, Percocet) may be prescribed by your doctor to alleviate pain as well. Any prescription medication that can be stop ped (after consulting with

the prescribing physician), should be discontinued for 1-2 weeks before the procedure and at least 2-4 weeks post-procedure.

Medication Examples Stop Prior To

Procedure (weeks)

Resume Post Procedure

(weeks) Notes

Anti-inf lammatories

Singulair, Advair, Nasonex, Flonase

2-4 6 Inc ludes some asthma

medications

Certain Blood Pressure Drugs and Ace Inhibitors

Lisinopril, Benazepril 2-4 2-4 Your doctor can substitute an

ARB

Immune Suppressant Drugs cyclophosphamide, cyclosporine,

Imuran, 3-6 6-8

Non-steroidal Anti-inf lammatory drugs (NSA IDs)

Advil, Alleve, Aspirins, Celebrex, Ibuprofen, Indocin, Indomethac in,

Motrin, Naproxen 2-4 6-8

Blocks the body's natural ability to heal

Statins

Altocor, Advicor, Crestor, Caduet, Lescol, Lipex, Lipitor, Lipostat,

Livalo, Mevacor, Pitava, Prevachol,

Selektine, Torvast, Vytorin, Zocor

2-4 6-12 Generally for high cholesterol

Steroids or cortisone ( in any

form - oral, injections, inhaled, topical, drops)

Cortisol/Cortisone 12 6-8

VERY IMPORTA NT. Suppresses the immune

system's inflammatory and allergic responses

Testosterone Blockers Propecia, Proscar 2-4 2-4

Anti-Rheumatic drugs Humira, Enbrel, Remicade,

Rituxan, Orenc ia, methotrexate, plaquenil, sulfasalazine

2-4 4-6

Non recommended supplements

over the counter supplements 1 1 Discuss w ith your Regenexx

Doctor

preparation DO NOT STOP ANY PRESCRIBED DRUG WITHOUT SPEAKING WITH A PHYSICIAN


Alternative Use Begin Prior To

Procedure End Post

Procedure Notes

Take Regenexx Advanced Stem Cell Support Formula

Support healthy joint function w ith 8 supplements in 1 liquid formula. Many of the supplements in theis formula have been show n to have

pow erful anti-inf lammatory proper-ties.

ASAP 6 months

No harm in taking for indefinate

amount of time. Available in clinic or online at http://

www.regenexx.com/regenexx -advanced-stem-cell-support-formula/

Omega 3s

Anti-inf lammatory properties. Helps w ith arthritis pain. Great substitute

for NSIA D drugs like Motrin, Advil, Aleve, Ibuprofen, Naprosyn, Mobic,

Melox icam, Voltaren, Celebrex, Celcoxib, DayPro

ASAP 6 months Recommended Brand: Regenexx

Available in clinic or online.

Turmeric (from curcumin spice)

Anti-inf lammatory properties. Helps w ith arthritis pain. Great substitute for NSIA D drugs like Motrin, Advil,

Aleve, Ibuprofen, Naprosyn, Mobic, Melox icam, Voltaren, Celebrex,

Celcoxib, DayPro

ASAP 6 months Recommended Brand: Regenexx

Available in clinic or online.

Discuss all medications and supplements you are taking w ith your Regenexx doctor prior to your procedure for specif ic

recommendations.

*These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose,

treat, cure or prevent any disease.

Table 3

Recommended Quality Supplements

Available at Clinic

preparation


preparation

Nutrition Eat low glycemic index foods, close to Paleo diet. The mainstay of the diet should be plenty of veg-

etables and fruits. Moderate amount of nuts, legumes, whole grains, organic grass fed meats if not

vegetarian. Decrease sweets, conventional meat, wheat, processed foods, fried foods, dairy. No

artificial sweeteners. Drink mostly water and teas, decrease sugary beverages. Cut down on Alco-

hol. No more than 1 glass of red wine/day if you drink. No more than two 8oz cups of coffee/day.

Read Nutrition 2.0: Nutrition 2.0 is a concise guide to eating and living healthy, written by Regenexx

regenerative medicine doctor, John Pitts. The book gives a basic foundation of information on most-

ly diet, but also supplements, physical activity, and stress-relief to improve your life.

Link: http://www.regenexx.com/nutrition-2-0-guide-eating-living-achieve-higher-quality-life-now-

golden-years/

Alcohol and Marijuana

Alcohol can have profound negative impacts on stem cell function, so this should be avoided for the

6 weeks before and after your procedure. A glass of red wine or white wine with dinner is not a

problem, but more than that could pose a risk to the cells. Cannaboids such as marijuana can also

promote bone formation over cartilage (not what we want in this case), so should be avoided.

What can you do to improve the quality of your stem cells?

See: http://www.regenexx.com/2012/05/how -can-i- grow-more-stem-cells-top-10-list-of-things-to-do/

http://www.regenexx.com/nutrition-2-0-guide-eating-living-achieve-higher-quality-life-now-golden-years/

http://www.regenexx.com/nutrition-2-0-guide-eating-living-achieve-higher-quality-life-now-golden-years/

http://www.regenexx.com/2012/05/how-can-i-%20grow-more-stem-cells-top-10-list-of-things-to-do/

http://www.regenexx.com/2012/05/how-can-i-%20grow-more-stem-cells-top-10-list-of-things-to-do/


WHAT TO EXPECT—YOUR SD STEM

CELL PROCEDURE (SD+ AND SD-DISC) What Is a Same Day Stem Cell Procedure? Our Same-Day Stem Cell Protocol is called a same-day procedure, because the stem cells are

harvested and reinjected on the same day. However, for most patients the complete protocol is

actually a series of injections that happen over the course of about a week, depending on your

unique situation. These injections include a pre-injection, the same-day stem cell extraction and re-

injection procedure, followed by a post-injection of multiple proprietary platelet mixes a few days

later.

When you are prepared for the first step of your stem cell procedure, your doctor will thoroughly

numb the back of the hip and take a small bone marrow sample through a needle. The procedure

we use is called a bone marrow aspirate. This is different than a bone marrow biopsy, which can be

painful. The bone marrow aspiration process is often described by patients as being only mildly

uncomfortable and well tolerated.

While your cells are being processed by a Regenexx Lab Technician, you will have some downtime

to relax. A short period later, you will be ready for the second part of the procedure, where the doctor

will reinject your stem cells and natural growth factors from your blood platelets using advanced

imaging guidance into the area in need of repair (real time fluoroscopy or musculoskeletal

ultrasound, using your MRI to plan the injection). This allows the doctor to pinpoint the exact location

of the injection, as well as the dispersion of the cells into the tissues.

stem cell procedure

http://www.regenexx.com/2009/03/is-a-properly-done-marrow-draw-painful/


Pre-Procedure Instructions If you are from out of town: On the day of your initial appointment, you will meet with the doctor and the

physical therapist. Please be sure to bring any pertinent or requested information, including imaging and

paperwork, if not sent previously. After your evaluation, you will have your pre-injection if that was

recommended for you.

Depending on your condition, you may have a pre-injection, re-injection of cells, and a post-injection.

If it is recommended that you have all of these injections, there will be a total of three injections over

a 5-10 day period. Not all conditions require all injections or the same timing. Please discuss the

schedule that is recommended for you when setting up your appointments. Please understand that it

is not possible to make an absolute pre-determination of the treatment plan that will be most

appropriate for your condition and that only after being evaluated can the doctor determine the best

plan for you.

If you have multiple joints that are requiring treatment, we have discovered a minimum number of

cells that we need in order to maximize the odds of any given patient having a good result with a SD+

stem cell procedure. Based on that cell count obtained after your bone marrow sample has been

processed we can determine if we have an adequate number of cells to treat multiple joints versus

only being able to treat 1 joint. For patients that want 2 joints treated at once you will either have

enough cells to treat 1 joint only and the other joint can be treated with our super concentrated

platelet mix only; enough cells to treat 1 joint adequately and maybe a partial dose to the second

joint; or enough cells to treat 2 joints adequately. Based on our data the chances of an average

patient obtaining enough cells to treat 2 joints adequately is between 20% and 40%.

After the procedure you may eat and drink as tolerated. Please refer to the Post-Procedure

instructions for activity after your procedures.

HELPFUL TIPS

Dress comfortably in clothes that are easy to get on and off

Stay hydrated (Eight 8-ounce glasses of water per day)

Wear supportive shoes-especially if you are having an ankle procedure

Arrange for a driver (patients taking Valium MUST have a driver)

If your are out of state, book return flight at least 24 hours after last

injection

preparation


stem cell procedure

Summary: Your first visit involves an injection of a special hypertonic dextrose solution that creates a mild

inflammatory environment and helps damaged ligaments tighten and repair. The purpose of this

part of the procedure is to cause the same kind of acute inflammation that might happen with

an injury. To use a farming metaphor, this step is like tiling the soil.

Average Duration:

30 minutes (1 joint)

40 minutes (2 joints)

Instructions:

• Follow all medication instructions (Table 2)

• Do not take any medication to reduce inflammation (Table 2)

• Tylenol can be taken to alleviate discomfort

1 VISIT

DAY 1

PROCEDURE

Pre-injection (Tilling the soil. You may or may not have this step)

First Visit


Aspiration Summary: The bone marrow aspiration is when your stem cells and blood platelets are harvested. The aspiration

occurs in one of our procedure rooms with the physician and technical staff. The procedure will require

you to have a bone marrow sample taken from the back of each of your hips (iliac crest). You will lie on

your stomach on the procedure table where an area at the back of your hip will be numbed. A special

needle will be used to draw marrow blood out of the back of your iliac crest. X-ray or ultrasound will be

used to assure the optimum location. This will be done on both sides of your hips. Some patients will be

given an oral sedative, to help to ease anxiety and relax the muscles prior to the bone marrow draw.

Please refer to the Post-Operative Instructions for activities after this procedure.

The doctor will numb the site thoroughly and then after the area is numb you ’ll feel some pressure and a

strange pulling sensation. If you are nervous about the procedure, the doctor may prescribe

a mild sedative or anesthesia. In most cases, IV anesthesia is NOT needed.

Aspiration Instructions: • Drink plenty of clear fluids (approximately 64

ounces/day)

• If you have pre-arranged to take a sedative

prior to the procedure, you must have a driver

with you

1 VISIT

DAY 2

PROCEDURE

Bone Marrow Aspiration (This step happens with all stem cell procedures)

stem cell procedure

Duration: 30-60 minutes

First Visit


Summary: The reinjection of stem cells into the affected area takes place at least three hours after the bone

marrow aspiration and no more than eight hours after. Local anesthesia is used to numb the area

and the stem cells are precisely reinjected using real-time imaging guidance (ultrasound or

fluoroscopy). Patients may be asked to stay in clinic 30-60 minutes after reinjection, keeping

the procedure site inactive.

Average Duration: 60 minutes - 1 joint

80 minutes - 2 joints

Instructions: • Bring prescribed brace – if applicable

• Do not ice reinjection site

• Avoid all anti-inflammatory medications (Table 2)

• Take Tylenol or prescribed medication as needed for pain

• Do not submerge the injection site (i.e. taking a bath) for 72 hours after the procedure.

Showers may be taken 12 hours after the procedure.

1 VISIT

DAY 2

PROCEDURE

Re-injection of Stem Cells (Planting the seeds)

stem cell procedure Second Visit


Summary: A sample of blood is taken from a vein in your arm. These samples are sent to our lab where they

are processed and prepared for reinjection within 24 hours. We use this blood to prepare advanced

formulations of highly concentrated platelet rich plasma and platelet lysate (which is the growth

factors isolated from your blood platelets).


Instructions: • Drink plenty of clear fluids (approximately 64 ounces/day)

1 VISIT

DAY 3

PROCEDURE

Blood Draw #1

stem cell procedure

Summary: This visit is to add additional stimulation for your cells to differentiate for repair and new growth.

SCP is a super version of platelet rich plasma (concentrated blood platelet injection that contains

healing growth components that increase the activity of the stem cells). It is created in an advanced

lab environment by a skilled technician who can utilize more of the good components and discard

the bad components. SCP is injected into the treatment site and works in conjunction with your

reinjected stem cells. Platelet lysate (PL), which is the growth factors isolated from your blood

platelets is also used, which acts an immediate release of helpful growth factors versus the slow

release from the whole platelets contained in SCP. See page 24 for PL procedures.

Duration: Instructions:

20 minutes (1 joint) None

30 minutes (2 joints)

DAY 3

PROCEDURE

Super Concentrated Platelets (SCP) Post-Injection (Fertilizer) This also includes platelet lysate and may include certain prescription medications at

physiologic doses to help your cells thrive.

First Visit

Second Visit


stem cell procedure

Post-Procedure Instructions

Immediately After Your Cell Transplant Procedure

The stem cell injection includes producing a micro injury in the joint. As a result, expect the joint to

be sore anywhere from 1 to 3 days. This can be everything from minimally sore to very sore. Your

physician may prescribe stronger pain medicines that are safe with the procedure. Continue to

AVOID anti-inflammatories and ice.

Activity

The goal is to allow the stem cells to attach and then to protect them while they differentiate into car-

tilage. For this reason, you will be asked to keep the joint as still as possible for 30 -60 minutes after

the procedure. Do not take a bath for three days, but a shower 12 hours after the procedure is fine.

These guidelines are a general recommendation on how you should progress through reha-

bilitation after a Regenexx procedure. This is not intended to replace your physician ’s spe-

cific recommendations for you as every patient and situation is different.

Ideally, you should work through rehab with our physical therapist or a good physical therapist con-

venient for you. In general we recommend that your progression through the rehabilitation phases

and return to activity should be based on your symptoms. The first 6 weeks we want you to be con-

servative. For most procedures there is very little down time (1-3 days) and then we want to bal-

ance some activity without over doing it. Pain during or after activity is a good indicator you are do-

ing too much. You should start off with light or easy activity then slowly progress to more strenuous

activity as tolerated. Start low and go slow. If an exercise or activity causes more than minimal pain

2/10 during or after the activity then you need to back down the duration or intensity of that activity.

If you are able to do light activity with no pain then you should progress to slightly harder activity or

increase the duration of your lighter activity.

1st –3rd Day: For the first day, you should limit activity on the joint. If you have post-procedure

soreness this may be easy to do, as you may have a natural limp or “antalgic” gait if it was a low-

er extremity problem (your body does this to reduce pressure on the area to allow healing). If you

don’t have this, then simply, naturally taking a bit of weight off this area as you walk is a good

idea this first day. For upper extremity treatments, limit the motion and stress on that joint. Avoid

all contact sports as well as jogging, running, or sports that involve impact on that joint. Wear all

recommended braces or boots.


Follow Up

If you have problems that need immediate attention, please call our clinic. In addition, it’s important

that you participate in the Interventional Orthopedics Foundation’s (a 501c3 non-profit) orthopedic

stem cell database registry. This is the world’s oldest and largest patient tracking registry and it will

allow you the opportunity to report health status relating to:

Quality of life Activity levels Complications

Joint function and pain Long-term procedure success

When Should I Call the Doctor? Notify your doctor immediately if you experience any of the following symptoms:

Fever Pus at injection site

Excessive swelling Local hardness

Chills Redness

stem cell procedure

Activity (continued)

4th Day - 2nd Week: For lower extremity treatments you can start to walk normally -- if you were

set up with a brace or a boot for the procedure, use this during activity. Avoid all contact sports

as well as jogging, running, or sports that involve impact on that joint. Bike riding is fine as are

stationary bikes, elliptical machines, and swimming. For upper extremity treatments, start range

of motion exercises and only light activities that do not stress the affected area much.

3rd –6th Week: Avoid all contact sports as well as jogging, running, or sports that involve impact

on that joint. You can walk as much as you like. Bike riding is fine, as are stationary bikes, ellipti-

cal machine, and swimming. Start strength training.

After the 6th Week: Start integrating back all desired activities, adding back 20% per week. For

example, if you were used to running 10 miles a week, you would start at 2 miles a week, then

the next week add back another 2 miles, and so on.

Note that every person and situation is different, so some people will progress faster or slower than

others. The speed of recovery has no bearing on overall success. Full healing can take up to 3-6

months for platelet procedures and 6-12 months for stem cell procedures.


When Will I Notice Changes?

Initial Reaction: You will likely experience mild to moderate pain and swelling as a result of your treatment. A few

patients can have severe pain the first night that will usually considerably reduce the next day.

Acetaminophen (Tylenol) can be taken to manage pain as you find it necessary. This usually lasts

12 to 24 hours and rapidly reduces every day. Your doctor will also likely give you a script for

a narcotic, which you should consider taking that first evening around or before dinner time.

For example, if you had your procedure at 2 p.m., you should consider taking a pain pill around

4 p.m. and then another one before going to sleep around 9 p.m.

First Three to Four Weeks: Most patients report a modest improvement in the first month. You will notice that as time goes on

your pain that occurred before is less severe and frequent. Most patients are able to resume light

activities after 5 to 7 days.

First Six to Eight Months: Usually at 6 to 8 weeks, you may begin to resume a more vigorous exercise schedule. Most of our

very active patients are able to return to their regular routine in 6 weeks and push their

performance to higher levels in 8 to 12 weeks. Improvements will continue throughout this time

period.

First Year and After: Most patients notice continued healing over many months. Our outcome data suggests peaking

at 1-2 years out. Of course this depends on the condition of the area treated, age and general

health (medications).

stem cell procedure


blood platelets

WHAT TO EXPECT—YOUR BLOOD

PLATELET TREATMENT

Super Concentrated Platelet (SCP) and

Platelet Lysate (PL) Procedures

Super Concentrated Platelets (SCP) and Platelet Lysate (PL) injection treatments contain healing

growth components from your own blood that increase your body’s natural ability to repair itself.

The use of PRP to repair joint, tendon, ligament, and muscle injuries is becoming well known,

thanks to exposure from professional athletes. Platelet injection treatments are effective because

they have a stimulating effect on the stem cells within the targeted area, making those stem cells

work harder to heal damaged tissues.

Our Advanced Platelet Procedures are more pure and concentrated than those created by the

automated machines used at most regenerative medicine clinics. Platelet procedures are

commonly used for soft tissue injuries, mild arthritis and spine conditions.


blood platelets

Summary: A sample of blood is taken from a vein in your arm by a certified phlebotomist. These samples are

sent to our advanced on-site lab where they are processed and prepared for reinjection within 24

hours. We use this blood to prepare advanced formulations of highly concentrated platelet rich

plasma and platelet lysate (which is the growth factors isolated from your blood platelets).


Instructions: • Drink plenty of clear fluids (approximately 64 ounces/day)

1 VISIT

DAY 1

PROCEDURE

Blood Draw

Summary: This visit will add stimulation for your cells to differentiate for repair and new growth. SCP is a super

version of platelet rich plasma (concentrated blood platelet injection that contains healing growth

components that increase the activity of the stem cells). It is created in an advanced lab

environment by a skilled technician who can utilize more of the good components and discard the

bad components. SCP is injected into the treatment site. Platelet Lysate (PL), which is the growth

factors isolated from your blood platelets is also used. This acts as an immediate release of helpful

growth factors versus the slow release from the whole platelets contained in SCP.


30 minutes (1 joint) None

45-60 minutes (2 or more joints)

DAY 1

PROCEDURE

Super Concentrated Platelets (SCP) Post Injection (Fertilizer)

First Visit

Second Visit


spine procedures

WHAT TO EXPECT—YOUR PLATELET

LYSATE DISC AND DEGENERATIVE

DISC DISEASE PROCEDURES

Platelet Lysate Disc (PL-Disc) and Degenerative Disc

Disease (DDD) Procedures

Platelet Lysate (PL-Disc) and Degenerative Disc Disease (DDD) Procedures are platelet based

spine treatments that are natural alternatives to epidural steroid injections and are a safe, non -

surgical treatment alternative for patients suffering from cervical, thoracic, or lumbar spine pain.

These procedures utilize healing growth components from your own blood that increase your

body’s natural ability to repair itself. Platelet injection treatments are effective because they have

a stimulating effect on the stem cells within the targeted area, making those stem cells work

harder to heal damaged tissues.


spine procedures

1 VISIT

DAY 1

PROCEDURE

Blood Draw

Summary: A sample of blood is taken from a vein in your arm by a certified phlebotomist. These samples are

sent to our advanced on-site lab where they are processed and prepared for reinjection within 24

hours. We use this blood to prepare advanced formulations of highly concentrated platelet rich

plasma and platelet lysate (which is the growth factors isolated from your blood platelets).

Duration: Instructions 15-30 minutes • Drink plenty of clear fluids (approximately 64 ounces/day)

1 VISIT

DAY 1

PROCEDURE

Platelet Lysate and Super Concentrated Platelet

Spine Injection (PL-Disc and Regenexx-DDD)

Summary: After your platelets have been processed, they will be precisely injected into your spine with the use

of fluoroscopic (x-ray) guidance. The precise placement of your platelets will add stimulation for your

cells to differentiate for repair and new growth. SCP is a super version of platelet rich plasma

(concentrated blood platelet injection that contains healing growth components that increase the

activity of the stem cells). It is created in an advanced lab environment by a skilled technician who

can utilize more of the good components and discard the bad components. Platelet Lysate (PL),

which is the growth factors isolated from your blood platelets is also used. This acts as an

immediate release of helpful growth factors versus the slow release from the whole platelets

contained in SCP.


30-40 minutes (1-2 levels) • All spine procedures require a driver

60 minutes (3 or more levels) • Avoid all anti-inflammatory medications (Table 2)

• Take Tylenol or prescribed medication as needed for post

procedure pain

• Do not submerge the injection site (i.e. taking a bath) for

48-72 hours after the procedure. Showers may be taken

12 hours after the procedure.

First Visit

Second Visit


spine procedures

WHAT TO EXPECT—YOUR SD STEM

CELL DISC PROCEDURE (SD+ AND SD-DISC) What Is a Same Day Stem Cell Procedure? Our Same-Day Stem Cell Protocol is called a same-day procedure, because the stem cells are

harvested and reinjected on the same day. However, for most patients the complete protocol is

actually a series of injections that happen over the course of about a week, depending on your

unique situation. These injections include a pre-injection, the same-day stem cell extraction and

re-injection procedure, followed by a post-injection of multiple proprietary platelet mixes a few days

later.

When you are prepared for the first step of your stem cell procedure, your doctor will thoroughly

numb the back of the hip and take a small bone marrow sample through a needle. The procedure

we use is called a bone marrow aspirate. This is different than a bone marrow biopsy, which can be

painful. The bone marrow aspiration process is often described by patients as being only mildly

uncomfortable and well tolerated.

While your cells are being processed by a Regenexx Lab Technician, you will have some downtime

to relax. A short period later, you will be ready for the second part of the procedure, where the

doctor will reinject your stem cells and natural growth factors from your blood platelets using

advanced imaging guidance into the area in need of repair (real time fluoroscopy or musculoskeletal

ultrasound, using your MRI to plan the injection). This allows the doctor to pinpoint the exact location

of the injection, as well as the dispersion of the cells into the tissues.

http://www.regenexx.com/2009/03/is-a-properly-done-marrow-draw-painful/


spine procedures

1 VISIT

DAY 1

PROCEDURE

Bone Marrow Aspiration and Blood Draw

Aspiration Summary: The bone marrow aspiration is when your stem cells and blood platelets are harvested. The

aspiration occurs in one of our procedure rooms with the physician and technical staff. The

procedure will require you to have a bone marrow sample taken from the back of each of your hips

(iliac crest). You will lie on your stomach on the procedure table where an area at the back of your

hip will be numbed. A special needle will be used to draw marrow blood out of the back of your

iliac crest. X-ray or ultrasound will be used to assure the optimum location. This will be done on

both sides of your hips. Some patients will be given an oral sedative, to help to ease anxiety and

relax the muscles prior to the bone marrow draw. Please refer to the Post-Operative Instructions

for activities after this procedure.

The doctor will numb the site thoroughly and then after the area is numb you’ll feel some pressure

and a strange pulling sensation. If you are nervous about the procedure, the doctor may prescribe

a mild sedative or anesthesia. In most cases, IV anesthesia is NOT needed. See page 18 for

details.

First Visit


spine procedures

1 VISIT

DAY 1

PROCEDURE

Antibiotic Infusion and Re-Injection of Stem Cells

Second Visit

Summary: Prior to any disc injection, IV antibiotics are given 30 minutes prior to the injection procedure to reduce the

risk of infection. The reinjection of stem cells into the painful disc takes place at least three hours after the

bone marrow aspiration and no more than eight hours after. Local anesthesia is used to numb the area and

the stem cells are injected into the disc. An epidural with platelets is also performed prior to the needle being

removed.

Average Duration: 60-90 minutes for 1-2 disc levels

Instructions: • Bring prescribed brace—if applicable

• Avoid all anti-inflammatory medications (Table2)

• Take Tylenol or prescribed medication as needed for pain

• Disc injections can cause a flare in pain for up to 2 weeks post procedure

• Do not submerge the injection site (i.e. taking a bath) for 72 hours after the procedure. Showers

may be taken 12 hours after the procedure


PATIENT BILLING

Regenexx procedures are not covered by medical insurance carriers, however, the office visits

associated with procedures can be submitted to your insurance. An estimated invoice will be written

after the doctor prescribes a treatment plan.

Payment is due in full on the day of your procedure.

INSURANCE PARTICIPATION

In Network: Blue Cross Blue Shield Medicare Many large employers have added Regenexx procedures to their self -funded health plan to give

Their employees access to the most advanced non-surgical orthopedic care available in the United

States. Please contact your benefits coordinator to learn if your procedure is covered.

We accept cash, check, or credit card (American Express, Discover, Mastercard, and Visa).

Please call the clinic at 515-421-4090 if you require further clarification on our policies.

Note: Some insurance carriers require a primary care physician to make the referral

to a specialist.

FINANCING PLANS ARE AVAILABLE

bil ling


PATIENT DATABASE REGISTRY Our clinic is proud to partner with the Interventional Orthopedics Foundation (IOF) to track

patient outcomes in a national patient registry. Long term tracking of our patient’s health enables us

to develop or improve interventional orthopedic treatment methods for future generations. This is

your chance to make a difference and help others who may suffer from your same orthopedic

condition several years from now.

The IOF truly needs YOU to accomplish their mission! Without patient participation, doctors and

scientists have limited case studies. The more patients that participate in the registry, the better

doctors and scientists can answer their questions and gain a more thorough understanding of

non-invasive options.

Being in the registry is simple. After your procedure, your outcomes will be tracked at different

timepoints (1, 3, 6, 12, 18, 24 months and every year thereafter up to 20 years) via online surveys.

All surveys can be completed in the comfort of your own home or office. No identifiable information

collected will ever be distributed or sold to 3rd parties. The Registry is voluntary and we will always

respect your decision, however our physicians take collecting data very seriously, so if you opt out

please discuss with a clinic physician.

For more information on the IOF and patient registry, visit interventionalorthopedics.org or email

[email protected] or 303-469-4431.

Your “yes” provides a bright future for interventional orthopedic treatments.

tracking your outcomes


for visitors

Near the Clinic and Hotel

J. Gilberts Wood Fired Steaks and

Seafood

Jack Stack BBQ

Q39 BBQ

Park Place Mall for a variety of shopping

and restaurants

Jovito’s Italian Café

The Plaza for a variety of shopping and

restaurants

LODGING

DINING

Embassy Suites Overland Park

10601 Metcalf Avenue

Overland Park, KS

(913)-649-7060

Regenexx Kansas City has a rate of $125 per

night.

PLANNING YOUR TRIP TO KANSAS CITY

We want to help make your trip to Kansas City as convenient as possible. Below are recommended

hotels and local area restaurants.


therapy support

BRACING

Your doctor may recommend a brace to be worn either prior to the procedure or post procedure.

Length of time wearing the brace depends on the area treated. The brace can be submitted to

insurance.

Unloader Braces and your Stem Cell Procedure

For knee procedures Regenerative Orthopaedic Institute commonly prescribes an unloader brace

that is to be worn for at least 6 weeks post injection. It is recommended that you use the brace with

activity prior to injection as it may provide some benefit of pain reduction during that time. The

usage of this brace is to reduce the forces on the stem cells in this area while still allowing activity

and cyclic loading (the type of intermittent pressure that comes from walking) which will help the

cells differentiated into cartilage or help repair meniscus.

For full thickness rotator cuff tears we will commonly prescribe an abduction sling that we would like

the patient to use for at least the first two weeks. After 2 weeks the patient can typically remove

the abduction pillow and use just the sling for the next 1-2 weeks depending on the treatment plan.


therapy support

Frequently Asked Questions-Your Knee Brace Q: Do I wear it to bed? What if I need to get up for something in the middle of the night? A: The brace should be put on in the morning and taken off at bed time (also in the document). You do not have to apply the brace if you get up for something in the middle of the night. Q: Do I wear the brace to swim? A: Do not wear your brace in the water. Q: Do I need to wear the braces when I am exercising (ex. stationary bike)? A: The brace needs to be worn during the 4 to 6 week period after your injection while you ’re weight bearing, including and especially during exercise. You do not need to wear it on a stationary bike as it is not a weight bearing activity. Q: Do I need to wear the brace while I shower? A: No, your brace can be removed for showering. Q: Do I need to wear the brace while I’m driving? A: Your brace can be taken off while driving. However, if you are getting in and out of the vehicle, it is likely simpler to just leave it on. Q: Why does my brace look different than other people's - medial vs lateral unloader? A: The braces look different based on which compartment/ligaments of the knee we are unloading (the inside-medial compartment, or the outside-lateral compartment). Medial unloaders have the gel pad on the lateral side of the knee and the lateral unloaders have it on the medial side of the condyle. Some of the Medial unloaders are single sided. We use this brace when the doctor determines that there are no ligament issues. The double sided braces also stabilize the ligaments. Patients who have no medial or lateral osteoarthritis, but only ligament issues (like an ACL) usually get a derotational brace. This brace looks similar to the double sided brace but has not adjustable hinge since there is no pressure being applied to the condyle.


PHYSICAL THERAPY

Our doctors may recommend 4-6 weeks of physical therapy post injection. We recommend physical

therapists who are trained in Postural Restoration. This type of therapy focuses on addressing

biomechanical changes that have occurred from the chronic injury or degeneration you have.

For patient convenience, ARC Physical Therapy has several locations throughout Kansas. If you

are more than 50 miles from an ARC location, ARC Physical Therapy can communicate with your

local therapist and discuss the exercises best suited for your specific therapy.

therapy support

ARC Physical Therapy Locations

Kansas City

10940 Parallel Parkway, Suite 1

Kansas City, KS 6

6109

(913)-378-0778

Kansas City

10400 Hickman Mills Drive, Suite 150


(816)-877-0561

Lee’s Summit

1174 NE Douglas Street

Lee’s Summit, MO 64086

(816)-875-3884

Liberty

527 N. State Route 291, Suite A

Liberty, MO64068

(816)-792-0849

North Kansas City

1931 Burlington Avenue

North Kansas City, MO 64116

(816)-241-2131

Olathe

15455 S. Rogers Road

Olathe, KS 66062

(913)-254-0854

Overland Park

6362 College Boulevard

Overland Park, KS 66211

(913)-754-0888

Shawnee

16018 W. 65Th Street

Shawnee, KS 66217

(913)-815-6677

Topeka

4015 SW George Center Drive

Topeka, KS 66604

(785)-273-1379

Wichita East

6505 East 37th Street North

Wichita, KS 67226

(316)-854-2330

Wichita West

6803 W. Taft Building 300, Suite 303

Wichita, KS 67209

(316)-347-7969


Frequently Asked Questions- General Q: Is SCP right for me? A: If you have a tendon or ligament injury and traditional methods have not provided relief, then SCP may be the solution. The procedure is less aggressive and less expensive than surgery. It heals tissue with minimal or no scarring and alleviates further degeneration of the tissues. Q: What if I have anemia? A: If your hematocrit is below 30 or your hemoglobin is below10, we may not be able to perform the proce-dure. If your hematocrit is between 30-36 or your hemoglobin is below 12, we may try to limit the marrow draw amounts and will have you follow up with your family doctor. Q: Is the injection painful? A: The injection is considered mild to moderately painful but it is typically well tolerated as the needles are slender. Q: Does insurance cover the procedure? Why not? A: There is a possibility our procedures are covered depending on your employer sponsored plan. Larger self funded companies have the option of including our procedures under their covered healthcare options. If this is not the case, the procedure would be out-of-pocket as it considered too new to be widely covered under all insurance plans. Q: Will insurance cover the initial consultation? A: Our new patient consultation and follow up appointments are covered like any other medical appointment under your insurance plan. We will bill your insurance carrier and coverage depends on your plan benefits. Q: Why can’t I be on certain medications during the procedure? A: Certain types of medications will negatively impact the stem cells. In addition, we generally see that many prescription medications will reduce stem cell number. Q: Are there any medications or supplements I can take that will increase the activity or heal-ing abilities of my stem cells? A: Regenexx Advanced Stem Cell Support Formula supports healthy stem cell function and cartilage produc-tion. This can be purchased at the clinic or ordered on line at www.regenexx.com.

questions


questions

Frequently Asked Questions– Pre-Procedure Q: What type of lab do you use to process the stem cells? A: Our lab is an extension of our medical practice. We only process cells in ISO-5 hoods (biologic safety cabinets) and these hoods are located in a lab with particle counts consistent with ISO-6. Q: Are there weight limits for the marrow aspirate? A: If you are less than 110 pounds in weight, the doctor will likely decide to take less marrow. Q: How is the marrow aspirate performed? A: The skin and tissues are numbed, then a needle is used to draw a bone marrow aspirate and this is sent to the lab. Q: Do you take marrow aspirate from more than one site? A: One skin site on each side of the iliac crest will be numbed and three samples are taken from each of those sites. Q: How long does a marrow aspirate take? A: About 30-60 minutes. Q: What about the patients who thought the marrow aspirate was painful? A: If you have a history of chronic low back pain, more discomfort can be expected. In that case, the doctor may offer you an epidural injection to better numb the area. Q: What happens to the stem cells after you take them out? A: The cells are isolated in the lab using a proprietary separation technique. For the same day procedure, this isolated stem cell fraction is placed right back into the body. Q: How much blood will you take from my vein? A: Up to 500cc of blood may be drawn. Less may be taken if you are less than 110 pounds. Q: What happens to the vials after they are drawn? A: The blood is isolated in the lab using a proprietary technique to achieve the desired platelet-rich plasma. This plasma will be re-injected right back into the body.


Frequently Asked Questions– Procedure Q: What is SCP? A: SCP stands for Super Concentrated Platelets. We isolate a proprietary formulation of platelet-rich plasma that will be used for the re-injection. Q: What is Platelet-Rich Plasma? A: Platelet-Rich Plasma (PRP) is an “autologous blood therapy” that uses a patient’s own blood components to stimulate a healing response in damaged tissue. Under normal conditions, platelets store numerous growth factors which are released in response to signals from injured tissue. Modern technology allows us to concentrate platelets and induce this growth factor release as we inject directly into injured tissue, stimulating the same healing response but in a more powerful form. Enhancing the body ’s natural healing capacity may lead to a more rapid, more efficient and more thorough restoration of the tissue to a healthy state. Q: What is PL? A: PL stands for Platelet Lysate. We isolate the proprietary PRP/SCP mix and “crack open” the platelets to allow all of the growth factors to be immediately available to your body. Q: What is the PL-Disc Procedure? A: PL-Disc is an advanced platelet injection procedure into the spine that can offer relief from lower back or neck pain, buttock and leg pain, or numbness and tingling in the arms, hands, legs or feet. It provides a non-surgical treatment alternative for patients suffering from bulging discs and herniated cervical, thoracic, or lum-bar disc related problems. Q: What is the Regenexx-DDD Procedure? A: Regenexx-DDD is an extension of the PL-Disc procedure and is used to treat degenerative disc disease and other conditions where spinal ligaments and stabilizers have weakened and become lax. Regenexx-DDD addresses the 3 components of degenerative disc disease: bulging discs causing irritated nerves, lax ligaments and facet joint pain. Q: When are the stem cells injected into the disc? A: The re-injection of the stem cells takes place the same day as the bone marrow aspiration. After the bone marrow is harvested, it is sent to the lab for processing. This can take a few hours. Then the cells will be ready for re-injection. Q: How is the injection performed? A: The procedure is similar to that of other epidural or facet joint injections. The procedure takes place in our procedure room with the use of fluoroscopic (x-ray) guidance. The skin and soft tissues are anesthetized, then a needle is directed to the symptomatic spinal levels. Once the needle is placed, the PL and/or SCP solution is injected. Q: How long does the re-injection take? A: About 60 minutes.

questions


questions

Frequently Asked Questions– Procedure (continued) Q: Am I put to sleep for the re-injection? A: No. We can pre-medicate prior to the procedure with anxiety type medications. Local anesthetics will be used to numb the skin and soft tissue for local pain control. Q: How painful is the procedure for implanting stem cells? A: Patients often confuse a bone marrow aspirate with a more involved and more painful bone marrow biopsy. We only perform the less involved and much more comfortable bone marrow aspirate. Because we extensively numb the area, about 8 in 10 patients say that the marrow draw is very comfortable and would do it again. Q: How do you know where to place the cells? A: We use real time x-ray known as fluoroscopy as well as ultrasound. Your MRI images are used to help plan the injection. Q: Do mesenchymal cells stay localized to the injection site...is there a risk of them traveling throughout the body? A: MSC’s do stay local at the injection site across multiple studies. This is likely linked to the fact that they generally do not circulate in the blood stream like other adult stem cell types and are primarily found resident in the tissues they serve.


Frequently Asked Questions– Post-Procedure Q: When can I expect to feel better? A: Following the initial injection you may feel “achy” soreness at the site of injury. This is a positive sign that the healing response has been initiated. This effect may last for several days but will decrease as healing and tissue repair occurs. The results should become apparent over 1-3 months, but sometimes can take as long as 6-9 months. Q: Will I need a second procedure? A: Some of our patients will require a second or even third procedure. Our usual protocol involves 1-3 injection cycles. Most patients get a single procedure. Q: When can I return to normal activity? A: This depends on the type of procedure. However, all of our procedures are designed to promote as much early activity as possible. Here is a general guide: Bone healing procedure (for fracture non-union): You must be off the area on crutches until the pain from the procedure subsides. You can then move toward slowly increasing activities over the next few weeks. Total time off the area for most patients is 1-3 weeks with normal activities at about 6 weeks. The only exception is when there is an existing rod or plate stabilizing the fracture site. In these cases you will be allowed more activity more quickly. Joint Procedure: If there is more minimal cartilage loss, low impact activities would be encouraged immedi-ately after the procedure. Full high impact activities would be expected at 4-6 weeks. Partial tendon/ligament/muscle tear: Low impact activities would be encouraged immediately after the proce-dure. Full high impact activities would be expected at 4-6 weeks. Disc Procedure: There may be a flare in pain above baseline for up to 2-3 weeks post procedure. After which the pain should steadily decrease. During this time, a back brace and activity modification is recommended. Then over the next 4-6 weeks, you can move toward increasing activity and working with physical therapy. Full activity would be expected at 8-12 weeks. Q: Is physical therapy needed after the procedure? A: In general, we always try to look at more than one injured part. As a result, it ’s very likely we will recommend other types of conservative care to restore normal biomechanics. This will include physical therapy and specific home exercises.

questions

www.regenexxkansasci ty.com

1300 E. 104 th St reet , Su i te 150


Documents

Helping Your Body Heal Itself - Regenexx Kansas Cityregenexxkansascity.com/wp-content/uploads/2017/04/RegenexxKans… · Helping Your Body Heal Itself PATIENT PROCEDURES AND PREPARATION