The field of orthopedic stem cell therapy, often referred to as “regenerative medicine,” has grown exponentially in the last decade. You may have first heard about it when Kobe Bryant went to Europe to have a “stem cell blood cycling” procedure done to help deal with his ailing left knee, or when Peyton Manning used it. These procedures have since become readily used in the professional sports world and steadily titrating down to the general population being sold on the idea of using orthopedic stem cells to aide or manage conditions like rotator cuff tears, tendon problems, arthritis, and meniscal tears.

The research on the effectiveness of orthopedic stem cell therapy in dealing with these types of musculoskeletal conditions is promising thus far, despite a small sample size, because it’s such a new procedure. However, when a procedure gets popular in the world of sports, the general population starts asking doctors about “that procedure Kobe used.” For example, were you one of the millions of people wondering what those big circles on Michael Phelps’ shoulders and back were during the 2016 Olympics?

Since the all-time most decorated Olympian introduced the world to cupping, it has gained significant notoriety. But the research behind it is tenuous at best. Whenever a new medical procedure or treatment comes into the lens of the general public, that means the potential for huge market growth and lots of revenue. As a result of that increased demand often comes providers trying to get theirs. It’s no different for orthopedic stem cell therapy. To reflect that demand, the number of clinics and providers marketing “stem cell therapy” has grown exponentially as well, with a 4,750 percent increase in the number of clinics marketing the procedures online from 2010 to 2016.

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The general reality of medical practice in the United States is that it’s a reflection of its country, which means money rules. Providers understand how much demand there is and just how little education the average American has on medical matters. Only 12 percent of Americans have proficient health literacy, according to the US Department of Health and Human Services. This is particularly troublesome in orthopedic stem cell therapy which has not been strictly regulated by the FDA yet.

So you advertise some medical buzzwords and know most people won’t be able to parse out the differences between amniotic, cord blood, and actual, live stem cells, or why all “same-day stem cell treatments” aren’t created equal.

Well, I’m here to help with that. Here are the five things to look for, ask, or understand when you’re shopping for orthopedic stem cell therapy.

1) The Website

Is the website full of information and research articles, or does it constantly slam you with sales pitches? The latter is a dead giveaway of a scammy practitioner.

2) The Source of the Stem Cells

Amniotic and cord blood “stem cells” are nonviable, meaning they are dead. On the other hand, stem cells taken from your bone marrow are live and viable. Legitimate providers will manually remove bone marrow from your body, often your hip or lower back region. At that point, they will do one of two things.

3) The Procedure

After the stem cells are taken out, they need to be isolated and concentrated using a centrifuge machine. This may be from where the “blood cycling” moniker came when Kobe had his procedure. Some providers claim they have a procedure that eliminates the need for that. It’s not true.

Further, when the stem cells are inserted back, a guiding instrument, typically ultrasound or fluoroscopy, allows for precision of the injection and getting the stem cells to the specific target. Doing the injection without guidance is akin to flying blind. Not even Maverick would condone that.

4) Who’s performing the procedure?

Make sure it’s a physician performing the actual procedure. Physician assistants (PAs), nurse practitioners (NPs), chiropractors, and acupuncturists are not qualified to perform the procedure.

Additionally, top-of-their-practice orthopedic stem cell providers will go through a detailed history and comprehensive manual exam before making any recommendations and may recommend more conservative approaches first.

5) What’s the clinic setting like?

If the clinic advertises like it treats everything under the sun, or if the procedure will be done in a non-specialized clinic (e.g. acupuncturist’s office, chiropractor’s office, etc.), it’s a serious red flag.

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Those are the five key factors to consider when choosing an orthopedic stem cell provider so you’re able to discern between those who want to help and those who want to help themselves. You’d imagine being a medical professional would imply the former, but that’s just not the reality, especially in the Wild West of high-margin, stem cell therapy. If you feel like someone’s trying to sell you on something or have a bad feeling, you’re likely dealing with a shady provider. There’s nothing more valuable than your health, so make sure you do your homework and take the time to find a provider who prioritizes your well-being rather than their own checkbook.