Many injuries and conditions can be treated with either stem cells or PRP. In many cases, stem cells are regarded as the “gold standard”, however, PRP is often effective as well. PRP is generally more appropriate than stem cell treatment for the smaller joints, such as wrists, elbows, fingers, certain foot injuries, etc.

See a list of specific conditions Dr. Bennett successfully treats with stem cells or PRP, as well as those that require surgery.

Usually, the patient determines whether they want stem cell or PRP treatment. Cost is the most frequent reason that Dr. Bennett’s patients elect to have a PRP procedure instead of stem cells. Some patients are fearful of the bone marrow extraction part of the stem cell procedure, and instead opt for PRP because it only requires a simple blood draw. However, in the last 10 years, Dr. Bennett has only had ONE patient call off a stem cell procedure due to discomfort.

Your blood is mostly liquid plasma, but it also contains small, solid components: red blood cells, white blood cells, platelets, hormones, proteins, and cytokines amongst otehrs. While platelets are usually known for their role in clotting, they also contain hundreds of different proteins known as growth factors. These growth factorsIcytokines) play a key role in healing injuries.

“PRP” in an acronym for “platelet rich plasma.” It refers to high concentrations of platelets (and therefore growth factors) used to augment the body’s natural healing process. PRP growth factor concentrations can be 5 to 10 times higher than what is found in the blood normally. PRP is created by drawing the patient’s blood and spinning it in special centrifuge equipment to separate and concentrate blood components. The concentrated platelets are then injected back into the site of the injury to invoke and stimulate the body’s healing mechanisms. Dr. Bennett uses PRP as an injection as an alternative to surgery, when appropriate, and he also uses it during surgery to speed up healing, cut rehabilitation time, and improve the quality of tissues repaired during surgery.

Orthopedic stem cell therapy uses “adult stem cells”- those harvested directly from the patient’s own body. (These are NOT embryonic stem cells and are NOT taken from a placenta). The “gold standard” for treatment of musculoskeletal injuries or conditions are Mesenchymal stem cells, which come from your own bone marrow.

Mesenchymal or “bone marrow” stem cells have the ability to divide, duplicate, and differentiate into more than one type of cell. Specifically, they can differentiate into cartilage cells, bone cells, tendon cells, etc. Because of this ability to form different types of cells, they have been used successfully to heal and regenerate cartilage, tendons, ligaments, and bone.

In orthopedics, the surgeon performs a bone marrow aspiration, which entails pulling the patient’s stem cells from the pelvic bone using a needle and syringe. The stem cells can be immediately injected into the injured tissue using an ultrasound-guided injection (stem cell treatment as an alternative to surgery). Or the stem cells may be used during a surgical procedure to enhance healing and improve the quality and health of the tissues being repaired during surgery, leading to better results, fewer complications, and less rehabilitation time.

It depends. For patients who have PRP or stem cell procedures without surgery, the injection is performed in Dr. Bennett’s office. Years ago, stem cell therapy was much more expensive because the bone marrow aspiration was done in a surgery center under anesthesia, however, Dr. Bennett now does this procedure in his office, saving the patient thousands of dollars-however, the patient can opt to do the procedure under anesthesia in a surgery center. Dr. Bennett is able to make patients comfortable while he draws bone marrow from the pelvis in his office by providing two oral medications prior to the procedure.

Dr. Bennett explains that in general, stem cell treatment is more powerful and “the gold standard.” However, PRP treatments can be effective too, and in some cases, PRP is preferable to stem cell treatment. So how do you know if you should opt for stem cell treatment or PRP?

Dr. Bennett explains that in some cases, such as smaller parts of the body, PRP works, clinically, similar to stem cells. Less expensive PRP may be a better option for treating tennis elbow, plantar fasciitis, stiff big toe, or wrist injuries.

Dr. Bennett says that when his patients choose PRP over a stem cell procedure, it is usually because of cost concerns (PRP costs less than stem cell procedures). Other patients may feel fearful about discomfort during the bone marrow aspiration procedure that is part of stem cell treatment. These patients may opt for PRP instead because it only requires a routine blood draw. Dr. Bennett prescribes oral medication to make his stem cell patients comfortable during the bone marrow aspiration, but this usually means that someone else needs to drive them home. Patients may opt for PRP for convenience because they don’t need medication and can drive themselves home immediately.

What percent of stem cell or PRP treatments are successful?

Dr. Bennett considers treatment successful when the patient expresses happiness and satisfaction with their outcome. More than 85 percent of Dr. Bennett’s PRP and stem cell patients express satisfaction with their treatment results. Patient testimonials can be found here.

As a board-certified orthopedic surgeon with 29 years of experience treating orthopedic conditions boteh surgically and without and 13 years with both stem cells and PRP, Dr. Bennett has been able to follow his patients’ outcomes and knows which types of injuries respond well to PRP or stem cell treatment, and which conditions require surgery.

Conditions / injuries Dr. Bennett has successfully treated with stem cells or PRP:

Shoulder

• Partial Rotator Cuff Tears
• Biceps Tendon Injuries
• Labral Tears
• Shoulder Arthritis
• Shoulder Pain
• Shoulder Impingement

Elbow

• Tennis Elbow
• Golfer’s Elbow
• Bicep Injury at the elbow level
• Elbow Arthritis
• To avoid “Tommy John surgery” for elbow ligament injuries

Wrist and Hand

Dr. Bennett usually recommends treating wrists and hands with PRP, not stem cells. The exception is wrist arthritis. While he has successfully used stem cells on finger joint arthritis in the past, PRP is what he generally recommends.

• Carpal Tunnel
• Wrist Tendon Irritation and Injuries
• Chronic Wrist Tendon Issues
• Wrist Cartilage Injuries
• Wrist Arthritis
• Thumb Arthritis (CMC)
• Finger Joint Arthritis

Hip / Pelvis

• Hip Arthritis
• Hip Labral Tears
• Gluteus Medius Tendon Injuries / Gluteal Pain
• Hip Pain
• Hip Cartilage Damage
• Iliopsoas Tendon Injuries
• “Snapping Hip Syndrome”
• Abductor Tendon Injuries
• Hamstring Injuries

Knee

• Knee Arthritis
• Knee Cartilage Damage
• Meniscus Tear
• Knee Cap (Patella) Problems
• Knee Ligament Injuries
• ACL Tears (Partial)
• MCL Injuries (Low and Medium Graded)
• Quadriceps Tendon Tear (Partial)

Ankle / Foot:

• Ankle Arthritis
• Ankle Cartilage Damage
• Posterior Tibialis Tendonitis
• Peroneal Tendonitis
• Achilles Tendonitis
• Partial Achilles Disruption
• Ankle Sprain (Mild to Moderate)
• Ankle Ligament Injuries (Mild to Moderate)
• Heel Pain
• Plantar Fasciitis
• Big Toe Arthritis (Hallux Rigidus)

Lower Back

• Sacroiliac Joint (“SI Joint”) Pain

Patients seeking stem cell treatment or PRP should be wary of corporate regenerative medicine businesses that are run by doctors who are not board-certified orthopedic surgeons. There are some orthopedic conditions that do NOT respond well to PRP or stem cell treatment alone, and patients may be wasting their money.

Dr. Bennett does NOT recommend PRP or stem cell treatment by itself for:

• Complete Rotator Cuff Tears. While Dr. Bennett has used PRP or stem cell injections alone to successfully treat partial tears, he recommends surgery to repair complete tears. Some of his patients have opted to use stem cells or PRP during the surgical repair to improve healing.
• Complete Quadriceps Tendon Tears. Dr. Bennett does not recommend adult stem cells or PRP alone for complete tears of the quadricep tendon. He repairs these surgically, and can apply PRP or adult stem cells during surgery to enhance healing and recovery.
• Frozen Shoulder. Dr. Bennett does not recommend stem cells or PRP alone for frozen shoulder. For resistant frozen shoulder, Dr. Bennett will typically perform a minimally invasive arthroscopic surgical release, during which the patient may opt for PRP to expedite healing and decrease rehabilitation time.
• High-Grade MCL Injuries. For High-Grade MCL injuries, Dr. Bennett does not recommend using PRP or stem cell injections alone. Instead, he does a minimally invasive surgical repair and can use PRP during the procedure to enhance healing and speed recovery.
• Patellar Maltracking. For Knee Cap Maltracking, Dr. Bennett does a minimally invasive patellar realignment, and recommends PRP as part of the procedure, not by itself.
• Severe or Chronic Ankle Sprains.
• Severe Ankle Ligament Injuries. Dr. Bennett advises surgery to repair severe ankle ligament injuries. His experience is that only milder to moderate injuries may improve with PRP alone

With 29 years of surgical experience, and 13 years using biologics such as mesenchymal stem cells and PRP both with and without surgery, Dr. Bennett has had the opportunity to follow his patients over the years. He has patients who have had surgery on both knees or both shoulders over the course of year, where one procedure was performed with the addition of biologics, and the other without. Dr. Bennett’s patients often report less pain and quicker recovery times on the side of the body where PRP or stem cells were used in conjunction with surgery. Also, rehabilitation times tend to be shorter with the addition of biologics, saving patients money and time on physical therapy. Many of Dr. Bennett’s patients are small business owners or have physically demanding jobs where they need to get back to work sooner, and biologics are a way to expedite healing.

Dr. Bennett also explains that with surgery alone, a surgeon must often bring together torn tissue that is unhealthy. By adding stem cells or PRP at the time of the surgical repair, he is able to improve the health of the tissues being repaired, leading to better outcomes and decreasing the likelihood of complications.

PRP procedures are performed in Dr. Bennett’s office and typically take about 40 minutes. A phlebotomist draws the patient’s blood. The amount of blood drawn is very similar to any other lab blood draw. The blood is placed in a special disposable container that is designed with work with special centrifuge equipment. (These supplies are expensive, are only used once by one patient, and make up a substantial portion of the $500/injection-*mx injections-$899 per PRP injection.) Dr. Bennett owns five different kinds of centrifuges and customizes PRP treatment for the specific type of injury he’s treating. The patient then waits in the waiting room while the blood is “spun” in the centrifuge to separate blood components and concentrate the platelets, creating the “PRP”.

Once the concentrated platelets are ready, the patient returns to the procedure room, where Dr. Bennett uses ultrasound equipment and feedback from the patient to inject the PRP into the precise spot of the injury. The injection site is covered with a band-aid and the patient can go home immediately afterward.

The blood draw is no different from any other blood draw procedure. Typically, lidocaine is added to the concentrated platelets (PRP), which makes the injection more comfortable, and often provides some pain relief at the site of the injection for several hours afterwards. The procedure is essentially an injection, so it is quick. Often any discomfort is similar to a flu shot, but some injection sites, such as the smaller joints of the fingers and wrists, can be more uncomfortable than larger soft tissues such as tendons and ligaments in the hips and knees. Individual pain tolerance also varies.

Dr. Bennett does stem cell procedures in his office, unless the patient opts to have them applied in conjunction with surgery. Prior to a stem cell procedure, Dr. Bennett prescribes two common oral prescription medications to make the patient comfortable during the procedure. Once the patient is comfortable, Dr. Bennett extracts mesenchymal stem cells from the bone marrow inside the pelvis, using a special needle. Most patients describe the sensation of the bone marrow extraction as “pressure”, or “like someone is standing on their hip” for a few moments.

The extracted bone marrow is spun in centrifugal equipment to prepare it for injection. The patient’s stem cells remain in the room with the patient and are never altered, sold, or stored– Dr. Bennett immediately injects the stem cells into the injured site using ultrasound guidance.

Dr. Bennett performs the bone marrow aspiration– the procedure to draw bone marrow stem cells out of the pelvis, in his office. He is able to do this by prescribing two oral medications, one of which is a pain medication, to make the patient comfortable during the procedure. In 12 years, doing thousands of procedures, Dr. Bennett has only had one patient call off a stem cell procedure due to pain. Most patients describe a feeling of “pressure”, like someone “standing on their pelvis” for the moments it takes to extract the bone marrow.

Patients who have a fear of the procedure can opt to have it done under anesthesia, but most don’t due to the cost of the surgery center and anesthesiologist. The biggest inconvenience for Dr. Bennett’s stem cell patients now is to arrange for a ride home after the injection so they don’t drive under the influence of oral pain medication.

Dr. Bennett recommends the use of a cane for 3 weeks by patients who have knee and hip stem cell procedures.

In general-no.

The patient’s best interests and their insurance company’s best interests are not always aligned. Cortisone injections have been around for decades and are cheap. PRP is a newer therapy, and the supply kits used to spin the patient’s blood in the special centrifuge equipment cost hundreds of dollars. Health insurance companies often have a duty to maximize their shareholders’ wealth. To do this, they must maximize premiums collected while minimizing the payments they make for healthcare services for their members. Insurance coverage decisions are often made based on the larger population of plan members, with consideration of the cost-effectiveness of treating large numbers of people. What’s best for an individual patient’s health may not be in the best interests of the insurance company or its shareholders to pay for a large number of plan members. So just because a particular treatment, like a cortisone injection, is covered by insurance, does not mean it is the BEST treatment option for individual patients.

Dr. Bennett believes that his patients have a right to choose what is best for their health and lifestyle, regardless of what their insurance company or a government agency wants to pay for. Dr. Bennett always gives his patients ALL their treatment options, regardless of whether they are covered by a particular insurance plan.

We understand that many patients choose a particular treatment because of financial considerations, such as whether their insurance covers it. Other patients feel strongly about avoiding surgery, even if surgery is covered by insurance, and PRP is not. Other patients don’t want to take time away from sports or other activities they love. Some patients can’t afford to take weeks off of work to recover from surgery. Dr. Bennett supports patient choice, and respects individual choices about what treatment option best fits the patient’s goals and lifestyle.

PRP prices vary depending on the type of PRP preparation and centrifuge equipment used. Dr. Bennett has several different machines and customizes treatment to get the best results. The price of a PRP injection can be as low as $500 per injection when multiple sites/procedures are involved. The typical complete cost for a single injection is $899-$999, which includes, the injection procedure, special supply kits (which are about $300 of the cost), centrifuge equipment, the phlebotomist’s services, and Dr. Bennett’s time. Also, because the plasma must be injected quickly after it comes out of the centrifuge, Dr. Bennett does not schedule other patients during that time.

Interest-free financing can be arranged through Care Credit, and major credit cards are also accepted.

The complete cost of stem cell treatment is $5,300 for the in-office procedure. The only additional cost may be the cost of oral pain medication, which is covered by insurance. The oral medications prescribed are common and inexpensive, even when not covered by insurance.

For many years, Dr. Bennett only did stem cell procedures in an outpatient surgery center with the patient under anesthesia. However, the facility and anesthesia costs drove the cost up to $20,000+, making stem cell treatments only available to the wealthiest patients. To make stem cell treatment more affordable and accessible to a larger number of his patients, Dr. Bennett developed a way to do the procedure in office, decreasing the price to $5,300, so that more patients could afford to avoid surgery, clunky artificial joints, etc.

Stem cell treatment done at the same time as a surgical procedure in an outpatient surgery center or hospital is typically about $4,300.

The cost reflects the fact that stem cell treatments involve two procedures performed by Dr. Bennett himself as a board-certified surgeon: the bone marrow aspiration procedure to harvest the stem cells, and the ultrasound-guided injection of stem cells into the site of the injury. Bone marrow extraction is more invasive than the blood draw used for PRP, and requires the surgeon. Disposable kits, supplies, and centrifugal equipment are also expensive. This procedure also takes more time than PRP.

Bennett Orthopedics and Sportsmedicine offers Interest-free financing through CareCredit. We accept major credit cards.

When new technologies and treatments emerge, regulation often lags behind. Unfortunately, there are lots of stem cell and PRP scams that patients should avoid.

Whether or not you ultimately decide to come to Bennett Orthopedics and Sportsmedicine, we hope that you will choose a board-certified orthopedic surgeon. Look for certification by the American Board of Orthopedic Surgeons (many scams involve fake accreditation boards)

• Only an American Board of Orthopedic Surgeons certified orthopedic surgeon is licensed to perform orthopedic surgery.
• There are stem cell “factories” staffed with other kinds of doctors who are not licensed to perform orthopedic surgery. These doctors often advertise that they are “orthopedic specialists,” but they are NOT certified by the American Board of Orthopedic Surgeons. They may list official-sounding “accreditation” or “certification” or “specialist” status, awarded by some self-created or corporate-created entity. This is NOT certification by the American Board of Orthopedic Surgeons!.
• Another advantage of seeing a board-certified orthopedic surgeon is that they can appropriately diagnose the underlying condition and tell you if you need surgery. Stem cell “factories” staffed with people who are not surgeons have financial incentives to take the patient’s money and inject them, even when stem cell treatment is ineffective because surgery is required. Not only does this waste thousands of dollars of the patient’s money, but it also contributes to a misperception that stem cells are less effective than they really are. Effectiveness rates are higher when stem cells are used correctly for the appropriate conditions by appropriately credentialed doctors.
• Beware of doctors or others offering stem cell or PRP treatment for a wide variety of non-orthopedic ailments. Reputable, board-certified orthopedic specialists will only use PRP or stem cells in their area of specialization- no truly board certified orthopedic specialist is going to offer stem cells or PRP for non-orthopedic conditions.
• Patients should also look for board-certified orthopedic surgeons who have several years of experience doing a high volume of stem cell and PRP procedures. Some surgeons are just starting out because the treatments are relatively new. Make sure you choose a surgeon with substantial experience with stem cells and PRP. Because Dr. Bennett has over a decade of experience with roughly fifty percent of his practice devoted to PRP and stem cells, he is able to customize treatment based on years of following patients that he has successfully treated.
• Fetal stem cells are not used in orthopedics by reputable professionals.
• Bone marrow stem cells, not adipose (fat) stem cells, are the gold standard for orthopedic conditions. Beware of doctors offering adipose stem cells for orthopedic conditions.

Celebrity athletes such as Rafael Nadal, Tiger Woods, Alex Rodriguez, and Kobe Bryant have used biologic treatments such as PRP and stem cells, but Dr. Bennett has a multitude of happy patients who opted for these treatments for a variety of reasons. Who are Dr. Bennett’s satisfied patients who had stem cell or PRP treatments?

• Professional athletes
• Student-athletes on scholarships who avoided surgery
• Active people who are too “old” for surgery (patients in their 80s and 90s who still play tennis, etc.)
• People with conditions that make surgery too risky (e.g. heart conditions)
• People who are young and don’t want multiple joint replacements in their lifetime
• Weekend warriors
• Small business owners who can’t take extended time off of work
• Patients who do manual work who would not be able to work or earn money during the extended down time required by surgery and rehabilitation.
• Patients who prefer more natural, or less invasive treatment options
• An increasing number of people with high deductible insurance plans, or who have high coinsurance percentages often find that the cost of PRP or stem cell treatment is less than the cost of surgery and physical therapy
• Busy executives
• People who travel from overseas to see Dr. Bennett because these innovative treatments are not available in their home countries
• People from out of state seeking a board-certified orthopedic surgeon who has over a decade of experience with these specific procedures.

Call 941-953-5509 to schedule a consultation with Dr. Bennett, or register and schedule your own appointment online at www.BennettStemCells.com