“Publish or Perish”… Bone marrow versus fat versus the combination

I’m very  happy to report that my manuscript comparing bone marrow stem cells to adipose stem cells to the combination of bone marrow stem and adipose stem cells for the treatment of knee arthritis and low back pain has been published in the Winter 2015 issue of “The Pain Practitioner”. Click here to see the full document.

I’ve been using bone marrow stem cells since February 2010. I started isolating stem cells from adipose (called the stromal vascular fraction, or SVF) in 2011, but soon after I started,  a lot of rumors started flying around as to wether or not it was legal. So I decided to stop doing SVF in order to see how it would play out. In the summer of 2014, after a number of doctors doing SVF were investigated by the FDA and no action was taken, I decided it was OK to start doing SVF again.

SVF must be combined with growth factors in order to activate. Most doctors suspend SVF in platelet rich plasma (PRP). My instinct was to suspend SVF in bone marrow aspirate concentrate (BMAC), because my experience had been ‘anything PRP can do, BMAC can do better’. However I thought to myself: here is an opportunity to see if SVF works well without BMAC, that will save time, money, and ’emotional expense’. So for four months, I asked people to choose between BMAC or SVF suspended in PRP.

What I discovered was that BMAC worked very constantly well (as had been my experience for the prior nearly five years). When the SVF worked, it worked better than BMAC, but about 3 in 10 people, it didn’t work at all. I wondered if combining BMAC with SVF would give me the constancy of BMAC with the augmented results of SVF. After surveying those that received the combo, my hunch was right. This is why most of the procedures we do at Docere Clinics are BMAC/SVF.