This article is prompted by a question posed to us by a fan on Facebook:
QUESTION: Why does Insurance not cover Stem Cell Therapy procedures. Is that because it has not had any validated research. Or, because it is performed by a chiropractor? I have an interest in learning more. I’m a physical therapist with very limited experience with patients who have had stem cell procedures, some has not been positive. I need to understand because patients are always asking questions. I realize stem cell therapy is new and therefore not reimbursed by insurance. My concern is effectiveness.
ANSWER: Thank you for your question and allowing us to respond. The research is ongoing and insurance companies typically take a while to catch up to new promising treatments, including “SAME-DAY” #StemCellTherapy.
Our clinic is Federal Trade Compliant (FTC) in that we do NOT make false claims of unusual medical cures or show only outcomes that are better than average. We attempt to present a fair and balanced set of options for our patients, giving true informed consent which includes the good, the bad and other outcomes.
Informed consent in its truest meaning is defined by giving the patient all of their options which include:
- Do Nothing
- Do Surgery (with all risks explained including the very serious risks of General Anesthesia, Bleeding, Infection, Trauma to nearby structures, Blood Clots after surgery, Failure of Surgery etc
- Do less invasive procedures: Synvisc injection (knee fluid augmentation with protein solution) , Prolotherapy (sterile sugar water injections) PRP, and Stem Cell Therapies
- Regular Medical therapies: Anti-inflammatory medications, narcotics or Tylenol.
- Physical Therapy and Rehabilitation focused medical therapies
- Osteopathic or Chiropractic Manipulation
Our clinic follows FDA guidelines in the preparation and handling of all cellular therapies including stem cells. All procedures done in the clinic are Level 1 procedures which are the safest class of procedures for the patient. This means the patient remains fully conscious during the procedure and that only local anesthetics are used.
Regarding the medical effectiveness of stem cell procedures the National Center for Bio Technology Information has this to say in a mini review:
“Total knee replacements come together with high effort and costs and are not always successful. The aim of this review is to outline the latest advances in stem cell therapy for knee osteoarthritis as well as highlight some of the advantages of stem cell therapy over traditional approaches aimed at restoration of cartilage function in the knee,” said Dr. Kristen Uth and Dr. Dimitar Trifinov, co-authors of the review.
They conclude: “Stem cell therapy may not become a standard treatment for knee Osteoarthritis until the end of the decade due to various aspects regarding the clinical safety (e.g., risk of complications after the procedure, compatibility of donor stem cells) and the affordability of this treatment for the general public.”
This is an HONEST appraisal of where we currently stand with Stem Cell Therapy. While there are some risks to any procedure and affordability concerns, this is true of any new medical technology. Lastly, we should not forget that there are many situations that arrive after surgery that create unexpected expenses and negative outcomes.
It is estimated that 1/3 of patients who undergo knee and hip replacement surgeries should never have taken them in the first place. Unseen costs and complications arise which should make us pause to consider alternatives. We are typically finding that patients are experiencing positive results from hybrid Stem Cell Therapies, including #Prolotherapy and #PRP which in our opinion carry less risk than invasive knee surgery . If we are able to help patients have less pain and perform activities of daily living with less limitations, that is a win-win situation. If we can do that while lessening surgical risks it is a triple win for patients.
We will only advise Stem Cell Procedures if we feel your body will holistically and positively respond to the treatment. We see ourselves as Functional Medicine proponents seeking long-term and lasting results for our patients. Finally, as discussed in the article above, we do not typically advocate Stem Cell Therapies for severely damaged, bone on bone type of knee osteoarthritis, although some patients have responded positively in that situation, despite having little visible cartilage. Hope wins…!
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