Stem Cell Injections (Fat and Bone Marrow : The Truth

What are the different types of stem cells that are used in Orthopedics?

There are 3 main types of injections that we call stem cells in Orthopedics:

AMNIOTIC /UMBILICAL:  These are donated from a placenta, and frozen before use.  We DO NOT advise using these types of stem cells.  Not only are they not your own body, but they carry a small risk of infection, and since they are frozen most studies show that the cells are not as effective as using live cells.

BONE MARROW (BMAC):  These are your own cells that are taken from your bone marrow.  This injection is a good option with good overall evidence, however it is a fairly invasive procedure, and most patients will have a fair amount of pain in the donor site where the needle enters the bone.

FAT / ADMSCs Adipose-Derived Mesenchymal Stem Cells (ADMSCs):  These are your own cells that are collected through a mini-liposuction of the love handle area, or abdomen.  This procedure is much less invasive than the BMAC procedure, and carries good overall evidence.  We currently offer this procedure, as it appears to be safe, well tolerated, and much less painful than the bone marrow procedure.

Is one stem cell better than the others ?

We don’t advise the placenta stem cells,  but both the BMAC and the Adipose-Derived Mesenchymal Stem Cells seem to be effective for arthritis pain.  In our opinion bone marrow is probably better when used during a surgery, or to help heal a bone fracture.

Adipose-Derived Mesenchymal Stem Cells and BMAC both have good studies in the treatment of OA (arthritis) pain.

We do not tend to use stem cells for the treatment of soft tissue injuries such as tendonitis , or tears. In those cases we prefer PRP injections.

Are there really stem cells in the BMAC and Fat/ Adipose Tissue?

Yes.  Bone marrow and Adipose-Derived Mesenchymal Stem Cells tissue contain a lot of stem cells, however we can not process out the stem cells.  That is not allowed by the FDA.  This is different than the procedure performed in other countries where stem cells are cultured out.

Is this FDA approved?

The U.S. Food and Drug Administration (FDA) is responsible for the evaluation of
drug and biologic product safety. The FDA regulates the use of stem cells as
Human Cells, Tissues, and Cellular and Tissue Based Products (HCT/Ps) under
CFR Title 21 Part 1271.

Therapies that use a patient’s own bone marrow or minimally manipulated adipose
tissue for homologous use are compliant with current FDA regulatory guidelines.

Stem cell based products that do not satisfy specific FDA guidelines are regulated
under Section 351 as a biological drug. These products require FDA approved
clinical trials to confirm safety and efficacy. Products that contain umbilical cord
blood, amniotic tissue cells or exosomes require FDA approval of a Biologics
License Application (BLA) before they are allowed to be marketed to patients. At
this time, such products are not FDA approved.

Which injection does Dr. Kanaan offer ?

We currently offer Adipose-Derived Mesenchymal Stem Cells (Fat) injections.  It is the least invasive and carries good studies in the treatment of arthiritis pain of the joints.

How does it work ?

Fat/ Adipose-Derived Mesenchymal Stem Cells is a type of autologous (from your own body), same-day stem cell therapy.

This means the collected stem cells are put into a different part of the body in the same person during the same day procedure. Adipose-Derived Mesenchymal Stem Cells / Fat  are obtained from the abdomen or love handle area through a quick liposuction procedure. The gentle liposuction takes a few minutes, and the whole time in the office is an estimated 60 minutes.

WHAT is the COST?

The first office visit IS COVERED by insurance, and will be a history and physical. We will discuss the process, and get the consent for the procedure.

We will then schedule you for a second visit for the actual injection. This visit is NOT covered by insurance, and will be about 1 hr long. You will need to pay up front for the injection.

Our current cost for Adipose-Derived Mesenchymal Stem Cells/ Fat Injections is $3500.00.   This covers all before and after visits.

Should I try PRP first?

YES.   We always advise trying PRP injections first.  PRP is very easy and has excellent results for orthopedic pain.   Dr. Kanaan rarely advised doing a stem cell injection before a PRP injection.

Do you mix PRP and Stem cells?

YES.   The majority of clinics in the US mix PRP and stem cells to thin the injection out.  Bone marrow and Adipose tissue is too thick to inject , and PRP helps to support the stem cells in most studies.


Here are some studies on the use of adipose dervied stem cells:




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3237 Blue Ridge Rd.

Raleigh, NC 27612

Phone: (919) 719-2270

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