Patients arrive with high hopes and misinformation about stem cell therapy in nearly equal measure. This FAQ is written to be handed to a patient before their consult so both sides can spend the visit on the treatment plan instead of correcting hearsay.
Case walkthrough: a rancher with knee osteoarthritis
Bill, 62, has grade III medial-compartment osteoarthritis. He is not ready for a knee replacement but corticosteroid injections have stopped working. His clinician harvests 60 mL of bone marrow from his posterior iliac crest under ultrasound and prepares 6 mL of BMAC. This is injected intra-articularly, sequenced with ECSWT the following week and HPLT for four weeks after. His WOMAC score drops 42% at 6 months and he defers surgery for what turned out to be two more productive seasons of work. BMAC did not regenerate his cartilage — but the paracrine and inflammatory shift bought him meaningful time.
Twenty questions patients ask
1. What is autologous stem cell therapy?
A treatment using your own cells — typically drawn from bone marrow or fat — processed and delivered back to a site of injury or degeneration on the same day.
2. Are these really stem cells?
A small fraction — the rest is stromal cells and signaling cells that together drive most of the therapeutic effect. Anyone claiming millions of pure stem cells from a same-day preparation is misrepresenting the biology.
3. Is it FDA approved?
It is regulated. Same-day autologous minimally manipulated preparations for homologous use are legal under 21 CFR 1271. Enzymatically prepared SVF has been enforcement-actioned outside of IND studies since 2017.
4. Where do the cells come from?
You — bone marrow from the iliac crest or adipose tissue from the abdomen/flanks. No donor tissue is used.
5. Does the harvest hurt?
Bone marrow harvest is done under local anesthesia; most patients rate it 3–5/10 during aspiration and mildly sore for 24–72 hours afterward. Liposuction harvest is done under tumescent local; soreness for a week.
6. What can it treat?
Knee osteoarthritis, rotator cuff healing augmentation, non-union fractures, femoral head osteonecrosis, and select chronic wounds.
7. What can it not treat?
Autoimmune disease reversal, neurodegenerative disease, and systemic "anti-aging" outcomes are not supported by current U.S. evidence.
8. How many treatments?
Usually one procedure; consider adjunct PRP or ongoing device work as maintenance.
9. Is it safe?
For well-selected candidates in a well-run practice, yes. The main risks are procedure-related (bleeding, infection, discomfort). Serious complications are rare.
10. How long is recovery?
Return to normal activity in 1–2 weeks depending on procedure and target site.
11. When will I see results?
Weeks 6–12 for symptom shifts; peak effect at 6–12 months.
12. How much does it cost?
BMAC-based joint therapy: $4,000–$8,000 per procedure. Adipose grafting: variable by complexity and volume.
13. Is it covered by insurance?
Rarely. Surgical augmentation of a covered procedure may be partially covered case-by-case.
14. Should I go to a clinic offering "IV stem cell infusions"?
Be very cautious. Same-day autologous IV infusion for systemic effect is not an established U.S. practice and often falls outside FDA framing.
15. What about clinics that claim to have "billions of stem cells" per dose?
Red flag. Same-day autologous preparations do not yield billions of pure stem cells.
16. Is it the same as PRP?
No — PRP is growth factors from blood. Autologous cell therapy delivers actual cells with a growth factor payload.
17. Can I have this if I am on blood thinners?
Case-by-case; requires coordination with your prescribing physician.
18. Can I have this if I have had cancer?
History of cancer is not an absolute contraindication but requires individualized oncology consultation, especially for hematologic malignancies.
19. Are results permanent?
Structural changes are durable; degeneration continues on its underlying course. Many patients benefit from maintenance PRP or device work at 6- to 12-month intervals.
20. How do I find a legitimate provider?
They will tell you the tissue source, the processing method, the delivery route, the cell count target, and the exact FDA framing under which they operate. They will not promise anti-aging or systemic disease reversal.