Connective Tissue Matrix
Amnion, chorion, amniotic fluid and umbilical cord are distinct placental and extracellular matrix tissues have been used for treatment of several orthopedic conditions. These substances are rich in collagen, proteoglycans and others molecules that aid in healing and repair. Amniotic tissue in particular has been used for over 100 years to treat help treat burns, chronic wounds and ophthalmic (eye) conditions with favorable outcomes and no adverse events reported in the literature.Amniotic membrane provides a variety of functions including the synthesis of growth factors, cytokines and proteins that help regulate and control inflammation. It also contains undifferentiated cells that could aid in healing and serve as “stem cells”. It has been shown to exert an anti-inflammatory effect by blocking the inflammatory cascade that occurs. In particular it is able to block cytokines which are protein mediators that induce pain and inflammation. The use of amnion therefore, can help dampen and improve healing and lessen pain in patients.
The FDA has classified amnion as an allograft tissue under Human Cells,Tissues, and Cellular and Tissue-Based Products (HCT/Ps) 361 and to meet the criteria for use it cannot be manipulated or combined with other cells or tissues in the United States. Amniotic tissue is commercially available in several forms with the majority being reconstituted and not having “live cells” nor can it be advertised as such.While its applications appear promising, very limited evidence is currently available regarding the overall efficacy and indications. In a recent study conducted at the Hospital for Special Surgery in New York, over 200 patients were randomized to receive amnion injection, saline injection or hyaluronic acid injection for knee arthritis. Those patients that received amnion had statistically significant improvements in pain and function at 6 months. This treatment may be a more viable and longer lasting option than steroid for patients trying to avoid surgery. Dr. Badman currently uses CTM products (CTMbiomedical.com) and serves on their medical advisor board. He holds stock ownership in the company as disclosure.
Are These Injections Safe?
Patients considering bone marrow aspirate will have a higher donor site risk. Hip aspiration can irritate some sensory nerves around the pelvis and cause local pain from the donor site for several days. This can be done in office or a surgery center where local anesthesia and general sedation can be performed to keep you more comfortable. The site of the injection can be painful for several days with mild bruising in the area. Infection, although possible, is extremely rare.
For those considering extracellular matrix injections, all materials used are terminally sterilized and processed. All donors go thru a rigorous screening process as dictated by the FDA and American Association of Tissue Banks (AATB). Irritation at the injection site can occur for several days. Infection, while possible, is extremely rare.
Am I A Candidate?
Patients suffering from any kind of joint, tendon, or ligament pain may be considered as candidates regenerative medicine therapy. Patients with severe end stage degenerative osteoarthritis may not be the most ideal candidates. These therapies DO NOT regrow cartilage, therefore, once the joint is completely destroyed joint replacement may be the only viable option to alleviate pain completely. These therapies are intended for patients earlier In their disease course or when surgery is simply not an option. Upon evaluation, Dr. Badman may be able to provide you with recommendations for other types of treatment options.
Does Insurance Cover These Injections?
Most insurance companies do not cover these treatments at this time. As such, this is fee for service due at the time of treatment. Many insurance companies, however, may cover the initial consultation as well as some aspects of the treatment, such as the injection fee, radiographs, and use of ultrasound guidance if necessary during your appointment.
Dr. Badman can help review the advantages, costs, and indications for the various treatments available and help you select which is best for you.
How Much Do These Injections Cost?
Extracellular matrix injection prices are approximately 2000.00 for 2cc of material. This covers the cost of the injection, office visit and use of ultrasound to administer the injection. A 2cc injection is standard size for a large joint injection.
BMAC injections are 3500.00. This covers the cost of the aspiration and injection and local anesthetic and imaging necessary to complete the procedure.
Dr. Badman strives to provide this treatment as cost-effectively and competitive as possible, with costs comparing favorably with other nationally prominent specialists