Why Orthobiologics Are The Future of Joint & Musculoskeletal Pain | Conversations in Regen Episode 7

Discover Why Orthobiologics Are The Future of Joint & Musculoskeletal Pain.

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Are you overwhelmed by the complex choices in regenerative treatments? Wondering which patients are the right candidates for advanced regenerative orthopedics? Curious how to confidently integrate orthobiologics into your practice without relying on insurance-based models?

In this in-depth episode of Conversations in Regenerative Medicine, I sit down with Dr. Chris Rogers—renowned expert in physical medicine and rehabilitation—to uncover the evolving science behind the Orthobiologics and DataBiologics breakthrough. This episode dives into the power of platelet rich plasma, the promise of culture-expanded adipose-derived stem cells, and the practical application of regenerative medicine in clinical practice. Whether you're curious about how to leverage regenerative orthopedics in a cash-based practice or need clarity on patient selection, this conversation provides valuable insight without overhyping results.

You'll hear firsthand how PRP therapy evolved from guesswork to guided outcomes, thanks to real-time patient tracking through the DataBiologics registry. We discuss how evidence-backed regenerative medicine is gaining traction as a first-line option for musculoskeletal care, and what this means for the future of orthobiologics. From early-stage challenges to long-term outcome trends, we share stories, data, and strategies that help bridge science with practical clinical decisions. You'll also learn about misconceptions around stem cell science, including key differences between stromal vascular fraction, MFAT, and culture-expanded cells—and how regulatory pathways like FDA clinical trials shape treatment access.

Plus, I reveal a few tools and resources—like the Regen Patient Magnet Method—that have helped me and others successfully integrate regenerative medicine orthopedics into our workflows, with an emphasis on quality outcomes and ethical transparency. Whether you're just getting started or aiming to grow your breakthrough regenerative orthopedics practice, this episode equips you with perspectives that matter.

Building a successful cash-based orthobiologic practice is not a single decision. It is a series of the right decisions made in the right order. The Business of Orthobiologics offers three distinct programs designed to meet physicians at different stages of readiness — whether you are just beginning to explore PRP, ready to build a full practice system, or committed to going all-in on a comprehensive transformation.

Learn More here: https://thebusinessoforthobiologics.com/programs-explanation 

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Transcript

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SPEAKER_01 0:00

Orthobiologics can serve as a first-line treatment when you have appropriate patient selection. It all comes down to patient selection. So we don't propose to cure everything. However, our thinking has evolved. You could be the best surgeon on the planet with the best surgical procedure, but if your patient doesn't trust you, they're not going to be compliant.

SPEAKER_00 0:20

I think my opinion is orthobiologic treatments will be first-line treatment for musculatal care in the next five years. This is history in the making and very, very exciting. So as we get started, I'll let everybody start to filter in. For those of you who don't know me, I'm Dr. Ariana Demers. I'm a board-certified fellowship trained orthopedic sports medicine surgeon and obsessed with regenerative medicine. I also train and educate in orthobiologics and ultrasound. And I have successfully moved my rural orthopedic practice away from insurance. And I focus on cash-based orthobiologic procedures and wellness. And the thing I'm most passionate about is helping other doctors incorporate orthobiologics seamlessly in their practices. I'm so excited to introduce to you my next guest, Dr. Chris Rogers. He is a powerhouse in the field. He is board-certified physical medicine and rehabilitation expert with 25 years of experience in the non-surgical orthopedic care. He's a global leader in regenerative medicine. If you've never heard him talk, you're missing out. If he is on the docket, you need to buckle up and hold on to your hats because his talks are awesome. If you get the opportunity to get the talks from either the Biologics Association, which we just hosted, or from the most recent Interventional Orthobiologics Foundation meetings, please look him up. He is not only humble, but man, I love his talks. They're so entertaining and so inspiring. He's also a pioneer in orthobiologic therapies. I'm going to let him tell you a little bit more about that pioneering spirit. And then additionally, he has some innovations that I'm also going to have him talk about from the Data Biologics Registry, as well as some FDA-approved stem cell trials. So without further ado, I am going to just welcome everybody to this exciting fireside chat where we get to hear from internationally renowned experts in regenerative medicine, explore more controversial topics in orthobiologics and regenerative medicine, and then gain actionable insights into how exactly you can implement these in your practice and get your burning questions answered in real time, which is amazing. So thank you so much. And I'm gonna make one bold statement, and then I would love to hear from you. I think my opinion is orthobiologic treatments will be first line treatment for musculoskeletal care in the next five years. This will be standard of care and we will be able to serve our patients better because of it. So, Chris, welcome. Thank you so much for taking your time. I would love for you to share a little bit more about you and kind of all of the amazing things you've done in the field thus far, and then maybe share a couple of your pet projects that you really are excited about.

SPEAKER_01 4:34

Well, thank you very much, Ariana, for inviting me today to talk with you. I always love talking with you. I had the pleasure of just talking with you a few weeks ago in our nation's capital, Washington DC, where you and I both presented some information to our colleagues. First of all, I share your enthusiasm for this field. I'm also obsessed about orthobiologics and regenerative medicine. I mean, it's really what we got into medicine for in the first place, which actually helped people to heal for so long. You know, my background, you asked about my background, I'm a physician, physical medicine rehabilitation board certified. And then I did a fellowship in interventional spine care. So I was basically injecting cortisone in people's nerves and joints and discs and things that were, we would probably laugh now that that we're that we did that, but that in that in many places that still is a standard of care. But I agree with your statement here.

SPEAKER_00 5:26

Don't miss out. Please subscribe to our newsletter now to stay ahead of the world of orthobiologics. You can find the link below. Additionally, if you're ready to start this journey with me in my Orthobiologics masterclass, come join us.

SPEAKER_01 5:40

Orthobiologics, based on the outcomes that we are seeing with our patients, based on the now robust scientific literature, registry data, all pointing in the same direction, showing that orthobiologics can serve as a first-line treatment when you have appropriate patient selection, right? It all comes down to patient selection. So we don't propose to cure everything. However, our thinking has evolved. So I first got excited about regenerative medicine. It's been, God, 17 years. I can't believe it. So here I am slogging along, doing, you know, non-surgical sports medicine, treating arthritis, treating tendon injuries, treating her native discs, things like this with cortisone and physical therapy, and when appropriate, referring to surgeons so they can do their work. And that still has its place, right? We're not we're not eliminating those tools that are that are shown to be helpful in our toolbox. But a friend of mine, who was a world-renowned golf instructor, actually co-founder of something called Titleist Performance Institute, knew about PRP. I didn't know about it. He knew about it because athletes were getting treated in Europe at the time. He ended up tearing a tendon in his elbow, asked me to do PRP. I said, what the heck is PRP? I don't know. So I did a little research. There was that one published paper, Alan Misra from Stanford, thankfully had published a paper on PRP for later epochondylitis. So I had been doing ultrasound guided injections since 2002. So I could see the tendon tear. I found a centrifuge somewhere. I made PRP, I had no idea what I was doing, injected way too much volume into that poor little tendon. It was painful.

SPEAKER_00 7:23

Oh yeah. Back in the day, remember we used to torture everybody?

SPEAKER_01 7:28

It was crummy PRP, it was bloody PRP. And but I, you know, would have him come to the office every two weeks, and I saw that tendon tear get smaller and smaller and smaller and smaller on the ultrasound. My God, what my mind was like blown. I could see the neovascularization, you know, all the Doppler signal on ultrasound, all this stuff. So that was my first foray into regenerative medicine. And at that point, I decided I gotta learn everything there is to know about PRP. So, like you, went to the conferences, read the books, read the papers, went to friends' clinics, and learned as much as we possibly could. And it just gets more and more exciting as we go on for the next decade and a half.

SPEAKER_00 8:10

Right, absolutely. So, will you share with our colleagues here on the call a little bit about two things and that really kind of have you have been an innovator for? Number one is the data biologics collection, data collection system and registry. And then the the star of the show, a little bit later, we'll be talking about what else you're working on currently.

SPEAKER_01 8:40

Yeah, so when I first started doing PRP treatments for patients, there were there wasn't a whole lot of publications. And so we were using it as the last resort, which is wrong. I can I can just flat out tell you right now, it's wrong. We didn't know, right? So we we felt bad charging patients for something that we didn't know whether or not it worked at the time, so 16 years ago or so. And I think the first 20 or so patients I just treated for free because I was learning along with them. And but it was very clear whenever I went to a conference or talked to colleagues, it was clear that we need more data, more data, more data. And I realized that for every published paper that had, you know, maybe 20 patients in the study, there were probably 200 patients that were being treated by pioneers in the field, and all that data was being lost. So I was at a conference with Jerry Malenga, our dear friend, and Jay Bowen, and we had been collecting data on Excel spreadsheets for a long time, you know, just handing out surveys to patients, and we said, you know, everybody's walking around with one of these things in their pockets. Maybe we can figure out how to collect data in a way that's easy. So we went with the what we call the SUP principle, had to be simple, simple to use, user-friendly, and practical. We wanted practical data. And so we started Data Biologics, which is a company and a product, and our dear friends in the field, you know, this is still a family of regenerative medicine doctors. So we're still kind of we're still the minority, right? This is not standard of care yet. So everybody's our friend. And 50 of our fellow colleagues agreed that this was important, and thanks to them, they adopted the software, and it's just grown and grown and grown. I think we're over 30,000 patients in the registry now. I think we have over 300 doctors using the platform, and we're getting really cool data insights. You've presented some of your outcomes at conferences, other physicians have done the same, and it's just allowing us to get real data in real time. And a lot of physicians, you know, I know you're doing this, are entering your cellular data on your PRP. So we can just sort of tease out where we can get another 5% in the response rate, another 10% in the response rate. You know, PRP works pretty well out of the gate. I tracked my first 200 patients after two years, and about 75% of them were getting better, even though I had no idea what I was doing, you know, 16 years ago. So now, so now we're getting more, you know, low 90s, mid-90% response rate, and there's lots of different ways you can define response. My definition is the patient happy with the result a year later after treatment. There's a lot of other outcome data we can look at, but you know, practically speaking, I think that's probably the most important. So data biologics covers probably 50 or 60 different types of treatments now. A lot of companies are using the platform to do pilot studies to learn where their products may work best or not as well. So it's really grown beyond what my initial thought was for the platform.

SPEAKER_00 11:52

That's so awesome. Yeah, it's been really instrumental for me being able to follow my patients and know what my outcomes look like, and know with really pretty significant confidence what I can expect, what in my hands, what my patients can expect, and you know, where do I need to get better? Where do I need to critically look at this? So it's been awesome. So thank you so much for you know sticking to it. And, you know, the road of entrepreneurship is not always easy and not always straightforward, but I think you've made such a contribution to the field, and I think it's so needed to be able to capture that data in the private practice and cash pay realm where, you know, the majority of registries are university-based, and we don't want to miss this huge amount of data that is you're, you know, just poof, gone, gone out into the atmosphere. And, you know, there's doctors that are doing a great job. So thank you so much for creating something that is easy to use and doctor-facing and created four doctors. So that's that's been awesome. So here's what I know is successful integration of orthobiologics in your existing practice is hard. And I want, I know there's so many of us that want a successful orthobiologic practice. We know that orthobiologics is the best treatment for our patients, but how do you actually become successful at this? And maybe some of our, you know, attendees are have tried some things, you know, but and you say, Well, I don't know the science, I don't know the technique, maybe I don't know about talking about cash, you know, or marketing or sales. Like, how do we do this? And it's not your fault. We didn't learn this in school. And I'm sure people have said, well, maybe I'm just not good at business. And maybe some of us are struggling with how to be successful and capitalize on this $4 billion orthobiologic market out there. So I definitely think we deserve more. And I'm sure all of us have thought, why is this so darn hard sometimes? But what I ask people to do is just put in the chat what you're struggling with in the chat so that I can kind of make sure that we hit all of the high points with this. So the question that we're asking is how do we win this? Well, when we we are talking about the science today, and then I'm gonna ask Chris some really very fun questions as we dive in, but we also need to consider how we talk about this with our patients. And so, uh, Chris, when we talk about all of these high-level scientific doctor type questions, I would love for you to kind of, and we'll talk about kind of how do we translate this for our patients as well. So we all win. So obviously we need a system, right? And we're not gonna go all of over all this today, but if we are gonna get a little further down this journaling to be wildly successful in your orthobiologics practice. So we're gonna start with that orthobiologics knowledge today. So, Chris, why don't we just get down to business? And yes, we have questions. And our first question that I have, and maybe share a little bit about your expertise in this field, is what you guys maybe don't know is you are looking at Dr. Chris Rogers, who is the preeminent expert in adipose-derived stem cells. And more importantly, adipose-derived stem cells that are culture expanded. And so, Chris, can you give a thumbnail version of what you're doing with these stem cells? Because, you know, last time I checked, culture expanded stem cells weren't allowed in the United States.

SPEAKER_01 15:44

Yeah, and that's still true today. So they're well, they're allowed, but only under certain circumstances, right? So, first of all, what is an adipose derived stem cell? So the MSC that Arnold Kaplan described and published on in the 80s and 90s, and by the way, it was a dinner with him over a decade ago that got me into learning more about adipose. I give him a lot of credit for my career path change, but uh understanding that you know that the cells within the adipose tissue are very robust for managing inflammation and for stimulating tissue regeneration. So that's why we want to use these cells. You know, prior to that we were deriving them from bone marrow aspirate, which is great if your patient's younger, not so great if the patient is older. But currently we are only allowed to use minimally manipulated tissues. So this is sort of my soapbox lecture. I'll try not to lecture too much, but I do not call BMAC bone marrow aspirate concentrate or MFAT microfragmented adipose tissue stem cell therapy. Don't call that stem cell therapy because when I think of stem cell therapy, I'm thinking about high-dose cell therapy. So more than 10 million cells. And if we're gonna, if we're gonna promise patient outcomes, then we have to base it off, you know, the literature that we're quoting from. So anyway, so microfat fragmented adipose tissue obtained through simple hypoaspiration will get us, on average, about a half a million to a million MSCs per treat. So if you're injecting 10 CCs of microfragmented adipose tissue, based on the cell counts that we've done with the lab that I work with, you get about a half a million to a million of these MSCs. It varies widely. Strangely, it doesn't seem to correlate very much with age, like where with the bone marrow MSCs. I think one of the highest cell counts I ever measured was in an 82-year-old woman. So it really is patient variance that is the greatest cause of this variance. It's not the technique, it's not the device you're using to make the MFAT. You know, the challenge though, so I adopted MFAT about, like say, over a decade ago. I was blown away by how well it worked for larger tendon injuries or for more severe osteoarthritis. I was tracking data in my patients, and I was getting better outcomes than I was with PRP. So I continued with MFAT. But then I realized if we're going to move the science forward, we need to standardize, you know, you hear this a lot. We need to standardize the product, we need to standardize the procedure. And to standardize it, that means you're actually counting the cells. You're doing flow cytometry, you're characterizing the cells. If you're doing culture expansion in a GMP facility, you are testing for sterility. These are things that are highly desirable in a product. And I dream of the day that we have an FDA-approved MSC product in a bottle where you know exactly what you're getting every time, and you can use it with comfort in knowing that it's safe and effective. When you manipulate that adipose tissue beyond the simple rinse, wash, resize, centrifugation type process, the FDA puts you in a new category, 351 product, which requires going through the BLA phase one, phase two, phase three process. So I was I'm involved with a company called Perslice Stem Cells, and I was able to conduct a clinical trial where we made uh sterascular fraction, which is which is a little bit more MSCs than we would get from MFAT, but not as high as you would get with culture expanded MSCs. But we showed really good results. And I haven't published my three-year data, but my three-year data is as good as my one-year data, where 88% of the patients who were told they needed knee joint replacement are still doing well without surgery. So, you know, if we can cut the number of joint replacements at half, that's gonna be huge cost saving to Medicare and other insurance programs. So, but that aside, you know, it's a simple procedure. If you can have a small surgery instead of a big surgery, you know, this is what our theroscopy was able to do, you would choose that. If you can have a shot as opposed to a surgery, you would choose that, as long as the outcomes are good, right? So still a lot of work to be done, but go ahead and do yourself a favor, do a lit review on PubMed, look at some of the meta-analyses on culture expanded MSEs, and you will be shocked at how good the outcomes are, regardless of the method used to culture expand the cells. There is a little bit of, you know, the soup is made differently in different labs around the world, but generally speaking, we're talking 85 to 90 percent of patients getting significantly exceeding MCID, uh, specifically for neosteoarthritis. There are a limited number of studies in other areas of orthopedics, but neo A is where we see the biggest benefit. Two big myths that the literature dispels. Myth number one using allogenaic cells from a perinatal tissue, a baby MSE, if you will, is superior to an 80-year-old woman's adipose MSE. Not true. The data does not support that. Do not let your patients tell you that I'm gonna go to some country and get some baby cells because they're better than myself. Not true. Second myth MSEs can't grow cartilage, not true. We have robust published data now out to five years showing that there's an improvement in cartilage thickness and cartilage density in published clinical trials in the need. So most meta-analyses that I've reviewed support that. So those are two common myths I hear.

SPEAKER_00 21:32

No, holy cow, stop, stop the presses. So ta you're telling me that culture expanded cells, treatment with culture expanded cells can improve your cartilage.

SPEAKER_01 21:47

Oh, for sure.

SPEAKER_00 21:48

How much how like what are we talking? Is this 10%? Is this 50%?

SPEAKER_01 21:55

The natural progression of osteoarthritis is you lose about one to two percent of cartilage. In your knee, let's just say, you know, on the tibia, on the femoral condyle per year. So there's a slow degradation. Most published that so we're looking, we're talking prospective randomized clinical trials. One group gets placebo, one group gets cultured expanded cells. And I'm just talking broadly. Adipose primarily outperforms bone marrow cultured MSCs and outperforms umbilical cord MSCs, but they all do well. And what you show is in most published studies, you will see an improvement in the thickness, uh, depending on how they measure, right? So in some cases MRI, it's very difficult. You know, the resolution of MRI is not great. So there are software programs where you can measure the cartilage volume, you can measure the size of the defect, you can go in there with second-look arthroscopy and poke at it, do your ICRS grading, or you can take a biopsy and say, holy crud, we've got articular cartilage here that's well integrated into the margins. So it's extremely exciting. If I were an orthopedic surgeon, I would definitely look forward to the day when I can add this to my, you know, my cartilage repair surgeries.

SPEAKER_00 23:09

Yeah, holy cow. That is, I mean, I I knew the SVF literature did support cartilage improvement, but I was not, I didn't realize that it was so robust in the culture expanded experience.

SPEAKER_01 23:27

It is. And then in the chondral defect literature, you're familiar with Dan Ceres' lab at Mayo Clinic, where he is using tolgous chondron. So he'll take a little chunk of your cartilage from a non-articular surface and combine it with allogenetics, so donor adipose MSC, and showing really robust cartilage healing for large osteochondrial defects. So the devil's going to be in the details, how many cells, what kind of cell, what treatment, what's the right patient. But again, just like with PRP 16 years ago, we're seeing great results with a very limited understanding of this technology.

SPEAKER_00 24:05

Don't miss out. Please subscribe to our newsletter now to stay ahead of the world of orthobiologics. You can find the link below. Additionally, if you're ready to start this journey with me in my orthobiologics masterclass, come join us. Yeah, that's that's amazing. So just to be clear, there are no products in the US that are approved by FDA for culture expanded at this point, correct?

SPEAKER_01 24:33

Correct. In orthopedics. We have one approval for graph versus host disease. That was big news last December when Mesa Blast, which bought Osiris, which was Dr. Ernie Kaplan's company that he started back in the 90s, they got through the gauntlet and they got FDA approval for their culture expanded bone marrow MSC product for graph versus host, pediatric graph versus host. But for orthopedics, we do not have an FDA-approved product, and it's going to be a while before we have a FDA-approved culture-expanded product. So the only way patients can get them in the states are if they're in a clinical study. We plan to run a phase two study this year for kneoster arthritis, single unilateral moderate neosteoarthritis, basically calogram-3s, and then that will be with culture-expanded MSEs, adipose autologists. And then if you don't qualify for a clinical trial, if you're a patient, you might be able to get in under expanded access if your physician applies to FDA and gives approval to do, you know, special case. But that's not broadly available.

SPEAKER_00 25:36

So that's awesome. So tell me this, because I know this is going to happen to doctors. Oh, well, well, we have this product, meso blast. It's approved by the FDA. You can just use it off label and inject it into your patient's knee.

SPEAKER_01 25:51

Yes, you can. But guess how much it costs?

SPEAKER_00 25:54

How much does it cost?

SPEAKER_01 25:55

One and a half million dollars.

SPEAKER_00 25:58

Fair enough. Well, I feel like maybe for one and a half million dollars, our patients could probably do something different besides mesoblast.

SPEAKER_01 26:06

Yeah, I think so. I think they have better options, more cost-effective options.

SPEAKER_00 26:10

Fair enough. Well, we have more questions. So, does the therapeutic gain of culture-expanding odipose-derived stem cell outweigh the ethical concerns for non-compliance and patient safety? I think there's been some patient safety concerns. Can you go into the patient safety concerns a little bit?

SPEAKER_01 26:31

So you're saying the safety concerns with culture-expanded cells?

SPEAKER_00 26:35

Yeah.

SPEAKER_01 26:35

And not ethical, but you mean safety concerns?

SPEAKER_00 26:38

Yeah, yeah, yeah.

SPEAKER_01 26:39

Oh, we have robust literature now showing extremely good safety. You know, what do we track? So in our study, with our SVF study, you know, we track per any FDA-approved study, you're tracking adverse events. So if I inject your knee and then you feel so good that you are now riding your bicycle every day and you crash into a fence like one of my patients did and break your arm, that's an adverse event, but it's not a treatment-related adverse event. But if you look at the literature, you will find that we really do not see serious adverse treatment-related events with culture-expanded MSCs, which is funny because that's in contrast to the what you hear in the media, right? You hear it's it's gonna cause a tumor, it's going to blind you. Yeah, there were three cases where nurses injected SVF into patients' eyes and they were blinded, but that was just bad judgment, that was bad health care, that was not a bad product. And so Okay.

SPEAKER_00 27:39

So, I mean, gosh, this sounds like it's too good to be true, but maybe it's just the new reality. So we have obviously more questions. And so the question that I have is are we overpromising what culture expanded can deliver due to these inconsistencies? And then the biggest inconsistency is the patient. So, how do we pick those right patients for culture expanded options or even a consideration? Where would you use regular PRP versus MFAT versus FVF versus culture expanded? Who would be that perfect patient for each of those identifications?

SPEAKER_01 28:24

Yeah, the perfect patient for culture expanded adipose MSCs appears to be that patient with more advanced joint disease, but not so advanced that they have a biomechanical problem. So a patient with a root tear of their meniscus that's unstable with extrusion of the meniscus. A patient who has a grossly unstable joint due to ligamentous injury, a patient with high degree of valgus or varus deformity, that's a that's a mechanical problem that requires an orthopedic surgeon, in my opinion. It doesn't mean you don't go back and augment the biology later with cell therapy, but you gotta fix both problems, the anatomical problem and the biologic problem, right?

SPEAKER_00 29:04

Okay. And so So barring those issues, you would say injection-based therapies is um a consideration when when we get this culture expanded approved, but and SVF is coming shortly. What do you what do you think the difference between SVF and Culture Expanded? Is there gonna be a timeframe where SVF isn't allowed and culture expanded is not?

SPEAKER_01 29:29

Yeah, GID, you're familiar with GID, they're in phase three with their device. This is a device you will use on site in the practice to manufacture SVF. So we should be getting that reasonably soon. That they should be able to get approval. I don't know what soon means, a year, two years. We're we're in weird times, you know. We have a new, you know, half the FDA just got fired. So I don't know what to tell you what the future looks like.

SPEAKER_00 29:55

Yeah, maybe faster, maybe slower.

SPEAKER_01 29:58

Correct. Yeah, so your guess is as good as mine, but if we're, you know, based on what the messaging has been from the FDA for the last 20 years, these companies, including the company I work for, has to get, you know, phase one, phase two, phase three approval, BLA approval by the FDA before these products are available to us. For GI has a device approval, so that's that's different than a drug. But and then you asked, you know, how does one compare to the other? How does SVF, which is a lower MSc count, but has other cells in the mix, right? Yeah, endothelioprogenitative cells work very nicely with the MSc for certain kinds of indications, like patients who have wound healing issues. That's that to me, that's a match made in heaven. You know, people with vascular issues, SVF is remarkable. So, but for culture expanded cells, strictly MSCs, that's gonna require an approval. But we have approvals in 10 countries around the world. When you go to South Korea, it's already approved for Neo A.

SPEAKER_00 30:58

Okay. All right. Well, that's really exciting. And I just I really have some, I'm like, when can we start? Right. So I have more questions, obviously. So this is the last one that I think it really requires us to think a little bit about. But, you know, should there be a global consensus or registry for clinics using these culture expanded ontologous stem cells? Or are are we still in the wild, wild west scenario? You know, I know offshore culture expanded cells, you know, you just said in 10 countries it's approved, right? And so there are clinics around the world that are doing these procedures. And the question is, you know, how is it up to the clinic to police themselves? Is it up, you know, wow, what should we how should we proceed? Or how what would be best practices to be able to proceed?

SPEAKER_01 31:52

Well, best practices, I think, at this point would be if each uh clinic globally who is doing this kind of work, because it is still investigational, uh, should make their clinical outcomes uh transparent, available. You don't get this. If you go to Mexico, Central America, you go to Bahamas, you go to Cayman, you know, to give Chris Centenno some props here. RegenX is very transparent with their outcomes. So they do culture expanded MSCs, bone marrow down in Cayman, and they publish their results. I think every clinic should do that. I think they should maintain a registry and they should share those outcomes. They may do that on a one-on-one basis with a potential customer, but they should publish their outcomes so that we can all be aware of what's best practice.

SPEAKER_00 32:42

Well, maybe we can get a list together of all our friends doing these and say, hey, well, let's get a special journal article together and say this is what you can expect from our worldwide experience with Culture Expanded, because it's a small cohort right now, and you are, you know, leading the way along with others who are doing this. And, you know, so I think if we can be collaborative, that would be, you know, best practices. And instead of being proprietary about that, not to give away all of your, you know, hard-earned stripes, but at the same time, publishing those results, I think is really important. And say, hey, listen, this is we're getting great results. You know, please, everybody else try to replicate this and prove that this is a real thing.

SPEAKER_01 33:33

Yeah, that's again, getting back to data biologics. That's why we created that registry. So I wanted to know who was, you know, getting the best outcomes. And it's not like there's best doctor. I know your outcomes, Dr. Murray. I'll just give you a little shout out. I know your outcomes are extremely good. I know you're in the top eight physicians in the United States in terms of your long-term patient outcomes. So, congratulations for collecting the data and congratulations for providing great care. I think your secret sauce is probably your orthopedic surgery training. It was very good. And so you know good patient selection, you know how to do an accurate complete diagnosis, and then you have excellent skills. I think that's all necessary. So, anybody on the call who's saying, How do I get into regenerative medicine? You know, we didn't learn this in med school, we didn't learn this in residency. So you gotta go to conferences, you gotta read as much as you can, you gotta get your skills set up, whether surgical skills or injection skills or ultrasound guided injection skills, you know, that's all important. I think with the patients, I think informed consent is mandatory. And informed consent means you give the patient an honest expectation of what their outcome may be and what their options are. And when you don't know, you just say, I don't know. And that will boost your satisfaction because if your patient's expectations are appropriate, then they will be more satisfied because they're uh on the same page as you are in their understanding of what to expect.

SPEAKER_00 35:01

Yeah, awesome, awesome. Well, you know, you bring this up, so this was perfect. So, what is the next step, right? And so you need our practice launch system, right? You want to be effective at this. And we really I appreciate you sharing your knowledge and your expertise. I mean, you're a giant in the field, and I feel so fortunate to have you as my friend and my colleague. It's been amazing. And we could talk all night about very nerdy things and just continue. It's awesome. But, you know, part of this is how do you find the right patients, the ones who are right for regenerative medicine, who are the ones who need your help, right? And so we talked a little bit about how do you attract the right patients who are good candidates for this. And then, you know, this it goes into, you know, how do we keep creating nice cash-based business? How do you convert with good results? And how do you put it all together for success, not only for the patient, but for yourself as well. So I have a really fun little region patient magnet method. It's a little webinar that I'm hosting this coming in a couple of weeks. And so if you're interested, please scan the QR code, come register and share this with your friends. It's gonna be figuring out how we choose those right patients and how we attract them to our clinic, how we get them to understand what we do and how we can help them. So if that's something of interest or need to you, please register. If you want the fast track, I'm very excited to tell you we have a business of orthobiologics live at Toby in August in Las Vegas. You cannot afford to miss this event because this helps you seamlessly integrate PRP and orthobiologics into your workflow. You get a step-by-step roadmap on how to attract patients, the right pricing, and then proven strategies to run a profitable and successful cash-based orthobiologics practice. So please, please, please come. It's gonna be so much fun. The price for a full day of the roadmap, patient-centered branding, pricing models, and insight from successful physicians, just like Dr. Chris Rogers, will be there. And then that is the price for the VIP lunch. If you want to uh hang out with me, that would be awesome. So, this is the QR code again, Chris. Thank you so much. I appreciate you and your time. And then I did want to open this up to any questions. So if you have questions, please pop them in the chat and we'll get that. Any questions for Dr. Chris Rogers? Either raise your hand or pop it in the chat and we can unmute everybody.

SPEAKER_01 38:03

There's a question that's relevant that someone posted is how do we convert patients?

SPEAKER_00 38:08

Yeah.

SPEAKER_01 38:09

And you know, the old adage that patients don't care how much you know until they know how much you care is absolutely true. We work in the trust business. You could be the best surgeon on the planet with the best surgical procedure, but if your patient doesn't trust you, they're not gonna be compliant. And what you're looking for is compliance, and you need to convey to them the confidence that you have that your plan is gonna work for them. And that means you've taken the time to listen to their history, you've taken the time to do a quality physical exam, you know how to read imaging, you know how to explain that imaging to the patient and give them some sense of what they're dealing with so that you're not just coming out of left field with some idea that they don't even know what you're talking about. The second is I, again, this is self-serving, but data biologics has helped me quite a bit in converting patients. I have a physical therapist who I've known for a long time, and she trusts me, and she had a TFCC tear, and she asked me, Will PRP work? You know, she treats all my patients that I've treated with PRP, and so she knows what we do. And I said, Well, gosh, I don't know if I've even treated a TFCC tear with PRP. And I pulled up the data biologics registry, and lo and behold, over the last five or six years, I've treated 10 of them. I don't know how I didn't remember, but there they were, and I had their 12-month follow-up data, and it was thankfully very good. So I said, well, apparently we get good outcomes with the PRP PRP.

SPEAKER_00 39:46

Yeah, I also use my data biologics registry data because honestly, that has really helped drive what they can expect in my hands, what I can deliver to them. And so that that has helped as well. And if you don't have those outcomes, you can use the literature and say, listen, what we know from the science that we have to date, this is the expectations that we can do when we use these techniques. And that's not wrong. I think that's helpful in the conversion process to equip your patients with as much information about what they can expect and what they can expect to avoid if they choose this treatment. Meaning, how long is it going to last? Can they avoid knee replacement altogether? And the exciting thing about what you're telling me about Culture Expanded is man, this horizon is bright. I am very, very excited to be a part of this and for everybody on the call. This is history in the making and very, very exciting. So, Chris, anything else that you are wanting people to understand about what we've talked about today? Uh, or any last parting shots, if you will.

SPEAKER_01 41:07

I will add that again, self-serving. Um somebody that I work for, even though we do not yet have FDA approval for culture expanded cells, any patient, any person can bank their stem cells now. You can. I actually, my wife and I both, Dr. Ambok, who you know and love, did lipoaspiration on us. Our MSCs have been culture expanded. I now have 20 bottles, each bottle containing at least 15 million culture-expanded MSCs, you know, all manufactured in GMP facility. I can't get them yet. I can't use them yet unless I'm in a clinical trial, perhaps, or have an expanded access use. However, I'm getting older and those cells are not. They're sitting there in suspended animation, frozen, and that is perfectly legal. That that lipoaspiration is a medical procedure, perfectly legal. To culture expand, the GMP lab has all the appropriate state and federal tissue, a license, a banking license. So it's just a matter of time before we get the approval to use them as a treatment.

SPEAKER_00 42:15

So well, awesome. Yeah. So what we'll do is when we we send out this replay, we'll send out the information about this ability to bank. If you're collecting adipose or MFAT or any of that, your patients can actually bank their cells. So that's really exciting and good job. Kudos to you.

SPEAKER_01 42:36

Yeah, any patient that I do MFAT for, I'm always telling them, let me take just a little bit extra and let's save it for the future. Or if you do a knee scope, say you do any surgical procedure, you can take a little surgical fat, that can also be turned into culture expanded cells. That's amazing. That's available now. There's a couple of companies around the country that do that, but they're not on the path to get FDA approval and you can't get yourself back if it's not FDA approved.

SPEAKER_00 42:59

Gotcha. So personalized stem cell is the company you are a part of, and we will send that out and make people aware that this is available. So thanks so much for sharing your time. Everybody who's been on the call, any uh parting questions? Otherwise, I appreciate your time and come join us either on our one-hour webinar on the regen magnet method, or if you want the fast track, come to Bob Live at Toby, which is in August in Vegas. So hope to see you there. And thank you so much. Thank you all.

SPEAKER_01 43:33

Thank you very much. We'll see you in Las Vegas.

SPEAKER_00 43:36

Yes, absolutely.