What does the Specialty Regenerative Medicine Institute treat?
Joint, tendon, ligament and disc problems such as knee arthritis, rotator cuff and other tendon tears, meniscus and labrum tears, and annular tears, using energy-based therapy, platelet-rich plasma (PRP), Gen III Biologics (EXOCUBE), bone marrow aspirate concentrate (BMAC) or microfragmented fat (MFAT). Physicians place each injection with image guidance after reviewing your history and imaging.
Different signals for pain relief and healing
Our regenerative program uses several treatments that send different signals to the injured area. They are ordered from the simplest to the most involved, and most people start at the top. Your physician recommends where to start from your exam and imaging, not from a package.
Light and pressure waves
Energy-based therapies
MLS laser, radial pressure-wave therapy and focused shockwave deliver energy to a named tendon, muscle or joint area to prompt a local tissue response and calm pain. No needles; each session takes minutes.
Often discussed for: Tendon and muscle pain, plantar fasciitis, tennis elbow, shoulder tendon problems
Platelet growth factors
Platelet-rich plasma (PRP)
A concentrate of platelets from a small sample of your own blood, placed with ultrasound or X-ray guidance. Our standard PRP is prepared as a high-dose platelet injection.
Often discussed for: Knee and other joint arthritis, tendon and ligament problems
Concentrated platelet and plasma proteins
Gen III Biologics with EXOCUBE
Your blood is separated, the platelets are activated so they release their growth factors before the injection, cellular debris is removed, and the plasma is concentrated into a smaller volume. Unlike standard PRP, which relies on platelets releasing their signals after the injection, the signals are released first, and plasma proteins such as interleukin-1 receptor antagonist (IL-1Ra, also called IRAP) and alpha-2-macroglobulin (A2M) are concentrated with them.
Often discussed for: Joint, tendon and muscle pain when your physician thinks a more concentrated product fits
Your own marrow cells and proteins
Bone marrow aspirate concentrate (BMAC)
Bone marrow drawn from the back of the pelvis under local anesthetic, concentrated in the same visit and placed with image guidance. It can also be placed inside the bone (intraosseous) for bone marrow lesions seen on MRI in more advanced arthritis.
Often discussed for: Annular (disc) tears, partial tendon tears, meniscus and labrum tears; bone marrow lesions in more advanced arthritis
Your own fat tissue, minimally processed
Microfragmented fat (MFAT)
A small amount of fat is harvested under local anesthetic, gently broken into small clusters and placed in the joint or around it in the same procedure.
Often discussed for: Larger joints and several joints at once; larger tears, which also get a surgical evaluation so you can compare options
What’s different about Gen III Biologics
Gen III Biologics are prepared with the EXOCUBE system, in four steps during one visit of about 30 to 60 minutes:
- Separation. A blood draw is processed to separate plasma and platelets.
- Activation. Glass beads activate the platelets so they release growth factors and other signaling proteins before the injection.
- Clean-up. Cellular debris is removed to reduce inflammatory content.
- Concentration. The proteins and growth factors are concentrated into a smaller volume for injection.
The product contains growth factors (PDGF, TGF-β, VEGF, EGF, IGF-1, HGF) and plasma proteins that are being studied for joint pain: IL-1Ra (IRAP), which blocks a key inflammation signal, and A2M, which can inhibit enzymes that break down cartilage.
In a manufacturer-sponsored laboratory study of five healthy donors, EXOCUBE processing gave about three times the growth-factor levels of standard activated plasma and about 5.8 times the A2M, with 91% platelet recovery and more than 10 billion platelets per dose. That study measured the blood product, not patient results, and it isn’t evidence that the treatment works better.
About FDA status
EXOCUBE is an FDA-cleared Class II device (510(k) BK251196) for preparing platelet-rich plasma from your own blood, and the devices we use to prepare bone marrow concentrate and microfragmented fat are also FDA-cleared for that preparation. FDA clearance covers preparing the material, not treating a particular condition: the FDA has not approved PRP, bone marrow concentrate or fat-based injections to treat arthritis, tendon or ligament tears, or spine problems. These are not stem cell treatments.
Results vary from person to person, the research is stronger for some uses than others, and no treatment here is guaranteed to work. Your physician explains what the evidence shows for your condition and the other options, including physical therapy, injections and surgery.
Conditions we treat, by body area
Elbow, hand and wrist
Treatment options compared
| What it is | Made from | Often discussed for | Insurance | |
|---|---|---|---|---|
| Shockwave and laser | Energy delivered to a named tendon, muscle or joint area | No injection | Tendon and muscle pain | Usually self-pay |
| Platelet-rich plasma (PRP) | A high-dose concentrate of platelets and growth factors | A small sample of your own blood | Joint arthritis, tendon and ligament problems | Usually self-pay; Medicare covers PRP only for chronic diabetic wounds |
| Gen III Biologics (EXOCUBE) | Activated, concentrated platelet growth factors and plasma proteins (IL-1Ra, A2M) | A small sample of your own blood | Joint, tendon and muscle pain | Usually self-pay |
| Bone marrow aspirate concentrate (BMAC) | Marrow cells and proteins concentrated in the same visit; can be placed inside the bone | Bone marrow from the back of your pelvis, under local anesthetic | Annular, partial tendon, meniscus and labrum tears; bone marrow lesions in more advanced arthritis | Usually self-pay |
| Microfragmented fat (MFAT) | Your own fat tissue, minimally processed | A small fat harvest under local anesthetic | Larger joints, several joints, larger tears (with a surgical opinion) | Usually self-pay |
| Cortisone injection | An anti-inflammatory steroid for short-term relief | Medication | Flare-ups of joint and tendon pain | Usually covered when medically necessary |
In-depth guides
What to expect
Consultation
Your physician reviews your symptoms, exam and any MRI or X-ray, and tells you whether regenerative treatment is a reasonable option or whether something else would serve you better.
Plan and price
You get a written plan: which treatment, how many injections, and the price, before anything is scheduled.
Treatment day
A blood draw for PRP, or a bone marrow draw under local anesthetic for BMC. The concentrate is prepared and placed with ultrasound or X-ray guidance. Most visits take one to two hours.
Recovery and rehab
Most people return to light activity within days. Our physical therapists, in the same buildings, guide the rehab that helps the treatment work.
Follow-up
We check your progress over the following weeks, because change after PRP or BMC is gradual.
Why patients choose us
Candidacy comes first
If a treatment isn't likely to help you, we say so, and we explain the other options.
Image-guided injections
Ultrasound or X-ray guidance places the treatment exactly where it's needed.
Care under one roof
Pain management, physical therapy and spine care share our buildings, so your plan doesn't stop at the injection.
Car accident and work injuries
We work with Michigan auto no-fault and workers' compensation claims.
What the research says
Results vary by condition and by person. The evidence for PRP is strongest for knee osteoarthritis and some long-standing tendon problems, but guidelines disagree: AAPM&R guidance supports PRP for knee arthritis after standard treatment hasn't worked, while the American College of Rheumatology and OARSI (2019) recommend against it. Concentrated platelet products, bone marrow and fat-based treatments are newer and still being studied, and manufacturer laboratory data doesn't show how well a treatment works for patients. The FDA has not approved these injections to treat specific conditions, and we won't promise a result.
Where we see patients
Dearborn
13530 Michigan Ave, Suite 120, Dearborn, MI 48126(248) 771-1300Mon–Fri 8:30 am–4:30 pmLocation detailsSterling Heights · 15 Mile
5456 15 Mile Rd, Suite 101, Sterling Heights, MI 48310(586) 799-3525Mon–Fri 8:30 am–4:30 pmLocation detailsFarmington Hills Opening soon
30840 Northwestern Hwy, Suite 400, Farmington Hills, MI 48334
Common questions
How long does a PRP appointment take?
Usually about an hour, including the blood draw, preparing the platelets and the image-guided injection. Bone marrow treatment takes longer because of the marrow draw.
How many injections will I need?
Many people need one to three PRP injections a few weeks apart. Your physician recommends a number for your condition and includes it in your written price.
When will I notice a difference?
Change is gradual. People who respond usually notice it over several weeks, and it can keep improving for a few months.
Is there downtime?
Most people return to light activity within a few days. You may be sore at the injection site for a short time, and your physician may ask you to avoid hard exercise while you heal.
Do I need to stop any medicines?
Some medicines, often anti-inflammatories, can affect how platelets work. Your physician will tell you what to pause and when. Don't stop a prescribed medicine on your own.
Is PRP covered by insurance?
Usually not. Medicare covers PRP nationally only for chronic non-healing diabetic wounds, and most private plans don't cover it for joints or tendons. Michigan auto no-fault insurance may cover it after a crash when it's reasonably necessary. We give you a written price first.
Is stem cell therapy FDA-approved for joint pain?
No. The FDA has approved stem cell products only for certain blood and immune disorders. We use bone marrow concentrate from your own body, and your physician reviews the evidence, the cost and other options with you first.
PRP or cortisone: which is better?
They do different things. Cortisone calms inflammation quickly, but relief is usually temporary and repeated shots aren't advised for some joints. PRP aims to support healing and works more slowly. Your physician will recommend what fits your condition.
What is Gen III Biologics?
A blood product prepared with the EXOCUBE system: the platelets are activated before the injection so they release their growth factors, debris is removed, and the plasma proteins are concentrated. It's made from your own blood in about 30 to 60 minutes. Whether it suits you is decided at your consultation.
Is EXOCUBE FDA-approved for joint pain?
No. EXOCUBE is FDA-cleared as a device for preparing platelet-rich plasma from your own blood. The FDA hasn't approved PRP or other blood, marrow or fat-based injections to treat specific joint, tendon or spine conditions.
