A Phoenix clinic visit starts with the sore joint

The Banner Estrella clinic is in west Phoenix

The Banner Estrella location is at 9305 W. Thomas Rd., Suite 460, Phoenix, AZ 85037. From downtown or Central Phoenix, take I-10 west to 91st Avenue and continue north to Thomas Road. From Maryvale or Estrella Village, Thomas Road runs directly west without a freeway.

The clinic phone is (602) 837-PAIN. Ask how long the first visit takes and whether a procedure may happen that day. If walking is hard, ask about the distance from your car. You can also find out whether someone may come with you.

Make sure you can manage the drive, walking, and full visit.

The first visit begins with an exam

Expect questions about the sore area and how the trouble began. The exam may cover sore spots, swelling, strength, and motion. Take earlier X-ray reports, your current medicines, and details about health problems affecting bleeding.

Name one daily activity that has become difficult. It might be shopping on foot, sleeping, or getting dressed. Use that same task to check later relief. Before discussing a procedure, ask what the exam showed.

Don't leave without knowing the likely cause of your soreness.

Clear questions make the procedure easier to understand

Ask exactly what the clinician plans to put into your joint. It might be prepared blood, marrow concentrate, medicine, or something else. Find out where it comes from and who prepares it. Ask who performs the procedure and what you may feel afterward. Also ask when you may return to daily movement.

For a marrow draw, a needle enters the pelvis bone near your lower back. Ask how sore that area may feel afterward. The letters PRP mean platelet-rich plasma. For PRP, the clinic runs your blood through a spinning machine to collect platelets. A needle then puts the prepared blood into the aching joint.

Before leaving, learn when progress will be checked and whom to call after hours.

Sources

1. The OARSI non-surgical management guideline evaluated 60 interventions with GRADE methodology and built its recommendations around core treatments - structured exercise, weight management and self-management education - for every patient with knee osteoarthritis, regardless of what else is added.

   Bannuru RR, et al. — OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage, 2019. DOI: 10.1016/j.joca.2019.06.011.

2. In a 480-patient, four-arm, multicenter randomized phase 2/3 trial, none of three orthobiologic cell injections - autologous bone marrow aspirate concentrate, autologous adipose stromal vascular fraction, or allogeneic umbilical cord tissue-derived mesenchymal stromal cells - was superior to any other, or to a corticosteroid injection control, on pain at 12 months.

   Mautner K, et al. — Cell-based versus corticosteroid injections for knee pain in osteoarthritis: a randomized phase 3 trial. Nat Med, 2023. DOI: 10.1038/s41591-023-02632-w.

3. FDA states in its consumer alert that the only FDA-approved stem cell products in the United States are blood-forming stem cells derived from umbilical cord blood, approved for disorders of the blood-forming system, and that NONE of these products - stem cells, stromal vascular fraction, umbilical cord blood, Wharton's jelly or amniotic fluid - has been approved for the treatment of any orthopedic condition, including osteoarthritis, tendonitis, disc disease, tennis elbow, back pain, hip pain, knee pain, neck pain or shoulder pain.

   US Food and Drug Administration, Center for Biologics Evaluation and Research — Consumer Alert on Regenerative Medicine Products Including Stem Cells and Exosomes. , 2020.

4. 21 CFR 1271.10(a) sets the four criteria a human cell or tissue product must meet to be regulated SOLELY under section 361 of the Public Health Service Act: it must be minimally manipulated; intended for homologous use only, as reflected by labeling and advertising; not combined with another article beyond water, crystalloids or a preserving agent; and either have no systemic effect and not depend on the metabolic activity of living cells, or else be for autologous use, use in a close blood relative, or reproductive use.

   US Code of Federal Regulations, Title 21 — 21 CFR 1271.10 - Are my HCT/P's regulated solely under section 361 of the PHS Act. , 2004.