BROOMFIELD - There seems to be no end to projected stem-cell therapies today, with reports of cures for conditions ranging from diabetes and autism to heart and Alzheimer's disease.

But for common orthopedic conditions the leap from study to practice has arrived.

"It's a valid medical procedure right now," said Dr. Christopher J. Centeno, medical director of the Centeno-Schultz Integrative Pain Management Clinic, 403 Summit Blvd. in Broomfield.  Though, "We still accept some patients to research various methods - something you may want to tweak this way or that way."

For many patients with knee, back, shoulder or hip injuries that's great news. It can mean avoiding surgery and months of rehabilitation with a procedure that just requires a few needles of treatment and uses mesenchymal stem cells from their own bone marrow.

While the success rate will vary according to the severity of the orthopedic condition and the age and the health of the patient, it would appear that the practice is well on its way to widespread acceptance, and the Broomfield clinic is leading the charge.

"About 70 percent of our patients fly in for treatment," Centeno said. "About half of them are coming in from outside the country."

The clinic has treated about 450 orthopedic patients, giving it the largest patient database in the country, and Centeno recently tracked 227 of those patients in a follow-up reviewed study published in the Dec. 2 edition of Current Stem Cell Research and Therapy. The study, which used high-field MRIs to ascertain that none of the patients developed tumors from the treatment, is getting attention from around the world from fellow stem-cell researchers.

Of course, this follows an incredible amount of animal research. Centeno was drawn to literature five years ago discussing possible stem-cell treatment for lower back problems. That was a common and difficult condition to treat at his clinic, which still treats about 50 percent of its clients for pain relief.

"As of this morning, there are over 10,000 published papers," said Centeno of the stem-cell research in animal and human orthopedics.

At a superficial level - and perhaps for patients, as well - the practice known as the Regenexx Procedure seems almost too easy to be true. After a necessarily frank review of the orthopedic condition and the patient's health, the patient comes in and has local anesthesia applied via X-ray guidance for a bone marrow draw from the hip. In a Westminster lab, the stem cells are separated from the rest of the draw (about one in 10,000 or 50,000 cells is a mesenchymal stem cell that can generate the needed connective tissue) and then amplified to provide 10 or 100 times more stem cells for injection.

The patients come in about a month later and the stem cells are injected into the afflicted area, a process that is repeated two and three months after the bone marrow draw.  The stem cells themselves differentiate into the cells needed for reformation of various tissues, including cartilage, tendon, muscle and bone.

"The body is in constant need of repairing itself," Centeno noted. What's more amazing than the differentiation, he said, is the ability of the stem cells to direct other cells and their traffic needed to complete the healing, or what he calls the "Bob the Builder" factor.

"Their function goes beyond being the brick mason, the brick and the mortar. They are more like general contractors," he said. "They secrete growth factors, ... bring in big cells that clean up an area and secrete growth factors that build vessels that keep the nerve alive during healing. It's a pretty amazing deal."

The clinic has self-funded all of its research, and Centeno hopes insurance companies begin to look on the procedure as a pretty amazing deal, as well. Most therapies cost about $8,000.

The success rates are pretty closely aligned with existing surgeries. For a younger patient in good health with a meniscus tear in the knee the success rate (total rehabilitation) probably approaches 90 percent, Centeno said. But if a knee is completely blown or missing all cartilage the success rate could drop to 60 percent. Much of that reduction in success can depend on the void that needs to be filled, for instance, how completely a rotator cuff is torn, but a good deal depends on the patient's overall health.

That doesn't necessarily only mean age, however. For instance, when Dr. Joseph Maroon, the director of neurosurgery at the University of Pittsburgh, was told he needed a knee replacement, the 67-year-old triathlete immediately looked for an alternative and chose Regenexx.

"His knee's not perfect, but it's a lot better than it was," Centeno said. And it also allowed Maroon to finish his seventh Ironman Triathlon, something that would not have been possible with a knee replacement.

That's an important factor for many patients facing orthopedic surgery. Not only are the success rates sometimes less than attractive, but even successful surgeries can mean a loss of athletic function and months or more of rehab. Regenexx patients more often than not don't experience any down time, Centeno said, and keep their existing athletic ability.

The stem-cell procedure is also being examined for an addition to orthopedic surgery, especially because a significant loss of athletic ability is often due to muscle degeneration from the sutures of surgery. The Regenexx Procedure itself is under consideration for licensing at numerous clinics around the nation today, Centeno said.

The clinic, which has worked with researchers from both the University of Colorado and Colorado State University, continues to research new methodologies, including drawing stem cells from healthy knees, which may improve cartilage growth. The researchers have been prominent in bringing strict guidelines to stem-cell therapies, helping to create a reimplant registry and vigorously supporting the International Cellular Medicine Society.

"That allows us to work within a strict set of clinical and lab guidelines," Centeno said.