Taliaferro, John

Update This article was updated on January 14, 2020, because of a previous error. On page 1, in the Abstract and the section entitled “Case Reports,” the word that had read “Genentech“ now reads “Genetech.” An erratum has been published: JBJS Case Connect. 2020 Feb 5;10(1):e0363ER. Case: The use of biologics is rapidly expanding. Over the past decade, there has been a significant increase in the number of cash-based “stem cell”/regenerative medicine clinics in the United States. These clinics provide cash-based services touting stem cell injections to cure a myriad of conditions. Largely, these clinics are unregulated and using injections in a non–Food and Drug Administration–approved manner. We report on 2 patients who presented with symptoms suggestive of septic arthritis following stem cell injections by cash-based local stem cell clinics. Case 1 involved a patient who developed septic arthritis following an injection of umbilical cord blood–derived cellular products (Genetech) and required an antibiotic spacer followed by a total hip arthroplasty. Case 2 involved a patient who developed a likely immune-mediated reaction following an injection of morselized human placental allograft tissue by a local chiropractic office at a cost of approximately $8,000. Conclusions: We present these cases to bring increased awareness to the issue and call for increased regulation of this practice.