Regenokine is an anti-inflammatory treatment for joint pain and inflammation. The procedure injects beneficial proteins collected from your blood into your affected joints.

Dr. Peter Wehling, a German spinal surgeon, developed the treatment. It’s been approved for use in Germany. Many prominent athletes, including Alex Rodriguez and Kobe Bryant, have traveled to Germany for Regenokine treatment and reported that it relieves pain.

Although Regenokine is not yet approved by the Food and Drug Administration (FDA), it’s used off-label at three sites in the United States that are licensed by Wehling.

In this article, we review what the Regenokine procedure is like, how it differs from platelet-rich plasma injections (PRP), and how effective it is for pain relief.

In his early development of Regenokine, Wehling successfully treated Arabian horses that had experienced joint injuries. After continuing his research with humans, Wehling’s formulation was approved for human use in Germany. Despite this, the treatment is still considered unproven.

The procedure concentrates the proteins in your blood that fight inflammation and promote regeneration. These are processed into a serum that is injected back into the affected joint.

Before the procedure, a Regenokine specialist will work with your doctor to determine whether you’re a good candidate for this treatment. They’ll make their determination by examining your standard blood work and imaging scans of your injury.

If you get the go-ahead, here’s what to expect during the procedure:

Your blood will be drawn

A healthcare professional will draw some blood from your arm. This takes just a few minutes.

Your blood will be processed

A healthcare professional will place the blood in a centrifuge, which is a machine that spins very fast and can separate different blood components.

In some cases, they might also add certain proteins to the blood.

According to Dr. Jana Wehling, an orthopedist and trauma specialist who works with her father at the Regenokine clinic in Dusseldorf, Germany, “Additions to the serum include recombinant proteins like IL-1 Ra, local anesthetics, or low dose cortisone.”

The treated sample is then frozen and put into syringes for injection.

Your blood will be reinjected into the affected joint

The newly created serum is injected into your joint. Your doctor may use ultrasound as an imaging aid to position the injection site accurately.

No recovery downtime needed

There’s no downtime following the procedure. You’ll be able to resume your activities immediately after the reinjection.

The time it takes for you to feel relief from pain and swelling varies by individual.

According to Peter Wehling, the treated Regenokine serum has up to 10,000 times the normal concentration of anti-inflammatory protein. This protein, known as interleukin-1 receptor antagonist (IL-1 Ra), blocks its inflammation-causing counterpart, interleukin 1.

Dr. Christopher Evans, director of the Rehabilitation Medicine Research Center at the Mayo Clinic, explained it this way: “The ‘bad interleukin,’ interleukin 1, combines with a specific receptor on the surface of the cell that responds to it. It docks there. And after that, all sorts of bad things happen.

“The good interleukin is the interleukin-1 receptor antagonist material. This blocks the (cell’s) receptor. The cell doesn’t see the interleukin-1, because it’s blocked, and therefore, bad things don’t happen.”

It’s thought that IL-1 Ra may also counteract the substances that lead to cartilage and tissue breakdown and osteoarthritis. However, research has not proven this.

While the proponents of Regenokine claim that it is effective, there are no large, high quality studies confirming just how effective it is. It’s important to bear in mind that it is not yet a proven treatment.

The Wehling clinic’s material states that they consider the Regenokine treatment successful when a patient’s pain or functioning improves by 50 percent. They use standard questionnaires for people who have the treatment to rate its effect.

The clinic claims that about 75 percent of people with mild to moderate knee osteoarthritis and pain will have success with the treatment.

U.S. doctors licensed to use Regenokine have a similar success rate. It’s been shown to postpone the need for a joint replacement or to completely avoid the need for a joint replacement in some people.

Why doesn’t Regenokine work for everyone?

We asked Evans, who worked with Peter Wehling early in his research, why Regenokine works for most people but not for everyone. Here’s what he said:

“Osteoarthritis isn’t one homogeneous disease. It comes in many variations, and it’s probable that there are various subtypes, some of which will respond, and some not. Dr. Wehling developed an algorithm for this using various components of the patient’s DNA. People with certain DNA sequences were predicted to be better responders.”

Dr. Thomas Buchheit, MD, CIPS, director of Regenerative Pain Therapies at Duke University — one of the three sites in the United States that are licensed to use the serum developed by Wehling — also noted, “We see the best outcomes with folks who have mild to moderate arthritis, not bone on bone.”

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What the studies say

Small studies have looked at the Regenokine treatment, also referred to as autologous conditioned serum (ACS), for joint pain. Some compare it to other treatments, while other studies look at specific joints.

It’s important to note that many of these studies are small, and most are not double-blind randomized trials. To get FDA approval, more large, randomized control trials are needed to prove that the treatment actually works.

Here are a few recent studies. It’s important to note that these are small, not double-blind, and have no control group, so they are not considered high quality research.

  • A 2020 study involving 123 people with osteoarthritis compared ACS to PRP, a similar treatment. The study found that the ACS treatment was effective and “biochemically superior to PRP.” The people who received ACS had significantly better pain reduction and function improvement than those who had PRP.
  • A 2018 study involving 28 people with knee or hip osteoarthritis found that the ACS treatment produced “a rapid decline in pain” and an increase in range of motion.
  • A 2020 research review of regenerative pain medicine compared Regenokine with other regenerative treatments. It indicated that ACS “reduces pain and joint damage in arthritis.”
  • A 2017 study involving 47 people receiving meniscus lesion treatment found that ACS produced significant structural improvements after 6 months. As a result, surgery was avoided in 83% of the diagnoses.
  • A 2015 study of 118 osteoarthritic knees treated with ACS found a rapid improvement in pain sustained for the 2 years of the study. Only one person received a knee replacement during the study.

PRP therapy involves medical professionals drawing your blood, processing it to increase the concentration of platelets, and then reinjecting it into an affected area.

Your blood is run through a centrifuge to concentrate platelets, but it’s not filtered. It’s thought that the higher concentration of platelets helps speed healing of the area by releasing necessary growth factors.

Regenokine uses a standardized processing regimen

Like Regenokine, PRP is a biologic therapy. But Regenokine has a standardized processing regimen, with no discrepancies in the formulation, says Jana Wehling.

In contrast, PRP is prepared individually with different methods. This makes it difficult to compare treatments in scientific studies because the PRP formulation varies.

Regenokine removes blood cells and other potentially inflammatory ingredients

Unlike Regenokine, PRP is not cell-free. It contains white blood cells and other parts of the blood that may cause inflammation and pain when injected. In contrast, Regenokine is purified.

According to many experts, the safety of Regenokine isn’t in question, according to many experts. There are no reports of adverse effects in the existing research.

FDA approval is needed to have Regenokine used in the United States because the reinjection of your treated blood sample is considered to be a drug. This requires a wide range of studies and millions of dollars to support the research.

Regenokine treatments are costly, about $1,000–$3,000 per injection.

A full series on average has four to five injections. The price also varies according to the body region treated and its complexity. For example, Jana Wehling said, in the spine “we inject into many joints and surrounding nerves during one session.”

Not covered by insurance in the United States

In the United States, Regenokine is used off-label by licensed affiliates of Peter Wehling. The pricing follows that of Wehling’s practice in Dusseldorf, Germany, and the treatment isn’t covered by insurance.

Orthopedic surgeon Dr. Laura Timmerman says that she charges $10,000 for the injection series for the first joint but half that amount for the second or subsequent joints. She also notes that one blood draw may give you several vials of serum that can be frozen for later use.

Each treatment plan is “custom-tailored” to the individual’s needs, according to Jana Wehling. Other factors may affect the cost, such as “the type and severity of disease, individual pain situation, clinical complaints, and comorbidities (preexisting illnesses).”

Whether Regenokine needs to be repeated varies by individual and by the severity of your condition. Peter Wehling estimates that relief for knee and hip arthritis can last between 1 and 5 years. People who respond well to the treatment usually repeat it every 2–4 years.

Regenokine is a treatment for joint pain and inflammation. The procedure requires processing your own blood to concentrate beneficial proteins and then injecting the treated blood into the affected area.

Regenokine is approved for use in Germany, where Dr. Peter Wehling developed it, but it does not yet have FDA approval in the United States. It’s used off-label at three sites in the United States that are licensed by Wehling.

The possible benefits should be weighed against the high price point of this treatment. If you want to avoid surgery, you can consider trying other alternative treatments while awaiting further research.