Orthokine is an experimental medical procedure in which a patient's own blood is extracted, manipulated, and then reintroduced to the body as an anti-inflammatory drug to reduce chronic pain and osteoarthritis.
Known in the United States as Regenokine, the process removes about two US fluid ounces (59 ml) of blood from a patient's arm, which is then incubated at a slightly raised temperature.
The liquid is then placed in a centrifuge until its constituent parts are separated. The middle yellowish layer is dense with agents that are believed to stop an arthritic agent known as interleukin-1, which causes degeneration of the joints and the breakdown of cartilage.
That serum is injected into the patient's affected area. The procedure reduces pain and discomfort in the joint. The treatment generally lasts five days, with six shots of the serum into the affected area. It is normal for a patient to receive annual injections to ease the joint discomfort.
Orthokine is a patented method developed by molecular biologist Dr. Julio Reinecke and Dr. Peter Wehling, a spinal surgeon in Düsseldorf, Germany.
A two-year study of osteoarthritis of the knee, published in the medical journal Osteoarthritis and Cartilage, confirmed the safety and effectiveness of the therapy.
Orthokine is less invasive than most, if not all, other forms of knee surgeries available.
It focuses on treating the inflammation as opposed to mechanical problems in the joints. Orthokine was first approved for widespread use in Germany in 2003. Most patients have reported positive results.
Orthokine differs from a similar procedure with platelet-rich plasma (PRP), where platelets are targeted instead of the interleukin antagonist. Platelets are thought to speed the healing process. Also, PRP does not require the blood to be heated as Orthokine does. The heating increases the anti-inflammatory proteins as much as 100 times.
As of August 2012, about 60,000 patients worldwide have received the treatment. Americans have traveled to Germany for the treatment, which has not been approved by the U.S. Food and Drug Administration (FDA).
Two offices, one in New York and another in Los Angeles, have licenses to provide a similar treatment, but they cannot advertise due to the lack of FDA approval. Dr. Freddie Fu, a professor of orthopedic surgery at the University of Pittsburgh, said more high-quality independent trials proving the procedure's effectiveness are needed before the FDA approves.
Wehling said the procedure has a 75% success rate and follows all regulations set by the World Anti-Doping Agency.
National Basketball Association star Kobe Bryant, who traveled to Germany to have the procedure performed by Wehling, is one famous case based on his recovery from his previously poor knees. Some basketball fans refer to the procedure as the "Kobe Procedure."
The procedure cost €6,000 (about $7,400) as of July 2012. The treatment is not covered by health insurance.
Chris Renna, a preventive medicine specialist who has referred American patients to Wehling since 2003, said that "because of its expense and status, the treatment is for the one and two percent of our society."
People who have received treatment
Orthokine is sometimes referred to as the "Kobe Procedure" after Kobe Bryant.
Gilbert Arenas, former NBA guard
Lindsey Berg, volleyball player
Andrew Bogut, NBA center
Sidney Rice, NFL wide receiver
Kobe Bryant, NBA guard
Andrew Bynum, NBA center
Gosder Cherilus, NFL offensive tackle
Adam Cooney, Australian rules football player
Fred Couples, golfer
Ari Emanuel, talent agent
Brent Guerra, Australian rules football player
Grant Hill, retired NBA guard
Jeff Kwatinetz, entertainment production company president
Tracy McGrady, NBA guard/forward
Greg Oden, NBA center
Jermaine O'Neal, NBA forward/center
Pope John Paul II, former Pope
Nick Riewoldt, Australian rules football player
Alex Rodriguez, MLB third baseman/shortstop
Brandon Roy, NBA guard
Wes Short, Jr., golfer
Vijay Singh, golfer
Brian Urlacher, former NFL linebacker
Dana White, President of the UFC
Ryan Sheckler, pro skateboarder
Joe Rogan, professional actor, comedian and UFC commentater.