NAMAD™ Procedure (Nanoplasty And Mechanical Axis Deviation)


The NAMAD® procedure enables tissues to naturally stimulate cartilage growth.  The stimulus for the algorithm was prompted initially by the work of Pridie at al. who performed drilling through the subchondral plate into the subchondral bone marrow, forming a type of cartilage called ‘fibrocartilage’ albeit with weakened mechanical properties.   The technique was later modified by Steadman et al. who enhanced the procedure further by removing the zone of calcified cartilage in the cartilage defect, followed by a microfracture technique using awls arthroscopically.  We have now further improved this procedure, taking a retrograde approach that does not violate the subchondral plate and given it our own name, the Nanoplastytm and Mechanical Axis Deviation Procedure, or NAMAD®.  The NAMAD® is a full clinical algorithm that restores mechanical stability and allows cartilage to regenerate in your joint.  Controversy exists about whether cartilage regenerates or not. It does and we’ve proven it using MR Cartigram® sequences from GE® Healthcare (Chicago, IL). 

Here’s what you need to know about what we do:

Step 1

Dr. Yeargan harvests the bone marrow. This is done with an instrument called the Jamshidi® which is carefully and painlessly inserted into the bone marrow of the iliac crest. We then concentrate that bone marrow which contains valuable cells.  We have developed a specific technique that maximizes cell capture and boosts total nucleated cell counts, which some authors have suggested may lead to a better clinical result with autologous marrow signaling cell transplants. At the same time, we harvest your clotting proteins, specifically factor 2 (Thrombin) that we use to ensure your injectate stays in the subchondral bone where it stimulates repair, regeneration and remodeling over the next two years.

Step 2

Dr. Yeargan then separates and isolates the bone marrow into basic constituents. He does this through isopycnic separation; by placing the bone marrow into a device called a centrifuge to spin it down and separating the cells from the valuable marrow plasma. He then collects the most viable layer of nucleated cells called the “Buffy Coat” (our viability rate exceeds 98% typically) where the signaling cells are found.

Step 3  

Dr. Yeargan decants the supernatant and passes the plasma fluid through a special nanometric- pore protein filter cartridge to capture anti-inflammatory molecules and eliminate pro-inflammatory molecules.  Importantly, we use an additional step that ensures capture of TSG-6, which is lost in all but our seventh-generation techniques.  

Step 4  

The signaling cells are placed into a fibrin scaffold derived from your own blood clotting proteins and injected into the bone beneath the cartilage where your arthritis started. Another concentrate of signaling cells and anti-inflammatory, immunomodulatory signaling proteins is placed directly into the knee joint at the same time with care taken to ensure direct delivery above and below the subchondral plate. 


The procedure takes approximately one hour and patients typically rest the day of the procedure and get back to work the next day if they desire although recovery is simple and easy.  Patients are seen at routine follow up intervals quite frequently at first and for five years total that is included in the cost of the procedure. There’s some fine-tuning to be done in most cases, but all of out patients say they think the cost is fair and have indicated they would have the procedure again.  

The procedure is not for everyone and there is indication criteria that must be met that depends on clinical and radiographic indices in addition to some general health concerns.  Most of our patients who elect to undergo the NAMAD®, have sought us out when their other orthopedic surgeon told them they were bone-on-bone and their only option was a total knee replacement.  We just have not found that to be the case. Approximately 80% of the patients we see with a TKA directive can be helped without this terminal surgery. Total knee replacement remains an excellent option in some patients. If you need a total knee replacement, our referral network includes only the best surgeons in the world and that’s what our patients typically demand. 



Since we wrote the first technique guide for the procedure we invented in 2006, more than 900 clinics in the United States have appeared that are primarily using our first and second generation techniques under the heading of regenerative medicine.  All of our procedures come from our own work and represent our own intellectual property. We are constantly reviewing our experience and the number of white papers we have published as a small, independent lab and clinic is staggering. Below you can find some of our original work and accolades in addition to links to useful FDA resources on biologics and gene therapy.  s to useful FDA resources on biologics and gene therapy.  


Put the PDFs for all of our original research here or have a link to every paper I’ve written on the web.  Use the title of the article for the ‘link wording’

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If you’re suffering from a joint injury, arthritis, joint pain, or a degenerative condition that isn’t getting better with traditional medicine approaches, there’s a reason.  It may be worth considering signaling cell transplant Nanoplastytm therapy (stem cell therapy). At The Regenerative Medicine Clinic, regenerative Austin Yeargan III MD, takes a simple and natural approach and offers signaling cell therapy to heal many musculoskeletal conditions. To learn more about immunobiologics and how it may benefit you, call the office in Wilmington, North Carolina, or click the online booking button. Telemedicine appointments are also available for consultations.

The ideal candidate for the procedure has moderate to advanced arthritis that primarily affects just one compartment of the joint, which is the majority of bow-legged patients that we see.  To test this, just stand with your ankles touching. If you have a space between your knees, you’re bow-legged and at risk for varus osteoarthritis. If you can’t get your ankles together, you’ve got knock-knees and are at risk for valgus osteoarthritis. 

We will work with you to determine which if any of our procedures suit your particular clinical condition and there is no charge for the initial consultation unless you elect to become a patient of ours.  Patients who are considered candidates for the procedure must have up to date labs and imaging and must meet certain general health criteria for inclusion. Not everone is a candidate for signaling cell transplant procedures for arthritis.  We’ll let you know if you’re not too. We’re about YOU. 100 percent.

Intra-articular signaling cell injections are for painful joints when the subchondral bone is not involved.  More often than not, it is, because it is where osteoarthritis starts. When the subchondral bone is involved, subchondral osseous Nanoplastytm is required to achieve long term restoration of bone material properties and enhance cartilage repair and regeneration. 

Signaling cell injections provide a non-invasive (non-surgical) treatment option, to provide long-lasting relief from chronic joint pain. The injections are performed under ultrasound or fluoroscopic guidance to ensure proper placement of the signaling (stem) cell concentrate.

These procedures can also be used for chronic tendonitis, some meniscal tears, muscle strains, ligament sprains, some cartilage injuries, limited rotator cuff tears and fractures that fail to heal.


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The Regenerative Medicine Clinic
5725 Oleander Drive, Suite E4
Wilmington, NC 28403
Phone: 910-769-7878
Fax: 910-769-8967
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