What is stem cell therapy?
Stem cell therapy is a regenerative treatment (also known as regenerative medicine) intended for pain in the musculoskeletal system. The surprising impact of stem cell therapy makes it a reasonable treatment choice for an assortment of musculoskeletal ailments. Stem cell treatments are used to treat musculoskeletal injuries, meniscus tears, rotator cuff tears, knee osteoarthritis, and various other complaints.
This procedure can be remarkably effective. It can have a profound anti-inflammatory effect,which in turn increases the patient’s quality of life. In stem cell therapy, we harness stem cells to regenerate and repair tissues – but admittedly, the research is still looking at how much actual regeneration occurs. Instead of using pharmaceuticals, we use the body’s fundamental repair mechanisms and direct them to the site that needs the most attention. It is one of the more”natural”minimally invasive treatments in medicine.
How does stem cell therapy work?
Stem cell treatment is a rapidly evolving field! Every few months, more research is published about the role stem cells play in the body. The body has several different types of stem cells, and these are used to help our body replace cells as they are injured and die. Mesenchymal stem cells (MSC’s) are stem cells found in the bone marrow and can differentiate or turn into specialized tissue such as cartilage, bone cells, fat cells, and so on. There seem to be 3 primary ways for pain-related treatment in which “stem cells” help the body with musculoskeletal complaints.
- Weakened or malfunctioning cells often have damaged mitochondria – it does not seem to matter if this is from aging or injury. Mitochondria are the powerhouse of the cell. Research has demonstrated that stem cells can identify these damaged cells and transfer their healthy mitochondria to injured cells. Another example of the importance of the power of sufficient, healthy mitochondria is with the use of CoQ-10. This common supplement has been shown to help the heart work better in heart failure patients due to its impact on heart mitochondria.
- With a fresh injury, inflammation is a valuable part of recovery; it is vital. The body breaks down the damaged tissue and stimulates the repair of new tissue. In the case of arthritis or severe injury, the body cannotovercome these issues; this process goes into overdrive and becomes harmful. The White Blood Cells are coming into the area to “eat” the damaged tissue; unfortunately, they can keep going and continue to inflame and irritate joints, as we see in arthritis cases. Stem cells can calm down the white blood cell destruction of the joint. They can also release anti-inflammatory compounds to slow the calm the area down.
- Stem cells also release chemicals that will attract other necessary healing cells to come to the area. Cytokines, a way cells chemically communicate, bring in the right repair cells at the right time. Additionally, once these cells are in the area, they stimulate them and “motivate” them to work. In other words, stem cells are quite the taskmaster!
You may have noticed we have not mentioned injecting stem cells into the body to “regrow” tissue. This is an old and outdated model of how stem cells work. While this may happen in some cases, it seems the stem cells need to be cultured in a lab first, and this process is not done in the US. If someone is trying to tell you to get stem cell therapy to regrow your cartilage, run the other way – fast.
Where do we get the stem cells from?
For our applications, we extract the stem cells from one of two places: bone marrow and fat (adipose). Each site has its pros and cons, and, in some clinics, they will combine stem cells from both fat and bone marrow into one treatment! Bone marrow sounds scary, but it is a simple procedure with minimal discomfort. Usually, the bone marrow is harvested from the hip bone. The skin and bone are numbed up before the procedure, and it is usually well-tolerated.
The other site is from fat, usually fat around the abdomen. We call thislipoaspiration,and it is a form of liposuction, only without the vacuum extractor. The area is numbed, and fat is extracted with a syringe. This method is preferred in older patients and for treating an anatomical defect like a rotator cuff or meniscus tear. In older patients, research shows the fat may have high quantities and quality of stem cells. Some doctors also feel the adipose provides scaffolding in torn or damaged tissue to “hold” the stem cells in place so they don’t drift off.
What happens next?
After the cells are harvested, they are taken to a lab and processed under sterile conditions. The specimen is spun in a centrifuge to separate the stem cells from the red blood cells (and other cells). Then the sample is concentrated to maximize the number of stem cells in the final solution. Finally, the final product is ready, and it will be injected into the damaged tissue.
What Conditions Respond to Stem Cell Therapy?
Stem cell therapy is a successful treatment for many conditions due to aging as well as injuries! For example,knee arthritis, hip arthritis, shoulder arthritis, and other osteoarthritis forms often respond well to this treatment.
Soft tissue damage like rotator cuff tears, meniscal tears, torn labrum, and tendon and ligament sprains respond well to this treatment.
What about stem cell therapy for knee pain?
Orthobiologictreatment of knee pain most commonly uses stem cells from adult patients themselves by taking samples of bone marrow or fat tissue.These are known as autologous stem cells, meaning they come from your own body.
Some individuals are using frozen samples from umbilical cord stem cells. Sadly, I have found many of these physicians or other providers do not understand the science. They believe the unscrupulous peddlers of these products who tell them they are loaded with stem cells. That is not the case. The cells in these samples are dead. They are not living. It is illegal in the US to put cells or tissue from one body into another, except in exceptional, highly regulated cases like transplants and transfusions.
It needs to be noted these injections are not a total waste. They do have some of the cell signals discussed previously, and that will help boost some anti-inflammatory effects. There also seems to be emerging benefits from exosomes.
Who is a suitable candidate?
Patients experiencing any joint, ligament, or tendon pain might be considered as candidate’s regenerative stem cell therapy. Patients with end-stage severe degenerative osteoarthritis may not be the best candidates – but mild to moderate arthritis responds very well in most cases. As the first step, we have you schedule your first appointment with Dr. Dan Williamsin Carmel, Indianapolis, a suburb of Indianapolis, Indiana. At this visit, we will look at your specific situation, goals for treatment, other health problems and do a physical examination. Once we have the data, we need we will discuss with you our treatment recommendations. Our goal is to help as many patients as we can – but we never sacrifice our ethics. If we do not believe you are the best candidate, we will let you know. While we don’t have a crystal ball, we try to make sure each patient understands our best estimate of what kind of outcome to expect.
What are some examples of musculoskeletal treatments using stem cells?
Now stem cell therapy for musculoskeletal treatments is performed at research centers as a controlled clinical trial component. Stem cell therapy is being created to treat bone fractures and nonunions, recover articular ligament in arthritic joints and mend tendons or ligaments. These are explained below:
Bone fractures and nonunions: In bone, progenitor cells may give rise to osteoblasts, which become full mature bone cells, or osteocytes. Osteocytes are the living cells in adult bone tissue. Stem cells may stimulate bone development and promote the healing of harmed bone. Generally, bone defects have been treated with strong graft material set at the crack or nonunion site. Stem cells and progenitor cells are currently positioned alongside the bone unite to invigorate and speed the healing.
Articular cartilage: The covering of joints is known as the articular cartilage. Harm to the articular cartilage can often prompt degeneration of the joint and painful joint inflammation. Current procedures to treat articular ligament damage use grafting and transplantation of cartilage to fill the imperfections. It is trusted that stem cells will developimportant hyaline ligaments to reestablish the ordinary joint surface.
Ligaments and tendons: Mesenchymal stem cells may likewise form into cells that are explicit for connective tissue. This would permit quicker recuperating of tendon and ligament wounds, for example, quadriceps or Achilles ligament breaks. In this example, stem cells would be incorporated as a component of an essential repair process.
How long does this therapy take?
Yes. If you havean in-office stem cell therapy, the aspiration typically takes about 15 minutes. There are approximately 30 minutes of processing time to allow our team to identify the stem cells and PRP from your bone marrow. The injection after that into your diseased joints takes a minute. If you have this in conjunction with surgery, it is all performed while under anesthesia.
Am I awake during the stem cell therapy?
Yes. The area is numbed using a small needle. If preferred, you can bring a driver, and we can have you take a mild sedative medication before the procedure, similar to what some people do before visiting the dentist.
Medication limitations after the therapy?
We prefer you avoid anti-inflammatory medications (NSAIDs) such as Ibuprofen (Motrin, Advil), Naproxen (Aleve) for a total of at least 2 weeks before and ideally 3 months following the stem cell therapy.
References:
- Stem Cell Treatment for Knee Articular Cartilage Defects and Osteoarthritis (nih.gov)
- Introduction to Stem Cell Therapy (nih.gov)
- Stem Cell Therapy and Regenerative Medicine (nih.gov)
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Patients travel to this practice from as far as 2 hours away, from the cities listed here, and more:
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