Regenerative medicine, which makes use of the body’s natural healing capacity, is one of the fastest growing areas of medicine and considered by many to be the next great frontier in healthcare. Cell therapy, and especially stem cell therapy, accounts for more than 60% of the regenerative market. At Rejuvé, we have been using these minimally invasive treatments to help bring patients relief from joint pain. Keep reading to learn more about this exciting new area in medicine!
How do stem cells work?
Stem cells are incredibly powerful. Unlike other cells, they are unspecialized. Introduced into different kinds of tissue, stem cells have the ability to develop into specialized cells (like cartilage, ligament, collagen, bone, and muscle) in order to replace damaged cells. They can divide virtually forever, too; rather than simply transforming into the needed type of cell, one stem cell can give rise to many new cells. Stem cells are extremely important in early development, when the different parts of the body are being created, plus they supply a continuous stream of replacement parts. Stem cells help replace cells lost or damaged due to injury, disease, or overuse throughout your life.
Adult stem cells — which are taken directly from the patient they will be used on — are now used in procedures in a wide array of fields, including cardiology, dermatology, oncology, and optometry. Physicians and scientists are still learning how stem cells work, and research is ongoing. There’s tremendous optimism: Some believe that in the near future, procedures like knee replacements may be rendered obsolete by stem cell therapy. Knee replacement or knee surgery (for example, to repair tears in the ligaments or lost cartilage) is invasive and requires a lengthy recovery period with extensive physical therapy. Stem cell therapy could potentially treat the same kinds of conditions, but with a simple outpatient procedure.
What kinds of conditions can be treated with adult stem cells?
At Rejuvé, we have begun using stem cell procedures to treat knee pain that comes from acute conditions (like injuries) as well as degenerative conditions (like osteoarthritis) that impact the meniscus, cartilage in the knee, the ACL, or the MCL. These kinds of conditions are often treated with arthroscopic knee surgery, which is why non-surgical treatment with stem cells is so appealing. Conditions that can potentially benefit from treatment with adult stem cells include arthritis, Baker’s cyst, patellar tendonitis, patellofemoral syndrome (chondomalacia), pes anersine bursitis, and sprains or tears of the MCL, ACL, PCL, or LCL.
What research is there about stem cell treatments for the knee?
Compared to other areas of medicine, the use of stem cells is still in its infancy. Though physicians and healers have long sought ways for the body to heal itself, cell therapy is not even 40 years old. Much of the research that’s being done is still in progress, but there are some promising studies that have been completed which look at using adult stem cells to treat knee injuries and conditions.
A study in published in the Journal of Bone and Joint Surgery used a randomized, placebo-controlled, and double-blinded methodology to look at the use of allogeneic stem cells (cells taken from another adult rather than from the patient) after surgery that removed part of the knee’s meniscus. Patients in the treatment groups received varying concentrations of stem cells, while those in the control group were injected with sodium hyaluronate. The researchers and the patients did not at any time during the study know which patients were in which group. MRIs and physical exams were used to track the patients’ progress at 6 weeks, 6 months, 1 year, and 2 years. At the completion of the study, the patients who had received stem cells were found to have had a greater increase in regenerated meniscus tissue and reported less pain than those in the placebo group. There also were not any adverse side effects reported in the treatment group.
Another study, published in the Journal of the Indian Medical Association, looked at outcomes for patients suffering from mild to moderate osteoarthritis that had undergone arthroscopic knee surgery. In this study, the treatment group received mesenchymal stem cells (stem cells found in the circulatory and lymphatic systems that can develop into bone, cartilage, and other connective tissues) in addition to the arthroscopic debridement. The control group patients were treated with surgery alone. Based on patient report during follow-up visits, those who had received the stem cell therapy had less pain and an improved quality of life compared to the control group.
A peer-reviewed study from clinicians in South Korea followed outcomes for 30 elderly patients suffering from osteoarthritis of the knee for two years following treatment. In this research, all of the patients received treatment with adipose-derived stem cells in addition to arthroscopic surgery. Some of the patients (16 in total) also had their knees examined again with arthroscopy. Nearly all of the patients experienced less pain and improved their physical function. Perhaps the most interesting finding from this study was that patients not only showed improvement from the time of treatment to when they were followed up with one year later — they also improved from that one-year follow-up, showing additional improvement when the researchers checked in with them at two years. Though there was not a control group for comparison, this study is notable for demonstrating via arthroscopy that patients maintained or improved the amount of cartilage in their knees.
How are adult stem cells harvested?
With the procedures that we use, adult stem cells are harvested from your body’s own fat (adipose) tissue. A small amount of fat (60cc) is taken from your stomach, and mixed with platelet-rich plasma (PRP) created using a sample of your blood. Platelets are the component of your blood that help to repair damage; PRP is blood that has been separated to leave just the platelets and plasma. The stem cells and healing PRP that are used are all autologous (from your own body), so there’s much less chance of rejection or reaction than there is with animal-derived cells. The PRP is also used to keep the stem cells alive during the transfer. The adipose-derived cells and PRP are injected directly at the site of injury or damage, introducing the stem cells directly to the cells that they are meant to replace.
What happens during stem cell therapy?
Unlike with knee surgery, stem cell therapy can be performed as an outpatient procedure, with the entire process taking less than four hours. Prior to beginning, the area where the fat cells will be removed from can be injected with a local anesthetic to minimize bruising and discomfort. A tiny incision is made so that a narrow surgical instrument (cannula) can be used to remove 60 ccs (about 6 tablespoons) of fat. The fat tissue is then processed to retrieve the stem cells. A small sample of blood (45 ccs) is also drawn and then processed to create PRP. When the adipose-derived stem cells and PRP are prepared, the stem cells are suspended in the PRP and the mixture is injected directly into the affected area.
Am I a candidate for stem cell therapy?
Though this treatment can potentially help people suffering from pain in the knee or in other joints that is linked to a variety of causes, it’s important to remember that every patient is different. To learn more about whether adipose-derived stem cell therapy could help you, schedule a one-on-one consultation to review your symptoms and medical history with Dr. Tang. Ready to get started? Call Rejuvé today at 408-740-5320.
