How Does Stem Cell Therapy For Knee Pain Provide Relief
Stem cells are the construction workers of the bodys repair mechanism.
The primary role of adult stem cells is to maintain healthy tissue and initiate the healing of damaged tissue by replenishing dying or damaged cells. When injected into your knee, stem cells find the damaged cartilage and have the potential to initiate its repair or regeneration.
The process is natural and takes place in every tissue in our bodies. Stem cell repair is the primary healing mechanism present in the body. In tissues, such as knee joint cartilage and the anterior cruciate ligament , there is limited blood supply. This limited blood supply prevents adequate delivery of stem cells to the damaged tissue to initiate the bodys natural healing mechanism.
The delivery of a large volume of stem cells by injection can help initiate the healing response. Stem cell therapy can repair degenerative knee cartilage, partially torn tendons, and provide pain relief when conservative treatments had been unsuccessful.
Stem Cell Therapy for Torn Meniscus for a Skier from Florida
Individual patient results may vary. Please contact us today to find out if stem cell therapy may be able to help you.
Advantages Of Stem Cells Over Other Knee Pain Treatments
- Minimally invasive: Stem cell procedures are performed in an office-based procedure suite and cause minimal tissue damage.
- Quick return to daily activities: Stem cell knee patients return to work in 1-2 days and typically do not require bracing or crutches.
- Quick recovery time: Patients are able to increase activity levels within a few weeks and return to sports in 4-6 weeks.
- Natural: Stem cells come from your own body and they trigger the bodys natural healing mechanism.
- Cost efficient: Although stem cell therapy is not covered by insurance, the actual cost of the procedure is much less than that of invasive surgery and the price per joint can be further improved when the patient undergoes a stem cell procedure for more multiple areas in the same day. Furthermore, the quick recovery time means that stem cell patients miss fewer work days and have lower rehabilitation costs.
- Less medication: Stem cell therapy requires little, if any, postoperative use of pain medication.
Stem Cell Culturing And Injection
Once the MSCs are extracted they are then isolated and cultured to increase their concentration and potency. This process typically takes 7-14 days, however, if the initial extraction contains a low concentration, a longer culturing time could be required6. Once the concentration of stem cells is deemed adequate they can be prepared for an intra-articular injection. This is accomplished by inserting a needle deep into the joint while being guided by ultrasound or other imaging devices7. The stem cells are then released into the damaged area of the joint.
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How Stem Cell Therapy Can Help
Stem cell therapy also uses your body to heal itself. In this case, it uses adult stem cells extracted from bone marrow or fat. Stem cells are basic cells that can turn into any cells the body needs. Extracting them and injecting them into injured areas can speed healing.
Injections of stem cells can help reduce inflammation, repair damaged tissue, and may even help prevent knee replacement surgery.
First, some bone marrow or fat tissue is extracted with a needle. Then the stem cells are harvested from the tissue. Finally, the stem cells are injected into the injured area. The process can take up to an hour.
Stem Cell Therapy For Meniscus Damage Is There Validity To The Treatment
In the above research, we are suggesting that there are native stem cells in a knee, specifically, the meniscus is trying to repair. Red zone stem cells move to the white zone to help with repair, cartilage stem cells and meniscus stem cells are trying to work together to fix a bone-on-bone situation, the knee is always trying to heal. The problem is that there is too much damage and there is too much knee instability causing unnatural and destructive motion in the knee. The repair cannot hold. And again, this is why stem cell injections for a meniscus tear may not work. Stem cell therapy is trying to patch a hole while the whole knee is crumbling around it.
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Stem Cell Injections For Knee Arthritis
One of the primary effects of knee osteoarthritis is the degeneration of cartilage. Knee cartilage is crucial for normal joint function as it provides protective cushioning for the bony surfaces of the joint and stops them from coming into direct contact with one another. In many cases of moderate or severe osteoarthritis, the pain and disability associated with bone on bonecontact is an important factor in the decision to undergoknee replacement surgery. Stem cell injections for knee arthritis may one day provide patients with a less invasive alternative to the common surgical procedures used today. Not only can stem cells potentially help relieve pain caused by knee osteoarthritis, they may also be able to slow, or even reverse the degeneration of cartilage.
The Destructive Cartilage/meniscus Environment This Is Why Stem Cell Therapy Can Fail And It Also Explains Why Some Peoples Knees Still Hurt After Surgery
- The suggestion is that the meniscus was trying to heal itself while the knee environment was collapsing towards degenerative disease. We have new meniscus tissue at 6 weeks being crushed by progressive degenerative changes. This is like trying to build a new house during an earthquake.
The researchers in this study performed a meniscectomy in the mice. This gives us an understanding of what happens in the knee after a meniscectomy.
- The left anterior halves of the medial menisci in mice were removed. Then the mice were observed to see how their knee dealt with this injury.
- On day three: Extensive macrophagic infiltration into the synovial membrane around the meniscectomized area was observed.
- Explanation: macrophages are immune cells that clean up and remove the debris left behind by injury. The body is removing hindrances to healing. In other words, the knee is getting ready to heal.
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Stem Cell Treatment For Knees In London
With over half a million procedures undertaken, you’re in safe hands
If you have suffered a knee injury, you will know that recovery is far from a straightforward road. What may have been a one-time incident, can easily spiral into lifelong, reoccurring complications and issues causing pain and discomfort longterm. Besides ongoing physio and avoiding activities that you may have once performed with ease, it may feel that there is very little that can be done to turn back the clock on a weakened knee – but now, thanks to stem cell therapy, there is light at the end the tunnel.
Stem cell treatment for knee injury is an extremely powerful healer. This is because, on a biological level, it is able to restore a joint to its state prior to the offending injury by rebuilding the structures beneath.
Please Note: Whilst the clinic does offer stem cell treatments, no treatment is undertaken until the patient has been reviewed by a consultant and approval has been given by the specialist. Patients are informed throughout the process of the limitations of stem cell treatment and it is for the patient to make a final decision in conjunction with his or her consultant.
Dr Khan Says
Regenerative treatments are an option for people who may have already tried, or considered, conventional treatments. Research using stem cells with latest technology has shown promising results.
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Stem Cell Therapy Effectiveness
Whether or not stem cells therapy is effective in treating osteoarthritis is a controversial subject among medical professionals, and research in the area is ongoing.
How researchers think stem cell therapy worksResearchers theorize3 that when applied to an arthritic joint, stem cells might:
- Develop into needed cartilage cells
- Suppress inflammation that can make arthritis worse
- Release proteins that slow down cartilage degeneration and/or decrease pain
It may be none, one, two, or all three processes at are work.
Proponents vs criticsLike many relatively new treatments, stem cell therapy has proponents and critics.
- Proponents of stem cell therapy point to clinical studies that have shown generally positive results.1,3–5
- Critics do not believe stem cell therapy works any better than a placebo.
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Questions About Our Treatments
We hope you found this article informative and it helped answer many of the questions you may have surrounding these various injection treatments. Do you want to ask about treatment for your knees? If you have questions and want to know how we may be able to help you, please contact us and get help and information from our Caring Medical staff.
Brian Hutcheson, DC | Ross Hauser, MD | Danielle Steilen-Matias, PA-C
References:
1 Hauser RA, Orlofsky A. Regenerative injection therapy with whole bone marrow aspirate for degenerative joint disease: a case series. Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders. 2013 Jan 6:CMAMD-S10951. 2 Anz AW, Hubbard R, Rendos NK, Everts PA, Andrews JR, Hackel JG. Bone marrow aspirate concentrate is equivalent to platelet-rich plasma for the treatment of knee osteoarthritis at 1 year: a prospective, randomized trial. Orthopaedic journal of sports medicine. 2020 Feb 17 8:2325967119900958. 3 Shaw B, Darrow M, Derian A. Short-term outcomes in treatment of knee osteoarthritis with 4 bone marrow concentrate injections. Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders. 2018 Jun 14 11:1179544118781080.
This article was updated on May 12, 2021
How Does The Stem Cell Treatment Process Work
If you choose to undergo stem cell treatment for knee pain, you can rest assured that the process will be quite simple in comparison to other treatments for chronic knee problems, such as knee replacement.
To prepare for stem cell treatment, you’ll need to stop taking anti-inflammatory drugs at least two weeks prior to the day of your procedure. When you make an appointment with Dr. Gombera, you’ll receive more specific instructions.
There are two different ways to derive stem cells for your knee injections. First, your doctor can use stem cells from donated umbilical cord blood. In this case, the procedure may begin immediately. Alternately, your doctor can obtain adult stem cells from your own bone marrow.
If it’s necessary to retrieve stem cells from your bone marrow, your doctor will numb your hip and place a specialized needle into part of your hip bone called the iliac crest. Then, after extracting a small amount of marrow from the hip bone, your doctor will send the sample to the laboratory, where it will spin for 10 to 15 minutes until a concentrated sample can be produced.
Finally, your doctor will numb your affected knee and use detailed images as a guide to place the stem cells exactly where they’re needed to facilitate healing.
The whole stem cell injection process typically takes less than one hour, so you’ll be able to return home to Beamont or Cypress from Dr. Gombera’s Houston office on the very same day.
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How Does Prp Therapy Work
PRP is short for platelet-rich plasma. This powerful healing factor helps repair damaged parts of your body when you are injured, much like stem cell therapy does. However, this healing factor resides in your blood. Instead of extracting stem cells from your bone marrow or hip, we take a draw of blood and pull out the PRP. We then turn it into an injection and inject it into your knee to promote healing. PRP Therapy is also used sometimes for cosmetic purposes as the healing factors of PRP have been found to refresh someones youthful appearance. Instead of making your face look young again, we can restore the youthfulness of your knee and help it heal faster, reducing chronic pain.
How Are These Treatments Revolutionizing Arthritis Care
Both stem cells and PRP work in different ways to activate your body’s natural healing process. Prior to the availability of these treatments, a joint replacement might be one of your limited options. Stem cells and PRP are different because they can actually repair the joint without surgery.
When your doctor at Orthocenter injects stem cells and/or PRP into an arthritic joint, those cells signal to the body that it’s time to build new, healthier cells in the area.
Several studies support the power of stem cells to restore arthritic joints, including bone, tendons, ligaments, and cartilage. One study showed that cartilage thickness improves with treatment. Loss of cartilage is one of the reasons arthritis is so painful. Yet another study supported the finding of the first in increasing cartilage thickness through stem cell therapy. And a third study showed the same results.
A small but well-controlled study on 156 knees showed that PRP can reduce pain and stiffness in patients with knee osteoarthritis. Participants showed statistically significant improvement in both knees that lasted for about six months after which most participants needed a second treatment to maintain the results.
When stem cells and PRP are done together, however, a patient can expect longer-lasting results.
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The Healing Elements: A Brigade Of Natural Native Stem Cells In The Meniscus That Move From The Red Zone To The White Zone
- In September 2017, in the Journal of Orthopaedic Research, doctors at the University of Iowa, working with researchers from the Harvard Medical School and the National Institutes of Health, looked for the healing elements in the meniscus and identified what they do.
Lets remember that these healing elements live in the meniscus. If you remove the meniscus, you reduce or remove the healing elements.
In this study, the researchers found that the meniscus has its own brigade of stem cells or chondrogenic progenitor cells specifically in the blood-rich red zone of the meniscus. Further, the cells in the blood-rich zone could be called upon to migrate across the meniscus and appear at the site of a white zone injury.
- In essence, the injury is calling for help and the chondrogenic progenitor cells respond to begin the rebuilding process. The meniscus has its own damage control mechanism, it sits in the blood-rich portion of the meniscus. When the red zone meniscus is removed, the meniscus ability to heal itself is can be removed with it.
Research like this reaffirms two things:
The superior aspect of the left knee displaying both the red and white zones of the meniscus. The white zone reflects that part of the meniscus where the meniscus has no blood flow and limited healing capacity.
Amniotic Stem Cell Therapy
Amniotic therapy uses stem cells concentrated in the amniotic sac and has often been used in the treatment of knee pain. Types of arthritis pain this treatment helps are:
- Degenerative
- Meniscal
- Instability, IT Band Syndrome, and more
Amniotic therapy works in over 80% of patients. There is an extremely low-risk treatment and can help you avoid getting surgery so you can get back to living your life.
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General Patient Type : Chronic Problems From An Old Injury Such As A Sprain That Happened A Few Years Ago The Injury Never Really Healed Has Progressively Worsened Causing Pain Discomfort
- Injury has not responded long-term to more conservative care options such as NSAIDs, medications, cortisone, physical therapy
- Soft tissue damage continues, joint instability has become more permanent.
- In this patient, it may not be enough to attract your own cells to this damaged area with Prolotherapy, in this type of case we may have to put cells there, by injection. Our first option would be Platelet Rich Plasma Therapy . This would put the healing factors found in your blood platelets into the damaged joint.
- WE DO NOT offer PRP as a stand-alone treatment or injection. While PRP brings healing cells into the joint, it acts to repair degenerative damage. In our experience, while PRP addresses damage deep in the joint, we must still address the joint instability problem created around the joint. We do this with Prolotherapy. Here damaged or weakened ligaments that are simply stretched, can be strengthened with treatment to help restore and maintain normal joint mobility.
- Simple PRP on the inside, Prolotherapy on the outside of the joint.
More Research On Bone Marrow Concentrate Alone
Others have cited this research in their own studies. A February 2020 study in the Orthopaedic Journal of Sports Medicine cited our research as well as the work of many others in comparing which is better Platelet Rich Plasma or bone marrow concentrate?
In their findings, they observed: Both PRP and bone marrow concentrate were effective in improving patient-reported outcomes in patients with mild to moderate knee osteoarthritis for at least 12 months neither treatment provided a superior clinical benefit. . Autologous PRP and bone marrow concentrate showed promising clinical potential as therapeutic agents for the treatment of osteoarthritis, and while PRP has strong clinical evidence to support its efficacy, bone marrow concentrate has limited support. This study did not prove bone marrow concentrate to be superior to PRP.
Lets also note in this study that the participants received one injection of PRP and one injection of bone marrow concentrate. That was the extent of the treatment. Then the studys patients were asked at one, three, six, nine, and twelve months how did their knee feel? So this study compared one injection of each.
A 2018 paper published in the journal Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders also cited our published study.
In this study, more injections were given. Here is what these researchers wrote:
Here the study participants had four bone marrow concentrate treatments. They had
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