Why Are Stem Cells Special
Stem cells are located throughout the body. What makes stem cells special is that they can:
How Does A Stem Cell Injection Reduce Knee Joint Pain
Though existing evidence strongly suggests stem cell treatments reduce knee joint pain and improve mobility, it is not yet clear why. But researchers believe that stem cell injection in the knee works by one or more of the following:
- Supporting cartilage regeneration
- Reducing inflammation that can worsen arthritis
- Releasing beneficial proteins called cytokines that protect cartilage and reduce pain
What Are We Seeing In This Image
Here is a patient with severe osteoarthritis on the inner portions of their knees. They also have knee instability on that same side. This means that the ligaments of the knees on that side can no longer hold the shin and thigh bones in their natural alignment. The two bones are now pressing against each other and have become bone on bone on the inner side surface.
Stem cell therapy will attempt to get into the bone on bone area and regrow cartilage. But the chances may be diminished if the knee instability is not addressed.
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Description Of The Intervention
Stem cells are specialised precursor cells which retain the ability to selfrenew, expand in number and develop into mature cells of a particular body tissue they can replace aged or damaged cells and thereby maintain the function of the organ or tissue in the adult .
A number of strategies currently exist for harvesting cells from adults that retain the potential to develop into cartilage and for optimising their function prior to inection into the osteoarthritic joint. Stem cells are harvested from various sites including bone marrow, fat tissue, peripheral blood, and the joint lining . The most commonly investigated cell type, the mesenchymal stem cell , is thought to give rise to all mature cells that produce cartilage, bone and fat tissue. However, recent evidence suggests that the in vitro behaviour of MSCs may not accurately reflect their biological role in the adult human joint, and that articular cartilage may in fact be derived from a separate stem cell population . MSCs accumulate in osteoarthritic joints and adjacent bone marrow lesions, which suggests that they may play a role in the response to joint injury or pathology, and that the regenerative function of native MSCs may be altered or inadequate in osteoarthritis .
Arthritis Of The Knee
Common symptoms of knee joint osteoarthritis include pain with activity, stiffness or swelling, loss of weight bearing capacity and loss of motion of the knee.Often times, the knee may feel like it is going to give out and falling does occur. Furthermore, treatment for Arthritis of the knee includes weight loss, activity modification, physical therapy, and medication.
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Stem Cells For Treating Bucket Handle Tears
A medial meniscus Tear: The Medial menisci can be found in the inner side of our knee joints. The torn medial meniscus diagnosis usually describes the severity of tear on the medial meniscus that is often caused by traumatic injury or sudden change of force or direction that occur in sports such as skiing, basketball, football, soccer, and volleyball. This type of injury can also occur due as a result of repetitive use injuries like long-distance running, track and field, and cycling along with long term degenerative knees in older patients. Stem cell therapies can treat medial meniscus tears and cartilage damage very efficiently and without the need for surgical intervention.
Complex Degenerative Meniscus Tears: Degenerative meniscus tears are most commonly found in middle-aged or elderly patients due to decades of repetitive stresses that have severely weakened the meniscal tissue. Unlike acute traumatic tears, Degenerative meniscus tears are not sudden and are more symptomatic. Common symptoms of degenerative meniscus tears include:
- Pain along the joint line
- Catching and locking
Why Is Stem Cell Therapy For Knees Important
With the growing power of regenerative medicine, more physicians are now able to offer affordable, cost-effective and most importantly long-lasting treatments that address pain in the short and long term. Stem cell therapy for knees carries with it the possibility to make knee joint pain obsolete.
Despite the promise of regenerative therapy, however, its still important to perform due diligence before making a decision. This requires understanding some facts about knee pain. These facts include what causes it, how stem cell therapy provides relief, how it works, and whos a good candidate.
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Stem Cells For Knees: Promising Treatment Or Hoax
Then the pain started, and the bad news. He had severe osteoarthritis, the ”wear-and-tear” type, in both knees. Doctors suggested surgery, but he chose instead an investigational treatment — injections of stem cells. Two months after the first treatment, he was out of pain. “I had been in pain of various degrees for 6 years,” he says.
Now, nine treatments and 3 years later, he is back to intense skiing. Last year, he also took up long-distance cycling, completed five double-century cycling rides, and earned the prestigious California Triple Crown cycling award.
Treatments with stem cells — which can grow into different types of cells — are booming in the U.S., with an estimated 500 or more clinics in operation. Some clinics offer treatment for conditions ranging from autism to multiple sclerosis to erectile dysfunction, often without scientific evidence to support how well they work.
Treatment for knee arthritis is especially popular. Itâs one type of osteoarthritis, which afflicts 30 million Americans. Fees vary, but $2,000 per treatment for knee arthritis is about average. Insurance companies usually deny coverage, although in rare cases they may cover it when done along with another, established procedure.
In another case, a patient who received stem cell injections after a stroke developed paralysis and needed radiation treatment.
Still, even doctors who offer the treatment for arthritic knees say more study is needed.
Study Design And Patients
This study is a phase I/II clinical trial with no active control conducted between March 2009 and September 2011 at SMGSNU Boramae Medical Center, Seoul, Korea. The protocol was approved by the institutional review board of our institute. All participants provided written informed consent.
The phase I study consisted of three doseescalation cohorts the low, mid, and highdose group with three patients each. Patients in each dose group received 1.0 × 107, 5.0 × 107, and 1.0 × 108 cells in 3 mL of saline, respectively. After three patients in each cohort were followed up for 28 days after injection, a safety review was done before moving to the next dose or phase . The phase II included nine patients receiving the highdose. Therefore, 18 patients were granted by the Korean Food and Drug Administration and were consecutively enrolled in the trial.
Eligible patients were between 18 and 75 years of age with idiopathic osteoarthritis of the knee of grade 2 or more according to KellgrenLawrence criteria and had an average pain intensity of grade 4 or more on a 10point visual analog scale for at least 4 months. Details of inclusion and exclusion criteria are listed in the Supporting Information Method 2.
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Stem Cell Treatment Vs Corticosteroid Injections For Knee Pain
How are you treating your knee pain? Is what youre doing working?
If you have osteoarthritis, a progressive type of knee arthritis, you probably know how challenging it can be to find a type of therapy that works. You may have worked your way through what feels like dozens of treatments, only to find your pain recurring.
Patients with osteoarthritis, also known as OA, usually start their treatment journeys with physical therapy , support devices, and lifestyle changes. Sometimes, dietary supplements and pain medications can also help.
But if these treatments are no longer controlling your pain or never worked to begin with your doctor may recommend surgery.
How Does Stem Cell Therapy Work
Although it may sound like an intensive procedure, stem cell therapy is relatively straightforward and usually minimally invasive. These days, physicians have many rich sources of adult stem cells, which they can harvest right from the patients own body. This obviates the need for embryonic stem cells, and thereby the need for moral arguments of yore.
Mesenchymal stem cells are one of the main types used by physicians in treating knee joint problems. These cells live in bone marrow, but increasing evidence shows they also exist in a range of other types of tissue. This means they can be found in places like fat and muscle. With a local anesthetic to control discomfort, doctors can draw a sample of tissue from the chosen site of the body. The patient usually doesnt feel pain even after the procedure. In some cases, the physician may choose to put the patient under mild anesthesia.
They then isolate the mesenchymal stem cells. Once they have great enough numbers, physicians use them to prepare stem cell injections. They insert a needle into the tissue of the knee and deliver the stem cells back into the area. This is where they will get to work rebuilding the damaged tissue. Although the mechanisms arent entirely clear, once inserted into a particular environment, mesenchymal stem cells exert positive therapeutics effects into the local tissue environment.
So, what can a patient reasonably expect when it comes to stem cell therapy, in terms of time and cost outlay?
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How Successful Is Stem Cell On Knees
The goal of stem cell therapy in the knee is to repair damaged cartilage as quickly as possible. A reduction in inflammation and pain can be beneficial. If you have a knee replacement, it is possible to postpone or prevent it from happening.
In the United States, stem cell treatments have grown in number, with 500 or more clinics available. There are 30 million Americans with osteoarthritis, and knee arthritis is the most common type of arthritis. The FDA is in the midst of a debate about whether to tighten regulations on stem cell clinics in the wake of reports of severe damage. Doctors inject stem cells from a patientâs bone marrow, fat tissue, or blood into their knee as part of the procedure. Joint stiffness and pain are the most common side effects after an injection. It is unknown whether stem cells act as a therapy to reduce inflammation or whether substances that harm other cells are released. Chung will continue to receive injections once or twice a year in order to stay active as long as possible. If a patient decides to obtain stem cells for any reason, the FDA recommends that he or she consult with their doctor about the risks and benefits. A typical stem cell treatment will be performed by an orthopedist, a plastic surgeon, a physical therapist, or a rehabilitation doctor.
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.
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.
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Some Biased Studies On Stem Cell Knee Replacement
Another meta kind of study in the British Journal of Sports Medicine identified potential challenges to many of the regenerative studies on knees. The issue is the risk of bias in many of the stem cell for knees studies. The authors conclude:
Six trials with high risk of bias showed level-3 or level-4 evidence in favour of stem cell injections in KOA. In the absence of high-level evidence, we do not recommend stem cell therapy for KOA.
I know that stem cell clinic doctors can find plenty of studies supposedly supporting what they are offering for knees, but the question is which studies are the strongest? Also, is there some coherent signal of benefit and safety rising above the noise overall? I didnt see it.
Arthritis Of The Knee And Hip Treatment Options Including Regenerative Therapy
Stem Cell therapy usually isnt a patients first thought when they are told they have arthritis of the knees or hips. After hearing about regenerative therapy and doing enough research, they start to understand what Stem Cells are and how they can benefit from the treatment. Most patients look into this treatment as an alternative to surgery.
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Top 10 Knee Exercises After A Prp Injection
In the first 5-7 days:
The goal is pain management, along with regaining range of motion as your bodys natural inflammatory response goes to work to begin the healing process. Ideally, you would do these exercises 2-3 times per day for 10-12 reps each. Use pain as your guide and gently complete each movement while avoiding forcing your knee into any of these positions. 3. Lateral kicks You will do this exercise on both sides.
*Use a kitchen counter or a wall for support as needed.
In weeks 2-3:
The goal is to start loading the joint once the pain is under control. It is important to make sure you are not overcompensating with your other leg on any of these exercises. We are looking to challenge your strength and balance in this stage. Both are extremely important for restoring optimal function. If you are having difficulty controlling your pain, continue the above exercises until you are able to find relief. Ideally, you would do these exercises at least once per day for 10-15 reps each. 6. Alternating cone taps You can use a cone-like in this video or you can simply find a household object to use as well.
In weeks 4+:
Once you have mastered the above exercises, without significant increases in pain, you can begin strengthening your knee. Ideally, you would do these exercises once per day for 8-12 reps each. Continue to listen to your body to avoid overdoing it. 8. Tandem dumbbell swings .
What To Expect After Treatment
Patients are often instructed to rest the injected area for a few days after either treatment, and soreness and some swelling is to be expected. A cold compress can be placed on the area to help with both of these issues. You should only take pain medications as prescribed by your doctor. Physical therapy and muscle exercises may be recommended to help maintain joint health.
If you have knee pain and want to see if platelet-rich plasma therapy or stem-cell injections can help you, book an appointment online or over the phone with Premier Spine and Sports Medicine today.
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How Do We Isolate Stem Cells
We aspirate them from fat by liposuction. Then we manipulate them by centrifuging. Then they are ready for injection.
Stem cell treatment for knee arthritis in India by Dr.A.K.Venkatachalam is done as an outpatient procedure. The patient can return home within a few hours. If spinal anesthesia is given, then discharge takes longer.
The cells can also be isolated like before and sent off to a tissue bank where they are cultured and stored. By this, their number is expanded to several million and they can be kept in cold storage for longer periods. Certain tissues have got a half-life but some tissues can be stored for a long time. Their potency decreases after one year. So when these cells are expanded, they can be returned to the doctor to be re-injected into the patient.
What Can A Stem Cell Injection Help With
Previously, people with joint pain and inflammation did not have many choices. Doctors might prescribe them anti-inflammatory medications or periodic steroid injections to promote healing and reduce pain. They might also administer hyaluronic acid injections or recommend physical therapy or surgery.
These treatments, unfortunately, are not that effective. Although they are not invasive, the results tend to fade with time.
The same is not true of stem cell procedures. Stem cells can help to resolve a range of medical conditions, including:
- Knee osteoarthritis
- Cartilage defects
The stem cells encourage the bodys own healing, as well as provide the building blocks for new tissue.
However, a stem cell injection may not work immediately, because it can take time for cells to exert their effects. In some cases, more than one injection is necessary. A physician may put their patient on a schedule or administer them one by one to see what works.
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What Is Stem Cell Therapy For Knee Pain
You may be wary of stem cells if youve heard about some of the controversy surrounding how theyre sourced. Its true that some kinds of stem cells are sourced from donated blastocysts that are just a few days old, but these kinds are not used for orthobiologic treatment.
Instead, orthobiologic therapy for knee pain most commonly uses stem cells from adult patients themselves by taking samples of bone marrow and other tissues.
During treatment, a doctor will take samples of stem cells from other parts of your body and reimplant them into an injured area. For knee pain, that may involve taking sample cells from bone marrow or fat tissue and injecting them into knee joints.
Your doctor will always discuss the source of your stem cells with you before starting treatment and will not inject you with any substance you do not consent to.