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Monday, November 23, 2015

Stem Cells for Arthritis

We've been getting quite a bit of questions lately about stem cell and Platelet Rich Plasma (PRP) injections for pain relief among many of our patients, including those with arthritis. As popular as these treatments have become, there are still a lot of inaccuracies about them - especially online.

Texas Orthopedics' own Dr. John McDonald has provided some important information to help shed some light on stem cell therapy.

Stem Cells for Focal Cartilage Potholes and Diffuse Osteoarthritis
There are multiple studies using animal models (pigs, sheep, dog, and rabbit) to evaluate the use of mesenchymal stem cells to treat focal cartilage defects. Nearly all of them found some improvement (often significant improvement) in cartilage regrowth. However, these stem cells are often embryonic or derived from a source (placenta) that we cannot use in the United States.

Clinical trails are limited in this country. The existing studies compare existing treatment options for cartilage defects (microfracture, autologous chondrocyte implantation) to those treatments and add stem cells to them. The results are essentially the same. There are currently a multi-center human randomized clinical trial comparing microfracture to arthroscopically obtained (from the fat pad in the knee) fat derived stem cells with no microfracture. Results are likely several years away.

Stem Cells for Arthritis
The best data about stem cells for arthritis comes from Asia. There are multiple studies that show injection of stem cells into an arthritic knee may induce new cartilage formation. These results were verified by surgical arthroscopy (with a camera) to look at the cartilage. Some caveats with the study: It took 100,000,000 fat derived stem cells in one injection to obtain these results and the number of patients treated was small (12). We don't have the ability to obtain this amount of fat derived stem cells in this country through simply harvesting from the fat pad in the knee.

The Bottom Line?
In summary, bone marrow derived and fat derived stem cells can be used to treat cartilage defects and arthritis due to an overwhelming amount of evidence of efficacy in animal models. However, human trials are lacking.

The field of orthopaedic biologics continues to evolve. We will update you as new, impactful research becomes available.

Click here for more information about stem cell therapy.

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