StemCell Therapy

Are you suffering from chronicjoint pain? If so, you may want to ask your doctor whetherstem cellinjections are right for you. If you want to avoid the surgical route of repairing a damaged knee or treating an arthritic shoulder, a stem cell injection may give you the relief you need.

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Stem cells are specialtypes of cells with the ability to self-renew or multiply. They have the potential to replicate any cell in your body. In other words, they canbecome a cartilage cell, a muscle cell or a nerve cell, says orthopedic surgeonAnthony Miniaci, MD.

They have a tremendous capacity to differentiate and form different tissues, so thats the thought behind regenerating cartilage, regenerating nerve cells and healing any injured tissues, he says.

The source of stem cells isfound in your own bone marrow orfat or you can also receive stem cells from donor sources, particularlyamniotic sourcessuch as the placenta or the amniotic fluid and lining surrounding a fetus. These cells are not part of the embryo, Dr. Miniaci says.

The number of stem cells that you have and theirquality and activity diminish as you get older, he says. Amniotic stem cells, on the other hand, are from young tissue, so theoretically these are younger, more active cells.

Thetreatment team harvests stem cells from your bone marrow or fat or uses donor cells . Later on, your treatment team injects the cells preciselyinto your joint, ligament or tendon.

Theoretically, the cells will then divide and duplicate themselves and develop into different types of cells depending on the location into which they have been injected. For example, if you have damagedknee cartilage, stem cells placed near the damaged cartilage can develop into new cartilage tissue.

However, for patients with asevere loss of cartilageor no cartilage at all, a stem cell injection is unlikely to createa new joint, Dr. Miniaci says.

Severe loss of cartilage typically leads to bone erosion or bone deformity, so a stem cell injection is highly unlikely to work in terms of reversing those changes, he says.

It can, however, improve your symptoms of pain and swelling.

The earlier you can treat someones joint pain, the better chance this has of working, making it less painful for thepatient, less inflamed, and improve their function, he says.

The main risk from a stem cell injection is in harvesting the stem cells. When taking the cells from your bone marrow, the treatment team inserts a large needle into your pelvis and removes some blood and the cells.

Any time you make incisions or insert sharp instrument into somebodys pelvis, they can have problems such as acquiring an infection, Dr. Miniaci says.

If youre taking the stem cells from fat, you you can remove some out from under the skin, he says. Again, you have a risk for an infection because were making little nicks into the skin to get to the fat.

While the use of stem cell injections to treatjoint painholds much promise, Dr. Miniaci cautions that this treatment option is still very new. Researchers needto study its effectiveness further.

We dont have a lot of data or proof indicating that stem cell injections actually repair the joint, he says.

He explains that if you have cartilage orbone damage, stem cells candifferentiate and produce bone and cartilage and tissues. So, theoretically, they could heal damaged tissue within a muscle, tendon, bone or cartilage.

Thats the theory behind it, but this type of treatment and research is just in its infancy, he says.

We really dont know whats effective, whats not effective, how many cells are necessary, how many actual injections you need and how often, he says. Nobody knows how well it works yet. But we will eventually.

Anecdotally, Dr. Miniaci finds that some patients can have significant improvement in their symptoms with stem cellinjections. But he has not seen any proof yet that they are regrowing or regenerating a joint.

Many people think that theyre going to come in with their arthritic joint and leave with a newer version of their knee joint. That doesnt happen, he says.

What does occur is a biological reaction which makes the environment in their joints a little healthier, which probably makes it less inflamed, and as result, gives them less pain.

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