July 2019

Understanding Stem Cell Therapy

Author: John P. Batson, MD, FASCM

Stem cells exist in an undifferentiated state in our bodies. They are capable of dividing and renewing themselves over a long period of time. Also, in adults, stem cells can become other cells to aid in tissue healing, repair and regeneration. If you think about a cut in the skin, stem cells are largely responsible for the healing process for that tissue. They are signaled to become the cells needed at the site of damaged tissue. In addition, when we are growing, stem cells become specific cell types that are needed for growth during those years.

Stem cell therapy
The ability of stem cells to differentiate into other tissue has scientist and physicians excited about their potential to help with certain diseases. With arthritis in particular, damaged cartilage and bone in a joint causes pain and dysfunction. It is our hope that stem cells can be injected into joints with arthritis and help with this pain and dysfunction, ideally helping to heal some of the damaged tissue. For this process, we take stem cells from your own fat and/or bone marrow and then inject the stem cells in the joint of concern. This process is performed in the office and takes about an hour from start to finish. Thus far, stem cell therapy is most commonly used for knee, hip and shoulder arthritis.

Stem cell fact/fiction:
• Stem cell injections are not covered by insurance. True. These treatments are out-of-pocket expenses for patients. Insurance does not cover these injections.

• I am too old to use my stem cells. False. Your stem cells in adipose tissue (fat) and stem cells in the pelvis/spine are still healthy and have regenerative ability in your older years.

• Stem cell therapy will grow new cartilage and make my x-ray look normal. False. No studies have documented this. We have some initial studies showing stem cell therapy helped patients with pain and function. I know of a study also showing stem cell therapy slowed the progression of arthritis (over a short period of time).

• Tissue bank products contain live stem cells. False. Recently, there have been a number of health care providers advertising “stem cell” injections. These embryonic derived products (amniotic tissue, placenta tissue and umbilical tissue) are obtained from hospitals, freeze dried and then packaged to send across the country. Obviously, these products are obtained from a different individual. These are not “live” stem cells. Some of these products do contain growth factors, and these injections may help with pain. We can obtain these products to inject for patients in which there is a contraindication to using their own stem cells for a treatment. However, when we use your own stem cells for a treatment there is no risk of contamination and little to no risk of infection, which is always a concern with tissue bank products.

•Stem cell treatments are proven to help with arthritis and chronic pain. False. We have a growing number of studies that look favorable using stem cells for knee arthritis. Other joints with arthritis may respond favorably as well to stem cell injections. Time (and more studies) will tell.

What treatments are proven to help with knee arthritis?
There is no silver bullet that treats knee arthritis. As best possible, avoiding trauma to the joint can prevent arthritis. Maintaining a healthy weight can both prevent and treat pain due to arthritis. A nutritional plan high in antioxidants and low in saturated fat and refined sugars can help lower inflammation and arthritis symptoms.

Physical therapy and exercises to strengthen the muscles around the knee can help with arthritis pain and improve function. For pain flares, steroid injections can be used to treat the pain and inflammation. There is evidence as well for hyaluronic acid and platelet rich plasma (PRP) injections for knee arthritis. For severe knee arthritis, a knee replacement is also an effective treatment. A board-certified sports medicine or orthopedic physician is best suited to tailor the treatment for your particular condition. Stem cell therapy can certainly be included in the discussion, but some of the other listed treatments are more appropriate to start with in most patients. I am hopeful stem cell injections can bridge the gap for patients who do not respond to the basic treatments for arthritis but are not yet ready for a joint replacement. 

Dr. John Batson specializes in the evaluation and treatment of spine disorders (neck and back pain) and sports medicine. For more information, visit www.spineandsportmd.com.

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