INTRA-ARTICULAR INJECTION OF MESENCHYMAL STEM CELLS
In recent years huge steps have been taken to improve tissue regeneration and to use this technique in arthropathies that do not respond to traditional therapies.
Laboratory and clinical studies have proven that mature stem cells can be used in a number of degenerative diseases. Such treatments provide patients with alternatives to the traditional methods of treatment, including surgery. Stem cell use is beginning to be an increasingly realistic alternative to degenerative musculoskeletal disorders, heart disease, diabetes, multiple sclerosis and many other diseases.
WHAT ARE THE STEM CELLS?
Stem cells are cells that are capable of dividing repeatedly and have the ability to differentiate into any other type of cell in the human body (e.g. muscle, skeletal, neural, etc.). Embryonic stem cells, which can be obtained at a very early stage of human development, have the potential to produce all types of cells of the human body. Adult stem cells found in certain tissues of a fully developed human being are restricted to producing only certain types of specialized cells.
WHAT ARE ADULT STEM CELLS?
Adult stem cells were discovered 40 years ago when the researchers observed that the cells in the bone marrow were capable of promoting the formation of various tissues. Adult stem cells under appropriate conditions are capable of growing into other types of cells with the ability to aid tissue regeneration.
HOW CAN STEM CELLS BE USEFUL?
Autologous Adult Stem cells have been used to treat many chronic degenerative diseases of the musculoskeletal system, such as osteoarthritis, tendonitis and tendon rupture. Currently, stem cells are used in degenerative diseases of the shoulder, knee, hip and spine as well as in soft tissue injuries (muscles, tendons and ligaments) and bone related injuries.
WHO CAN BE CANDIDATE FOR THE USE OF STEM CELLS?
In order to determine whether or not the patient is a suitable candidate for stem cell therapy, the physician must obtain a detailed history of the injury and then perform a detailed physical examination, x-rays and possibly recommend magnetic resonance imaging. Stem cell therapy is not indicated for all musculoskeletal disorders, but for a limited number and under appropriate conditions. However, it can be a viable option for people with arthropathy.
Suitable candidates for stem cell therapy are:
- Patients suffering from injuries or chronic degenerative diseases of the musculoskeletal system (bones and soft tissues)
- Patients who would be better off avoiding surgery. due to their medical history
- Patients with chronic pain who are interested in an option that offers improved quality of life
Each patient is different, and the success of stem cell therapy depends on the severity of the disease and the body’s response to the treatment itself.
HOW IS STEM CELL INTRA-ARTICULAR INJECTION PERFORMED?
Essentially, it is a process of regeneration of tissues by enhancing the body’s natural healing mechanisms. This procedure uses autologous adult stem cells from the patient’s own bone marrow.
During the procedure, the doctor absorbs a small amount of bone marrow from the iliac bone of the pelvis. After special process, which lasts about 15 minutes, the concentrated substance is injected at the site of injury or degenerate joint. In total, the process takes less than 45 minutes.
The procedure is quick and in most cases can be completed with moderate anesthesia administered to the patient.
PATIENT PREPARATION AND REHABILITATION
Before any action the doctor explains the whole procedure to the patient and answers any questions. In general the guidelines before and after stem cell therapy are as follows:
Avoid using non-steroidal anti-inflammatory drugs (e.g. ibuprofen) at least 3 days before injection.
- Ice therapy, ice application every 4 hours for 20 minutes, during the first 48 hours
- Avoid using non-steroidal anti-inflammatory drugs (e.g. ibuprofen) 5 days after injection.
- Stop smoking if possible
- Removal of the bandages from the hip trauma 5 days later
- Walking for 2 weeks without strenuous activities or splint use and avoiding charging as directed by the attending physician.
- Depending on the case, of physiotherapy after 1-2 weeks
- Orthopedic re-examination after 2 weeks
WHAT ARE ADULT STEM CELLS?
Adult stem cells are undifferentiated cells, capable of two important processes: Self-renewal and differentiation. These are vital processes for the maintenance and renewal of tissues such as the internal organs, the skin and the blood.
Adult stem cells are deeply hidden in the organs surrounded by millions of ordinary cells and can replenish some of them when needed. In fact, some adult stem cells are used for therapeutic purposes today. Stem cells have been found in various organs that require constant renewal of their cells, such as blood, skin, intestinal epithelium, and have also been found in unexpected places, such as the brain, which, as we know, does not renew its cells. Unlike embryonic stem cells, adult stem cells are already somewhat specialized.
ARE THERE DIFFERENT TYPES OF ADULT STEM CELLS?
Yes, there are many types of adult stem cells in the human body that have different abilities to differentiate. In particular, adult stem cells that help repair degenerated tissues are multipotent mesenchymal stem cells found in the bone marrow and adipose tissue.
WHERE DO ADULT STEM CELLS COME FROM?
In adults, stem cells are present in various tissues and organs, but mainly in the bone marrow and adipose tissue. Other sources of stem cells include the liver, skin, retina, muscles, intestine and more.
WHAT ARE THE DIFFERENCES BETWEEN EMBRYONIC AND ADULT STEM CELLS?
Adult stem cells are found in human tissues, including bone marrow and adipose tissue. In contrast, embryonic stem cells do not come from the human body but from in vitro fertilization, a process that raises many ethical issues. Because embryonic stem cells are not autologous there is a possibility of immunological rejection. On the other hand, adult stem cells do not pose a moral problem, nor do they pose a risk of immune rejection.
ARE THERE ETHICAL ISSUES WITH THE USE OF ADULT STEM CELLS?
No, adult stem cells do not raise bioethical issues, as they are collected from the patient’s own body.
IS THERE A CANCER RISK RELATED TO TREATMENT WITH STEM CELLS?
No. Although embryonic stem cells have been associated with some forms of cancer (tumors), there is no evidence to suggest that adult stem cells can lead to any form of cancer.
HOW ARE STEM CELLS COLLECTED?
In the vast majority of cases, the doctor uses a bone marrow aspiration system.
THE STEM CELLS COLLECTED ARE SUBJECT TO PROLIFERATION PROCESSING?
No, the doctor does not use in vitro methods of culture. Stem cells are harvested, processed and injected into the patient.
HOW CAN THE STEM CELLS BE USED IN SURGICAL INTERVENTIONS?
During surgery, the stem cells are collected from the patient (bone marrow aspiration), processed and used at the site of injury, thus assisting in the healing process.
HOW DO THE STEM CELLS KNOW WHAT TYPE OF TISSUE IS REQUIRED?
Stem cell differentiation depends on many factors including growth factors and the microenvironment where they are. Based on the stimuli of the microenvironment they can evolve and differentiate into different types of cells. For example, multipotent stem cells injected at the site of a fracture will differentiate into bone cells to promote fracture healing. The exact mechanism of this process remains unknown.
WHERE CAN STEM CELLS BE USED TODAY?
Stem cells are now used both in the laboratory for research and in clinical practice for therapeutic purposes. The laboratories use human and non-human stem cells for in vitro studies. Autologous adult stem cells are used for therapeutic purposes to help restore degenerated tissues.
IS THE USE OF STEM CELLS SAFE?
Yes. Talk to your treating physician to answer any questions you may have.