This past week an interesting paper on mesenchymal stem cells (MSCs) and cartilage repair appeared. While there are about a thousand such papers, this one had a twist. They took normal mice and mice bred to have “super healing” and severely injured their joints (cartilage injury involving fracture). This is the rough equivalent in a human patient of what’s called an osteochondral defect (OCD)-an injury of the cartilage that goes down into or involves the bone. They then injected MSCs (a stem cell arthritis shot) versus saline and tracked the animals longer term to figure out which ones got arthritis after the big injury. Not surprisingly, the MSC injected joints got much less arthritis over time, which would normally be very common after a big joint injury. There was no difference between the “super-healer” strain and the normal mice. This certainly begs the question, should our patients be getting stem cell shots after the first big injury to prevent the later onset of arthritis? This will be a question that likely won’t be fully answered in humans for some time, as the onset of arthritis in many patients can take five to thirty or more years. So don’t expect a definitive answer on this one, given our current regulatory regime for 30-40 years. However, the study, if replicated (based on what else has been published in animals it would seem likely that the result will be replicated), could mean that we should be treating patients earlier-before significant arthritis sets in and after that first big knee, ankle, hip, or shoulder joint blow-up. This also begs the question for professional or college athletes, should they be getting stem cell shots after the first career injury? I can tell you that having examined many of them later in life, they tend to be an arthritic mess by the time they hit their late 30s to early 40s. The upshot? The study makes sense, but until we have a definitive answer, like many things in medicine, each individual patient will have to weigh the evidence, risk, and possible benefits and decide.
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About the Author
Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…