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Stem Cells for Bone on Bone Arthritis? Replenish Stem Cell Reserves

POSTED ON IN Knee Latest News Regenexx-SD BY Chris Centeno

stem cells for bone on bone

Do stem cells for bone on bone arthritis work?  Based on questions from all sources, cartilage is something on many people’s minds. Patients often ask why we inject mesenchymal stem cells (MSCs) in patients with severe degenerative arthritis if the expectation is that we won’t be able to grow the large stretches of new knee cartilage in the way that a tire gets “retreaded.” The answer lies in the crucial need for an MSC reserve and the relief MSCs provide without resorting to drastic invasive surgeries, like joint replacements, that aren’t really all they’re cracked up to be.

Study Shows Fewer MSCs in Arthritic Joints

The stem cells that live in many tissues in your body and allow for maintenance and self-repair are called mesenchymal stem cells (MSCs). Every healthy joint must have a certain number of healthy MSCs kept in reserve to assist the joint when the main MSCs kept for cartilage repair can’t function anymore. Like reserve soldiers, these cells are called upon when the main troops are burnt out. However, when even the reserve troops are all used up, an injection of your own stem cells into the joint may help replenish those critical warriors against continued joint breakdown.

A new study shows that stem cells for bone on bone arthritis is likely a good idea, as it was found that the MSCs within the joint weren’t sufficient to maintain the joint. The study found fewer MSC’s in arthritic joints, and the cells found were more likely to become bone or fat than cartilage. In addition, the MSCs found within the joint were less able to make additional copies of themselves, which is a critical function of stem cells.

If My MSCs Are All Used Up, How Do You Harvest Them?

While the MSCs in your joint may be all used up, there are other areas that are rich in stem cells. For orthopedic applications, two main MSC sources have been used: bone marrow and adipose (fat). Bone marrow MSCs are taken via a needle through a bone marrow aspirate. The bone marrow aspiration procedure sounds like a big deal, but we are consistently told by patients that the procedure is very comfortable.

The second type of MSC is derived from fat tissue (adipose). This can be obtained via liposuction. For orthopedic applications, fat derived MSCs consistently and dramatically underperform bone-marrow-derived cells. In studies of cartilage repair, bone repair, and soft-tissue repair, bone-marrow-derived MSCs are much more adept at these tasks. This makes sense, as they perform this function naturally every day. For example, if you break a bone, it’s these bone marrow MSCs that help mend that bone. Fat stem cells in your belly don’t perform these tasks naturally.

Watch my video below if you want a more in-depth lesson on bone marrow vs. fat stem cells. If you are considering stem cell treatment, this will also help you know what questions to ask your doctor regarding the types of MSCs he or she may be using.

Why Stem Cells Instead of Surgery?

The traditional orthopedic, or surgical, approach to severe arthritis is to amputate the joint and insert an artificial joint. What are the risks of cutting out a joint? A dramatic rise in heart attack and stroke risk, wear particles from the joint prosthesis, toxic metal levels in the bloodstream, and chronic pain.

The interventional orthopedic, or nonsurgical, approach? Discover and treat the underlying causes of the issue, and treat the arthritis in the joint itself. In addition, look at the whole body. Are there low-back nerves misfiring which affect the function of tendons and ligaments which in turn affect the function of the knee? Are the ligaments in the knee itself unstable, allowing for sloppy movement creating wear and tear beyond the knee’s ability to repair? Is there damage to the cartilage, meniscus, or bone marrow lesions?  These issues are treated by highly skilled physicians with customized and precise image-guided injections of platelets and/or stem cells directly into the problem areas. Does this work for stem cells for bone on bone arthritis? Our treatment registry data suggests that it helps many patients.

If Stem Cells Don’t Regenerate Large Stretches of New Cartilage in Patients with Severe Arthritis, What Do They Do?

While we have seen MRI evidence of smaller holes in the cartilage filled in, in general, we don’t see MRI evidence of cartilage regeneration in patients with severe arthritis where there is none. Having said that, stem cells can do some pretty cool things, all of which are pretty revolutionary:

  1. Control inflammation by deactivating bad “Pac Man” cells called “macrophages”
  2. Release helpful growth factors that can assist in repair
  3. Help dying or damaged cells by recharging their mitochondrial batteries
  4. Help other cells produce proteins that can help initiate repair

The upshot? If you have small cartilage problems, bone-marrow-derived MSCs using precise placement of stem cells into the problem area, performed by an experienced interventional orthopedics provider, may help repair your cartilage or at least provide relief. If you have severe cartilage loss, then a stem cell procedure isn’t going to “retread” your knee with loads of new cartilage. However, based on our extensive registry data, stem cell procedures can often provide years of pain relief and improved function in “bone on bone” patients.

When considering a drastic surgery, such as a joint replacement, for your arthritis, it’s a good idea to look beyond the traditional orthopedic approach. Explore the interventional orthopedic approach to see if replenishing your MSCs might be the right answer for you.

 

    comments

    Yvonne says

    Can you provide a list of orthopedic specialists who provide this treatment and is it an approved treatment by health ins providers? Thank you.

    replies

    Chris Centeno says

    Yvonne,

    No stem cell treatments of any kind are covered by any type of insurance in the US, yet. Like Interventional Cardiology which replaced most open heart surgery with procedures done through a catheter,it will eventually get there: http://www.regenexx.com/the-future-of-orthopedics/ and http://www.regenexx.com/explain-interventional-orthopedics/ Here is the interactive list of Regenexx Providers: http://www.regenexx.com/find-a-physician/

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    Barb culllen says

    I AM about to have my hips done with stem therapy. Does the same apply to hips as well?

    replies

    Chris Centeno says

    Barb,
    Yes, all joints. Replenishing stem cells in hips is even more important, as there are less local ones present, and hip arthritis escalates much more quickly.

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    Victor says

    Can this procedure be used for lower back repair and base of thumb area?

    replies

    Chris Centeno says

    Victor,
    Yes. Please see: http://www.regenexx.com/hand-basal-joint-cmc-arthritis-treatment/ (be sure to watch video). and http://www.regenexx.com/the-regenexx-procedures/back-surgery-alternative/ (scroll all the way down, lots of info)

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    Wayne Fought says

    IN 2009. I dropped a spare wheel to my truck on the top of my ankle. I could move my ankle without pain, just a lot of swelling. After a week or so, the swelling would not go down with ice packs and raising the ankle, I went my designated Orthopedic surgeon and X-rays were taken nothing broken or cracked showed up. I was given a cortisone shot and told to rest the ankle. All to no avail. A month or so later new X-rays were taken from a different angle and small particles of broken bone were floating in the ankle. So an arthroscopy was scheduled to grind up and suck out the particles. This was recorded a DVD and I was shown that the cartilage in the ankle was worn. I was asked if I had any problems before the event. The answer was no because I was walking 2 miles a day on a treadmill. I was using a treadmill because I had a double hip replacement done in 2002. I was told that if the arthritis didn't bother me before that my ankle would heal back to normal. Not so. Now I am told I need ankle fusion. Is there any way to determine if I have enough cartilage left for a Regenexx procedure? I am starting to have problems with the opposite knee and I'm sure it due to body mechanics compensating for the opposite ankle

    replies

    Chris Centeno says

    Wayne,
    Unfortunately, as you've already figured out, not a surprising series of events. You're also right re the biomechanics issue. An MRI would give us a good look at what's going on with your ankle and along with a medical history whether you'd be a good Candidate. Please see: http://www.regenexx.com/the-regenexx-procedures/ankle-surgery-alternative/ and http://www.regenexx.com/new-ankle-surgery-alternative/ You'll find a Candidate form on both pages.

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    Gar howard says

    Emile clue was successful treating many major illnesses
    And diseases by having the patient tap into their sub conscious
    And tell the selves they are getting better
    Proof is unless one does not expect great results they probably
    Won't get any
    Gary Howard
    Charlottesville
    If I could afford it I would get this stem cell great science

    replies

    Chris Centeno says

    Gar,

    Very clever! While it doesn't look like the near future, someday, stem cell procedures will be covered...

    replies

    Amy Thomas says

    How about a finger? I have a ring finger on my right hand that if you asked me what my pain level was from 1-10 I would say 15. I think the rest of my fingers on my hands are going to follow eventually. My ortho specialist gave me the choice of bone fusion, joint replacement or a cream. I opted for the cream and it did nothing. It's osteoarthritis and there is no cartilage on either joint.

    replies

    Chris Centeno says

    Amy Thomas,

    Thankfully there is another option, please see: http://www.regenexx.com/treating-hand-arthritis-without-surgery-regenexx-way/ and http://www.regenexx.com/treating-hand-arthritis-trigger-finger-prp/ and http://www.regenexx.com/hand-basal-joint-cmc-arthritis-treatment/

    replies

    Jason says

    I am in my early 40's and have lots cartilage loss in my shoulders from paddling and surfing. I am considering stem cell injections. I have a question. How many times can you repeat the procedure? How many times can you extract the stem cells from the hip over your lifetime?

    replies

    Chris Centeno says

    Jason,
    A very important part of Regenexx treatment is the exam, which for a shoulder would include looking at instability and what's causing it, and matching the right procedure to the right issue, which is part of the Candidacy process. If you'd like us to take a look and see what would likely be needed in your case, please submit the Candidate form. There's not a cap on treatment, but we do limit Bone Marrow Aspirations. For patients who require more, or more stem cells, we recommend our advanced care site in Grand Cayman. Please see: https://www.regenexx.com/the-regenexx-procedures/shoulder-surgery-alternative/ and https://www.regenexx.com/blogging-from-the-caymans-again-5/ and https://www.regenexx.com/bloging-from-the-caymans-again/

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    Joe says

    How long must you refrain from smoking before stem cell treatment for it to be most effective?

    replies

    Chris Centeno says

    Joe,

    We recommend refraining from smoking for 12 weeks (3 months).

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    Tiffany says

    How much does the procedure cost for an ankle joint?

    replies

    Chris Centeno says

    Tiffany,
    It depends on what's needed for each individual case. To see what would be needed in your particular situation, please submit the Candidate form, or call 855 622 7838.

    replies

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    About the Author

    Chris Centeno

    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.…

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