By Debra K. Brinker, RN
Research shows that stem cells accelerate and enhance bone and cartilage repair in osteoarthritic joints. Since surgery comes with many disadvantages, stem cell injections to restore cartilage and alleviate pain provide an exciting alternative. Stem cell therapy has become a popular out of network treatment when patients have tried and failed the limited symptom control-only treatments offered through insurance doctors. While there are many promising possibilities with stem cell therapy, patients need to understand that all treatments are not alike.
One shot magic cure?
Many advertised treatments may involve just one injection of stem cells, which is generally insufficient at providing long-term pain relief and joint repair. While the approach may sound appealing, there really are no shortcuts when it comes to effectively restoring joint function in osteoarthritis. Joint injuries that lead to arthritis, such as a ligament sprain or meniscus tear, may have started small, but the arthritis will eventually destroy the entire joint. Sadly, a single injection to the inside of the knee, is simply not powerful enough to restore the integrity of the whole joint.
Breakdown of cartilage inside the joint happens over years and is a direct reflection of the stability and strength of the supporting structures of the joint. Therefore, from a comprehensive treatment standpoint, regenerative injections should be delivered via a multi-injection technique, such as H3 Prolotherapy. Whether using stem cells or other ingredients that naturally activate healing, treating both the inside of the joint as well as the surrounding, supporting structures is preferable.
Correcting joint instability in arthritis patients
When ligaments are strong, they prevent abnormal joint motion and chronic subluxations. When ligaments are injured, the joint moves in an abnormal pattern, injuring other joint structures, and eventually leading to cartilage loss and joint destruction. This can be compared to a damaged cabinet door wobbling due to a loose hinge.
Soft tissue and bone heal over time, and usually need several regenerative injection treatments to sufficiently heal. It is as if each treatment stimulates the body to “tighten the loosened screws” a little more each time, usually taking around 4-8 total treatments for curative results.
Amniotic “stem cells”
Amniotic stem cell injections have become a trendy, headline-grabbing treatment. But did you know that amniotic “stem cell” therapy contains no actual living stem cells? Companies purchase the afterbirth materials, then process and freeze-dry it. Although the process preserves the fluid, it also kills the live cells. What remains are healing growth factors found in the extracellular matrix of the amniotic tissue. In their pre-donated state, amniotic fluid does have an abundance of stem cells, but they do not survive the processing.
Myth: My stem cells are not good enough
Many people have been misinformed that their own stem cells are too old or too few, and that donated amniotic “stem cells” or cultured cells are better. First, stem cell counts are higher in joints with osteoarthritis. Another fascinating research finding involves evidence of the reduction in the usual progressive destruction of articular cartilage in osteoarthritic disease by mesenchymal stem cells. These cells release growth factors that combat osteoarthritis and the degenerative process, enabling healing mechanisms to repair articular cartilage and relieve chronic pain. So even in elderly individuals, sufficient stem cells are alive and ready for the right stimulus to come along! For patients considering regenerative injection therapy, the use of your own cells (autologous) from blood, fat, or bone marrow has still been shown to produce the best long-term outcomes.
The future of pain medicine
In contrast to trendy shortcuts, regenerative injection therapies have been proven to effectively activate cells for regeneration and repair in degenerated joints when a comprehensive approach is taken. The treatment can be considered truly successful when the joint motion has returned to normal, which demonstrates ligament strengthening, alleviation of 90% or more of painful symptoms, and return to activities without the need for ongoing pain medication. H3 Prolotherapy can include a patient’s own cells and has regularly been shown to obtain these curative results.
1. Wakitani S, et al. Mesenchymal cell-based repair of large, full-thickness defects of articular cartilage J. Bone Joint Surg. Am. 1994;76:579-92.
2. Burke J, et al. Therapeutic potential of mesenchymal stem cell based therapy for osteoarthritis. Clinical and translational medicine. 2016 Aug 10;5(1):27.
3. Chang HX, et al. Age-related biological characterization of mesenchymal progenitor cells in human articular cartilage. Orthopedics. 2011;24(8):e382-8.
4. Hauser R, et al. Treating osteoarthritic joints using dextrose prolotherapy and direct bone marrow aspirate injection therapy. The Open Arthritis Journal. 2014;7:1-9.
5. Hauser R, et al. Evidence-based review of dextrose Prolotherapy for musculoskeletal pain: a scientific literature review. Journal of Prolotherapy. 2011;3(4):765-789.
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