Stem cells, PRP, and HA, oh my! We are not in Kansas anymore… Part 2

This blog will discuss the use of stem cells. It has become a catch-word, for “can heal everything” in the lay press and public’s mind. Not so, and the research is in its adolescence. Scientists have known of stem cells since the 1950s, There are 2 types of stem cells: embryonic (found only in embryos) and adult (which live throughout the body). Embryonic stem cells can differentiate into all 220 tissues in the human body. Adult stem cells typically differentiate into their tissue of origin. For example, those in bone marrow tend to grow into red blood cells, white blood cells, or platelets but not nerve cells.

Adult stem cells come from 2 sources;
1. Bone marrow; This requires placing a large needle into the pelvic bone and drawing out bone marrow. Most of the bone marrow will make blood products. The number of stem cells to make cartilage, muscle, tendons are very small. 1 cell for every 100,000 removed. In Europe, these cells are grown outside the body and multiplied and used after there are large numbers cultured. This is not allowed in the US. The bone marrow aspirated is concentrated through a centrifuge, and then injected.
2. Fat cells; There is a part of the fat called the stromal vasacular fraction (SVF). A mini-liposuction is done on the flank (love handles) and the fat is digested with some enzymes, then centrifuged to separate the components and remove the enzymes. The SVF is a mix of platelets, growth factors, endothelial cells, T cells, red and white cells, and, of course, stem cells. This is part that is injected.

On a basic level, the procedure makes sense. Stem cells help repair tissues, so why not add them to damaged areas? The issue is that scientists, for example, still don’t know why a given stem cell will differentiate into one tissue and not another. They also can’t predict when some stem cells will go rogue and turn into unwanted masses. Until scientists learn more, it will be impossible to say with complete confidence that any treatment comes without risk. It is important for patients to understand that the use of stem cells is still considered investigational in orthopedics. There are several studies that show that the technique has much promise in the treatment of tendon injuries, cartilage damage, inflammation of joints and arthritis. The data gathered by networks, such as the Surgical Cell Network, have shown safety in over 600 patients. (Data to be published). Since the patient’s own tissues are being used, the chance of a reaction is minimal.

I have used stem cells from the bone marrow for treating knee injuries, but have decided to use the fat cells instead going forward, since the harvest is much safer, and there are 100-1000 x more cells obtained. We hope to have this procedure available to patients who are candidates in late May or early June. I am very excited about being able to offer this technique to those who are not ready for joint replacement or more invasive procedures. Not everyone is a candidate, and we will do our best to educate candidates on their various options. More information will be available on the specifics of our treatment center in the next few weeks. Look for Golden Gate Stem Cell Treatment Center.

Lesley Anderson MD
April 16 2016

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