From the Research Department
Amniotic Tissue Allografts for Joint Degeneration
By Ted Swing, Ph.D.
Degeneration of the joints is one of the most common causes of chronic pain, affecting tens of millions of Americans. This is often due to osteoarthritis (OA) — gradual deterioration of the cartilage in the joints. OA is most common in older adults. Other forms of joint degeneration include rheumatoid arthritis (RA), which is an autoimmune condition that produces degeneration of the cartilage in joints. These conditions can cause chronic pain in joints including the shoulders, lower back, hips and knees. OA and RA also impair patients’ ability to complete daily activities and lower their quality of life.
Treatment of Joint Degeneration
Painful joint degeneration is often treated with non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen. These drugs can help relieve the symptoms of arthritis. A number of other treatments are often used to alleviate pain and improve daily functioning. Eventually, many patients end of receiving joint replacements. Total joint replacements have some downsides, including a long recovery period and, for many patients, significant pain even after surgery. The limitations of existing treatments have led doctors to look for other ways to effectively treat joint degeneration.
Amniotic Tissue Injections
Joint degeneration involves the breakdown of cartilage occurring faster than the body can repair it. The body’s natural healing process is complicated, involving stem cells and growth factors. Stem cells — cells capable of becoming many different types of cells — are present in our bodies throughout our lifetime, but often are not in sufficient concentrations at a particular site where healing is required. Some treatments may be able to enhance this healing process. For example, amniotic tissues — tissues in the fluid that fetuses gestate in prior to birth — contain a mix of cells and proteins that aid in tissue growth.
Amniotic tissues contain a matrix of collagen (a connective tissue found in the body) that can serve as scaffolding for the body to build new tissues around. Additionally, amniotic tissue contains a high concentration of stem cells. These cells are particularly useful because they do not contain the markers found in more mature cells that cause body reactions when an incompatible donor is used. Amniotic tissue also contains other growth factors involved in tissue growth. Due to this combination of beneficial properties, amniotic tissues have received considerable interest as a potential therapy for treating conditions such as joint degeneration. Research on this therapy is still early, but promising so far. In one study, researchers found that amniotic membrane was capable of creating growth in cartilage from joints.
Amniotic Tissue Therapy
Applied BiologicsTM produces Amniotic Tissue Therapy, an allograft of amniotic tissues collected from donors during planned caesarian births without harming the mothers or infants. Donors and the tissues are screened to ensure health and they are cryopreserved until needed for treatment. Because this treatment is relatively new and has not been researched much, Medicare and insurers generally do not pay for this treatment. In order to determine the efficacy of this treatment in relieving joint pain, we are studying the efficacy of Amniotic Tissue Therapy in treating pain caused by joint degeneration. We are able to subsidize the cost of this treatment for patients taking part in this study.
This study consists of baseline assessments of pain, quality of life, and medication usage as well as four follow up assessments over six months after a single injection of Amniotic Tissue Therapy. These assessments can be completed in the clinic or by phone. Patients eligible to take part in this study must have significant pain (an average of 5 or greater on a 0-10 scale) for at least three months due to degeneration or joints in the upper extremities (e.g., shoulder), lower extremities (e.g., hip, knee), or lower back (e.g., facet, SI). If you are interested in learning more about amniotic tissue treatments or this study, you can speak with your pain management providers or contact me directly at TedS@arizonapain.com.
Ted Swing has more than nine years of research experience and four years of teaching experience in psychology, has published in top psychology and medical journals, and has presented his research at major conferences. He received his Ph.D. in Social Psychology from Iowa State University and has been the Research Director at Arizona Pain Specialists since May 2012.
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