Stem cells start out as blank slates, but have the unique ability to transform into specialized cells, whether bone, muscle, or organ, depending on the body’s needs. Because of their transformational abilities, stem cells have the power to help the body regenerate damaged areas, including knee cartilage.
This therapy has emerged in headlines recently, and sometimes generated controversy, but stem cells can come from adults or be collected at the time of birth without harming the mother or the baby.
This allows people to take advantage of this cutting-edge treatment without the ethical concerns.
1 type of stem cell treatment that uses tissues gathered at birth is called amniotic tissue therapy. Amniotic tissue is especially helpful for patients looking for relief from knee pain because it contains connective tissue in addition to stem cells. When inserted into the knee, the connective tissue helps the body regenerate its own, healthy connective tissue and repair the damaged areas.
Because stem cells remain an integral part of healing and growth throughout a person’s lifetime, adults also have stem cells, although in lower quantities than found earlier in life. In adults, stem cells are often removed from the bone marrow, blood, or fat.
Stem cells found in adult bone marrow are called mesenchymal stem cells. These cells have the ability to transform into bone, cartilage, or cells involved with the growth of connective tissue, according to the National Institutes of Health. Early research shows the cells help repair damage by encouraging healing, decreasing inflammation, and helping patients regain mobility.
When stem cell therapy is used in an effort to alleviate knee pain, high concentrations of the cells are injected into the joint. In the case of adult stem cells, the material may come from the person needing treatment, called an autograft, or from an adult donor, called an allograft.
Exciting new research is now quantifying the vast potential of stem cell therapy to alleviate knee pain.
Stem cell therapy is part of an emerging medical trend known as regenerative medicine. While traditional medicine frequently focuses on cutting out injured parts, regenerative medicine is opening the way to encourage the body to heal itself by re-growing healthy tissue.
Common circumstances in which people receive stem cells in hopes of reducing knee pain include injection after surgery or treatment to mitigate osteoarthritis-related degradation of the joint. Studies of both scenarios have yielded promising results.
A study published in the Journal of Bone and Joint Surgery found that people who received injections of stem cells following meniscus surgery healed faster and experienced less pain than people who didn’t receive the injections.
Meniscus tears are 1 of the most common knee injuries. The meniscus is located between the thighbone—femur—and the shinbone—the tibia, and its purpose is to absorb shock caused by the 2 bones pressing together.
To evaluate the ability of stem cells to spur regeneration in the meniscus, researchers recruited 55 patients aged 18 to 60 who had surgery to remove a portion of the injured structure. Most patients had arthritis, although patients with a severe form of the condition were not included in the study.
Patients were separated into 3 groups. 1 received low-dose injections containing 50 million stem cells, another received a higher dose of 100 million stem cells, and a 3rd received injections of sodium hyaluronate. Researchers followed patients for 2 years to measure their pain levels and examine the meniscus’ healing progress through magnetic resonance imaging (MRI) and X-ray.
Patients who received the low-dose injections fared the best in the study, with 24% experiencing “significantly increased meniscal volume” compared to 6% of patients in the high-dose group and none in the control group. The re-growth all occurred within the 1st year of follow-up, with no statistical improvement evident in the 2nd year.
The injections also reduced pain in patients with osteoarthritis. Researchers say the success of the single injection led them to wonder what added benefit patients could derive from receiving multiple injections.
People with arthritis who’ve undergone knee surgery may also benefit from stem cells injections, researchers say.
Of 200 patients treated with stem cells at a Colorado clinic, about 80 experienced 75% relief from knee pain, according to ABC news. Over 60% of patients experienced more than 50% pain relief, doctors say.
1 patient treated in Colorado was considering knee replacement because of arthritis, but instead opted to receive stem cell injections and experienced significant relief, returning to hiking and biking as a 72-year-old. Doctors took the cells from bone marrow in the patient’s hip, and injected them into his knee. Not everyone experiences such dramatic results; about 8% of the doctor’s patients still opted for knee replacement after receiving stem cells.
Other research, published in the journal Stem Cells, found that high doses of stem cells injected into patients’ knees stalled the progression of osteoarthritis while increasing the volume of cartilage. Patients experienced less pain and no side effects.
The treatments are safe, particularly because they don’t pose risk of rejection if the cells come from the patient’s body. Tissue rejection occurs when the immune system recognizes implanted material as foreign and begins attacking it. However, the body typically won’t fight against its own tissue.
Considerations do include cost.
Stem cell therapy is still very new and being studied. Insurance companies consider it experimental and don’t cover it. Patients interested in receiving stem cell therapy might be able to enroll in studies that partially or wholly cover the cost of treatment. The treatment is not a 1st line of defense and should be considered only by patients who have explored traditional medical options, but experienced little relief.
However, the future of this emerging therapy looks bright. People with knee pain resulting from osteoarthritis or injury may soon see stem cell therapy gaining prominence as a treatment option.
What are your thoughts about stem cell therapy?
Image by Umberto Salvagnin via Flickr
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