Stem Cells and Platelet Rich Plasma in Orthopedics

 In Cartilage, Knee Injuries, Research

Stem Cells and Platelet Rich Plasma are being used in orthopedics – the basics

 

STEM CELLS are a hot button concept in medicine these days.  Stem cell products are being used in orthopedics with regularity, despite the fact that we do not fully understand their efficacy.  It could be years before we have all the answers, so should we plunge forward now?  There are many reports of success with stem cells and PRP, though the number of high quality research studies are relatively few.  However, the literature is favorable to the outcomes of stem cells in orthopedic conditions, and the adverse effects are reported to be negligible.

What are stem cells and PRP?

These are injections that would be classified as biologic therapy.  Bio-active substances are derived and injected into the area of damaged tissued.  The expectation is that these substances will stimulate a reparative or healing response in the body.
PRP (platelet rich plasma) is derived from your blood. Platelets are those cells in your blood that contain an abundance of growth factors and anti-inflammatory agents. The platelets will then, in theory, live in the injected area for hours/days/weeks and secrete bioactive agents to assist in tissue repair and healing.
 This is an office procedure.  It takes 30 minutes, or so.  We draw blood from your arm.  The blood sample is processed, usually by centrifugation, and the layer of blood rich in platelets is isolated, removed and injected into your affected joint.
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Stem cells are more accurately called “progenitor cells.”  These are cells that have the ability to transform into varying cell types and tissues.  So, lets say you break a bone. The body needs more bone to heal a fracture.  In theory, stem cells are signaled to  populate the area of damage and facilitate the production of new bone.  The same goes if it is skin, heart or cartilage that is damaged.  Sounds rather straight forward, but the actual process is exceedingly complicated with likely thousands of metabolic steps.
There are a variety of progenitor cells in the body.  Hematopoeitic stem cells and mesenchymal stem cells (MSCs) live primarily in the bone marrow.  Pericytes are progenitor cells that live in fatty tissue.  Amniotic fluid is thought to be rich in progenitor cells.

 To date, there are several basic sources of Stem Cell therapy (though there are certain to be more in the future)

  • Bone marrow derived (BMAC–Bone Marrow Aspirate Concentrate)
  • Adipose of fatty tissue derived
  • Amniotic fluid derived
Stem cell injections can be performed in the office or procedure center.  It is a minor procedure and take 30 to 60 minutes. Bone marrow stem cells are derived from the crest of your pelvic bone.  Adipose precytes are derived from the fatty tissue in your belly or flank.
Amniotic stem cells are shipped frozen and simply injected into the joint—quite simple.
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