Stem Cells and Mesenchymal Cells
Stem cells are undifferentiated biological cells that can transform into any cell in the body and become human organs and tissues. There are two broad types of stem cells: embryonic and adult. In adults, stem cells act as a repair system for the body.
Mesenchymal cells are one type of adult stem cells that have been used in orthopedic literature for a variety of treatment. Mesenchymal cells are sterilely harvested with a needle from the patient’s bone marrow (usually the pelvis region) and immediately injected into the injured area. The harvesting technique, injury location, position, region used for stem cell harvest and the experience of the surgeon performing the procedure are all important factors that may affect patient outcome. A band aid is applied once the procedure is complete and patients are often discharged home within the first hour of the procedure. Patient will require some pain medication usually for pain at the site of cell harvest.
There are no large or strong clinical studies to evaluate the effect of mesenchymal cell treatment for orthopedic conditions, and the efficacy of this treatment has yet to be established. However, clinical case reports in the treatment of various orthopedic conditions are available. A published safety study conducted in a large group of patients over a 3-4 year period showed adequate safety and minimal complications associated with mesenchymal cell transplantation. Wakitani has also published a small case series of nine cartilage defects in five knees involving surgical transplantation of mesenchymal stem cells with coverage of the treated cartilage defects. Vangsness et al. published their data in 2014 on Adult Human Mesenchymal stem cells injected into the knee following meniscectomy. They showed evidence of meniscus regeneration and improvement in knee pain following treatment.
Cell therapy in humans is highly regulated through the US Food and Drug Administration (FDA). FDA has specific guidelines regarding current approved use of any stem cell including mesenchymal cell. These include but not limited to same day harvest and application, minimal manipulation, and no use of any additional growth factors as an adjuvant to treat and enhance the cells. At this time, stem cell treatment is considered investigational. However, stem cell therapy has been available to veterinarians to treat various conditions in both large and small animals for years. These include ligament and cartilage injuries, arthritis, muscle and tendon tears, and bone repairs.
Mesenchymal stem cells treatment is not the answer for every injury although it may prove to be a good option for specific patients and conditions. Since every patient is unique, our team is happy to evaluate your condition, and to provide you more information as to the potential for mesenchymal stem cell injection for your specific circumstances.