Overview
Stem cells are undifferentiated cells that can develop into many kinds of tissue. There are two broad types: embryonic and adult. In adults, stem cells act as a repair system for the body. Mesenchymal cells are one type of adult stem cell that has been studied in the orthopaedic literature for a variety of conditions.
The procedure
Mesenchymal cells are harvested under sterile conditions with a needle from your bone marrow — usually the pelvis — and injected into the injured area the same day. Harvesting technique, injury location, the harvest site and the experience of the physician are all factors that may affect outcome. A bandage is applied and patients are often discharged within the first hour. Some pain medication is usually needed for discomfort at the harvest site.
What the evidence shows
There are no large or strong clinical studies establishing the effect of mesenchymal cell treatment for orthopaedic conditions, and its efficacy has yet to be established. Clinical case reports are available. A published safety study of a large group of patients over three to four years showed adequate safety and minimal complications. Wakitani published a small case series of nine cartilage defects in five knees treated with surgical transplantation of mesenchymal stem cells, and Vangsness et al. (2014) reported evidence of meniscus regeneration and improvement in knee pain after mesenchymal stem cell injection following meniscectomy.
Regulation
Cell therapy in humans is highly regulated by the U.S. Food and Drug Administration. FDA guidelines include same-day harvest and application, minimal manipulation, and no use of additional growth factors to enhance the cells. At this time, stem cell treatment is considered investigational.
Mesenchymal cell treatment is not the answer for every injury, though it may be a good option for specific patients and conditions. Our team is happy to evaluate your condition and discuss whether it may be appropriate for you.