A Review of Mesenchymal Stem Cell Therapy in the Treatment of Osteoarthritis

A Review of Mesenchymal Stem Cell Therapy in the Treatment of Osteoarthritis

With nearly 30 million people in the US affected by osteoarthritis (OA), the condition continues to be among the leading causes of chronic pain and disability. Considering that advances in medical technology have increased overall life expectancy, the number of people living longer and dealing with the effects of OA is expected to increase for the foreseeable future.

Although modern medicine has improved the way most diseases and chronic conditions are diagnosed and treated, OA treatment has not benefited from these advances.  As a result, treatment and prevention of OA continue to focus primarily on controlling and minimizing symptoms associated with the condition, not treating or preventing the condition itself. Unfortunately, for many, when symptoms of OA progress to a point where the pain is no longer able to be managed, their options look to surgical replacement of the affected joint.

While there are many contributing factors related to the onset and progression of OA, including obesity, history of trauma, genetics, and heritable and acquired disorders, there also appears to be an association between the onset of OA and a depleted local population of mesenchymal stem cells (MSCs).

Considering the apparent relationship between OA and MSCs, Freitag et al. reviewed the reparative pathways, safety, and efficacy of MSC therapy in the treatment of osteoarthritis.

With their ease of harvest and ability to expand into chondrocytes, MSCs have continued to gain interest when exploring various stem cell therapies for the active management of pain and symptoms associated with OA.

Freitag et al. found that preclinical and clinical results of studies of cartilage repair techniques that utilize MSCs, including MSC scaffold transplantation techniques, MSC injectable techniques, MSC as a vehicle for platelet-rich plasma (PRP), and hyaluronic acid (HA) as an active carrier of MSCs, have all shown favorable results in supporting the benefits of MSC for the improvement of function and regeneration of new tissue in those afflicted with OA.

With over 400 active trials currently examining the efficacy of MSCs in the treatment of a variety of conditions, including OA, the safety of utilizing MSC therapy continues to draw interest from the medical community. 

Although some early studies appeared to raise the question of abnormal cell growth, and ultimately the safety, associated with MSC therapy, the authors’ systematic review of clinical trials found that, while caution needs to be undertaken when culturing MSCs, the evidence demonstrates MSCs are generally safe for therapeutic use for the treatment of OA.

Freitag et al. conclude that the rapid progression of OA and related conditions demonstrate the need for therapies that repair and prevent these diseases, not just manage pain and related symptoms. As such, the authors feel MSC therapy offers a safe and viable option for the eventual treatment and prevention of OA and calls for further randomized controlled trials to evaluate the most effective applications of MSCs for managing osteoarthritis.

Source:   (2016, May 26). Mesenchymal stem cell therapy in the treatment of osteoarthritis. Retrieved from https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-016-1085-9

PRP Therapy – Post Management Care

PRP Therapy – Post Management Care

Many studies support platelet-rich plasma (PRP) to help benefit patients with chronic pain and injuries. This article will cover the major aspects of post management care and the best tips to optimize results.

Important tips to keep in mind:

·   Avoid Taking any anti-inflammatory drugs after the procedure avoid for 14 days following the procedure

·   Apply heat only for 10-14 days , you may experience some soreness and swelling in this time period.

·   Avoid any strenuous activities, exercising and physical therapy for the week following treatment

·   Stay hydrated

·   Improvements typically begin after 2 weeks

About a week after the procedure, patients should start physical therapy, which involves myofascial release, gentle stretching, engaging the articular range of motion, and core stabilizing exercises.

Other activities (e.g., stationary bike, swimming) are also an appropriate choice during the recovery phase. Interventional imaging techniques such as stimulation therapy and Transcutaneous electrical nerve stimulation (TENS) should not be used at this stage.

Once 4-8 weeks have passed, patients can gradually engage in more intense activities, including yoga, Pilates, and light weight lifting. However, forceful rotation and manipulation are not recommended.

Following the correct guidelines during the first few weeks of recovery is crucial for the success of the procedure. The injected cells are quite delicate, hence the need to avoid strenuous physical activities that may cause irreversible damage to the cells.

Patients should also keep in mind that the side effect profile is diverse and can only be evaluated on a case-to-case basis. In other words, one patient might experience pain and inflammation after the procedure, while another presents with no symptoms.

The severity and extent of these symptoms are also dependent on the site of injection, with articulations being the most susceptible to traumatic injuries and side effects.

Recovery by weeks

Weeks 1 & 2

During this phase, you should restrict your movements and physical activity to avoid putting too much tension on your body. However, this doesn’t mean giving up to a sedentary lifestyle as it’s not the best approach.

Expect to experience pain, inflammation, and soreness.

Moreover, remember to avoid running, weight lifting, or any other strenuous exercise. Other activities, such as gentle stretching, are still allowed.

If you experience serious inflammation, consider using ice bags on the affected area , but try to avoid ice and NSAIDS until after the 14 day period. You can also use natural compounds that have potent anti-inflammatory properties, such as turmeric, CBD, and arnica.

Weeks 3 & 4

At this stage, the pain and inflammation should slightly subside, which allows you to practice more intense activities, but do not attempt to lift heavy weights or perform high-impact exercises. An appropriate number would be to keep the intensity of the workouts under 50% of what you’re used to. This will allow the stem cells to implant themselves in the damaged tissue and kick start the healing process.

Weeks 5 & 6

In this stage, focus on core-stabilizing exercises to strengthen your core muscles and give time for the joints to get used to the new routine. Activities such as stationary bike, elliptical, stretching, yoga, Pilates, and swimming exercise are permitted.

Weeks 7 & 8

Inflammation and pain might be gone at this time; however, you should still be careful about the type of exercises you’re performing. For patients who are still dealing with pain and swelling, you can use ice bags to accelerate the healing process.

Months 3–6

During this period, stem cells have reached their peak healing potential, which should not get interrupted with intense physical activity. Instead, settle down for less-strenuous workouts that do not involve any compressive, twisting, or pivoting movements. Avoid uneven ground. Contact a Care Coordinator today for a free assessment!

The Differences Between Platelet Rich Plasma (PRP) Therapy and Stem Cell Therapy

The Differences Between Platelet Rich Plasma (PRP) Therapy and Stem Cell Therapy

Orthopedic injuries occur each day and from different causes. An injury can result from a fall or a trauma to a musculoskeletal part of the body (e.g., knees, hips, shoulders). Many times, age or overuse can create a more common occurrence for these types of injury.  

Some injuries are minor and the recovery is as easy as rest and at-home recovery methods. Other more serious injuries may require surgery and physical therapy to return to normal function. Some patients, however, may never recover fully and develop complications related to the initial trauma, such as decreased range of motion, chronic pain, psychological issues, or risks from surgery. 

Today, regenerative medicine has presented innovative biological advances that offer an opportunity to address their medical issues in innovative ways that involve using biomedical therapies, such as platelet-rich plasma therapy and stem cell therapy.

What Is Platelet-Rich Plasma (PRP) Therapy?

Platelet-rich plasma (PRP) is a substance featuring concentrated platelets and proteins which are derived from whole blood. When the platelets are isolated and their concentration is increased, their growth factors are amplified by five to ten times. 

This concentrated solution holds tremendous potential for promoting wound-healing and accelerating the process of regenerating lost tissue to help patients regain their physical function as soon as possible and relieve their pain.

Platelet-rich plasma (PRP) treatment is widely regarded as a safe and effective therapy since it is one’s own blood source. The potential benefits can be decreased pain, medication intake reduction, promotion of faster healing rate, slowing down of cartilage destruction, and stimulates cell growth and repair at site of injury.

In a 2014 study, scientists analyzed the effects of PRP therapy when associated with ultrasound guidance. They concluded that “According to the current results, which document full muscle recovery and no relapse except for one case, platelet-rich plasma ultrasound-guided injection represents a valid mini-invasive treatment for muscle injuries.”

What Is Stem Cell Therapy?

Stem cells are undifferentiated cells that can develop into various cell types and tissues. Scientists were extremely enthusiastic about the therapeutic potential of these cells in restoring damaged tissues, the functionality of organs, and managing symptoms brought on by chronic and degenerative conditions such as Rheumatoid Arthritis, Traumatic Brain Injury, and Multiple Sclerosis.

Many studies have used various types of stem cells in the treatment of different types of sports injuries. Mesenchymal Stem Cell (MSCs) is one of the most common stem cells in today’s research and applications. They are sourced from various tissues; adipose (fat) tissue, bone marrow, and the umbilical cord tissue.

In a 2017 review, scientists reveal the beneficial outcomes of mesenchymal stem cells from eight different studies. The studies were performed on patients that had varying degrees of osteoarthritis. The findings concluded were promotion of cartilage regeneration, reduction of pain, and improved joint function. In addition, they were able to determine that the more stem cells used, the better the outcome of the therapy. 

What Is The Difference Between These Two Treatments?

Despite the similar regenerative properties that both treatment options offer, there is a clear difference in their mechanisms of action, as PRP therapy focuses on the recruitment of immune cells, growth factors, and hormones to stimulate the regeneration of the damaged tissue.

On the other hand, stem cell therapy works by replacing the basic building blocks of the damaged tissue, which are the cells. Simply put, stem cells will differentiate into myocytes chondrocytes, osteocytes, fibroblasts, and other cells found in the muscle/joint capsule to restore the physical function of patients.

Regardless of these differences, they are both promising options due to their non-invasiveness, quick results, and lack of any serious side effects. Contact us today for a free consultation!

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