Stem cell therapy is a form of regenerative medicine that utilizes the
body’s natural healing mechanism to treat various conditions.
Stem cells are being used in regenerative medicine to renew and repair
diseased or damaged tissues, and have shown promising results in treatments
of various orthopedic, cardiovascular, neuromuscular and autoimmune conditions.
Stem cells are present in all of us acting like a repair system for the
body. However, with increased age sometimes the optimum amounts of stem
cells are not delivered to the injured area. The goal of stem cell therapy
is to amplify the natural repair system of the patient’s body.
Types of Stem Cells
There are two major types of stem cells embryonic stem cells and adult
stem cells. Embryonic stem cells (ESCs) are stem cells derived from human
embryos. They are pluripotent, which means they have the ability to develop
into almost any of the various cell types of the body.
As the embryo develops and forms a baby, stem cells are distributed throughout
the body where they reside in specific pockets of each tissue, such as
the bone marrow and blood. As we age, these cells function to renew old
and worn out tissue cells. These are called adult stem cells or somatic
stem cells. Like embryonic stem cells, adult stem cells can also replicate
into more than one cell type, but their replication is restricted to a
limited number of cell types.
Use of Stem Cells in Orthopedics
The unique self-regeneration and differentiating ability of embryonic stem
cells can be used in regenerative medicine. These stem cells can be derived
from eggs collected during IVF procedures with informed consent from the
patient. However, many questions have been raised on the ethics of destroying
a potential human life for the treatment of another.
Adult stem cells are most commonly obtained from the bone marrow, specifically
the mesenchymal stem cells, which have the ability to replicate into cells
that form the musculoskeletal system such as tendons, ligaments, and articular
cartilage. They can be obtained from the iliac crest of the pelvic bone
by inserting a needle and extracting the stem cells from the bone marrow.
Currently, stem cell therapy is used to treat various degenerative conditions
of the shoulder, knees, hips, and spine. They are also being used in the
treatment of various soft tissue (muscle, ligaments and tendons) as well
as bone-related injuries.
Who is a Good Candidate for a Stem Cell Procedure?
You may be a good candidate for stem cell therapy if you have been suffering
from joint pain and want to improve your quality of life while avoiding
complications related to invasive surgical procedures.
Preparing for the Procedure
- It is important that you stop taking any non-steroidal anti-inflammatory
drugs (NSAIDs) at least two weeks before your procedure.
- Preparing for a stem cell procedure is relatively easy and your doctor
will give you specific instructions depending on your condition.
Stem Cell Procedure
The procedure begins with your doctor extracting stem cells from your own
bone marrow. Bone marrow is usually aspirated from your hip region. Your
doctor will first clean and numb your hip area. A needle is then introduced
into an area of your pelvic bone known as the iliac crest. Bone marrow
is then aspirated using a special syringe and the sample obtained is sent
to the laboratory. In the laboratory, the aspirate is spun in a machine
for 10 to 15 minutes and a concentrated stem cell sample is separated.
Your doctor then cleans and numbs your affected area to be treated and
then, under the guidance of special x-rays, injects the stem cells into
the diseased region. The whole procedure usually takes less than one hour
and you may return home on the same day of the procedure.
- You will most likely be able to return to work the next day following your
- You will need to take it easy and avoid any load bearing activities for
at least two weeks following your procedure.
- You will need to refrain from taking non-steroidal, anti-inflammatory medications
(NSAIDS) for a while as this can affect the healing process of your body.
Advantages & Disadvantages
- Stem cell therapy is a relatively simple procedure that avoids the complications
associated with invasive surgical procedures.
- As stem cell therapy uses the cells derived from your own body it reduces
the chances of an immune rejection.
The disadvantage of adult stem cell therapy is lack of data about its long-term
effects as it is a newer evolving therapy.
Risks and Complications
Stem cell therapy is generally considered a safe procedure with minimal
complications, however, as with any medical procedure, complications can occur.
Some risks factors related to stem cell therapy include infection as the
stem cells may become contaminated with bacteria, viruses or other pathogens
that may cause disease during the preparation process.
The procedure to either remove or inject the cells also has the risk of
introducing an infection to the damaged tissue into which they are injected.
Rarely, an immune reaction may occur from injected stem cells.
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