Biologic Therapy

Stem cell therapy is a form of regenerative medicine that utilizes the body’s natural healing mechanism to treat various conditions. Stem cells are present in all of us acting like a repair system for the body. However, with increasing age fewer stem cells are delivered to the site of injury. The goal of Stem Cell therapy is to amplify the natural repair system of the patient’s body.

Stem cell therapy can be used to treat various degenerative conditions of the shoulder, knees, hips, and spine. It is also being used to treat various soft tissue (muscle, ligaments and tendons) as well as bone-related injuries. In the spine, stem cell therapy helps heal degenerative disks and alleviate pain.

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. The stem cells can be obtained from the iliac crest of the pelvic bone.

Stem cell therapy is a relatively simple procedure that avoids the complications associated with invasive surgical procedures. As it uses the cells derived from your own body, the chances of an immune rejection are low.

In order for joints to move smoothly they must contain an adequate amount of synovial fluid, which acts as a lubricant and shock absorber. Osteoarthritis causes synovial fluid to lose its properties by depletion of a component called hyaluronan. This leads to loss of cartilage and painful rubbing of the bones in the joints. A gel-like form of hyaluronan called hyaluronates or hyaluronic acid may be prepared and injected into the joints to increase their lubricating and shock-absorbing properties. Hyaluronate injections can relieve pain, improve mobility and delay the need for surgery.

Hyaluronate injections are usually performed after other non-surgical treatments for osteoarthritis such as medications, physical therapy and steroid injections have failed.

The procedure, also called viscosupplementation, first involves removal of any excess joint fluid with a syringe. Hyaluronates are then injected into the joint. Immediately following the injection, you may experience pain, swelling and warmth, which can be eased by ice applications. Avoid weight-bearing or strenuous activity involving the joint for the next 48 hours. The pain and swelling from osteoarthritis is gradually relieved with effects lasting for several months. A single dose or a total of 3 separate doses over several weeks may be required for optimum benefits.

Complications are rare but occasionally an allergic reaction may develop, intensifying symptoms.

Our blood consists of a liquid component known as plasma. It also consists of three main solid components which include the red blood cells (RBCs), white blood cells (WBCs), and platelets. Platelets play an important role in forming blood clots. They also consist of special proteins, known as growth factors, which help with our body’s healing process. Platelet-rich plasma or PRP is a high concentration of platelets and plasma.  A normal blood specimen contains only 6% platelets, while platelet-rich plasma contains 94% of platelets and 5 to 10 times the concentration of growth factors found in normal blood, thus greater healing properties.

Indications

PRP is a relatively new method of treatment for several orthopaedic conditions such as muscle, ligament, and tendon injuries; arthritis; and fractures. PRP injections can help alleviate painful symptoms, promote healing and delay joint replacement surgeries.

Procedure

Your doctor will first draw about 10 cc’s of blood from the large vein in your elbow. The blood is then spun in a centrifuge machine for about 10 to 15 minutes to separate the platelets from the remaining blood components.

The injured part of your body is then anesthetized with a local anesthetic. The platelet-rich portion of your blood is then injected into your affected area. In some cases, your doctor may use ultrasound guidance for proper needle placement.

Post-Procedural Care

• It is normal to feel some discomfort at the injection site for a few days after your procedure.
• You will be prescribed pain medications by your doctor.
• You may use cold compresses to alleviate your symptoms.
• You will be instructed to stop any anti-inflammatory medications.
• You may resume your normal activities but should avoid any strenuous activities such as heavy lifting or exercises.

Risks and complications

There are very minimal risks associated with PRP injections.  Some of the potential risks include

• increased pain at the injection site
• Infection
• Damage to adjacent nerves or tissues
• Formation of scar tissue
• Calcification at the injection site