Across the United States, doctors are now commonly offering treatments that are being called “stem cell injections” or “stem cell treatments” or “cell based therapies” (CBT). More recently there has been a move to refine the description of the treatments to help patients understand how the treatment works. The term ‘medicinal signaling cell’ is appropriate because it describes what the cell treatment is doing. The cell type is frequently abbreviated as “MSC”.
Bone marrow is the best source for MSCs and CBT and that’s where we harvest your own stem cells. The pelvis has the best cells and they are very easy to obtain. The procedure is done under local anesthetic. We have not observed any complications in hundreds of cases over ten years. We have only had two patients require total joint replacement inside of 10 years, but over a decade of experience with the concepts and cell based procedures probably gives us an unfair advantage in selection criteria.
The bone marrow is harvested easily and separated out first by centrifugation. Next, a proprietary process to remove pro-inflammatory chemicals and build a scaffold for the cells from your bone plasma is completed. Without this step, chemicals your body makes that stir up inflammation and pain are still present and just re-injected, leaving a net gain around zero that you just paid $5k or more for.
The separation process retains anti-inflammatory chemicals that are responsible for the majority of the pain relief that accompanies the procedures. These exact same anti-inflammatory chemicals are even made and sold by big pharma, one is called Kinaret®, all cost over $3800 per drug, per month. All act by modifying the immune system and decreasing inflammation.
The easiest way to understand CBT is to consider them to be two-part treatment modalities: a cellular part and a protein part. The cells themselves contribute in large part by signaling to other cells. They respond to the arthritic environment based on signals they receive in the injured joint fluid and tissue, usually breakdown products of destroyed cells or matrix. The proteins are either already present in the plasma after filtration or in platelets.
The proteins already in the plasma are signaling proteins and growth factors. The proteins present in platelets are also growth factors, so called because they encourage cell and tissue growth through actions like causing new blood vessel formation or more new cells to be formed.
Now that CBT can no longer be denied as a viable therapeutic option for properly selected patients, it remains to be seen what role they play in protocol based arthroplasty algorithms that are certain to arise in the future.