Don’t Believe Some Of The Stem Cell Cartilage Regrowth Claims!

Today I saw a middle aged patient with middle aged knee arthritis and he was looking for another option for arthritis pain relief. He had been to two seminars discussing umbilical cord blood, Wharton’s Jelly, Exosomes, and other regenerative medicine injections. His question for me: “How much cartilage will YOUR procedure grow back” Seems that he had been told that he would grow 1 inch of cartilage back at one seminar and about 0.5 inches at the other seminar. I found this funny and interesting and probably a bald faced lie…. because the upper range of normal human cartilage thickness in the knee is 3-4mm…….FAR less than the 25mm promised in one seminar and still far less that the 12mm promised in the other seminar.

PRP for Patellar Tendinopathy? The Jury is still out….

Is there strong evidence for using PRP to treat Patellar Tendinitis/Tendinopathy?

Not according to this recent study!

This study was just published in AJSM, a well-respected, high impact Sports Medicine Journal. Authors include well know lecturers and active clinical researchers in orthobiologics at major academic centers. The study was prospective and randomized with 1 year follow-up. Patients all had persistent symptoms with or without activity for at least 6 months. 19 patients got a single LR-PRP injection, 19 patients got LP-PRP, 19 patients got placebo normal saline. All patients had rehab. At no time in follow-up was ANY group’s results superior. So…..we can argue about the sample size being maybe a little small….or about the technique being only a single injection….or about the platelet “dose” delivered….but there is pretty good level 1 data here that PRP for patellar tendinopathy is by no means a “slam dunk” and that we might just need some level 1 evidence showing efficacy of PRP for patellar tendinopathy!

Canadian Study shows benefits of autologous Bone Marrow Stem Cells for Knee Arthritis.

Interesting Canadian pilot study (N=12) on cultured bone marrow derived MSCs used for knee osteoarthritis (KL3 and KL4) This is one of the very few published papers showing dose dependent outcomes (higher dose…better outcome) with autologous cultured bone marrow derived MSCs.
Of note is that the MRIs didn’t change out to one year.  Clinics routinely telling patients that their xrays and MRIs will improve from a stem cell procedure should just stop!
Remember we can’t culture stem cells and use them without specific FDA regulatory approval in the USA so even the lowest dose in this study (1 million, 10 million, 50 million) is far out of reach of our same day procedures where we can expect to be delivering 5,000 up to 50,000 MSCs depending on how much marrow we harvest and whether it is centrifuged or not.  Hint:  We draw more bone marrow and then centrifuge because we get 3-5x more stem cells on the same day that way!

We do have some published data on same day bone marrow MSC outcomes for knee osteoarthritis so it is interesting to compare improvements in pain and functional score to see if culturing is “worth it”. Maybe the pain and function improve so much more than a same day procedure that culturing will ultimately be shown to be worth the additional cost?

LINK FOR PAPER

Stem Cells for Knee Arthritis….avoid knee replacement

Our patient in this video is 2 years after a single stem cell injection for knee arthritis. We only use bone marrow derived stem cells because any supposed “stem cell” injections from umbilical cord blood, or amniotic fluid or Wharton’s Jelly or placental tissues have been shown to not actually have living stem cells. That’s right …..scam alert!!! Furthermore, there is no published peer reviewed data for human outcomes with those products for the orthopedic uses they are being peddled for. Finally, they are all classified incorrectly with the FDA and the legal crackdowns have already begun!
Wen a patient gets an autologous, actual, living stem cell injection, the result can be like the one this patient has….

Bucket Handle Medial Meniscus tear? Don’t remove the meniscus…repair it and add stem cells!

I have been repairing virtually all meniscus injuries and adding an orthobiologic injection to maximize healing. This combination of surgery + stem cells has been shown to result in better healing rates of the meniscus and allows me to “save” more meniscus tears for patients than I could before.
The video is a 60 sec clip showing how we can repair a bad meniscal injury a young patient and get it to heal about 90% of the time by adding a stem cell injection.