Stem Cells

Scientists and doctors have made tremendous advances to make tissue regeneration a reality in treating many joint diseases that have failed to respond to traditional care. Through regenerative medicine, a person can take advantage of their body’s ability to heal itself by using the healthy adult stem cells that are found throughout the body. Laboratory and clinical research has shown that it is possible to use adult stem cells to restore lost, damaged or aging cells. The treatment effectively regenerates tissue in the body, providing patients with an alternative to more traditional methods of treatment, including surgery. Regenerative therapies are showing promise in orthopedic medicine, burn treatment, nerve restoration, and treatment of heart conditions, diabetes, multiple sclerosis and other diseases.

What are Adult Stem Cells?

Adult stem cells were discovered over 40 years ago when reseachers found that cells derived from bone marrow had the ability to form various tissues. Adult stem cells are early stage cells, and under the right conditions, are capable of developing into other types of cells with the potential to regenerate damaged tissue.

What Conditions Do Stem Cells Treat?

Autologous Adult Stem cells (ASCs) are used to treat many types of chronic pain and degeneration, along with intraarticular pathology, tendinopathy and tendon tears. Currently, our doctors use stem cell treatments for shoulder, knee, hip and spine degeneration, in addition to soft-tissue (muscle, tendon, ligament) and other bone-related injuries.

Who is a Good Candidate for a Stem Cell Procedure?

In order for your physician to determine whether you would be a good candidate for stem cell treatment, a detailed history of your injury, along with a physical examination, x-rays, and possibly a MRI are required. While stem cell therapy may be appropriate in treating certain conditions, it is not applicable for every condition. It has, however, proven to be a viable option for individuals suffering from pain related to joint disease or injury.

Good candidates for stem cell treatment include:

• Patients suffering from soft-tissue and/or bone disease or injury
• Patients wanting to avoid the inherent complications that come with an invasive surgical procedure.
• Patients suffering from pain that are interested in an option that offers potential for an overall improved quality of life.

Every patient is different. The success of the stem cell therapy is dependent on the severity of your condition and your body’s ultimate response to the stem cell therapy.

What is a Stem Cell Procedure?

• A regenerative cell procedure harnesses and amplifies the body's natural mechanism for healing (and anti-inflammation). This mechanism uses adult autologous stem cells derived from your own bone marrow.
• In the procedure, the physician will aspirate bone marrow from your hip, concentrate, then apply the concentrate to the injury site of the knee. In all, the process takes less than 45 minutes.
• Because your therapy will utilize a concentrated preparation of your own cells, the procedure is considered "autologous point-of-care". The procedure is fast, and in most cases can be completed with moderate sedation.

Overview of the Procedure:

An adult stem cell procedure harnesses and amplifies the body’s natural mechanism for healing and anti-inflammation. Once you have been identified as a good candidate for the procedure, a member of our staff will review the procedure with you and answer any questions you may have. Once scheduled for the procedure, you can expect the following:

• The mechanism uses adult autologous stem cells, derived from your own bone marrow.
• In the procedure, the physician will aspirate these cells from your hip, concentrate them, and then deliver them back into your body in the damaged or injury area. These cells will aid in your body’s natural healing processes.
• The process takes less than 45 minutes, and the concentration of the cells takes about 12-14 minutes.

Procedure Preparation and Recovery:

You and you physician will discuss your specific pre-injection and post-injection instructions. However, general pre- and post-injection care following the below guidelines:

• Before Injection:
  • Avoid NSAIDs (i.e. Ibuprofen, Aleve, Advil) for 3 days prior to injection
  • Remember to fill prescription for Niravam and bring it with you to your procedure (if applicable)
• After Injection:
  • Apply ice every 4 hours as needed for pain for the first 48 hours
  • Avoid NSAIDs (Ibuprofen, Aleve, Advil) for 5 days after procedure
  • Avoid smoking if possible
  • Remove steri-strips from your hip wound 5 days after procedure
  • It is OK to shower without the dressing/bandage
  • Normal walking only for 2 weeks; no vigorous exercise involving hip or knee
    • You may also utilize protective weight bearing devices such as crutches or a cane if it helps with pain
  • You may use an ACE wrap or knee sleeve if it helps with pain
  • Based on your recovery, the doctor may prescribe physical therapy or other follow-up care after 1-2 weeks
  • Follow-up office visit with your physician after 2 weeks

FAQs:

Q: What is Regenerative Medicine?

A: Regenerative Medicine is a new and advancing scientific field focused on the repair and regeneration of damaged tissue utilizing stem cells.

Q: What are adult stem cells?

A: Adult stem cells are unspecialized or undifferentiated cells, capable of two processes: self-renewal and differentiation. They are vital to maintaining tissues in the body such as internal organs, skin and blood.

Q: Are there different types of adult stem cells?

A: Yes, there are many types of adult stem cells found in the body, which have variable differentiation potentials. The adult stem cells that aid in the repair of damaged tissue are multipotent, mesenchymal stem cells. These are located in bone marrow and adipose (fat) tissue.

Q: Where do adult stem cells come from?

A: In adults, stem cells are present within various tissues and organ systems, the most common being bone marrow and adipose (fat tissue). Other sources include the liver, epidermis, retina, skeletal muscle, intestine, brain, placenta, umbilical cord and dental pulp.

Q: What is the different between adult stem cells and embryonic stem cells?

A: Adult stem cells are found in mature adult tissues including bone marrow and fat, while embryonic stem cells (ESCs) are not found in the adult human body. ESCs are obtained from donated in vitro fertilizations, which raises many ethical concerns. Because ESCs are not autologous, there is a possibility of immune rejection. Adult stem cells do not raise ethical issues nor pose any risks for immune rejection.

Q: Does the Physician use embryonic stem cells in clinical procedures?

A: No, the cell therapy systems used by our physicians use only autologous adult stem cells isolated from the patient during surgery. The physician does not participate in embryonic stem cell research or use embryonic stem cells in clinical procedures.

Q: Are there ethical issues associated with harvesting adult stem cells?

A: No, adult stem cells do not raise ethical questions, as they are harvested from the patient’s own body.

Q: Are there cancer-causing risks associated with adult stem cell treatments?

A: No. Where embryonic stem cells have been shown to form teratomas (germ cell tumors), there is no data that suggests adult stem cellshave the same potential to promote the development of tumors.

Q: How does the Physician obtain adult stem cells for use in cell treatments?

A: The physician currently utilizes a system that harvests adult stem cells from bone marrow aspiration during your surgical procedure.

Q: Are the harvested adult stem cells expanded in a laboratory setting prior to delivery back to the patient?

A: No, the Physician does not use in vitro expansion. The cells are harvested, processed in the operating room, and delivered back to the patient at point of care.

Q: How are adult stem cells used in surgical procedures?

A: During a surgical procedure, adult stem cells are isolated from the patient (bone marrow aspiration), concentrated, and delivered back to the site of injury to assist in the healing process.

Q: How do stem cells know what type of tissue to develop into?

A: The differentiation of stem cells is dependent on many factors, including cell signaling and micro-environmental signals. Based on these cues, stem cells are able to develop into healthy tissue needed to repair damaged tissue. For example, multipotent stem cells delivered to damaged bone will develop into bone cells to aid in tissue repair. The exact mechanism of lineage-specific differentiation is unknown at this point.

Q: Will my body reject the stem cells?

A: No, adult stem cells are autologous and non-immunogenic.

Q: Is stem cell therapy safe?

A: Yes. Speak with your doctor regarding specific clinical studies that have been done to show that stem cells are safe and effective.

Q: Where are stem cells currently being used?

A: Stem cells are currently being used in both laboratory and clinical settings. Laboratories are using human and animal derived stem cells to conduct in vitro studies, as well as in vivo studies with small and large animals. Autologous adult stem cells are currently being used in hospitals and clinics during surgery to aid in the repair of damaged tissue.

Q: How long will the stem cells last?

A: It will depend on your injury, the area that is treated, and your body’s natural response to the therapy.

Q: What is the difference between autologous and allogeneic cells?

A: Autologous cells are taken from the same patient, typically at point of care. Allogeneic cells are taken from another patient and are often manipulated before they are given to a patient.

Q: How much will it cost?

A: There are 2-3 fees associated directly with stem cell treatment procedure. However, since insurance plans do not cover stem cell procedures, payment for this treatment is collected directly from the patient. The patient will be responsible for the Physician’s fee, as well as the Facility fee. Should the patient opt for anesthesia during the procedure (anesthesia for stem cell injections is not required), there would be the Anesthesia fee as well. Please contact the doctor’s billing department for specific cost estimates and payment options.