Bone Marrow Derived Stem Cell Injections at R3 Stem Cell Clinics
Nonoperative pain management for joint arthritis, such as in the hip, knee and shoulder, has to date consisted mostly of pain suppressing medicines. This often includes cortisone injections, topical analgesic creams and anti-inflammatory medications by mouth. What these conditions really need is a game changer, a treatment that alters the condition’s underlying arthritis.
Regenerative medicine offers the potential for a real cure with stem cells, growth factors and platelets to heal damage. One of the main medical procedures that continues to increase in popularity is bone marrow derived stem cell injections. This bone marrow contains a significant amount of the biologic materials necessary for regeneration, with the added benefit that the material comes from the patient’s own body.
What are bone marrow derived stem cell injections?
One of the reasons why stem cells are used as therapy for conditions that manifest through joint pains is the fact that they have regenerative properties, meaning the potential to repair and reverse damaged joints.
Bone marrow is a spongy tissue inside a person’s bones, and produces cells that are vital to existence including platelets, white blood cells and red blood cells. All of these cells begin in the marrow as stem cells, which are essentially a “blank slate” type of cell. With a “blank slate”, the stem cell can differentiate into virtually any type of cell necessary in the body such as cartilage, tendon or muscle. There are three types of adult stem cells in the human body. One type eventually turns into blood components, with a second destined to become lining of the endometrium.
The third, and most important for musculoskeletal regenerative medicine, are mesenchymal stem cells found in bone marrow. They have been used in animal models to regenerate cartilage and in human models to regenerate bone. (Centeno et al, 2008)
The richest sources of stem cells in the body for concentrated amounts of bone marrow are in the iliac crest of the hip and the bones of the spine. For the easiest acquisition process, the iliac crest is used for the procedures in an outpatient procedure.
How are these injections performed?
First of all, the doctor will extract bone marrow from the patient’s hip bone at the iliac crest. The area is prepped sterile and numbed considerably to make it tolerable. Since the patient continuously makes new bone marrow, it does not present any lasting problem to harvest some of the bone marrow.
Approximately 30 to 60 cc’s of bone marrow is acquired, and it is processed immediately to concentrate down the stem cells and growth factors. In the past, obtaining regenerative cells from a patient’s bone marrow was very difficult and expensive. Now, thanks to new technologies and medical advancement, it actually takes the doctor very little time and it is a fairly simple outpatient procedure to obtain the bone marrow.
Once the marrow is harvested, it is then placed in a centrifuge and spun until a concentrated substance is obtained consisting of the most important regenerative components. Afterwards, the patient is injected with the substance in the same day, without the need for hospitalization.
Is the procedure painful?
Harvesting bone marrow from the iliac crest does entail some moderate pain. While plenty of numbing medicine is used during the procedure, there will be some mild to moderate discomfort. This may persist for a few days to weeks and slowly subside as the area heals up.
The injection of the prepared bone marrow into the affected joint is no more painful than a typical cortisone injection. For a few days afterwards, the joint may have slight increased pain due to the inflammatory reaction generated. This reaction is normal, as inflammation is the first stage of healing.
Who do Bone Marrow Derived Injections Help?
As with other types of regenerative medicine, bone marrow derived stem cell injections work better for some cases than for others. There have not been large scale studies to date looking at bone marrow derived stem cell injections in humans. In a 2011 study out of the Beijing Institute of Technology, bone marrow mesenchymal stem cells were shown to have an excellent potential for cartilage production in animals (Li et al, 2011). A recent study in canines showed that bone marrow mesenchymal stem cells were effective in repairing bone defects(Kang et al, 2013).
With the positive results seen in animals, the treatments have been introduced for humans. R3 Stem Cell Clinics has research beginning looking at the effect of bone marrow derived stem cell injections for the following applications:
- Spinal Arthritis in facet joints (neck and back)
- Extremity arthritis including knee arthritis, hip arthritis, ankle and shoulder arthritis
- Sacroiliac Joint Arthritis
How are these injections different from cortisone shots?
Bone marrow derived stem cell injections have as goal to treat the damaged tissue, so that the body can heal. Not only to heal the problem, but to provide pain relief at the same time. Cortisone shots, on the other hand, do not have any other role than pain relief by providing anti-inflammation. While cortisone (steroid) injections are effective, they are not long term.
Are There Risks With the Procedure?
With the procedure being outpatient and minimally invasive, the risks are low. But they do exist and include potential for infection, allergic reaction, bleeding, pain at the harvest site, wound drainage and failure to relieve a person’s pain. Risks should be discussed with your treating doctor.
What Are My Options?
R3 Stem Cell Clinics offer various research projects and treatment opportunities with bone marrow derived stem cell injections for both extremity and spinal joint pain and arthritis.