If you are a regular reader of our blog, by now you know a good amount about osteoarthritis (OA). This disease, characterized by chronic inflammation and breakdown of cartilage, is a leading cause of disability in the United States. Sadly, no cure has yet been discovered, and many patients end up eventually having a joint replacement surgery. However, there are several effective non-surgical treatments available to help slow down or even reverse the progression of OA and prolong the lifespan and overall health and function of the joint, which can help postpone or eliminate the need for surgery.
Stem cells live throughout the body, with different concentrations in each tissue type. Since cartilage has no blood supply, it has no stem cells in its matrix. That’s why cartilage has such poor potential to heal on its own and why OA is such a relentless process. Researchers have found a way to overcome this problem — by taking healthy stem cells from bone marrow or fat (adipose) tissue and transferring them into an OA joint. These stems cells are much more responsive and can hone in on the areas of damaged tissue. Transplantation of stem cells can both inhibit additional cartilage loss and repair the damaged areas.
In 2014, a group of researchers in Korea conducted a study with 18 women, all age 60, who had been suffering from knee osteoarthritis for more than five years. These patients all had advanced OA (grade 3 or 4) and had failed all other conservative treatments, with no relief from their symptoms. They all underwent a stem cell transplantation procedure (the harvest site used in this study was bone marrow) and had arthroscopy (camera inside the joint) and MRI imaging performed before the treatment and six months after the procedure. The findings were impressive:
A 40% reduction in measured cartilage defects
Biopsies conducted at the beginning of the study had revealed in some patients the total lack of articular cartilage. Biopsies conducted six months after the treatment showed smooth, regenerated articular cartilage integrated with the bone.
The average thickness of the participants cartilage increased by 300%
Four of the sixteen patients who had been seen to have zero cartilage before the procedure had 1.6mm of cartilage after six months
39% reduction in overall pain at six months
50% increase in function when measured at six months
While there are some drawbacks to this study, such as the lack of a control group and the small number of participants, it is exciting to see clinical research demonstrating cartilage repair in patients with advanced knee OA.
Regenerative medicine procedures are quickly revealing their amazing potential. Stem cells are attracted to diseased tissue, which means they are directed naturally towards the defective areas of cartilage. Not only is stem cell transplantation the most promising step towards a cure for OA, but it is also a very safe procedure. There is an incredibly low instance of adverse effects, for instance, infections only occur for two out of every 100,000 treatments, compared with total knee replacement surgeries where infections occur once in every 100 patients.
While more research and larger studies still need to be conducted, these are very encouraging results, indicating that researchers are on the right path to finding a cure for osteoarthritis and potentially eliminating the need for knee replacement surgeries in the future.
Learn more about Stem Cell Transplantation at Reflex.