Stem Cell Treatments for Osteo Arthritis
Arthritis treatments control symptoms. But your stem cells can address the problem itself.
Learn how we use stem cell therapy to address the causes of osteoarthritis, to reverse or prevent its progression
The articular cartilage that cushions between joint bones has a limited capacity for spontaneous healing; therefore any joint damage from trauma, chronic overuse, and age-related degeneration ultimately progresses to osteoarthritis.
Arthritis most commonly affects hands, knees, hips shoulders and ankles. It reduces joint functionality, causes pain and disability as cartilage progressively breaks-down in the joint. Once osteoarthritis has progressed to end-stages, the remaining treatment option is a joint replacement.
- Emulsified fat (lipoaspirate)
- Bone marrow aspirate
- Pure adipose or bone marrow derived MSC (AdMSC, BdMSC)
- Stromal vascular fraction (SVF)
Aspirated fat initially contains about ±2% MSC; but post emulsification, there will be fewer viable cells and a basic biological residue. Bone marrow aspirate contains about 0.2% MSC and good handling of these aspirate should leave ±90% of all cells as viable. Stromal vascular fraction is aspirated fat that’s been concentrated and contains ±10% MSC.
Pure AdMSC and BdMSC are similar MSC that have been isolated and cultured to produce a >100% ‘pure’ cell population. The advantage of ‘pure’ cells versus the alternatives is; that repeat, or multiple joint, treatments do not require another tissue sample procedure; and that the physician actually knows how many stem cells are being employed to treat a joint.
Similarly, a physician with facility to undertake a viable cell count can have a reasonable estimate of bone marrow and SVF cellular composition. Our focus is on SVF and AdMSC as they’re easily obtainable from a small fat sample and they have a higher, more characterisable, MSC content.
Symptoms or causes
Osteoarthritis is characterised by pain, loss of cartilage and joint inflammation. Mechanical damage and inflammation to the joint explain key biological factors that contribute to OA; but, there are also senescence cells present in the multiple tissues that constitute the articular joint.
Senescence is a common feature of genesis, homeostasis, and age in cells. Subject to cell type and context they have a positive or negative impact. The chronic presence is of senescence is associated with loss of tissue function via their secretion of factors that are toxic to the microenvironment. Why cells become senescent (go into cell cycle arrest) and their myriad roles is complex. Although not OA specific, cells that become senescent generate an inflammatory and degenerative microenvironment in joint tissues.
Cartilage is synthesized from, and maintained by, chondrocytes. Senescent chondrocytes accumulate with age and are present in higher numbers in OA diseased cartilage compared with samples of age-matched healthy cartilage.
Inflammation of the synovial membrane (synovium) that encapsulates the joint, along with a mechanical failure of tissue, causes pain in OA. Cartilage is poor at regenerating itself, and is also dependent on the synovial fluid in the joint that provides it with the equivalent benefits of the blood supply it lacks. Synovial fluid also adds to the cartilage buffer acting as a ‘lubricant’. This synovial fluid is made in the synovium; and in OA, becomes compromised over time in composition and volume and thus additionally causal to the disease.
Key facets to a treatment of the causes thus symptoms of OA include an:
- senescent removal
- regenerative effect
Conventional drug treatments for OA (e.g. Analgesics, NSAIDs) aim to control disease symptoms like pain rather than address the disease itself. Such drug treatments demonstrate only modest and limited benefits; and, may have unwanted side effects. Hyaluronic acid (HA) and Platelet Rich Plasma (PRP) may give a transient symptomatic anti-inflammatory benefit in the early stages of OA.
- Stem cell based therapy is designed to address the causes of OA and in doing so to prevent or reverse disease progression.
- AdMSC based therapy has been shown to provide significant reduction in pain and function improvement of the joint; and this results in improved quality of life scores.
- MSC based therapy is less onerous than the various costs attached to joint replacement surgery.
Sometimes OA is accompanied with other damage, such as musculoskeletal soft tissue damage from a sports injury. In such cases there may be multiple benefits to leveraging you body’s natural healing powers with a AdMSC based therapy.