Not a day goes by without a reference to the magical effects of stem cell therapy for the regeneration of nerves and muscles for diseases such as spinal cord injury and heart attacks. Recently, sports doctors and orthopaedic surgeons in the UK have been turning to stem cell therapy for their potential to regenerate cartilage. It is part of the new regenerative medicine therapy. But is there any evidence of regeneration of tissue? More importantly, does injecting stem cell therapy for arthritis UK work?
What are Stem Cells?
Most practices offering expensive stem cell therapy do not inject actual stem cells. Instead, they inject cells called pericytes or mesenchymal stem cells found on the walls of small blood vessels. These cells come from various sites – the most common being the fat on the tummy or thigh. The fat is removed via liposuction and processed to produce a pure pericyte population. In addition, pericytes or MSCs also come from bone marrow. We inject this fluid into diseased joints or tendons.
How does stem cell therapy for arthritis UK Work?
We don’t know. We think these pericytes or MSCs improve the environment of the injected joint or tendon. However, no evidence exists that these cells regenerate new tissue, such as cartilage or tendon.
What about Pain?
A few studies demonstrate reduced pain in joints or after stem cell therapy for arthritis. However, these studies have low-level evidence, so the proof of an effect is not strong.
Higher-level evidence, such as randomised controlled trials, is not so rosy for stem cell injections:
- A higher-level study conducted by the Mayo Clinic in the USA found that the impact of stem cell therapy was no different from injecting sterile water into the knee in patients with knee arthritis.
So, Are There Alternatives to Stem Cell Therapy for Arthritis UK?
Yes. I wrote a blog on the evidence for platelet-rich plasma (PRP) injections. PRP is derived from spinning whole blood to separate the different cell layers. We inject plasma into joints and tendons. Evidence suggests that PRP helps some types of arthritis and tendonitis. Unlike stem cells, 23 randomised controlled trials show a more significant PRP effect than placebo and cortisone for knee arthritis. Also, in one study comparing PRP to stem cells for knee arthritis, there was no difference between groups. Recently, there has been increasing evidence that high-concentration PRP, such as Arthrex ACP Max, yields better results than low-concentration PRP.
Another alternative to stem cell injections is a high-molecular-weight hyaluronic acid such as Durolane. Evidence suggests that Durolane is effective for knee and hip joint arthritis. It requires only one injection under ultrasound guidance and can last up to 18 months. In addition, repeat injections have shown effectiveness for up to 5 repeated injections. Finally, Durolane is less expensive than PRP therapy.
Even better, there is more evidence that simple treatments such as exercise are highly effective.
Final word from Sportdoctorlondon about Stem Cell Therapy for Arthritis UK
In sports medicine, we use stem cells to improve pain in arthritis and tendonitis. Stem cells usually come from fat on the tummy or thigh. We remove this fat by liposuction and treat it with chemicals. Then, this fluid containing stem cells is injected into joints and tendons. Injections improve pain, but not by regenerating tissue. Other treatments, such as exercise, work much better.
More injection information:
- Ultrasound-guided injection expertise
- Cost of cortisone injection: is it worth it?
- How long does it take for a cortisone shot to work?
- Hyaluronic acid injection
- Durolane injection for arthritis
- Platelet-rich plasma injection
- Combined hyaluronic acid and PRP injection
- Cortisone shot London: a new low-cost injection service.
- Arthrex ACP Max: the new generation of PRP
Interesting. I am an 80 year old woman with severe osteoarthritis of the right hip necessitating a walker for even in-home ambulation. My 58 year old son recently had a supposed placental stem cell injection to his back for herniated disc as well as protruding disc causing tingling, numbness and inability to raise his foot. This was given at a chiropractor’s office by a medical doctor trained to do stem cell injections. One injection cost $5000 and no guarantee it would work, that another injection might be necessary in three months. My question: Does this all sound legitimate?
No. There is no evidence that stem cell or placental injections are any better than other injections. We still need studies to show that these more expensive injections work better than other injections, such as hyaluronic acid or PRP.
Do you think that arthosamid treatment will one day be available for thumb arthritis? I am 65 years old and otherwise in good health, but due to a job that caused repetitive stress injury to my thumb joint there is no cartilage left in some places in that joint and it can be very painful and I can barely use that hand times. I have tried other injections, PT, and splints, but do not want to do more radical surgery. I would love to hear that arthosamid will likely be available for thumb joints also eventually.
Dear Becky,
Arthrosamid is only licensed for knee joint osteoarthritis. The company has yet to make plans to expand its use to other joints.
Lorenzo