One of the most frequent questions we receive in our office is can cartilage be regrown? “I AM BONE ON BONE.”
Medical research and clinical observation has clearly shown that cartilage has poor ability to spontaneously repair itself. Traditional treatments such as microfracture (a surgical option that creates small holes in the bone to allow blood flow to the damaged cartilage area in an attempt to stimulate new cartilage growth), bone drilling and autologous osteochondral graft (cartilage from one area patched into the “hole”) were not fully satisfactory to fulfill the patient needs. This is why medical research centers on regenerative medicine (bone marrow aspirate concentrate injections or sometimes referred to as stem cell injections) as possible care methods that should be further researched.
We are proud to have authored numerous research papers and forthcoming research papers on the use of stem cells in regenerative healing. These include the following peer-reviewed studies.
We are proud to have authored numerous research papers and forthcoming research papers on the use of stem cells in regenerative healing. These include the following peer-reviewed studies.
- Treatment of shoulder osteoarthritis and rotator cuff tears with bone marrow concentrate and whole bone marrow injections –
- Stem cell therapy for knee osteoarthritis – Short-Term Outcomes in Treatment of Knee Osteoarthritis With 4 Bone Marrow Concentrate Injections
Research in the medical community is focused on how bone marrow stem cells work in rebuilding the damaged part of the body, a knee, a shoulder, hip, etc., from within by turning a diseased joint environment into a healing joint environment.
Numerous studies support the healing and repair effects of bone marrow stem cells. To be balanced, it should be pointed out that some studies suggest limited or little or no positive impact of treatment.
Bone marrow stem cell – Research studies and reviews
Bone marrow stem cell therapy is the injection, into a damaged joint and surrounding area, of stem cells drawn from the patient’s own bone marrow. Stem cells are “de-differentiated pluripotent” cells, which mean that they continue to divide to create more stem cells; these cells eventually “morph” into the tissue needing repair—for our purposes, collagen, bone, and cartilage.
In the following articles, research into bone marrow stem cell injections are explored:
- Low back pain treated with bone marrow derived stem cell injections.
- Bone-marrow derived stem cells and tendon repair.
- The role of blood platelets in bone marrow aspirate injections.
- Physical therapy, Cortisone, Bone Marrow and PRP injections for elbow pain.
- Injections for knee pain: Bone marrow aspirate concentrate vs. PRP
The use of bone marrow-derived stem cells was first tested in the 1960s. Even then, doctors knew that stem cells had unique regenerative powers due to their ability to morph into bone and cartilage and migrate to the site of damage once introduced into the body. Using stem cells from a patient’s own bone marrow was particularly interesting, because these types of autologous stem cells are readily available from the patient themselves. Some research suggests that the introduction of stem cells into the joint also reawakens and revitalizes the stem cells already present in the synovial fluid, cartilage and bone.
Recent research
Mesenchymal stem cells in the treatment of osteoarthritis and chronic joint pain
A May 2023 paper (1) writes: “untreated osteoarthritis will not heal spontaneously, and current standard treatments are very limited due to the lack of vascularization in the cartilage tissue. Therefore, stem cell therapy seems to be the most promising for the regeneration of joint tissue, especially in the middle to late stages of the disease. Of the various stem cell types, mesenchymal stem cells are the most promising since they are relatively easy to harvest, proliferate very well, do not cause tumor formation, and are very well tolerated by the immune system.”
A March 2023 paper review study (2) compared the efficacy and safety of platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC), and hyaluronic acid (HA) injections for the treatment of knee osteoarthritis (OA).
- Twenty-seven studies met inclusion criteria, including:
- 1,042 patients undergoing intra-articular injection(s) with PRP (mean age 57.7 years, mean follow-up 13.5 months),
- 226 patients with BMAC (mean age 57.0 years, mean follow-up 17.5 months),
- and 1,128 patients with HA (mean age 59.0 years, mean follow-up 14.4 months).
The research team concluded their review by suggesting: “Patients undergoing treatment for knee osteoarthritis with PRP or bone marrow aspirate concentrate can be expected to experience improved clinical outcomes when compared to hyaluronic acid patients.
Do higher stem cell doses work better?
A January 2023 study (3) suggested that after a review of the literature, higher-level doses of MSCs stem cells may not necessarily result in better therapeutic effects following intra-articular injections. In six studies using autologous MSCs, only two studies detected better effects in the higher-dose groups. The results of other studies did not support better effects in higher-dose cases. A study found pain reduction and functional improvement in all treated cases but observed statistical significance only in the lower-dose group; only patients in the higher-dose group had worsened pain and decreased functional scores. . . autologous MSC injection with higher-level doses may not necessarily result in better therapeutic effects than those with lower doses.
References:
1 Thoene M, Bejer-Olenska E, Wojtkiewicz J. The Current State of Osteoarthritis Treatment Options Using Stem Cells for Regenerative Therapy: A Review. International Journal of Molecular Sciences. 2023 May 18;24(10):8925.
2 Belk JW, Lim JJ, Keeter C, McCulloch PC, Houck DA, McCarty EC, Frank RM, Kraeutler MJ. Patients With Knee Osteoarthritis Who Receive Platelet-Rich Plasma or Bone-Marrow Aspirate Concentrate Injections Have Better Outcomes Than Patients Who Receive Hyaluronic Acid: Systematic Review and Meta-analysis. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2023 Mar 11.
3 Wei P, Bao R. Intra-articular mesenchymal stem cell injection for knee osteoarthritis: mechanisms and clinical evidence. International Journal of Molecular Sciences. 2023 Jan;24(1):59.