Knee osteoarthritis is a common medical condition in the elderly and the obese. Although there are several treatment options, in recent years, stem cell therapy has been applied in an ever-increasing number of clinical cases. Knee osteoarthritis is a chronic, indolent disease that will affect more and more people every year increasing number of patients. The pain, tenderness and stiffness is caused by degeneration of the cartilage substance inside the knee. Estimates are that by 2030, only in the United States, this medical condition will partially or completely disable 67 million people. Conventional options like physiotherapy or drugs offer only temporary relief of clinical symptoms and can have side effects. A complete healing of normal cartilage function does not come from those treatments alone. In severe cases of knee osteoarthritis total knee replacement may be required. These surgical interventions come together with high effort and costs and are not always successful.
Self-healing of the cartilage can take a prolonged period in those patients lucky enough to be able to produce the healing components. The fluid inside the joint contains mesenchymal stem cells (MSCs) which can differentiate into chondrocytes. This newly formed cartilage is very weak as well as soft and can be destroyed with a small amount of stress within the joint. Normally, there are a limited number of MSC’s in the joint at any time.
The purpose of using stem cells is to support the body’s own process to heal the cartilage which will lessen the pain of osteoarthritis relief from OA. Although repairing the cartilage can occur, at the present time there is no permanent cure for osteoarthritis.
The stem cell candidates for use in these therapies are multipotent adult MSCs, because they are available in several tissues. MSCs can be harvested from bone marrow and adipose tissue that the patient with osteoarthritis has. A big advantage in harvesting the treatment substance from the patient themselves is that MSCs and platelet-rich plasma ensures that the patient’s immune system will not reject the cells. After this procedure, it is important that the joint is limited in its’ weight bearing for a period as little as possible because the newly differentiated cartilage is highly susceptible to damage. MSCs treatment offers a quick and relatively uneventful recovery.
The MSC treatment should only be used if the degeneration of the cartilage is not complete. If there is cartilage and joint fluid is available, stem cells can differentiate because of necessary growth factors are present in the joint fluid. In cases where there is bone-on-bone contact, stem cell treatment is not indicated. It is crucial for the patient is to limit physical activity and pressure on the involved joint in the immediate period after the therapy so there can be limited stress on the joint improve the chance of successful recovery. It is common that more than a single session is required to get the amount of cartilage needed to regenerate enough cartilage to accomplish full healing.
