A decade has passed since the first clinical application of stem-cells to restore damage cartilage and tendons in knees. Much data has been collected over that period of time to show that stem cells harvested from the patient’s own marrow or those from frozen commercial preparations have a profound effect on healing damaged knees.
How do we know this healing is occurring after stem cell injection to the knee? The answer is, first, return of function meaning full range of motion and of strength occurs over the period of a year depending on the level of damage. Secondly, the serial MRI’s evidence direct healing of structures such as cartilage and lining tissue, tendons and ligaments. Collecting MRIs of the same treated joint at 4-6-8-12 month intervals are the best way to compare the rate of healing and the level of thickness in restored tissue.
Where do we obtain stem cells? In younger patients we offer both stem cell treatments derived from the patient’s own bone marrow or commercially prepared stem cells from amniotic and placenta tissues. Both are applied with equal success rates. In older patients, we have sometimes encounter a “dry” tap with poor or little bone marrow collected. Therefore, for patient over the age of sixty, commercial preparations of stem cells offer an effective alternative.
How are the procedures done? To collect the patient’s own stem cells, we anesthetize locally the target tissue in the lower back over the top of the hip, the iliac crest. The skin and the layers of soft tissue below that are individually numbed with a small injection of Lidocaine. Finally, the periosteum covering the bone is numbed and the marrow harvested with a wide-gauge needle. In the few cc’s collected rich with have several hundred million stem cells. These are processed at once and injected into the damaged knee. In the case of commercial stem cells, these are thawed from their vials and injected immediately into the targeted areas.