Category: Knee

Interesting Canadian pilot study (N=12) on cultured bone marrow derived MSCs used for knee osteoarthritis (KL3 and KL4) This is one of the very few published papers showing dose dependent outcomes (higher dose…better outcome) with autologous cultured bone marrow derived MSCs.
Of note is that the MRIs didn’t change out to one year.  Clinics routinely telling patients that their xrays and MRIs will improve from a stem cell procedure should just stop!
Remember we can’t culture stem cells and use them without specific FDA regulatory approval in the USA so even the lowest dose in this study (1 million, 10 million, 50 million) is far out of reach of our same day procedures where we can expect to be delivering 5,000 up to 50,000 MSCs depending on how much marrow we harvest and whether it is centrifuged or not.  Hint:  We draw more bone marrow and then centrifuge because we get 3-5x more stem cells on the same day that way!

We do have some published data on same day bone marrow MSC outcomes for knee osteoarthritis so it is interesting to compare improvements in pain and functional score to see if culturing is “worth it”. Maybe the pain and function improve so much more than a same day procedure that culturing will ultimately be shown to be worth the additional cost?

LINK FOR PAPER

Our patient in this video is 2 years after a single stem cell injection for knee arthritis. We only use bone marrow derived stem cells because any supposed “stem cell” injections from umbilical cord blood, or amniotic fluid or Wharton’s Jelly or placental tissues have been shown to not actually have living stem cells. That’s right …..scam alert!!! Furthermore, there is no published peer reviewed data for human outcomes with those products for the orthopedic uses they are being peddled for. Finally, they are all classified incorrectly with the FDA and the legal crackdowns have already begun!
Wen a patient gets an autologous, actual, living stem cell injection, the result can be like the one this patient has….

I have been repairing virtually all meniscus injuries and adding an orthobiologic injection to maximize healing. This combination of surgery + stem cells has been shown to result in better healing rates of the meniscus and allows me to “save” more meniscus tears for patients than I could before.
The video is a 60 sec clip showing how we can repair a bad meniscal injury a young patient and get it to heal about 90% of the time by adding a stem cell injection.

Our patient has now had 2 good years with minimal knee pain after being told she needed a total knee replacement!  All from a single injection of Platelet Rich Plasma (PRP) made from her own blood in the office.  She now wants the other knee done :). Who wouldn’t!

30 second example of an obstructive meniscal tear that often continues to cause knee dysfunction despite nonsurgical treatment. The degenerative tears have been shown in multiple studies to get better most of the time without surgery, orthobiologics, or anything more than physical therapy. A meniscus tear diagnosis on a MRI reading is not a reason for any invasive procedure….rest, rehab….time…will allow most patients to return to their “baseline” knee function.

With orthobiologics, although there may be a degenerative meniscal tear…we are usually treating the joint milieu by chronic inflammation and the chondral catabolic processes.

Just the first 30 seconds of this video!: https://lnkd.in/e5tTvV3