Stem cells are perhaps nature’s best-kept secret.
Adult stem cells are taken from the patient, and can be used to help in the repair and regeneration of damaged joint tissues and structures. This is a possible treatment for arthritis and cartilage regeneration in the knees and hip.
Stem cell therapy is a relatively new procedure. However, it has created so much interest worldwide that extensive research has been taking place in this field. Animal and human studies have been published that have suggested a safe and favourable response to stem cell therapy in hips, knees and even ankles.
There are two basic forms of stem cell - the embryonic stem cell and adult stem cell. Adult stem cells, which are also known as mesenchymal stem cells or MSCs are of great interest to researchers, scientists and surgeons alike. MSCs are free of the controversy that surrounds the embryonic stem cells and yet have the potential to form new tissues, giving the ability to repair and regenerate tissues such as cartilage and bone more effectively.
MSCs can be found at various locations in the body, including bone marrow, adipose tissue (fat) and peripheral blood. Stem cells are taken directly from the patients.
In joint preservation, one role of stem cells is in the possible treatment of arthritis of the hip and knee joints. This can potentially be accomplished by regeneration of cartilage (gristle). Stem cell therapy may be used in an attempt to encourage regeneration of this gristle layer. The procedure is designed to help preserve the natural hip and knee joints and perhaps to delay or prevent the need for more major operations such as replacement of the hip or knee joint.
Another area of particular interest for stem cell therapy in the hip and knee is to help with the regeneration of dead bone. In a condition called avascular necrosis, or AVN, there is death of a segment of the bone near the joint. This can sometimes progress onwards to become severe arthritis. Early reports of the use of stem cells to regenerate bone in AVN are encouraging.
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The procedure is in the form of arthroscopy (keyhole surgery) of the hip or knee. A single operation is normally required, normally carried out as day-case procedure for knee arthroscopy; most hip arthroscopy patients will have one night’s stay in hospital.
Once the patient is under general anaesthesia, an aspirate of their blood and/or marrow is taken with a special needle. The aspirate is then processed in the operating theatre, and while the patient is still asleep, in order to harvest the stem cells. At the same time the keyhole operation (arthroscopy) is commenced to access the hip or knee joint.
The surgeon uses specialist arthroscopy techniques to prepare the tissue bed so that it is ready to receive the stem cells. The harvested stem cells, alongside a suitable scaffold, are then injected through the same keyholes that are routinely used for the arthroscopy.
Any surgical intervention carries a degree of risk however the surgical procedures used for stem cell therapy are the same as those for routine hip or knee arthroscopy operations. There is a theoretical risk of infection, but this is low and surgery is in any event covered by antibiotic treatment.
As for the stem cells, these are derived from the patient’s own blood or marrow, so there is no risk of rejection or disease transmission.
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The treatment described on this page may be adapted to meet your individual needs, so it's important to follow your healthcare professional's advice and raise any questions that you may have with them.