It seems that not a day goes by without a reference to the magical effects of stem cells for the regeneration of nerve and muscle for different diseases such as spinal cord injury and heart attacks. Recently, sports doctors and orthopedic surgeons are turning to stem cell injections for their potential ability to regenerate cartilage. But is there any evidence of regeneration of tissue? More importantly, does inject a stem cell for arthritis work?
What are stem cells?
Most practices that offer expensive stem cell injections are not actually injecting true stem cells. In fact, they are injecting cells called pericytes, which are found on the walls of small blood vessels. These cells come from various sites – the most common being the fat lying on top of the tummy or thigh. The fat is removed by liposuction and processed to produce a pure form of pericytes. We inject this fluid into diseased joints or tendons.
How do stem cell injections work?
We think these pericytes improve the environment of the injected joint or tendon. However, there is no evidence that these cells regenerate new tissue such as cartilage or tendon.
What about pain?
There are a few studies that demonstrate improved pain in a joint or after injection of a stem cell for arthritis. However, these studies are low level meaning that the proof of an effect is not strong. One higher-level study performed by scientists in the USA suggested that the effect of injecting stem cells was no different from injecting sterile water in knee arthritis.
Are there alternatives to stem cell injections?
Yes. An expert wrote a blog on the evidence for platelet-rich plasma (PRP) injections. PRP comes from spinning whole blood into different cell layers. We extract and inject the plasma into joints and tendons. Evidence suggests that PRP helps some types of arthritis and tendonitis. Unlike stem cells, there are 16 randomized controlled trials showing a greater effect of PRP compared to placebo and cortisone for knee arthritis. Even better, there is more evidence that simple treatments such as exercise are highly effective.
In summary, we use stem cells in sports medicine to improve pain in arthritis and tendonitis. Stem cells usually come from fat from the tummy or thigh. We remove this fat by liposuction and treat the fat with chemicals. Then, this fluid containing stem cells is injected into joints and tendons. Injections improve pain but not by regeneration of tissue. Other treatments such as exercise work much better.
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