Stem Cells are undifferentiated cells that have the potential to become other, more specialized types of cells. Stem cells are broadly categorized as either “embryonic” or “adult.” As the name implies, embryonic stem cells are derived from human fetuses, whereas adult stem cells are obtained from adults.
Currently, there are over 70 proven therapies using adult stem cells, while there are none using embryonic stem cells. This is in part because scientists have had tremendous difficulty controlling how embryonic stem cells differentiate; they have a nasty habit of causing tumor formation, including teratomas. Adult stem cells, on the other hand, do not suffer from this pitfall.
Mesenchymal stem cells, or MSCs, are multipotent stem cells that can differentiate into a variety of cell types, including: osteoblasts (bone cells), chondrocytes (cartilage cells) and adipocytes (fat cells). This has been demonstrated in ex vivo cultures and in vitro or in vivo. MSCs are obtained from the bone marrow, most commonly the back of the iliac crest (the “hip bone”)
How Are MSCs Obtained? Harvesting MSCs for injection therapy is done right in the office. Stem cells can be obtained from the bone marrow (they can also be obtained from fat; see below). The skin is numbed first with a little Novocain. Next, the hip bone is numbed with more Novocain. A special needle is then passed through the cortex of the bone into the marrow cavity. This is a painless procedure in most cases. The liquid marrow is then very slowly drawn into a syringe. Once an adequate amount of liquid marrow is obtained, the needle is removed and a bandage applied.
It’s critical to note that if the bone marrow is not properly harvested then most of what is drawn into the syringe is peripheral blood with very few stem cells in it. In this case, you are paying for a very expensive PRP procedure, not a stem cell procedure! At Valley Sports Physicians we use the Marrow CELLutions® device (see video link above), which is the latest technological advancement in harvesting marrow stem cells and results in the best stem cell yields with the least amount of discomfort for the patient.
The best source for marrow stem cells is the iliac crest. But, sadly, there are some YouTube videos showing the doctor drilling into the front of the shin bone and calling it “Stem Cell Prolotherapy.” Or doctors using outdated inferior harvesting techniques.
How Are Stem Cell Injections Given?
All of our stem cell, PRP, and prolotherapy injections are given under direct ultrasound guidance or x-ray guidance. We first numb the skin with a little Novocain. Then, using ultrasound or x-ray, we guide the needle to the precise location and inject the stem cells. The ultrasound guidance ensures both accurate and safe injections. We are nationally-recognized experts in musculoskeletal ultrasound. Following injection, for weight-bearing joints (ankles/feet, knees, hip) patients need to avoid bearing weight for 24-48 hours. But it is critical that the joint NOT be immobilized. Gentle protected movement is critical to stimulate healing. For non-weight bearing joints, gentle protected movement is generally encouraged, but forceful or aggressive activity, such as sports, is prohibited. Your doctor will give you more specific post-injection activity guidelines.
Treatment Protocol In our office, in cases where the stem cells will be injected into a joint, we prefer to perform a Prolozone treatment first, 3-4 days before the stem cell procedure. The prolotherapy helps prepare the joint biologically for the healing process generated by the stem cells.
In the case of treatment for joint arthritis, a PRP injection is commonly given 3-4 weeks after the stem cell injection. Stem cells have been shown to survive for 10 weeks or more after being injected in the joint. And this follow-up PRP helps keeps the stem cells active
However, the field of Regenerative Medicine is evolving rapidly. As such, our treatment protocols will continue to evolve as we strive to find the optimum approach to get the best – and safest – results for our patients. We continue to monitor both our own experience as well as the data shared by others in the research (see “What Does the Research Show” below) in deciding whether and how to modify our treatment protocols.
How Often are Injections Given? In most cases, patients respond very well to just one round of treatment. However, 2-3 treatments may be needed in very severe cases. Treatments are never given more frequently than every 6-12 months. More commonly, “booster” injection treatments of either PRP or Prolotherapy/Prolozone are given 6-12 months after a stem cell treatment.
59 Sycamore St, Suite 301 Glastonbury CT 06033
At the New England Stem Cell Institute our goal is to provide the highest quality care and an exceptionally personal level of service for persons suffering from musculoskeletal injuries and painful orthopedic problems, as well as to provide industry leading regenerative medicine treatments for recovery, health, and wellness. We strive to ensure that not only do you completely understand your diagnosis but also that you understand the proposed treatment plan.