Stem cell therapy is an emerging technology, especially in the field of musculoskeletal medicine. And, while embryo-derived stem cell use and research remains controversial, other methods of stem cell harvest, such as extracting a patient’s own cells, can provide new treatment opportunities for musculoskeletal disorders. Stem cell therapy has been shown to not only to provide pain relief, but also serve as a potent inhibitor of joint inflammation.
Stems cells aren’t new but the methods to obtain them are advancing quickly. So now, we physicians ask ourselves, who is the best candidate for this type of therapy? I treat athletes every day and often see players suffering with pain and decreased function associated with early arthritis. As an orthopedic sports medicine specialist, I typically treat patients with knee, shoulder and elbow injuries. Even though I am a surgeon, many typical sports injuries do not require surgery. However, in many cases, the pathway to a quick successful return to activity for non-surgical problems remains unclear. This is where stem cell therapy may provide some help. Common ailments in athletes that can be treated with stem cell therapy include: inflamed joints, ligament sprains, muscle strains, early osteoarthritis and even bone bruises.
Over the last year, technology has emerged that allows us physicians to retrieve stem cells (pericytes) from a patient’s fat. These stem cells exist in very high concentrations in our fatty tissue. Using a simple liposuction technique, these types of cells can be harvested and easily prepped for therapeutic injections. This is often an in-office procedure but it can also be done in the operating room. Prior to this breakthrough, cortisone was really the only injectable we could use to relieve pain and decrease inflammation. These adipose based stem cells may ultimately be able to replace cortisone with more durable clinical success.
It’s clear that there is a place for stem cell therapy on the treatment spectrum. We are still figuring out the long-term effects of stem cell treatments, but we do know that stem cell preparations that are currently available can provide good short-term relief for certain diagnoses. Stem cell therapy might be considered a novel first line of defense for musculoskeletal disorders. If successful, patients may be spared a procedure. However, as stem cell injections do not “burn any bridges”, the opportunity to address the problem surgically still exists and is not compromised down the line.
There is very little downside to trying a stem cell treatment on a patient who fits the right profile. I’ve been treating athletes’ knees with stem cell therapy for the past 10 years or so. I’ve used these methods alone and in concert with surgical procedures. In general, I have observed faster healing rates using these cells as surgical adjuncts. Moreover, some athletes have been able to avoid surgery using stem cell injections. The short- to mid-range results that I’ve observed are very encouraging. In polling my colleagues, it seems that most sports surgeons have not yet adapted stem cell therapies in athletes. Yet, I expect that this will change as the field continues to evolve and more clinical evidence of its effectiveness is published.
There are a lot of claims about biologic therapies. I for one am not advocating stem cell therapy as a “cure-all” for a majority of orthopedic injuries. However, I am convinced that there are diagnoses and patients who can be helped by stem cell therapy today. And now, I have early clinical results to back it up. Our field keeps changing and I am doing my best to keep things on the cutting edge for the betterment of my patients.
Dr. Riley J. Williams III is the Medical Director & Head Team Physician for the Brooklyn Nets & New York Red Bulls. He is also the Team Physician for USA Basketball and works as the Team Physician for the Iona College Department of Athletics.
