The doctors and scientists in the HSS Center for Regenerative Medicine study a range of regenerative medicine therapies. These treatments seek to heal or regenerate tissues that have been damaged by injury or disease. They may also stimulate the body to heal injuries that previously could not be repaired.
The goal of the HSS Center for Regenerative Medicine is to identify and study new treatment options and improve their effectiveness. It will bring together HSS physicians, surgeons and scientists to establish a world-class program. We can use regenerative medicine techniques for many difficult-to-treat conditions such as osteoarthritis, chronic tendonitis, degenerative disc disease in the spine, muscle strain injuries in athletes and more.
The field of regenerative medicine is rapidly growing and changing. Our approach to studying these cutting-edge therapies and providing them to our patients is based in the strong scientific and clinical research programs at HSS.
Regenerative medicine uses biologic therapies to improve symptoms and possibly enhance the healing of musculoskeletal tissues. These include cartilage, tendon, ligament, bone, muscle, spinal disc, and meniscus. The therapies are also referred to as orthobiologics.
Two commonly used types of orthobiologics are platelet-rich plasma (PRP) and cell-based therapies.
Platelet-rich plasma (PRP) is produced from a small sample of a person’s own blood. The blood is centrifuged (spun down) to isolate and concentrate platelets. The platelets and a fluid portion of blood called plasma is then injected back into the person at the site of their injury. The injection contains a number of proteins that can potentially decrease inflammation and improve pain and tissue healing.
PRP has been used for many soft-tissue injuries, including to ligaments, tendons, meniscus, cartilage and muscle. PRP is generally safe, since it is derived from the person’s own blood.
The major limitation at this time is the significant unpredictability in outcomes. This is due in large part to the wide variability in PRP formulations and lack of information about the best PRP formulation for different conditions. Further information is required to define the exact type of PRP that will be most effective for a specific condition or injury. Additionally, most medical insurance companies do not cover the cost of PRP therapy because of the lack of strong clinical data supporting its effectiveness.
At HSS, we are committed to clarifying and understanding the biological role of PRP therapy in different conditions through our research program. To learn more, read a detailed overview of PRP treatments.
Cell-based therapies involve the injection of living cells. They are becoming increasingly popular in orthopedics. The two most common types use either bone marrow or adipose (fat) tissue. The bone marrow is harvested from a person’s pelvis, while the adipose tissue is taken from the abdomen or thigh. In both cases, the cells are used to make a concentrated solution, which is then injected at the site of the person’s injury.
There is much hype about stem cells for healing and regeneration of numerous different tissues, though the term is not always used correctly. Stem cells are defined by their ability to undergo self-renewal, and to regenerate other types of cells and tissues. There are stem cells in many tissues, in addition to bone marrow and fat. However, the number of stem cells is very small – only approximately 1 in 10,000. There is some limited data to suggest that cells derived from bone marrow, fat or placental or amniotic tissue may improve the symptoms of various musculoskeletal conditions. This effect may be due to the cells’ production of anti-inflammatory chemicals, rather than the cells themselves.
Cell-based therapies have tremendous potential for treatment of numerous injuries and diseases. However, much more research is needed to identify:
At HSS, we are committed to exploring, studying and using regenerative medicine approaches in a responsible and rigorous way. Many people can gain relief with these treatments. But it is important to use them only when they are appropriate. We believe that responsible use of regenerative medicine treatments is the best way to both provide cutting-edge care for our patients and contribute to the knowledge base that will advance this rapidly developing field.
HSS is a world leader in musculoskeletal clinical care and research. In 2018, we cared for more than 139,000 patients and performed over 32,000 surgical procedures annually across a wide range of orthopedic and rheumatologic specialties. The number of patients we see combined with our highly specialized, nationally recognized doctors and scientists will allow us to carry out the research needed to ensure safe treatments are made available to patients as quickly as possible. Our extensive experience with managing musculoskeletal conditions and studying their underlying causes gives us a full picture of the potential uses – and limitations – of current regenerative medicine approaches.
At HSS, we are committed to furthering the science and understanding of regenerative medicine treatments in addition to providing them to our patients. Our research program brings together clinicians and researchers across many departments, including the Sports Medicine, Physiatry, Foot and Ankle, Spine, Adult Reconstruction and Joint Replacement and Rheumatology services. HSS has a coordinated research program linked to translational research in the HSS Research Institute.
We aim to enroll all patients treated with regenerative medicine therapies in a clinical registry so that we may carefully study their outcomes over time.
We aim to enroll all patients treated with regenerative medicine therapies in a clinical registry so that we may carefully study their outcomes over time. Working together with our Precision Medicine Laboratory, we are studying the composition and biologic activity of the specific formulations given to individual patients. This allows us to further understand and define the relationship between what is given to a patient and their ultimate clinical outcome.
Our physician-investigators are also leading cutting-edge clinical trials to elucidate optimal treatments for individual patients using different orthobiologics. (See Understanding Clinical Trials.)
These are some of the clinical trials we are currently conducting in the field of regenerative medicine (View a full list of clinical trials at HSS):
Philanthropy is vital to research and care at HSS. Funding is particularly important to efforts focused on ambitious new ideas, technologies and techniques that may shape the future of orthopedic health. The Center for Regenerative Medicine is dedicated to delivering exceptional, leading-edge care. We are also pursuing research that will drive better orthopedic and rheumatologic care not only at HSS but globally. Philanthropic support will be critical to the launch of this new center. It will accelerate and build our research program and allow us to disperse novel and innovative regenerative medicine techniques across HSS. As the global leader in musculoskeletal health, we are committed to applying our specialized expertise and experience to improve quality of life for countless people worldwide.
It is our purpose – it is our mission.