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Stem Cell Therapies
According to the US Centers for Disease Control (CDC), one in every four Americans will develop painful hip arthritis by the time they are 85. More than 512,000 total hip replacement procedures were carried out in 2011 in the US, with osteoarthritis accounting for 85% of those procedures.
Regenerative treatments for hip pain and osteoarthritis offer an alternative to such invasive and extensive surgeries. Interestingly, there is a long history of successful use of stem cell treatments for hip dysplasia and other orthopedic issues in dogs, but it is only in recent years that clinical research has begun to confirm the benefits of such treatments in human patients.
Hip pain is typically caused by problems with muscles, ligaments, tendons and other soft tissues in the hip, upper thigh, or outer buttock. The structures in the hip joint can be directly affected by diseases such as osteoarthritis, and hip pain may also result from problems in the lower back or in the knees.
Regenerative treatments for hip pain and hip osteoarthritis work by encouraging the growth of healthy cartilage, bone, and other tissues in the hip joints. This helps to relieve pain and enhance mobility, reducing the risk of accidents and falls that can result in hip fracture.
These non-surgical procedures offer a safe and effective alternative to complete hip replacement surgery that has a lengthy recovery period and a significant risk of complications. In some cases, regenerative treatments may be used as part of standard surgical procedures in order to expedite recovery, reduce the formation of fibrous scar tissue, and assist fusion in the case of bone grafts.
Regenerative, cell-based treatments are at the cutting edge of orthopedic medicine. Injections with platelet rich plasma, or bone marrow aspirate promote natural healing processes to support healthy tissue growth and to relieve hip pain and other symptoms such as abnormal gait and stiffness.
Mesenchymal stem cells (MSCs) stimulate the activity of chondrocytes, specialized cells in the joints that promote cartilage regeneration by increasing the production of proteoglycans and type II collagen in joint tissue. MSCs may also help in the repair of damaged nerve tissue and tendons.
Hip cartilage lesions have been successfully treated using intra-articular injections of mesenchymal stem cells and platelet-rich plasma, as well as expanded mesenchymal stem cells seeded in a collagen membrane.
Regenerative therapies based on stem cell injections offer a number of advantages. For example, such therapies:
Regenerative treatments can help busy people to get back to their normal routine more quickly and rely on stimulating the body’s natural healing processes. This means that such therapies are significantly more effective long-term than treatments that simply address immediate hip pain.
Non-surgical regenerative treatments for hip osteoarthritis and pain are usually performed as outpatient procedures, and can include the use of:
Bone marrow concentrate
Bone marrow concentrate is created by drawing fluid from the bone marrow using a needle and syringe and then centrifuging that fluid to separate out the stem cells. Bone marrow concentrate is rich in mesenchymal stem cells that go on to create cells that make up the bones, cartilage, tendons, muscles, and other tissues in the hip joint.
Bone marrow concentrate injections are considered safe and effective for orthopedic conditions such as hip osteoarthritis and have a low rate of adverse effects compared to other treatments.
BMC injections have also been found to help in the management of early-stage osteonecrosis of the femoral head (ONFH), which is a complex cause of hip pain. Specifically, BMC injections are associated with improvements in symptoms of ONFH and are better than bone marrow aspirate injections for reducing lesion size and halting the disease process when combined with core decompression. Such injections can delay the need for total hip replacement.
BMC Injections can be especially helpful for younger patients who wish to avoid or delay complete hip replacement surgery, as well as to restore or preserve joint motion, strength, and stability. Older adults can also benefit from BMC injections as they can help counteract decreases in stem cell concentrations in joint tissue seen with advancing age.
Hip problems related to rheumatoid arthritis or other autoimmune conditions may also benefit from BMC injections. There is evidence of abnormal stem cell activity in such conditions, while injecting normal stem cells can help counteract abnormal cell function.
Platelet rich plasma (PRP)
Platelet rich plasma (PRP) is a rich source of numerous growth factors involved in the development of health joint tissue. PRP injections have been seen to promote healing and joint repair, relieving hip pain associated with osteoarthritis and other joint conditions.
PRP is derived from a patient’s own blood, which is centrifuged (spun very fast) to separate out plasma and stem cells.
PRP’s plethora of growth factors help to override undesirable biologic activity that may be at play in hip degeneration. PRP can also help facilitate the repair of connective tissue, including tendons, by enhancing cell proliferation and differentiation into active tenocytes.