Knee Pain and Osteoarthritis

Stem Cell Therapies

Regenerative treatments for knee injuries and osteoarthritis

Knee osteoarthritis is one of the top five causes of disability in adults and can restrict a person’s ability to carry out everyday tasks, including personal care. The prognosis for people with knee osteoarthritis has long been considered poor, but newer regenerative treatments for knee conditions are showing great success at reversing joint tissue damage and improving mobility and quality of life.

Non-surgical stem cell and blood platelet procedures provide a safe and effective option for anyone with knee pain or restricted mobility resulting from a knee injury or osteoarthritis. Some of the most common indications for regenerative treatments include:

  • Knee arthritis
  • Meniscus tears
  • Anterior cruciate ligament tears (and other ligament tears in the knee)
  • Patellar tendonitis
  • Baker’s cyst
  • Patellofemoral syndrome (chondromalacia, or ‘runner’s knee’)
  • Bursitis
  • Hamstring tendinopathy
  • Knee instability
  • Biceps femoris insertional tendinopathy.

The knee joints and bones are made up of basic building blocks including collagen, calcium, and glycosaminoglycans. The production of collagen and glycosaminoglycans, and the incorporation of calcium into bones slows down as we get older. Over time, this can result in weaker joints and bones that are more vulnerable to injury and osteoporosis.

Trauma to the knee can also lead to persistent pain and restricted mobility, with anterior cruciate ligament (ACL) tears a common source of knee pain. Such injuries can take a long time to heal and may not fully resolve, leaving a person with chronic knee pain and disability. For athletes, such injuries can cut short a professional career.

Regenerative treatments for knee injuries and osteoarthritis are an exciting advancement in orthopedic medicine. Innovative treatments such as injections with platelet rich plasma, or bone marrow aspirate work by harnessing the body’s natural healing potential to repair damaged and diseased tissue and relieve pain and other symptoms.

Mesenchymal stem cells (MSCs) found in bone marrow are able to stimulate the activity of chondrocytes in the joints to promote cartilage regeneration. These stem cells help to increase the concentration of proteoglycans and type II collagen in knee tissue, and clinical trials have found that injections of MSCs help restore cartilage defects in the knee, resolving symptoms including knee pain and restricted mobility.

A number of clinical trials have been carried out using injections of MSCs from bone marrow aspirate, as well as adipose-derived stem cells (ASCs) for knee conditions. Results from these studies show that the treatments are typically well tolerated, with few, if any, adverse effects, and are an effective solution for chronic knee pain and disability.

Regenerative treatments offer the advantage of actually repairing the underlying issue causing symptoms, rather than simply masking the symptoms while damage continues unchecked. Cell-based therapies offer symptom relief and the potential to promote healing so as to gradually improve joint function over time.

These non-surgical treatments are usually able to be administered in an outpatient setting causing minimal disruption to everyday life. Regenerative therapies for knee conditions also help to promote long-term strength and flexibility, making them especially attractive for younger adults who wish to return to physical activity and who are, therefore, reluctant to undergo surgery for joint replacement.

Regenerative treatment of the knee may involve injections with:

  • Bone marrow concentrate
  • Platelet-rich plasma.

Bone marrow concentrate

Bone marrow is a rich source of mesenchymal stem cells that go on to create all of the tissues of the joints and bones. Given that there is a reduction in stem cell concentrations and activity in older joints and in long-standing joint injury, the injection of fresh stem cells from bone marrow can instigate healing and tissue repair to relieve symptoms of joint damage and osteoarthritis.

To create bone marrow concentrate, a needle and syringe are used to extract a patient’s own bone marrow fluid, usually from the hip bone. This fluid may be directly injected into a joint during orthopedic surgery, or may be centrifuged (spun very fast) to separate out the stem cells and create a bone marrow concentrate (BMC).

Injections with BMC are especially advantageous for younger patients who want to explore therapeutic options that can help preserve joint motion, strength, and stability. BMC may also help slow down degenerative processes in older knee joints and overcome the age-related decline in stem cell concentrations that can hinder successful recovery after knee surgery.

Bone marrow derived mesenchymal stem cells have also demonstrated significant benefits for anterior cruciate ligament (ACL) reconstruction. Typically, people healing from ACL tears develop fibrous scar tissue that is inferior to healthy tissue and which may be too weak to adequately support the joint during rehabilitation. This can further compromise joint function and lead to subsequent injury, pain, and dysfunction.

BMC injections have been found to help accelerate bone-tendon healing, reducing scar tissue by encouraging the formation of healthy tissue, which helps support the joint and enhance mobility while resolving knee pain.

Read on for more about bone marrow concentrate.

Platelet rich plasma (PRP)

Platelet rich plasma (PRP) treatment is an easily accessible material that offers a rich cocktail of growth factors to promote tissue healing and relieve joint pain. PRP is derived from a patient’s own blood, which is drawn and then centrifuged to separate out plasma and stem cells.

Concentrated PRP contains a range of growth factors that, when injected into damaged or diseased tissue, trigger the body’s natural healing processes. The constituents of PRP can also override dysfunctional biologic activity, helping to prevent further joint degeneration.

Although PRP is at the leading edge of regenerative therapy research, studies so far show significant benefits for knee pain and improved mobility, especially for knee osteoarthritis.

Read on for more about platelet rich plasma.