Injection of mesenchymal stem cells (Stem Cell Therapy) has been shown effective in patients as a stand alone treatment and now as a remarkable treatment that can rebuild the meniscus tissue of the knee as discussed in the previous article. In yesterday’s article we discussed Stem Cell Therapy, Platelet Rich Plasma Therapy, and Dextrose Prolotherapy as part of a Comprehensive Prolotherapy program that takes an aggressive approach to healing the problems of osteoarthritis and cartilage deterioratioon.. As such, therapies are combined because empirically, therapies in combination are shown to be more effective in many cases than therapies as stand alone options.
Stem cell and PRP therapy for knee repair
Recent research discussed the beneficial effects of stem cell injections. Doctors in Iran followed six women whose MRIs suggested advanced knee osteoarthritis. The knee osteoarthritis was so severe that knee replacement surgery was recommended. The women, average age 54, received a stem cell treatment with the stem cells derived from their bone marrow. The results?
“During a one-year follow-up period, we found no local or systemic adverse events. All patients were partly satisfied with the results of the study. Knee Pain, functional status of the knee, and walking distance tended to be improved up to six months post-injection, after which pain appeared to be slightly increased and patients’ walking abilities slightly decreased. Comparison of magnetic resonance images (MRI) at baseline and six months post-stem cell injection displayed an increase in cartilage thickness, extension of the repair tissue over the subchondral bone and a considerable decrease in the size of edematous subchondral patches in three out of six patients.”1
Platelet Rich Plasma Therapy for Knee Osteoarthritis
It is easy to speculate that had the treatments been more aggressive, a more positive result would have been achieved. Platelet Rich Plasma Therapy as a stand alone treatment has already shown very positive results in numerous studies.
Combining stems cells with Platelet Rich Plasma Therapy as a means to accelerate tissue regeneration in advanced degeneration has been the subject of numerous animal and human studies. The initial findings have been very positive.2,3,4
How does PRP enhance stem cell treatments?
Platelet Rich Plasma (PRP) has the ability to both increase stem cells and guide them in healing. In initial findings, PRP assisted stem cells in “figuring out” what they needed to be – whether a cartilage cell, or a bone cell, or a collagen cell for ligaments and tendons. Here is what the science says: “Platelet-rich plasma has recently emerged as a potential biologic tool to treat acute and chronic tendon disorders. The regenerative potential of PRP is based on the release of growth factors that occurs with platelet rupture. Its autologous nature [the recipient and donor are one and the same person] gives it a significant advantage in tissue engineering applications.”5 So the platelets are already attuned to provide a healing environment or “scaffold” to build on. In the research cited, results confirmed that PRP enhances MSC stem cell proliferation and suggested that PRP causes chondrogenic differentiation of MSC in vitro – the platelets told the stem cells what to do.
Growth Factors in Cartilage Regeneration
Growth factors or PROLIFERANTS (Prolotherapy is so called because of its able to proliferate growth factors) act when tissue is injured. In the cause of chronic pain caused by joint degeneration, PRP and Prolotherapy release substances that activate the healing response. (See cartilage repair) The platelets themselves secrete a variety of cytokines (messenger cells that regulate various inflammatory responses), including adhesive proteins and growth factors such as platelet-derived growth factor, transforming growth factor beta, vascular endothelial growth factor, basic fibroblast growth factor, Insulin-like growth factor-1 (IGF-1), and epidermal growth factor.
FOr more information on Stem Cell Treatment for knee pain please see our article: Stem Cell Injection Therapy for Knee Osteoarthritis