Case Example: Knee Osteoarthritis
How do stem cells introduced into a knee with osteoarthritis build new cartilage cells?
Stem cells used in this application are thought to have a repairing effect through several different mechanisms:
- Trigger an anti-inflammatory effect – through secretion of growth factor molecules (exosomes, vesicles) released by the stem cells
- Homing to the damaged tissue and differentiating into new cells
- Attracting other cells into the area that help in the “clean up” of old tissue debris, repair, and remodel
- Inhibit apoptosis (cell death)
The knee on the right in this image example left / above shows cartilage loss, with cracks and “potholes” in the cartilage surface, compared to the knee on the left showing healthy, smooth cartilage surface.
At a more microscopic level, in the picture below or right, depicts the action of stem cells homing to the areas of damaged cartilage where they will attach and stimulate the body’s natural repair process.
Once the stem cells are activated by the body’s own chemical signals, a natural and reliable healing cascade of the body is set in motion. The introduction of cells creates a “micro-injury” that promotes healthy inflammation.
Not all inflammation is bad.
In this case of your body’s naturally healing cascade it is a necessary and first step for tissue regeneration, remodeling, and eventually healing.
Once initiated, this is a process that will take between 6 weeks to 6 months or more – depending on the tissue type, the extent of damage, and the number of healing stem cells that can be placed precisely in the area of damage.
Now, if you have an arthritic joint, what do you know about the medication(s) you were likely offered or prescribed for treatment of your symptoms?
Were you told that NSAID medications such as ibuprofen, Naprosyn, Motrin, Celebrex, Meloxicam and others will block inflammation?
They will also block this natural healing response!
This is why all of our patients are taken off this class of medication and recommended other suitable natural alternatives such as curcumin, proteolytic enzymes, collagen, fish oil (EPA/DHA), and joint health supplements to help with symptoms from arthritis and other inflammatory musculoskeletal issues.
Nutritional supplements are not regulated by the Food and Drug Administration (FDA), so it is essentially an honor system whether or not companies are truthful in the labeled ingredients or will subject their products to third-party purity testing. There is typically more marketing sizzle than actual science when it comes to supplement claims, but that is probably a whole other Consumer’s Guide I should write!
Sourcing the correct nutritional supplements is critically important if you are to see a clinical benefit, so consult an educated provider who can recommend the correct type, dose, and combination.
What about cortisone shots?
What do you think the effect may be from corticosteroid, or cortisone, injections commonly offered for pain related to arthritis?
You guessed it – corticosteroids have a potent anti-inflammatory effect and they certainly work to reduce pain and inflammation quickly if you ever had an injection.
However, they will also impair your body’s natural ability to work through the steps from inflammation to healing.
In an excellent study done by Wernecke et al. at Stanford University, published in 2015 in the Orthopedic Journal of Sports Medicine, they demonstrated that a dose of corticosteroid around 3mg or less may show positive benefit for decreasing inflammation.
But here’s the kicker. They found that doses exceeding 3mg could be toxic to the cartilage. You are reading that correctly. When evaluated in the lab it decreased inflammation but also killed some of the cartilage cells. As they increased the dose they showed even more cells were killed off.
What is the standard dose of corticosteroids generally administered in an injection?
At least 40 milligrams, and some physicians may use as much as 80!
This is toxic to cartilage. The very tissue that we would want to be sparing if you have an arthritic joint you are literally killing off each time you receive a cortisone injection.
Despite this evidence being published in peer-reviewed journals and performed at reputable institutions, unfortunately NSAIDS and corticosteroid injections are still considered to be “standard therapy”, i.e. covered by your insurance company, for “treatment” of arthritic conditions.
This is the practice of what I have coined “Degenerative Medicine”.
What is covered and recommended to thousands of patients across the country daily to more than 30 million Americans dealing with some form of arthritic pain is literally impairing healing and degenerating their bodies.
Since this is what is covered by insurance, forward patients march, unknown to them, toward a destiny of further deterioration of health, accelerated degeneration, and an almost certain future need for joint replacement surgery.
Do you see a problem with the logic here?
Insurance companies cannot possibly be reviewing the scientific literature to make informed decisions about covered treatment(s).
Otherwise, why on earth would they cover something proven to be wrought with side effects and detrimental to your health?
It also seems they choose to turn a blind eye towards the data showing the powerful effect of Regenerative Medicine treatments that have little to no side effects or negative impact on your health if performed correctly.
Why is that?
Draw your own conclusions – and choose your own adventure.
I am going to keep this guide focused on presenting the known data at hand, rather than spinning conspiracy theories!
Now, back to our program and something to be excited about – how Regenerative Medicine procedures such as stem cell therapy can do the polar opposite of NSAIDS and corticosteroids – and have a powerful healing effect on injured/damaged tissue.
Here is a simple graphic to come back to help you understand the step process that is being triggered in the body through the use of Regenerative treatments.
The overall health of your body will dictate the health of the stem cells. The collective regenerative power of any stem cell treatment is heavily influenced by your health.
This is a most critical concept to understand, and one that will certainly influence your best response to treatment. It will also influence the longevity of the treatment effect. You owe it to yourself to find a practice and a provider that will work with you to optimize your health before, during, and after your treatment – not simply willing to inject some cells into your joint!
In our PRO-MEND™ process we may spend 1-3 months, and sometimes longer, preparing a patient for treatment by first optimizing their overall health, nutrition, etc.
You can check out a couple of videos illustrating the PRO-MEND™ Process
7790 N. Oracle Road, Suite 150
Oro Valley, AZ 85704
Rejuv Medical Southwest is located in Southwest Arizona and provides clinical services to the surrounding cities: Tucson, Oro Valley, Catalina, Saddlebrooke, Oracle, Marana, Casa Grande, Green Valley, Nogales, Vail, Sahuarita, Phoenix, Gilbert, Chandler, Mesa, Tempe, Scottsdale, Glendale.
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