A Re-Look at the Value of Cell-Based (Formerly "Stem Cell") Therapy

Human bone marrow mesenchymal cell-based injection in subchondral lesions of knee osteoarthritis: a prospective randomized study versus contralateral arthroplasty at a mean fifteen year follow-up.

Philippe Hernigou  et. al.

6 April 2020

# SICOT   International Orthopaedics

Conclusions This study showed that subchondral bone marrow concentrate (BMC, as compared with knee replacement surgery, TKA) had a sufficient effect on pain to postpone or avoid the TKA in the other, affected knee joint of patients with bilateral [both knee] osteoarthritis.

Biologic Subchondral Injection

For over seven years, Kelly Cunningham MD, of Austin OrthoBiologics has been using mesenchymal cell-based treatment (BMC, from a patient’s own bone marrow) to successfully treat the pain and disability of mild to moderate knee arthritis.

Now, the cell-based therapy frontier is yielding good results of another exciting procedure that can be combined with BMC joint injection:

Subchondroplasty is the intraosseous (in-bone) injection of cell -based therapy, with or without a bone substitute, to augment the pain relief of BMC joint injection alone.

In layman‘s terms, your own harvested cell-based BMC can now be used not only in the joint, but in the adjacent stress-affected knee bone (end of femur/top of tibia-shin) to magnify the effect; lessening pain and improving function.

Based on the pioneering work of Dr. Philip Hernigou & others, years of European trials & treatments have revealed that the response of damaged bone to the growth factors and “paracrine” signals from these cell-based products can be dramatic. Now, the longer time period of follow-up of a previous paper reveals a statistically significant delay in "second-side" knee replacement surgery, presumably due to prolonged pain relief from the injections.

These are innovative applications of the pain-relieving effects of cell-based treatment. They pair well with office- or day surgery-based treatments of not only the knee, but shoulder, hip, elbow & ankle as well.

Dr. Cunningham was one of the first surgeons in Austin to offer subchondral cell-based injection as both an office and co-surgical treatment for his patients. Early results with respect to return to sport/activity can be remarkable; often far sooner than surgery or traditional treatments alone.

Other regenerative treatment options for orthopedic injury & arthritic joints include PRP "Platelet-Rich Plasma" and Lipo-aspirate (MFAT, fat cell-based therapy, to be discussed in an upcoming blog).

Orthopedic regenerative techniques continue to evolve, to the benefit of our patients!

Kelly Cunningham MD

Board-certified Orthopedic Surgeon

Regenerative Sports Medicine Specialist

           Austin Ortho Biologics          austinorthobio.com

Author

Dr. Kelly Cunningham Physician