Cal Sports patients can benefit from a unique non-surgical procedure using stem cell injections or surgical implantation of stem cells. This treatment uses your own body’s repair mechanisms and growth factors to promote healing.
What is the benefit of Stem Cell treatment?
Stem Cell injections provide a non-invasive (non-surgical) treatment option to reduce pain while still providing long-lasting relief from chronic tendinitis, ligament and joint pain. The injections are performed under Ultrasound guidance to ensure proper placement of the stem cells.
Implanting the stem cells allows the surgeon to use a higher concentration of stem cells that can be delivered to a smaller more focused area. The stem cells can be ‘glued’ down to ensure they stay in the proper place. Other benefits include the ability to add a microfracture during the implantation to further enhance the effectiveness. Surgical implantation can also be combined with other arthroscopic procedures in the area such as meniscal tears or debridement.
Who is a candidate for this treatment?
In general, Stem Cell injections are advised for moderate osteoarthritis in the hip, knee, shoulder, ankle, or thumb, where there is not complete collapse of the joint space and not “bone on bone” changes. There are some medical issues (like lymphoma and leukemia) that will preclude you from having a stem cell procedure done.
Stem Cell implantation is advised for patients typically over 40 who are active and have cartilage damage / loss in their knee. These patients have failed other treatment options including rest, medications, and physical therapy and are not candidates for total knee replacement.
Who is not a candidate for Stem Cells?
- Patient with a blood borne Cancer (such as lymphoma or leukemia), not in remission for at least 5 years
- Certain other malignancies or blood borne diseases that you are being treated for
- Patient with any current infection
- Patient who uses a high dose of coumadin
- General procedural contraindication
- Patients with multiple medical issues may not be good candidates
Which joints / body parts can stem cells be applied to?
We most commonly use stem cell injections for larger joints, such as hips and knees but also treat shoulders, ankles, and thumbs. Stem cell treatment is also an option for chronic tendon issues that have been resistant to other treatments. These are typically in the elbow and Achilles tendon. Currently, we do not treat any spinal conditions with stem cell therapy.
At this time, we only surgically implant stem cells in the knee to treat early arthritis and / or cartilage damage.
Where do the stem cells come from?
Bone marrow and adipose (fat) tissue are the two sources of stem cells that we use. We harvest the bone marrow stem cells (called BMAC) from the posterior iliac crest (the back of the hip) and the Adipose stem cells (called ADSC) from the abdomen or buttock area. We may harvest only BMAC but ADSC or a combination of BMAC and ADSC may sometimes be used. The source of the stem cells is decided on a case-by-case basis. Sometime we will also mix PRP with BMAC or ADSC, but BMAC already contains platelets so it just depends on the individual case and how large or small the joint is we need to inject.
Will the procedure regenerate cartilage in my joint?
There is some limited data suggesting an ability to regenerate cartilage in joints, but it also appears that whether or not the cartilage regenerates has little correlation with relief of pain. If there is significant spurring and significant loss of the joint space, there is little chance of cartilage regeneration.
What is the success rate of a Stem Cell injection?
Our experience is that most patients will have significant relief of pain around 1-2 months post injection. This will often continue to improve for the first 3-6 months after the stem cell procedure. There are patients who will not get any improvement at all from this procedure, probably around 10-20%. This is still an experimental treatment, and there have not been a lot of long term outcomes studies done so far so we are still figuring out who is an ideal candidate to have this done.
Does the treatment consist of one injection or multiple injections?
Typically we do one stem cell injection, followed up 6 weeks later with a platelet rich plasma injection. If you are coming in from out of town, this will be taken into consideration and may be modified. Our protocol is continually evolving, so this is ultimately decided on a case-by-case basis.
Can I drive myself home after the procedure?
You should plan on someone driving you home after the procedure as there can be some mild to moderate discomfort in the first few hours following the procedure.