What Is Regenerative Medicine?
Regenerative medicine is the catchall term for a burgeoning field of medicine that focuses on harnessing the body’s innate ability to heal itself in the management and treatment of orthopaedic injuries. Two of the most common procedures that fall under the umbrella of regenerative medicine is stem cell therapy and platelet-rich plasma (PRP) injections. While many clinicians believe that these procedures hold great promise, they are still in the very early stages of study and regulatory approval.
The ultimate goal of regenerative medicine in orthopaedics is to use the innate healing ability of a patient’s own body to regenerate diseased or damaged tissues. While regenerative medicine as a whole has applications well beyond the muscles, bones and connective tissues of the musculoskeletal system, orthopaedic regenerative medicine is specifically focused on delivering a specific set of cells to the site of an injury. These cells, through their natural anti-inflammatory and healing properties, in turn, act on the damaged tissue to help drive recovery.
Platelet-Rich Plasma (PRP)
Platelet-rich plasma (PRP) is the end product of a patient’s own blood that has been extracted and refined to create a far higher concentration of platelets than would normally be present. Best known for facilitating the clotting of blood, platelets, which contain hundreds of proteins called growth factors that reduce pain and inflammation, are now being recognized for the crucial role they play in the healing process. This concentrated preparation is injected into the site of injury and the platelets are allowed to go to work promoting healing in the injured area. PRP injections are always created from a patient's own blood, so there are never any foreign substances being introduced to the body during the procedure; it is simply a patient’s own blood that has been processed, without additives, to contain high levels of platelets, our body’s naturally occurring healing cells.
Stem Cell Injections
Stem cell therapy is a developing orthopaedic treatment modality that aims to harness the power of the body’s own stem cells to promote healing and recovery. Adult stem cells, which are found throughout the body, have many regenerative and anti-inflammatory properties and possess the unique ability to differentiate or change themselves. This allows stem cells to “grow” into a wide variety of cell types, including muscle, nerve, cartilage and even bone. Many orthopaedic surgeons believe that stem cells may have the ability to treat common soft tissue injuries and conditions, such as torn cartilage, arthritis, and muscle tears.
There is evidence to suggest that stem cell therapy has the potential to repair and strengthen damaged tissues throughout the entire musculoskeletal system, but the science is not yet conclusive on the effectiveness of the treatment. Each treatment is unique to the patient and results can vary from case to case. Furthermore, there are not yet clearly defined clinical protocols for how and when to deploy stem cell treatments in the management of orthopaedic conditions. To that end, there are research studies and trials currently underway around the world to better understand if and how these procedures can impact common orthopaedic injuries and conditions. As part of his clinical practice, Dr. Chris O’Grady offers regenerative medicine procedures like stem cell therapy alongside traditional treatment modalities to ensure his patients have the best chance of success.
What Are Commonly Treated Conditions
Anyone suffering from a musculoskeletal injury or disorder could be a candidate for regenerative medicine treatments. There is strengthening evidence to suggest that regenerative medicine could help promote healing and recovery, regardless of whether a patient’s pain is the result of chronic wear-and-tear or acute injury. Dr. O’Grady commonly uses regenerative medicine to treat the following conditions:
-Arthritis: Arthritis literally translates to “inflammation of the joint,” and describes any disease process which leads to cartilage loss. Arthritis in the knee is very painful because the injury to the cartilage of the knee can eventually lead to bone-on-bone contact. This leads to increased stiffness, pain, swelling and decreased the range of motion of the knee.
-Meniscal Injuries: The meniscus is a pliable, rubbery disc that distributes body weight equally across the knee joint. This connective tissue can tear if the joint undergoes stress or sudden impact, preventing normal functioning of the knee and causing pain and inflammation.
-Ligament Injuries: The knee has four major ligaments: the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial cruciate ligament (MCL), and lateral cruciate ligament (LCL). Sprains or tears to these ligaments can occur gradually over time or through acute injury to the joint; in any case, these injuries cause pain and instability in the knee and may need to be treated surgically. However, regenerative medicine can be used alongside or in place of traditional surgical treatments in some cases.
-Rotator Cuff Tears: The rotator cuff, a group of four muscles that attach the humerus (upper arm bone) to the shoulder blade, is one of the most crucial components of the shoulder. It allows the muscles and tendons of the shoulder to lift and rotate the humerus and is essential to almost every basic and complex movement we require of the joint. The rotator cuff can be injured through acute injury or it can tear gradually over time; in any case, injury to the rotator cuff is very painful and severely limits the shoulder’s ability to move and function as intended.
-Arthritis of the Shoulder Joint: Arthritis describes any disease process which leads to cartilage loss. Cartilage serves an incredibly important role in joints of the body, as it “cushions” space and prevents bone-on-bone contact. Arthritis can be very painful because the wearing down of cartilage causes bones to grind against one another. This leads to increased stiffness, pain, swelling and decreased use of the shoulder.
-AC Joint Separation: The acromioclavicular (AC) joint is the point in the shoulder where the collarbone (clavicle) and the acromion of the shoulder blade are connected by ligaments. An AC joint separation occurs when these ligaments are strained or separated, typically from a sharp blow to the shoulder. Grade 1 separations generally involve a sprain of the AC ligament, while Grade 6 separations involve total tears of the ligaments and noticeable deformity in the shoulder.
-Labral Tears or Degeneration: The labrum is a ring of firm fibrous tissue that surrounds the shoulder socket (glenoid) and stabilizes the joint. When the labrum is torn or degenerates, it can cause pain, stiffness, a decrease in athletic ability, and a popping or clicking sensation with movement.
Why Regenerative Medicine?
While the safety and efficacy of regenerative medicine procedures are still under review, it is believed that there are some major advantages to these procedures versus traditional treatments, particularly surgery. First, these procedures are far less invasive than traditional surgical approaches and are therefore done in the outpatient setting. There are no incisions required for these procedures and, as such, the risks of infection and complication are dramatically lower than surgery, and recovery is very minimal. Oftentimes the only immediate side-effect of the procedure is soreness at the site of injection. Second, stem cell therapy requires very little, if any, pain medication during recovery, so there is no risk of adverse side effects to opioid medication. Given that we are currently in the midst of an opioid epidemic on par with some of the worst drug scourges in our nation’s history, keeping patients off of narcotics during recovery is no small matter. Finally, stem cell therapy relies on the body’s own cells to drive recovery, so there are no foreign chemicals, additives or implants being injected into your body.