Stem Cell Therapy for Bone on Bone Knee

Revision Knee Surgery

Dr. Marc Darrow Stem Cell Therapy

In this article Marc Darrow, M.D., explains Stem Cell Therapy for Bone on Bone Knee

          • Research on Stem Cells for cartilage Repair
          • Research on bone regrowth in damaged joints

Knee osteoarthritis is a chronic, indolent disease that will affect an ever increasing number of patients, especially the elderly and the obese. It is characterized by degeneration of the cartilage substance inside the knee which leads to pain, stiffness and tenderness. By some estimations in 2030, only in the United States, this medical condition will burden 67 million people. While conventional treatments like physiotherapy or drugs offer temporary relief of clinical symptoms, restoration of normal cartilage function has been difficult to achieve. Moreover, in severe cases of knee osteoarthritis total knee replacement may be required. Total knee replacements come together with high effort and costs and are not always successful.  (World J Stem Cells. 2014 Nov 26;6(5):629-36. doi: 10.4252/wjsc.v6.i5.629. Stem cell application for osteoarthritis in the knee joint: A minireview.)

When the doctor says you have “bone-on-bone,” it can be used as an umbrella term to describe various levels of knee degeneration. In the knee joint, cartilage protects the shinbone, the thighbone, and the back of the knee cap – the patella. In addition to this cushion is the thick meniscus – the padding between the bones. A healthy knee has all its surfaces glide smoothly atop these cartilages for pain free, efficient, and in the case of athletics – explosive movement.

“Bone-on-bone” means one, some, or all the cartilage and/or the meniscus has defects or “holes” in them and sometimes these holes go all the way to the bone and thus – painful, debilitating “bone-on-bone” osteoarthritis develops. Many times a patient will assume that “bone-on-bone” means extreme or advanced deterioration, many times that is not the case at all.

When to consider Stem Cell Therapy for Bone on Bone Knee ?

When a patient asks us this question we respond by saying that following a physical examination we discuss our non-surgical treatment methods including Prolotherapy, Platelet Rich Plasma Therapy, and Stem Cell Therapy. In minor deterioration, sometimes we start with simple dextrose. In advanced deterioration we may employ both PRP and stem cells.

When stem cells are recommended, we draw stem cells from you. Stem cells have the ability to “morph” into a variety of cell types including: osteoblasts (bone cells) and chondrocytes (cartilage cells). So it is understandable why so much research and effort are being put into this therapy.

Stem Cell Therapy for Cartilage Regeneration

Rebuilding cartilage in severe osteoarthritis is considered one of the great challenges in orthropedic medicine. A recent medical paper sums it up:

“Drug interventions and surgical treatments have been widely attempted for cartilage regeneration in osteoarthritis. However, the results were largely unsatisfactory. Autologous chondrocyte implantation (ACI) or matrix-induced autologous chondrocyte implantation (MACI) offers potential for the regeneration of cartilage over the long-term.

However, due to the limitations and disadvantages of ACI, alternative therapies for cartilage regeneration are in need.

The availability of large quantities of mesenchymal stem cells (MSCs) and the multilineage differentiation (the morphing ability), especially their chondrogenic (for cartilage) differentiation property, have made MSCs the most promising cell source for cartilage regeneration.” -1-

“MSCs can modulate the immune response of individuals and positively influence the microenvironment of the stem cells already present in the diseased tissue.” -2-

In other words, spark a new healing cascade for advanced osteoarthric cases.

Stem Cell Therapy for Bone Regeneration

Researchers are looking at the osteoblasts, specialized mesenchyme-derived (stem) cells accountable for bone synthesis, remodelling and healing. What they are finding is that these cells rebuild bones through various mechanisms. -3- Other research suggests positive results even in cases of Avascular necrosis. -4-

Should you consider stem cell therapy for your bone-on-bone? The Darrow Wellness Institute has long been recognized for utilizing advanced, non-surgical options for degenerative joint disease including Stem Cell Therapy. Stem Cell Therapy, like Prolotherapy and Platelet Rich Plasma Therapy are designed to stimulate the immune system to heal and rebuild damaged joints without the significant risks that surgeries, joint replacement, or other invasive procedures come with.

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1. Qi Y, Yan W. Mesenchymal stem cell sheet encapsulated cartilage debris provides great potential for cartilage defects repair in osteoarthritis. Med Hypotheses. 2012 Sep;79(3):420-1. Epub 2012 Jun 1.

2. Qi Y, Feng G, Yan W. Mesenchymal stem cell-based treatment for cartilage defects in osteoarthritis. Mol Biol Rep. 2012 May;39(5):5683-9. Epub 2011 Dec 20.

3. Titorencu I, Pruna V, Jinga VV, Simionescu M. Osteoblast ontogeny and implications for bone pathology: an overview. Cell Tissue Res. 2014 Jan;355(1):23-33. doi: 10.1007/s00441-013-1750-3. Epub 2013 Nov 29.

4. Calori GM, Mazza E, Colombo M, Mazzola S, Mineo GV, Giannoudis PV. Treatment of AVN using the induction chamber technique and a biological-based approach: Indications and clinical results. Injury. 2013 Sep 19. pii: S0020-1383(13)00423-3. doi:  10.1016/j.injury.2013.09.014. [Epub ahead of print