What is Regenerative Medicine?
When most people think about regenerative medicine, they think of it as something that is years in the future. In reality, the practice of regenerative medicine has been around for decades – starting with the first bone marrow transplant – while the study of it has been around for over a century. In that time, regenerative medicine has helped thousands upon thousands of people live better lives. Currently, regenerative medicine is being used in a number of different areas, including orthopedics and sports medicine.
Regenerative medicine facilitates repair of injury or illness, or the regeneration of tissue, using the body’s own innate ability to heal itself, boosted in a very powerful way. How amazing – and game changing – is that?
Doctors use stem cells to treat a wide variety of sports injuries, including damage to:
These injuries may be due to a one-time trauma or chronic overuse. Some of the painful conditions regenerative medicine can treat include:
~ Osteoarthritis (knees and shoulders).
~ Plantar fasciitis.
~ Wrist and joint pain.
~ Tennis or golf elbow.
~ Rotator cuff tears.
~ Muscle and tendon injuries (such as calf and hamstrings).
Stem cells can be applied to an injured area via:
Direct surgical application
A surgeon may apply stem cells directly to the torn ligament, tendon, or bone being repaired.
Stem-cell bearing sutures
A surgeon may stitch together a torn muscle, ligament, or tendon using a thread-like material that is coated in stem cells. (The suture
material itself will dissolve and be absorbed in the body over time.)
A physician may inject stem cells directly into the affected area which is the most common.
The National Institute of Health defines regenerative medicine as a rapidly developing field that has the potential to transform the treatment of human disease and injury through innovative new therapies that offer a faster and more complete recovery – with significantly fewer side effects or risk of complications than surgery or drug therapies.
HOW DOES IT WORK?
The regenerative medicine protocol we use at Regenerative Medicine Doctors of Florida incorporates a series of injections comprised of an extracellular matrix that creates a stimulating factor in your body, causing your damaged cells to regenerate and recover in an appropriate way.
Our regenerative protocol includes:
~ A physical exam to evaluate your injury
~ Imaging (i.e. X-ray, CT, diagnostic ultrasound, MRI to determine the significance
of your injuries),
~ Temporary stabilization using orthotics, bracing devices, or walking boots.
WHAT ARE STEM CELLS?
Stem cells are different than skin cells, muscle cells, liver cells, or any other human cells.
What makes stem cells special is that they can:
1.Divide and duplicate themselves.
2.Develop into different types of cells. A stem cell itself does not serve a specific bodily function, but it can develop into a cell that does, such as a cartilage cell or a tendon cell.
Many physicians who use stem cell therapy hypothesize that, when placed into a certain environment, stem cells can transform to meet a certain need. For example, stem cells that are placed near damaged Achilles tendon are hypothesized to develop into healthy
Achilles tendon cells.
STEM CELLS FOR PATIENTS
In almost all cases, the stem cells used in sports medicine come from the patient. Clinical use of fetal or embryonic stem cells is banned in United States. The process of collecting stem cells is often called harvesting. Physicians usually harvest stem cells from the patient’s fat, blood, or bone marrow.
~ Fat: During surgery or liposuction a doctor can harvest adipose (fat) stem cells.
~ Blood: A blood sample from the patient can be used to harvest peripheral blood stem cells, which are found in the bloodstream.
~ Bone marrow: Doctors typically harvest bone marrow stem cells from the tibia, calcaneus or pelvic bone using a needle and syringe. The process is called bone marrow aspiration. Before a bone marrow aspiration, a patient is given a local anesthetic and may also be given a sedative.
~ Mesenchymal stem cells: All three types of stem cells listed above—adipose (fat), peripheral blood, and bone marrow—belong to a category of stem cells called mesenchymal stem cells. These stem cells, sometimes called adult stem cells, can be obtained from the patient’s own body and are being increasingly used for treating sports injuries.
GUIDELINES FOR WHO CAN RECEIVE STEM CELL THERAPY
Right now, there are no formal medical guidelines regarding who can receive stem cell therapy for sports injuries. The use of stem cells for treatment is up to patients and their doctor. Some physicians have specific criteria for recommending stem cell therapy or PRP treatments. The suitability of regenerative therapy is decided on a case-by-case basis after a thorough examination and medical history.
Some doctors have certain criteria for recommending stem cell therapy. For example, they only recommend it to patients who are healthy and younger (e.g. under 50). Other doctors make recommendations on a case-by-case basis.
For professional athletes, the World Anti-Doping Agency (WADA) regulations for regenerative therapy may or may not prohibit the use of stem cell therapy or PRP, depending on how the cellular material is manipulated or modified for use. Stem cell injections are prohibited if the product is modified in a way that can offer performance-enhancing benefits. WADA further clarifies that athletes are
not permitted to use both normal and genetically modified cells in any way, if the process causes performance enhancement. Athletes should be aware that the use of stem cell products cannot justify a positive doping test, if any prohibited substances are identified in
MIXING STEM CELLS WITH PRP
Many sports medicine doctors use stem cell therapy in combination with another regenerative medicine therapy, platelet rich plasma (PRP). These physicians believe that PRP can make the most of the stem cells potential effects. PRP is derived from a sample of the patient’s blood. In the bloodstream, platelets secrete substances called growth factors and other proteins that:
~ Regulate cell division
~ Stimulate tissue regeneration
~ Facilitate healing
PRP can be used alone to treat sports injuries, such as Achilles tendinopathy. Soft tissue injuries are most responsive to PRP treatment. Some examples of these injuries include:
~ Joint pain resulting from inflammation after an acute injury.
~ Chronic degenerative joint disease.
~ Ligament and muscle injuries.
~ Partial tendon tears when caught early.
~ Early degenerative arthritis.
Tendonitis, such as Achilles tendonitis, patellar tendonitis in the knee, or tennis elbow are common overuse conditions that plague many athletes. Many of these injuries involve microscopic tearing and formation of scar tissue. It is often difficult for these tendon injuries to heal due to inadequate blood supply to the area. With PRP treatment, however, the concentrated platelet injection enhances the nutrients and growth factors in the injury which allow the body to heal itself. Both research studies and clinical practice have shown PRP therapy to be very effective at relieving pain and returning patients to their normal lives. Ultrasound and MRI imaging show definitive tissue repair and healing following PRP therapy. Treating injured tissues before damage progresses and making the condition irreversible, can significantly reduce the need for surgery.
PRP therapy alone can be effective for acute sports injuries, but it is often not sufficient for treating chronic arthritic joint injuries and degenerative disc disease that cause lower back pain. Much more profound results (tissue regeneration and pain relief) are often seen when PRP is utilized in combination with the injection of stem cells. In many cases, both stem cells and PRP are used to treat
an injury. Like stem cell therapy, PRP therapy is a not a standard therapy and may not be covered by
In addition, the regenerative treatments themselves include:
~ Platelet-Rich Plasma (PRP)
The patient’s blood is processed, often in a centrifuge, to create a concentrated solution of platelets and plasma to make PRP.
The natural healing properties found in the blood’s platelets and plasma help facilitate healing and repair of the injury. PRP can also be injected or applied to an injured area during surgery. PRP therapies vary, depending on factors such as differences in patients’ blood,
the method of blood processing, and the addition of other substances, such as an anesthetic.
~ Regenerative interventions
A stem cell does not serve a specific bodily function, but it can develop into a cell that does, such as a cartilage cell or a tendon cell. Medical professionals theorize stem cells can transform to meet a medical need when placed in a specific environment. For example, stem cells that are injected into a damaged Achilles tendon develop into healthy Achilles tendon cells. Furthermore, the collection of the stem cells for treatment come from the patient’s fat, blood, or bone marrow.
Inflammation increases blood flow and attracts other cells that can repair and heal damaged tissues; therefore, sports injuries usually cause inflammation. In some cases, the inflammation subsides before the injury is completely healed. When this occurs, a physician may use prolotherapy to increase inflammation to allow the body time to heal. Prolotherapy includes an injection of an irritant into the injured area temporarily increases inflammation, which facilitates further healing. However, prolotherapy treatments are not considered regenerative therapy unless they include platelet- rich plasma (PRP) and/or stem cells.
~ Amniotic tissue matrix
This protocol is a tried and true method of healing that restores health and hope to people without the pain, stress, and cost of surgery. So if “healthcare as usual” no longer works for you, or if you’d like to explore a medical option that revolves around cutting-edge protocols, it may be time to consider regenerative medicine to find the root cause and a cure for what ails you.
IS REGENERATIVE THERAPY AN ALTERNATIVE TO SURGERY?
Treatment for patients suffering from chronic musculoskeletal injuries traditionally involves arthroscopic surgery or joint replacement. These treatment options can often require months of rehabilitation to regain strength and mobility. There are also the typical surgical risks including complications from the anesthesia, blood transfusions, blood clots (deep vein thrombosis), slow healing, and even paralysis (possible with spinal surgery).
Most cases of stem cell and PRP treatments are successful and avoid the pain, disability, downtime, and the risks associated with major surgery. Regenerative Therapy does involve some soreness and bruising in the treated area; even so, there is minimal recovery from a stem cell or PRP treatment.
Stem cell treatment can be repeated in a joint, if necessary, to obtain optimal results where a second surgery may not always be possible. Additionally, undergoing regenerative therapy does not preclude a patient from future surgery in the area.
Finally, there have been no reports of serious adverse effects in the scientific literature when adult mesenchymal stem cells are used in these procedures. Regenerative Medicine Doctors of Florida strives to provide the safest and most effective care for our patients.
We have developed our Regenerative Therapy Program to give patients access to the latest treatment options with proven results.