Ask a Vail Sports Doc column: Cell therapy could provide promising alternative to surgery
January 9, 2017
Regenerative medicine is the latest game-changer in orthopedics, utilizing a patient's own cells to accelerate repair and recovery. Various treatments such as platelet-rich plasma and mesenchymal stem cell therapy have shown to be promising non-surgical options for some of the more commonly seen orthopedic issues. Osteoarthritis, tendonitis, scar tissue prevention and pain or inflammation control have all been treated with these therapies.
• What are mesenchymal stem cells? — MSCs are undifferentiated cells that have the unique ability to transform into cells of different structures. They can be found throughout the body but are concentrated in certain areas such as bone marrow and abdominal fat.
A physician can remove some of these stem cells and inject them where needed to encourage remodeling of the surrounding tissues. There is evidence that MSCs are capable of "plugging" small areas of lost articular cartilage as in early arthritis.
• What is platelet-rich plasma? — Platelet-rich plasma is a concentration of growth factors and anti-inflammatory components that comes from processed blood. A sample of the patient's blood is spun in a centrifuge and separated into three isolates: platelet-poor plasma, platelet-rich plasma and red blood cells. The platelet-rich plasma is then collected and used to treat a variety of orthopedic injuries.
The growth factors encourage the healing of soft tissues, and the anti-inflammatory components can decrease pain and swelling. This treatment has been used more commonly than stem cells.
• Which is better? — Exciting results have been published in research journals, and many patients have reported tremendous results from mesenchymal stem cell and platelet-rich plasma therapies. To decide which is better is tough. It really depends on which orthopedic issue is being treated. An analogy that has been proposed by other physicians is to describe platelet-rich plasma therapy as fertilizing and watering a plant and mesenchymal stem cell therapy as planting new seeds.
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Unfortunately, neither of these treatments will be covered by insurance, and the out-of-pocket expense can be large, but the results can help reduce the need for a surgery. In the long run, this can help save a patient money and time. Regardless of the cost, regenerative medicine such as platelet-rich plasma and mesenchymal stem cells is the future, and more advances are made every year.
Dr. Rick Cunningham is a knee and shoulder sports medicine specialist with Vail-Summit Orthopaedics. He is a physician for the U.S. Ski Team and president of Vail-Summit Orthopaedics. Matt Vinnal, ATC, is an athletic trainer to Cunningham. Do you have a sports medicine question you'd like him to answer in this column? Visit his website at http://www.vail knee.com to submit your topic idea. For more information about Vail-Summit Orthopaedics, visit http://www.vs ortho.com.
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