What is a stem cell?
A stem cell can develop into many types of mature cells. Often referred to
as a “predecessor” or an “undifferentiated” cell,
stem cells are immature cells that have not developed into their final
cell type.
What a stem cell turns into is determined by an intricate system of intrinsic
and environmental signals. Stem cells range from totipotent embryonic stem
cells, which can transform into virtually any cell, to multipotent adult
stem cells, which can only change into a specific family of cells. Stem
cells also recruit growth factors to speed up the healing process. Because
of this, the clinical potential to re-grow damaged tissue is promising.
Our own bodies produce stem cells well into our adult life. We believe
these regenerative cells can be harnessed to heal cartilage and bone. A
patient’s own adult stem cells, or autologous mesenchymal stem cells,
have immense clinical promise to both heal damaged tissue and restore missing
tissue. Although the use of embryonic stem cells ignites a lot of controversy,
adult stem cells come from the patient’s own body.
What do we know about orthopaedic stem cells?
A specialized group of adult stem cells called mesenchymal stem cells are
of particular interest in orthopaedics because they can differentiate
into high-quality bone and cartilage to restore damaged or missing tissue—often
the result of acute trauma injuries or chronic disease such as arthritis.
Essentially, stem cells deliver the growth factors to the repair site.
There, the stem cell either produces or recruits growth factors, which
speed up the rate of repair and increase the quality of tissue regenerated
by the healing process.
What stem cell-based therapies are in use today?
We use stem cells to improve the healing response in our articular cartilage
paste grafting technique. In an arthritic or chondral lesion, marrow
stem cells are exposed. A paste graft of cartilage and bone is mixed
with those marrow cells to stimulate healing.
For more information on articular cartilage
paste grafting, click here.
This March, Arthroscopy:
The Journal of Arthroscopic and Related Surgery published our 12
year data on our first 125 patients demonstrating the successful outcomes
in 85% of patients who had improved pain scores and 78% of patients who
had improved function. This is the first, and largest, study demonstrating
the use and long-term outcome of adult marrow cells to augment cartilage
repair.
Future Research
- We will concentrate marrow cells to get a higher number of stem cells
into the cartilage repair site.
- We will add autologous stem cells to
our ACL reconstructions, meniscus transplantations, and other repair
sites, to speed healing.
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