Growth Factors and Lubrication: Injections to accelerate healing
At The Stone Clinic, an evolution of injectable regenerative therapy has occurred. We started with blood injections in the 1990’s intuiting that the blood had all the healing components required. This evolved to isolating the platelets in blood that release the most important growth factors. These growth factors act to both directly stimulate healing and to recruit stem cells from the walls of vessels to migrate to the site of injury. Today growth factors from platelets drawn from the patient in the office constitute an important part of our injection therapies.
Stem cells are potent growth factor producers and also participate in tissue healing and remodeling. We initially only isolated these cells from the bone marrow, however, data has shown that with aging the concentration of the stem cells that are potent declines precipitously each year. While we often release these marrow stem cells at the time of surgical repair, in the office a frozen source of amniotic stem and reparative cells is now available. One cc of amniotic fluid contains one to two million active amniotic stem and other reparative cells and 2-50 times the concentration of growth factors found in platelet preparations.
Hyaluronic acid is the normal joint lubrication material found in all joints. By injecting a syringe full into the knee many patients find relief from pain and inflammation, but the response is variable. We choose to augment the lubrication injections with growth factors from platelets or amniotic stem cells to potentiate the biologic response.
PRP: growth factors derived from platelets
In acute injuries, our preference is to augment healing with PRP or amniotic fluid with stem cells.
In arthritis, we prefer to add hyaluronic acid to the PRP or amniotic fluid with stem cell injections.
It is only cost that limits our ability to inject amniotic fluid and stem cells each time since at this time most insurance companies do not reimburse for the growth factor or stem cell injections.
The risk of any joint injection is possible infection or reaction. For each of these preparations the risk is extremely low but not zero. The amniotic stem cells are from healthy mothers fully tested for all known diseases and provided by the leading commercial entity. The Stone Clinic and Stone Research Foundation collaborate with this entity to push forward the research and development that can improve the efficacy and document the outcomes of this regenerative therapy.