STEM CELL THERAPY
WHAT IS IT?
Stem cells are immature cells that have the ability to grow into many different types of cell. In sports medicine, stem cells are harvested and then injected into an injured area, says Jonathan Finnoff, professor of physical medicine and rehabilitation at the Mayo Clinic and medical director of the Mayo Clinic Sports Medicine Center in Minneapolis, US. While PRP therapy stimulates the healing process of tissue that is already there, stem cells may create new tissue. This is why researchers think this therapy may help joint injuries caused by worn-out cartilage; in cell cultures, stem cells can grow new cartilage and if this can happen in a joint it may prevent the need for a joint replacement. Bone marrow is generally harvested from the hip using an incision and a specialised needle capable of penetrating bone. Then, in a similar fashion to PRP therapy, the bone marrow is centrifuged to separate the stem cells and platelets, which are injected, under ultrasound guidance, into the injured area.
WHAT DOES IT TREAT?
Stem cell therapy is most commonly used for tendon, ligament, joint and muscle injuries that are not responding to other treatments, including PRP, says Finnoff. ‘I would almost always recommend PRP first – it is less invasive, less expensive and there is more evidence supporting it.’
HOW EFFECTIVE?
The scientific literature on stem cell therapy is relatively scant. The most encouraging studies are in sheep, where stem cells have been shown to regenerate cartilage, in essence reversing the process of osteoarthritis. ‘This is still very experimental,’ says Finnoff. ‘That said, I’m having runners respond to stem cells, runners who might otherwise need major surgery.’
WHO’S HAD IT?
Outside the world of running, American football star Peyton Manning reportedly had stem cell therapy in 2011 as a last-ditch effort to treat a bulging disc in his neck. While Manning appeared to recover eventually, he also had at least one surgery after his stem cell treatment. Finnoff says he’s treated a handful of runners with stem cells, some of whom had great success.
DOES IT HURT?
The bone-marrow-extraction process is typically performed under a local anesthetic, so you won’t feel this part. Similar to PRP, the injection of stem cells shouldn’t be very painful.
WHO OFFERS IT?
This is really one for the future, but stem cell therapy is already available in a researchrelated context at some major academic medical centres in the UK, while Basildon Hospital in Essex has pioneered stem cell therapy to treat damaged cartilage. You should be aware that outside of this, many orthopaedic stem cell treatments are largely unproven and unregulated; however, there is hope for fully approved stem cell treatments. The UK Stem Cell Foundation (UKSTF) has funded a range of research projects that aim to speed up the process of making stem cell therapy safer and more widely available.
WHAT’S THE COST?
Around £3,000 to £8,000 for stem cell therapy to treat damaged cartilage at Basildon Hospital.
TREATMENT PLAN?
Stem cell therapy is usually a one-off treatment. ‘The only time I’ll administer a second injection is if someone had a good, but partial, response,’ says Finnoff. ‘If a runner with osteoarthritis is starting to regrow cartilage, but they haven’t grown enough to run without pain, I’d consider a second treatment.’