STEM CELL THER­APY

Runner's World (UK) - - In­jury Treat­ment -

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.’

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