Stem cells in treatment a hot topic

Rarely a day goes by that I am not queried about the potential for stem cells to cure an orthopaedic ailment that one of my patients has encountered. I find this trend concerning. There has been a proliferation of “stem cell” treatments in recent years and unfortunately it turns out these offerings represent far more hype and false hope than they do legitimate potential to help patients.

I use quotation marks around stem cell because what practitioners claim are stem cell treatments in actuality include very minimal if any true stem cells.

In most cases fat cells are harvested from a patient or bone marrow is aspirated from sites such as the pelvis.

In some cases tissue from the amniotic sac of a newborn child has been used for its purported healing potential.

This material is then processed, sometimes with the use of a centrifuge, with the intention to “concentrate” the stem cells for reimplantation in the patient often by injection.

The problem is that there is no way to determine what portion of these specimens contains stem cells if at all, so the notion that the patient is receiving anything of benefit is theoretical and highly variable.

Even if we were able to guarantee that there were actual stem cells going back into a patient’s shoulder or knee, what would that mean?

Patients have been drawn in by the suggestion that these cells can regenerate tissue such as cartilage or tendon, and in so doing help to reverse damage and perhaps avoid surgery.

These are patently false claims, as there exists no treatment at this time to regenerate cartilage or tendon, a fact proven by multiple clinical trials.

Some patients report improvement in their symptoms following what they are told are stem cell injections.

What is happening in these cases? Is this placebo effect? Is there some antiinflammatory property to these injections much like a steroid shot?

The answer to this question is unclear, but what is clear is that there is no regeneration of normal tissue occurring.

The FDA has not been shown adequate safety and efficacy of any of the aforementioned treatments to garner its approval (https://www.fda.gov/ ForConsumers/ConsumerUpdates/ucm286155.htm).

Perhaps more troubling than the dubious claims about the regenerative properties of so called stem cell treatments are the outrageous prices being charged by practitioners for these interventions.

Because they lack FDA approval, these treatments are not covered by government-issued or even private insurance. Therefore no reasonable fees have been negotiated with practitioners, allowing the professional to charge whatever they think patients will pay.

Often feeling some degree of desperation and clinging to the hope that they will be blessed with a miracle, patients are vulnerable to price gouging.

Prices for these injections range from several hundreds of dollars to upwards of $5,000.

Before dismissing stem cell treatments as modern day snake oil, it is important to point out that cell-based treatments hold tremendous promise in many areas of medicine and warrant continued study. However, when specifically considering stem cell treatments for joint and other musculoskeletal conditions unfortunately the substance does not support the hype. Buyer beware.