Let’s talk about why we would consider using a stem cell or BMAC (see part 2) in the first place.
Why Use Stem Cells?
Consider joint cartilage. This is the special covering that lines the joints of the knees, hips, shoulders, etc, and it is smooth and healthy when we are born. Over time, we lose some of the blood vessels that deliver important nutrients to the cartilage. With little blood supply and nutrients, it loses its ability heal after an injury or after a long slow process of degeneration.
When joints degenerate over time like in “wear and tear” arthritis, they release chemicals on the inside, which make the cartilage become hard and wear away. This cascade can lead to pain and disability. If not stopped or altered, this could eventually lead to the dreaded “bone-on-bone” or end stage disease at which point patients can either live with the pain and decreased function or consider joint replacement.
Stem Cell = Nature’s Drug Store
Dr. Caplan (who discovered the MSC) has since suggested we start calling these cells from BMAC “Medicinal Signaling Cells.” Why? Well it turns out the cells we get from the bone marrow act like a powerful drug store in a tiny package. They release powerful signals that help the body provide anti-inflammatory effects, alter the immune system, stop cell death, and even improve blood flow. Some doctors and scientists now debate whether this is in fact more important than the early ideas that cells could multiply into new tissues.
How Many Stem Cells Do We Really Need?
But do numbers of cells not matter then? This debate continues. We do know that low numbers of cells have worse outcomes, and so there is a minimum threshold we need to get to for best results. However, this threshold may be different for different body parts. Why not take the cells out and grow them for a while? This process is called culture. It is timely, costly, increases the risk of infection, causes cells to lose their “stem” abilities if done for too long, and is also not approved by the FDA in the US.
So how do you improve your chances of a good procedure? Stay away from tobacco, NSAIDs at least 1 week before and after your procedure, and get regular light aerobic exercise. And of course, make sure you see the most qualified Regenerative Orthopedics provider to boost your chances of long term success. Stay tuned for Part 4 where we will discuss what is unique about the care at Carolina Orthobiologics.