The most important among several factors is the severity of the osteoarthritis (OA). We grade osteoarthritis using the Kellgren-Lawrence grading system. Grade I is minimal OA. Grade IV is “bone on bone”. There must be some cartilage and joint space left in order for the stem cells to have something to work with.
Other factors include:
Finally, a person’s expectations factor into whether or not he/she is eligible. While many patients are experiencing significant improvement, you will not feel like you are 21 again.
Most of our patients have done well in terms of both symptomatic relief and showing increased cartilage thickness, as measured by ultrasound at 6-7 months following the procedure. The success rate for knees is 80 percent. The amount of cartilage growth varies, of course, with younger people generally showing more improvement than older patients.
We also determine the success rate using such things as the WOMAC scale, a standardized measurement of functional capacity for patients with osteoarthritis. In addition, we assess the pain a person feels when walking 50 feet and measure the patient’s perception of their pain on a visual analogue scale.
There is only minimal discomfort associated with providing the local anesthetic.
The recovery time can vary depending on the joint being treated. For knees you will need to be non-weight-bearing for 7 days. After that, you can gradually increase your activity. You will probably be able to return to work in one to two weeks, depending on the nature of your job. You will likely need to use a special brace called an “unloader brace” for several weeks.
Following a stem cell procedure on a hip, you will need to be on bed rest for 48 hours. After that, you will need to use crutches with NO weight bearing on the treated side for four weeks. You will also need to use traction to the hip several times a day.
You will be given a local or regional anesthetic and also some oral Valium prior to the procedure.
No. You will need to have someone drive you home after the appointment.
It is a long, slow process and may take up to a year to see measurable differences in cartilage. In knees, we use ultrasound to measure cartilage thickness at 6-7 months following the procedure because it is more sensitive. So far we are seeing improvement in cartilage thickness as early as six months.
Yes, you should be feeling better in about 4 weeks or so. This is because we will also be injecting the platelet rich plasma into the joint, which promotes healing in the area.
The biggest advantage is that it is much less invasive. Also, there is less risk of infection and other surgery related complications. Like PRP, the use of your own stem cells is as “natural” a treatment as there is. No metal or plastic. Joint replacements last approximately 10 years and need to be repeated. Stem cell treatment may also need to be repeated every few years, but again, it is a simpler, less invasive procedure. In contrast, joint replacement surgery is not reversible.
Since this is still a new treatment, we don’t know the long term results, such as how long it lasts or how long you will continue to grow cartilage.
Again, we don’t know the exact amount. It will not return the amount you had when you were 20, but it will be better than what you had before the treatment. It depends, in part, on strictly following the post procedure instructions.
There does need to be some cartilage present for the stem cells to be able to generate new cartilage. We do not recommend a stem cell procedure for patients who have no cartilage left.
We use autologous stem cells. These are your own stem cells that we obtain from your bone marrow from the iliac crest of your pelvis. We also use fat cells.
It is assumed that if you are in general good health, and under the age of 75, the stem cells will be good.
There is no exact answer to that. It varies depending on the joint being treated. If you have a desk job, then it may be possible for you to return to work in a few days. If your job requires you to be more active, then it may take longer.
In general, you should allow at least 3 months before returning to any strenuous athletic activities or exercise. It may take up to one year depending on the individual and the type of activity.
Because this procedure is still considered experimental, it is not yet covered by insurance companies. Medicare does not cover this procedure.