Regenerative Med/Pain Mgmt

Cell therapy injection is a powerful form of medical care that uses cells to treat knee and joint problems. Popular cell therapies for knee pain include mesenchymal stem cells, bone marrow and platelet rich plasma. Studies have tied cell therapy to improvements of up to 73% in knee pain and disability.

What Is a Cell Therapy Injection for Knee or Joint Pain?

Cell therapy injections use live human cells to replace or repair damaged cells and tissues. Orthopedic cell therapy injections apply this principle to the cartilage, muscles and tissues in the knees, hips and other joints. Doctors commonly inject bone marrow concentrate and/or platelet rich plasma in these areas.  Cell therapy has successfully helped patients suffering from common forms of joint pain.

How Does a Cell Therapy Injection Work?

Cell therapy treatments work by replacing or enhancing damaged or missing cells and tissues in the knee or other joints. The specific mechanism of action varies depending on the type of cell therapy used.

• Platelet Rich Plasma (PRP): PRP treatments collect helpful blood components, called platelets, from a patient’s own blood. Once the platelets are concentrated, a doctor injects them into the injured area of the spine. The platelets then release growth factors that tell nearby cells to grow and divide.
• Bone Marrow Concentrate (BMC): BMC treatments collect platelets and cells from bone marrow tissue. Mesenchymal stem cells (MSCs) and other adult stem cells are components of BMC. Once the adult stem cell-containing BMC is prepared, a doctor injects it into the injured area of the joint. The platelets can release growth factors that encourage new tissue to form. The mesenchymal stem cells can control inflammation and help damaged cells recover. MSCs can also differentiate into cartilage, bone, and/or other connective tissues.

Cell therapy injections generally do not provide immediate pain relief or symptom improvement. This is because cell therapy results depend on biological processes that span weeks to months. Instead, patients often notice pain relief and other benefits 2 to 6 weeks after treatment.

You can understand this better by considering the nature of conditions treated by cell therapy. Knee pain often appears after years of biological and physical damage and/or failure. Cell therapy injections are intended to address some of these long-term problems at the root. Since this requires overcoming months or years of damage, it makes sense that results take time.

In the study, patients with arthritic knee pain had one injection of bone marrow cells. Researchers tracked the patients’ pain and knee function scores. At six-month follow-up, patients still in the study had about 75% improvement in pain. They also had about 35% improvement in knee function.

Cell therapy treatment results can vary depending on several factors. These include the severity of injury, the type of cell therapy used and patient health. The results seen in this study may not be typical. But patients interested in cell therapy for joint pain should discuss it with a specialist.  A regenerative medicine doctor can help patients understand what this type of treatment may do for their individual case.

Benefits of a Cell Therapy Injection for Knee or Joint Pain

Cell therapy injection benefits can vary based upon the type of treatment, the area treated and patient factors. Cell therapy joint injections can provide several potential benefits, including:

• Decreased pain
• Faster recovery versus surgery
• Improved ability to function in daily life
• Keeping other treatment options open
• Postponing or avoiding an invasive surgery
• Potentially addressing the root cause of pain rather than just a symptom

Cell therapy injection patients may not experience all of the above benefits. Patients weighing the benefits of cell therapy joint injections should discuss this procedure with a physician. The physician can explain how a cell therapy injection may or may not benefit the patient.

Side Effects of Cell Therapy Injections in Knees or Joints

As with all medical procedures, cell therapy injections in the knee or other joints may cause side effects. In one knee injection study, none of the patients reported a significant side effect. But other studies reported mild side effects like injection site pain and temporary soreness at the blood or bone marrow draw site.

In rare cases, patients may develop inflammation or infection of the treated tissue. According to medical literature, this side effect is quite rare. Doctors can generally manage this side effect with steroids and/or antibiotics.

Another fairly common side effect is a vasovagal response during injection. This occurs when the patient’s heart rate slows and blood vessels relax, causing them to faint. Vasovagal episodes are generally brief and considered.

Eligibility for Cell Therapy Injections in the Knees or Other Joints

Eligibility for cell therapy injections in the joints can depend on several factors including the specific condition, its severity, and the patient’s goals.  Patients considering cell therapy for knee pain should speak with a regenerative medicine doctor.

Cell Therapy Procedures for Knee and Joint Pain

Joint pain can come from many different conditions. Studies show some knee and joint conditions have responded to cell therapy injections. Conditions treated with cell therapy injections include

• Arthritis: Arthritis occurs when a joint is inflamed and can occur for many reasons. The most common form of arthritis is osteoarthritis, which often comes with age. It generally worsens over time and can lead to disability and joint replacement.
• Ligament Tears: Ligaments are strong tissues that connect joints and help stabilize bones and muscles. If ligaments are torn or injured, they can cause pain, joint weakness and disability.
• Tendinopathy: Tendons are strong tissues that connect muscles to bones. Tendon damage, injury or breakdown-over-time can cause the pain and inflammation of tendinopathy.

Doctors may use cell therapy procedures to treat any of the above conditions. In these procedures, doctors typically inject some form of cell therapy into the affected tissue. Specific procedures include:

• Intra-articular Joint Injection: Intra-articular joint injection is simply an injection into the joint compartment. Doctors often use PRP or BMC in this procedure to treat joint pain and arthritis.
• Ligament Injection: This procedure is a simple injection of PRP or BMC into a damaged or painful ligament.
• Tendon injection: This procedure is a simple injection of PRP or BMC into a damaged or painful tendon.

Cell therapy joint injections often take place in a doctor’s office. They are minimally invasive and generally well-tolerated. So patients usually do not have to take time off from work or their regular lives to accommodate them.

Procedure Details: What to Expect From a Cell Therapy Injection for Joint Pain

Cell therapy injection procedures will vary due to the injection location, the type of therapy and physician preferences. However, cell therapy injections for joint pain do share a few common features.

1: Consultation Appointment

Before a doctor prescribes BMC or PRP, they will evaluate the patient for eligibility. This evaluation includes a general physical in addition to examination of the patient’s symptoms. Often, the patient already has a diagnosis at this point. In such cases, the consultation appointment gives the doctor a chance to look over x-rays or MRI reports. These imaging records help the doctor determine if cell therapy may be a good fit for the patient’s condition. If the patient is eligible, they will generally schedule a treatment appointment for a few days later.

2: Pre-Treatment Preparation

Before undergoing treatment, many doctors recommend patients stop taking NSAIDS. NSAIDs are non-steroidal anti-inflammatory drugs like ibuprofen and naproxen. They may limit the efficacy of cell therapy injections. Doctors may ask patients to avoid NSAIDs for the five days leading up to the procedure. During this time, patients may also need to withhold or limit doses of blood thinners. Patients should only alter their dosage of prescribed medications at the specific request of a licensed physician.

3: Cell Therapy Injection for Joint Pain

During the cell therapy injection appointment, the procedure generally includes the steps below.

1. Collection of Blood or Bone Marrow: A healthcare provider will draw blood from a vein or bone marrow from the patient’s hip bone. Both procedures take less than 10 minutes. Bone marrow aspiration involves additional preparation, as a numbing agent is used to ensure patient comfort.
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2. Processing of Patient’s Cells: A trained specialist will process the blood or bone marrow in a sterile device. It takes less than 20 minutes to complete processing with the [BMC device name] or [PRP device name]. Once processed, the PRP or BMC is ready to inject.
3. Preparing the Injection Site: While the specialist processes the patient’s cells, the patient may be prepped for treatment. The doctor may spray the injection point to numb the patient’s skin. Doctors often use an anesthetic injection in the muscle and other tissue around the targeted area. This helps keep the patient comfortable during injection. While numbing agents take effect, the doctor often uses x-ray or ultrasound imaging to set up the injection.
4. Injecting the Cell Therapy: The doctor may or may not continue using x-ray or ultrasound throughout the injection. Once the needle is placed, the doctor injects the prepared cell therapy into the affected area of the spine.
5. Monitoring the Patient and Releasing to Home Care: The treatment team will monitor the patient for potential reactions for a short time after treatment. Once they confirm the patient isn’t having unexpected side effects, the patient can be released to go home. For some joint injections, doctors may prescribe pain medication to help manage post-procedure pain.

4: Recovery and Rehabilitation

Cell therapy injections can achieve powerful results, but these results take time. After a cell therapy injection for joint pain, doctors often advise patients to limit activity for a week or two. After this time period, doctors may also suggest working with a physical therapist. A physical therapist can help the patient provide mechanical signals that help the cell therapy work as effectively as possible.