Can Stem Cells Cure Knee Arthritis?
Unfortunately, the answer to that question is not known today. It is clear, however, that many novel regenerative therapies are emerging to help the tens of millions of patients worldwide that are suffering from knee arthritis.
First, we must explore what type of stem cells could be helpful in the treatment of arthritis. Stem cells of various types can be obtained from your blood (peripheral derived stem cells), bone marrow (mesenchymal stem cells), fat (adipose derived stem cells), and even from umbilical cord blood. Studies today are exploring various ways to extract, purify and concentrate many types of stem cells. The cells can then be injected as a suspension into your knee, used as part of surgical procedure or even injected after an operation.
Microfracture of Damaged Knee Cartilage
One recent study (Vangsness et al 2014) showed how an injection of mesenchymal stem cells could lead to more meniscus tissue after a knee arthroscopy. 24% of the treated group were found to have at least 15% increased meniscal volume. This is a small amount in only a a quarter of the patients but it does represent a start. Another study published last year (Saw et al 2013), injected peripheral derived stem cells after a microfracture procedure and noted improvement in the cartilage quality. Other approaches (Pak et al 2014) use adipose derived stem cells from liposuction in combination with platelet-rich plasma to treat meniscus tears. Finally, a review (Anderson et al 2013) of potential stem cell therapies for knee cartilage outlines many potential and emerging options.
Also, a variety of procedures also use non-stem cells to treat arthritis of the knee. One of the oldest is called autologous chondrocyte implantation. This is where a biopsy of your own cartilage is taken and then grown in a lab. The expanded cells and then reimplanted into an arthritic lesion of the knee. Another procedure simply penetrates the bone under the defective cartilage. This leads to leakage of some of the bone marrow along with your own the stem cells within the marrow into the defect. This is called microfracture. Yet another procedure uses juvenile cartilage that is minced and then glued into a arthritic zone of the knee.
It is clear that there are many competing approaches to the use of cells and stem cells to treat knee arthritis. None have "cured" the problem. There is, however, an earnest worldwide research effort that will produce clinically meaningful options for clinicians and patients.
Millions worldwide are waiting for that day.
Anderson et al 2013
Saw et al 2013
Vangsness et al 2014
Pak et al 2014