Knee osteoarthritis is one of the most common conditions that affects patients’ quality of life, especially with age. While traditional treatments focus on pain relief or surgery in advanced stages, a promising alternative has emerged: stem cell treatment for knee osteoarthritis, which works to regenerate damaged tissues and naturally improve joint function.
What is joint roughness?
Rheumatoid arthritis, also known as degenerative arthritis, is a common medical condition in the elderly (the world’s fourth leading cause of disability) characterized by the wear and tear of the protective cartilage lining the joints over time, which leads to a reduction in the space between the bones inside the joint, causing the bones to fuse together when moving the joint causing pain, swelling, and stiffness in the joint. Osteoarthritis often affects:
- Hands
- Knees
- Hips
- Neck (cervical vertebrae)
- Lower back (lumbar vertebrae)
Causes of knee roughness
This condition usually occurs gradually with age as a result of an injury to one of the cartilages of the knee joint:
- Sports injuries
- Falling
- Traffic accidents
- Health conditions that affect the joints, such as Ehlers-Danlos syndrome or joint hypermobility syndrome
The most common symptoms of knee stiffness
- Pain in the joint (especially when moving it)
- stiffness of the joint
- Swelling near the joint
- Reduced range of motion (range of motion of the joint)
- Feeling that the joint is not as strong or stable as it used to be
- A noticeable change in the shape of the joint (joint deformity)
- Bone spurs.
- Hard pieces of bone may form around the affected joint
Risk factors for joint roughness
- Obesity (BMI greater than 30) or overweight (BMI greater than 25).
- Adults over the age of 55.
- Post-menopausal women.
- Diabetes.
- High cholesterol (hyperlipidemia).
- Certain immune diseases affect the joints.
What are stem cells?
Stem cells: A type of pluripotent cell that can differentiate, proliferate, and transform into different types of specialized cells in the body, such as bone and other tissues, and has the properties of immune regulation, self-renewal, and repair of damaged tissues. They are found in various places in the body, such as bone marrow, underlying bone, fat, synovial membrane, and other tissues.
Types of stem cells used to treat knee osteoarthritis
The following table shows information on the types of all stem cells used to treat knee osteoarthritis in terms of source, characteristics, advantages, disadvantages, and clinical outcomes:
| Source | Characteristics | Advantages | Disadvantages | Clinical results |
|---|---|---|---|---|
| Bone marrow (BM-MSCs) | Pluripotent stem cells, available in bone marrow, with good differentiation ability and moderate proliferation | Easy access, high differentiation capacity | The speed of reproduction is lower compared to other species | Improvement in pain, increase in cartilage volume, improvement in knee function with long-term safety of use |
| Adipose tissue (AD-MSCs) | Stem cells from fat, with a high capacity for proliferation and differentiation, possess an excellent immunological effect | High reproduction rate, strong immunological effect | Lack of adequate clinical studies | High safety, pain relief, improved function, promising results with some long-term studies |
| Umbilical cord (UC-MSCs) | Umbilical cord stem cells, characterized by high proliferative capacity, active differentiation, and excellent immunogenicity | Highest reproduction rate, strong anti-inflammatory effect | Few clinical studies, and the amount of cells extracted is low | Significant improvement in pain and function, some minor side effects such as temporary swelling, and overall positive results |
How is knee osteoarthritis treated with stem cells?
- Stem cells are collected from bone marrow or adipose tissue by withdrawing a small amount (under local anesthesia).
- The sample taken in the lab is processed to separate and condense the stem cells. The cells are checked for quality and contamination-free before they are injected into the joint.
- The cells are injected directly into the affected knee joint and are guided by ultrasound or X-rays to ensure that the cells are localized to the site of the injury. Hyaluronic acid may be added to the stem cells to improve the effect of the cells.
The number of injection sessions is 1 to 3 sessions over several months, depending on the progression of the condition. The sessions are repeated after 6 weeks to optimize the effectiveness of the treatment. Each session lasts between 30 and 60 minutes, which includes collecting and preparing the cells and performing the intra-articular injection under radiological supervision.
Types of injections
- Ultrasound-Guided Injection: Ultrasound is used to locate the injection site and ensure that the needle is placed in the correct location, thus achieving greater accuracy and minimizing potential risks such as injury to neighboring tissues or blood vessels.
- Fluoroscopy-Guided Injection: An ultrasound that provides a moving image is used to precisely guide the needle’s path into the joint, as the needle is directly viewed during the injection, ensuring the accuracy of the results.
- Use of supportive materials (Hyaluronic Acid – HA): Hyaluronic Acid is used to enhance the effectiveness of the treatment, as it improves intra-articular stability, reduces friction, speeds up the healing process, and stabilizes the stem cells within the joint.
Advantages of stem cell treatment for knee osteoarthritis
- Reduce inflammation and pain: Stem cells are able to reduce inflammation in the affected joint, leading to pain relief and improved mobility.
- Promote cartilage and tissue regeneration: Stem cells regenerate damaged tissues within the joint, such as cartilage, which helps improve joint function.
- Delay or avoid surgery: Stem cells can reduce the need for surgical interventions such as knee replacements or other complex surgeries.
- A safe and natural procedure: Stem cell treatment for knee osteoarthritis is a relatively safe procedure that uses the patient’s own cells (autologous cells) or cells from a compatible donor (donor cells). The procedure does not involve large surgical incisions, which minimizes the risk of complications and allows for a quick recovery.
Side effects and potential risks
Although stem cell knee treatment is generally considered safe, there are some potential harms and side effects that you should be aware of:
- Pain and swelling at the injection site: There may be mild pain and swelling at the injection site, which usually go away within a few days.
- Allergic reactions: In rare cases, allergic reactions to the stem cells or the materials used in the injection may occur.
- Infection: There is a small risk of infection at the injection site, but this risk can be minimized by following your doctor’s instructions for wound care.
- Abnormal cell growth: In very rare cases, abnormal cell growth may occur at the injection site, but this risk is considered very low.
Stem cell therapy compared to conventional treatments
The following table shows the most important differences between stem cell treatment for knee osteoarthritis and conventional treatments
| Criterion | Stem cell therapy | Traditional treatment |
|---|---|---|
| Results and effectiveness | – Effective in reducing pain and joint inflammation. – Promotes the regeneration of damaged cartilage and tissue. | – It relieves pain but has little effect on tissue or cartilage regeneration. |
| Side effects and risks | – Rare or minor side effects such as swelling or allergic reactions. – Fewer risks compared to surgery. | – Common side effects such as infection or adverse reactions to medications, with greater risks due to surgery (such as injury to surrounding tissues). |
| Recovery time | – A relatively short recovery period (weeks to months, depending on the case). | – Longer recovery period (several months to a year, depending on the type of treatment or surgery). |
| Cost | – High initial cost compared to conventional treatment. | – The cost is lower initially, but it can add up due to the need for ongoing sessions or surgical interventions. |
| Long-term benefits | – It offers long-term benefits by regenerating tissue and minimizing the need for surgery. | – It may require ongoing treatment, and surgery may be needed after a while. |
How to care after stem cell treatment for knee osteoarthritis
Care after stem cell treatment for knee osteoarthritis is carried out through a number of procedures, including:
One to two weeks after stem cell treatment for knee osteoarthritis
- Bandages at the injection site for bone marrow harvesting may not be removed for 48 hours.
- Rest in the early days: Avoid straining or activities that place too much strain on the knee.
- Use ice: Use several times a day on the knee for 15-20 minutes to reduce swelling.
- Knee elevation: This is done with pillows to reduce swelling.
- Temporarily avoid heavy weights and high-impact sports: Avoid doing sports activities or lifting heavy weights to avoid putting pressure on the injected joint.
- Mild to moderate joint pain is not an issue at first, but severe pain requires a doctor’s consultation.
A month after stem cell treatment for knee osteoarthritis
- Muscle strengthening exercises: Exercises to strengthen the muscles around the knee and improve joint function, such as knee stretches and quadriceps strengthening. These exercises are done after a period of treatment under the supervision of a specialist.
- Light-loading exercises: Exercises that aim to stimulate joint movement while avoiding applying too much pressure to the joint, such as walking or swimming.
- Maintain a healthy weight: A healthy body weight should be maintained because being overweight causes additional pressure on the knee, which impairs the effectiveness of the treatment.
- Proper diet: Eat foods rich in vitamins and minerals such as calcium and vitamin D, which support healthy bones and joints. Eat foods rich in omega-3 fatty acids, which increase bone flexibility and help reduce inflammation.
- Patients with pain can take anti-inflammatories.
In conclusion, stem cell treatment for knee osteoarthritis is a revolutionary option in orthopedic medicine, offering cartilage regeneration, pain relief, and reduced need for surgery. Although outcomes vary, many studies confirm significant improvements in mobility, making it a valuable alternative for patients seeking to avoid surgery or long-term medication.
Sources:
- Leung, V., & Cheng, J. (2014). Stem cell therapy for knee osteoarthritis. PMC.
- California Institute for Regenerative Medicine. (n.d.). Stem cell-based therapy for cartilage regeneration and osteoarthritis. CIRM. Retrieved from
