Despite their relatively young age, many people already suffer from joint deterioration as a consequence of overweight and overstress from physical activities. The joints most commonly affected are knees and shoulders as well as hips that are also common among older people. Quite often besides weight reduction, only physiotherapy and specific training are prescribed for these diseases which are considered medically as arthritis. In most cases, nothing more than that is done. If the condition gets worse, an artificial joint (joint implant) is inserted. However, an artificial joint can never replace a natural joint. In addition, the surgeries under general anesthesia that last several hours are complicated, complex, costly, and frequently also require blood transfusions.
The regenerative power of stem cells has been used in veterinary medicine for quite some time: For instance, joint problems of race horses and dogs are successfully treated by means of stem cells that are extracted from the fat of these animals. The stem cells are isolated and injected under strictly sterile conditions into the corresponding joints. In most cases there is a successful outcome: Joint problems improve and the cartilage seems to regenerate. This raises the question whether it is also possible to perform this treatment in humans?
Due to the fact that the autologous fat particularly contains an especially high number of stem cells, it is not surprising that cosmetic surgeons had been the first ones who discovered the stem cells as a “waste product” of liposuction surgery. Hence, the cosmetic surgery which rather deals with plastic surgeries, breast augmentations and facelifts, has become the spearhead in the development of stem cell therapies to remedy “real” problems.
In fact, such treatments have already been performed in some centers worldwide: Stem cells are isolated from some fat that is liposuctioned and are injected into the corresponding joint. Subsequently after, it leads to a swelling that impairs the mobility. The therapeutic effect can already be seen after a few weeks: Improved mobility and reduced problems. This all takes place outpatiently and based on experience, with a significant less effort and risk than the implantation of artificial joints would require.
Physicians are not yet sure how the actual mechanism of action in terms of cartilage regeneration by means of stem cells proceeds in detail – either new cartilage cells are really generated from the injected stem cells or certain substances that are released by the stem cells cause a regeneration of the existing cartilage cells.
Questions on the exact mechanism of action are usually of subordinate importance to patients – the main thing is the fact that the therapy is successful and that it brings an improvement in terms of mobility and state of mind! Will stem cells be able to replace artificial joints one of these days? Probably, irreparably damaged joints will still be replaced by implants in the future. However, some patients with arthritis – who are treated early enough with stem cells – may be helped to that extent that he/she – at least for the time being – do not have to receive an artificial joint implant.
What is your opinion on this development?
DDr. Heinrich, MD