Regenerative medicine is an area of medicine that focuses on using the body’s own natural healing ability to heal injured or degenerative tissue. While the field is branching across many medical specialties, in my office I focus on the orthopaedic applications. The field holds promise to heal tissue, such as tendon or cartilage, which we previously thought was irreparable. Regenerative medicine can also help accelerate healing of tissue that has slow or poor healing potential such as ligament. Regeneration of damaged tissue can lead to improvements in pain and function. And because regenerative medicine uses the body’s own cells or tissues, there is no chance of rejection or negative side effects for patients.
The regenerative procedures that I currently perform in the office include platelet-rich plasma, stem cell, and alpha-2 macroglobulin. Let me take a moment to explain what each of these procedures are and their benefits.
Platelet-Rich Plasma, or PRP, is an innovative approach to tissue regeneration that uses the patient’s own blood. The body’s natural reaction to injury is to send platelets to the damaged tissue. At the injury site, the platelets release growth factors and stem-cell recruiting factors to trigger a healing response.
With PRP therapy, the platelets are concentrated from the blood using a centrifuge. The concentrated platelets are then injected into the damaged structure and “activated”. I use ultrasound or fluoroscopy to inject the platelets to make sure that the cells are delivered to the area of injury. Activation means that they release all the growth factors contained within the cells.
Conditions commonly treated with PRP include chronic tendonitis or ligament sprains. It can also be injected for painful arthritis or stable meniscal/labral tears. PRP initiates a healing response, thus typical pain relief occurs over four to six weeks. In tendons and ligaments, patients can expect healing and symptom relief to be permanent. For arthritis, pain relief can be temporary as the degenerative process may slow but will still progress over time. However, many people get several years of relief.
Stem Cell Therapy helps the body repair itself naturally Stem cell procedures are performed by concentrating the patient’s own stem cells and then injecting them into the diseased tissue to promote regeneration. Adult stem cells are cells that can differentiate into many different types of tissue. Mesenchymal stem cells, one kind of stem cell that is present in bone marrow or fat, can multiply and become cartilage. These cells can be collected from a patient’s hip bone or belly fat. They are then concentrated, like PRP, and injected into the injured tissue using either ultrasound or fluoroscopy. Stem cells are most commonly used for arthritis but can also be used for meniscal or labral injuries. Patients typically notice pain relief and functional improvement within six to eight weeks. Often, I will recommend a PRP “boost” six weeks after stem cell injections to stimulate continued healing.
Alpha-2-macroglobulin, or A2M, is a blood protein that can block cartilage breakdown. The levels of this protein have been found to be low in arthritic joints. The idea is that concentrating the protein from the blood and injecting it into the joint will slow the degenerative process. This molecular discovery is new, but we have seen encouraging results so far. Currently, we inject this molecule along with PRP to also get a healing response.
Regenerative medicine is a rapidly expanding field researching the ways that we can optimize the body’s natural healing abilities, and radically change the way musculoskeletal conditions are treated. Most of these treatments are still new, however, clinic studies show significant and lasting reduction in pain for a variety of injuries.
If you’re interested in learning more about regenerative medicine or to schedule a consultation, call HFM Lakeshore Orthopaedics at (920) 320-5241.
About the author.
Marjorie J. Delo, MD is a primary care sports medicine physician at HFM Lakeshore Orthopaedics. She specializes in medical and nonsurgical orthopaedic injuries and other sports related conditions. Also, she has taken extensive post¬graduate training in musculoskeletal ultrasound diagnostics and minimally-invasive procedures.