Can stem cells be a long-term alternative to knee replacement? I saw a patient in the clinic last week who I had treated two and a half years ago with a series of stem cell injections instead of a knee replacement. He’s a local physician and like many health care providers had seen one too many bad results from knee replacement to want that for himself. So he chose to have his own stem cells harvested and placed back into his knee via precise imaging guidance. He had a femoral condyle osteochondral defect and an old tibial plateau fracture that had partially healed over, so his knee wasn’t in great shape. He also had an old ACL knee graft that along with his MCL was lax. His result? He got 100% relief for 2.5 years and returned to heavy skiing – his passion. His knee is starting to ache a bit again, so he came back for an update treatment.
This patient brings up a number of important things about what we do. First, in some patients, update treatments are not uncommon. This usually happens every few years. Second, the fact that his ACL graft was loose and we were able to use exacting fluoroscopic guidance to place stem cells into that graft, I think made all the difference in his result. As I’ve blogged before, ACL grafts that come from a cadaver are frequently acellular, meaning that the cells die after the graft is placed. Why is this important? Those cells are needed to maintain the integrity of the graft. Think about any part in a car – eventually it wears out in the order of years. In your body, the parts last decades because they have cells inside them that are constantly repairing small amounts of damage. Without those cells, the ACL graft is just another part to be quickly worn out. So we believe that placing the patient’s own live cells into an existing graft can revive the ability of the graft to self-repair.
The upshot? We’re happy we could help this physician get back to high level Colorado type of activities. Having said that, we believe his excellent results came by precise placement of his cells. Finally, like some patients, he needs an update treatment to keep him going!