Ask Dr. C-Episode 19: Hip Arthritis and Stem Cells
A patient in our holiday edition of Ask Dr. C asked about hip arthritis, which is a different animal than other types of arthritis we treat. Hence, that question needs a full blog to answer. Let’s dig in.
Can cartilage in the hip be restored with stem cells? And if there is OA can it work?Request a Regenexx Appointment
While it’s hard to conceptualize that your hip joint could be different than your knee joint in terms of arthritis, it is different. For example, we’ve known for many years that the cartilage in the hip is less capable of self-repair when compared to other joints (1). Our research team has tracked almost 3 thousand patients treated with their own bone marrow stem cells. Here’s what that data shows as of today:
At Regenexx have been tracking the results of all of our treated and consented patients since 2005. While this hip data above shows self-reported percentage improvement and represents many patients that did well, it’s not as good as our knee data that you can also find on our online outcome tool. This is consistent with our published research on using the patient’s bone marrow stem cells to treat hip arthritis (2). What our peer-reviewed study showed was that patients with more severe arthritis in the hip just don’t have the same positive results as older patients with more severe knee arthritis. Younger patients under the age of 55 years of age with less arthritis did much better.
Why Is This Happening?
Last year, researchers at Duke published the results of cartilage protein testing in various joints. They found that the cartilage proteins in the ankle were younger than the knee which were still younger than those proteins in the hip (3). Basically, this explained why the hip was less likely to have good self-repair qualities as we age.
Can We Regrow a New Hip?
No, if you have bone on bone hip arthritis, no stem cell procedure will produce new cartilage. These procedures, as I have shown above, work the best in younger patients (under the age of 55) who have mild or moderate hip arthritis and not severe hip arthritis.
What About the Hip X-rays On-line?
You may see chiropractic clinics using dead umbilical cord or amniotic tissue that contains no stem cells advertising showing x-rays that seem to show that new hip cartilage has grown. Regrettably, these represent a scam that is accomplished by tilting the x-ray beam relative to the patient, which makes the joint space look bigger. I’ve covered that scam below in my video:
The upshot? If you check out other providers offering stem cell procedures for hip arthritis, the only candidacy information is whether or not your credit card clears. Not so with Regenexx, where we have used our published registry data to see who responds best to our procedures. In the case of hip, it’s younger patients with less severe arthritis!
(1) Catterall JB, Hsueh MF, Stabler TV, et al. Protein modification by deamidation indicates variations in joint extracellular matrix turnover. J Biol Chem. 2012;287(7):4640–4651. doi: 10.1074/jbc.M111.249649
(2) Centeno CJ, Pitts JA, Al-Sayegh H, Freeman MD (2014) Efficacy and Safety of Bone Marrow Concentrate for Osteoarthritisof the Hip;
Treatment Registry Results for 196 Patients. J Stem Cell Res Ther 4: 242. doi: 10.4172/2157-7633.1000242
(3) Hsueh MF, Önnerfjord P, Bolognesi MP, Easley MP, Kraus VB. Analysis of “old” proteins unmasks dynamic gradient of cartilage turnover in human limbs. Science Advances 09 Oct 2019: Vol. 5, no. 10, eaax3203. DOI: 10.1126/sciadv.aax3203