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Stem Cell Patient Experience

Stem Cell Patient Experience

By: Edward G. Loniewski, DO, FACOS, FAOAO

We treat numerous patients for arthritis of their joints with cell based therapies including bone marrow derived stem cells.  Most our patients improve and lead more productive lives, and some do not improve as much as they hoped and we work on alternative methods such as joint replacement to help these patients.  Joint replacement is a very reliable, reproducible and durable solution for advanced arthritic joints.   Close to 90% of the patients receiving a total joint replacement have pain relief and over 80% of these patients will still have this same joint functioning fine 20 yrs. or more out the date of their surgery.[1]  However, almost 30% of these patients are unsatisfied with their joint replacement.[2]  Issues such as pain with kneeling can be painful and descending stairs can feel unnatural. In addition, there is up to a 16% complication rate with these surgeries which concerns patients and families if this is the most appropriate and safest decision. [3]  On the other hand, cell based treatments such as bone marrow derived stem cells or platelet rich plasma have a success rate ranging from 80-90% and a 1% or less complication rate.[4]

One patient who refused to consider joint replacement and needed to have a high functioning knee for his career was Kim Sticker.  He is a world renown professional fisherman who produces, edits and stars in a nationally syndicated fishing show called Hook n’ Look on the Outdoor Channel.  Kim is an accomplished professional fisherman winning the prized Bassmaster Michigan Top 100 tournament at Lake St. Clair, Michigan and thus had high demands on his knees.    Kim was a very compliant patient and did everything we asked him to do to try to salvage his knees including therapy, injections, proper shoe wear, glucosamine sulfate and even arthroscopic surgery.  When we exhausted all our conservative measures, we suggested partial knee replacements.  However, Kim pointed out that it would be very difficult for him to continue to fish with knee replacements since he needed to kneel throughout the day.   Joint replacements can produce significant pain with any sort of kneeling or squatting. Thus, we agreed to try a stem cell procedure to salvage his knees and allow him to get back to fishing, kneeling and squatting without fear.

Kim underwent this procedure and slowly and carefully he returned to a lifestyle he was accustomed to.   As he states in his testimonial video, he is not 18 yrs. old again, but his knees are reliable and not painful.   His recovery did take some time to take effect, but now he is back to fishing and enjoying his new grandchildren with little to no pain.

At Advanced Orthopedic Surgeons, we strive to provide you with ethical and effective treatments for your orthopedic conditions.  We only recommend treatments with proven benefits that we would only use on ourselves with or our cherished family members.  In fact, I received a stem cell procedure back in November of 2016, and I have also used these same treatments on my own father with great results.   We provide you with an honest and comprehensive evaluation of your condition.  You can find out if you are a candidate for stem cell therapy by taking our free and easy Stem Cell Questionnaire and you can call us for an evaluation at 810-299-8550.

[1] http://www.aahks.org/care-for-hips-and-knees/do-i-need-a-joint-replacement/total-hip-replacement/)

[2] Lam, YF et al, A Review of the Clinical Approach to Persistent Pain Following Total Hip Replacement, HongKongMedJ , 2016 Dec: 22(6): 600-7

[3] Courtney, PM et al. Complications Following Outpatient Total Joint Arthroplasty:  An Analysis of a National Database. JArthroplasty, 2016 Dec 14

[4] Hernigou, P, et al, Cell Therapy of hip necrosis with autologous marrow grafting , Indian J Orthop.2009 Jan-Mar; 43(1): 40-45

[4] Michalek J et al.,  Autologous adipose tissue-derived stromal vascular fraction cells in patients with osteoarthritis, Cell Transplant, 2015 Jan 20. doi: 10.3727

 

How Long Will Stem Cell Therapy Last?

 

Upload: February 3, 2017

Patients rightfully ask this question.  Here is some evidence to show that this is not a short-term solution, but hopefully a long-term solution.     First, many of the studies using stem cells for arthritis have  results at 2 years and some as short as 6 months.  However, this does not mean that the treatment stopped working at this interval.  This merely means that the study was designed to stop at this point.  If you look at some of these studies, there are some promising results showing positive structural reversal of the arthritic disease.  For example, Koh et al in his arthroscopic second look study revealed reversal of the arthritic changes on visual inspection of the knee through arthroscopy.  This finding was confirmed by the South Korean dosing study.[1]    In addition, Khanh Hong-Thien Bui and colleagues found positive structural changes on serial MRI’s. [2]  Thus, we can conclude that this is not just a band aide type of treatment, but this evidence helps point us in the direction of positive reversal of the underlying destructive process of arthritis.  This is unlike many other current treatments available in orthopedics.

Some more recent studies from Iran show further long term success.  Eighteen patients were treated with a bone marrow concentrate in multiple joints including knee, ankle and hip and followed for 30 months with careful laboratory, radiographic and MRI studies.  The research team reported the “All” patients received therapeutic benefits confirmed by pain and function scores and were confirmed by MRI.[3] Researchers at the University of Paris followed 534 patients up to 18 years after a bone marrow stem cell treatment for avascular necrosis of the hip which is an arthritis caused by the lack of blood supply to the hip.  This long-term study revealed that only 15.7% of the patients went on to receive a total hip after this treatment and many of the x-rays and MRI’s of the hip stabilized.[4]

We also have a “white paper” result from a very interesting long term study comparing bone marrow stem cell therapy to our traditional total knee replacement in elderly male patients.   A white paper is a study which is not yet published and thus it has not been peer reviewed and one must be careful in using this data because it has not yet been validated.  However, this same researcher, Philippe Herniguo, M.D., PhD,  has published hundreds of peer reviewed studies and is a very respectable source.   This study took 60 elderly male patients all 85 years old or older.  Group A was treated with the standard total knee replacement for both knees.  Group B was treated with the bone marrow stem cells to both knees injected directly into the bony part of the knee next to the joint.   Group C had one knee injected with the stem cells and the other knee replaced.   After an average of 6 yrs. (ranging from 2 to 15 yrs.), the patients in Group B (stem cell group) had the following:

  • Improved knee function scores (Knee Society Scores)- A 16.3-point improvement for the stem cell group vs. only an 8.9-point improvement for total knee group.
  • Faster Functional Recovery- At 9 months, the stem cell group had faster recovery than the total knee group.
  • Lower Complication rates- Blood clots occurred in only 2% of the stem cell group compared to 12% in the knee replacement group. None of the stem cell patients required a blood transfusion and 29.3% of the total knee group required blood transfusions.  Higher use of analgesic medications such as narcotics were used in the total knee group.
  • Lower Re-operation rate- None of the stem cell patients required further surgery or conversion to a total knee. However, 5% of the total knee patients required further surgery.
  • Higher Overall Satisfaction- When patients were asked to point to the knee which they preferred, 70% of the patients pointed to the stem cell therapy knee.

A large multi-national, multi-center study evaluating patients of all ages with all levels of severity gives us some further evidence that this is a longer term treatment for arthritis.  In the study by Michalek J, et al.  entitled  “Autologous adipose tissue-derived stromal vascular fraction cells in patients with osteoarthritis,”(Cell Transplant, 2015 Jan 20. doi: 10.3727)[5] followed 1128 patients for up to 54 months (over 4 yrs).  A majority of these patients (63%) had at least 75% improvement of pain and function and 91% had at least 50% improvement.  However, obese patients and patients with more severe arthritis took longer to respond.   This is one of the largest and longest term study showing promising positive results in the longer term.  Our own experience confirms this result. Our own unpublished evaluation of pain and function using a visual analog scale and the WOMAC on hundreds of patients receiving a similar procedure for over 3 years reveals similar results with an excellent safety profile and no serious adverse events.

Although some  of these studies are not controlled, blinded, or randomized, but they do show a common pattern of:

  • This is a safe procedure with very low rates of complications.
  • Consistent reduction of pain.
  • Consistent restoration of function.
  • High rate of patient satisfaction.
  • Improved MRI or physical findings (microscopic or arthroscopic).
  • Midterm and long term relief of symptoms
  • Superior results to other orthopedic conditions such as hyaluronic injections and even joint replacement.

Advanced Orthopedic Specialists offers this state of the art care in a friendly environment with skilled surgeons and staff.   Dr. Loniewski has developed a simple questionnaire to determine if you may benefit from cell based therapies.   This only takes about 3-5 minutes to complete.   You can read more and download the questionnaire at:  http://www.advancedortho.net/candidate-stem-cell-therapy.php

If you would like to schedule an appointment  , please call our office at 810-299-8550.

[1] Koh YG et al, Mesenchymal stem cell injections improve symptoms of knee osteoarthritis. Arthroscopy, 2013 Apr; 29(4) 748-55.


[2]
Khanh Hong-Thien Bui et al , Symptomatic knee osteoarthritis treatment using autologous adipose derived stem cells and platelet-rich plasma: a clinical study, Biomedical Research and Therapy, 2014 (1):02-08

[3] Emadedin M., et al, Long-Term Follow up of Intra-articular Injection of Autologous Mesenchymal Stem Cells in Patients with Knee, Ankle or Hip Osteoarthritis, Arch Iran Med. 2015, Jun;18(6): 336-44

[4] Hernigou, P, et al, Cell Therapy of hip necrosis with autologous marrow grafting , Indian J Orthop.2009 Jan-Mar; 43(1): 40-45

[5] Michalek J et al.,  Autologous adipose tissue-derived stromal vascular fraction cells in patients with osteoarthritis, Cell Transplant, 2015 Jan 20. doi: 10.3727

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