Liza Maniquis-Smigel, MD use of Stem Cell Therapy in the treatment of joint and spine degeneration.
Stem cell therapy is exploding in the medical field, and for good reason. Stem cells have the potential to regenerate into any type of body tissue. The amazing thing about stem cells is that when you inject them into the body, they know what kind of cells your body needs – for example, meniscus cells or cartilage cells. It is a very exciting time for medicine, especially in the field of regenerative medicine.
In Stem Cell Therapy we use a person’s own healing cells from fat, and blood (alone or in various combinations) and inject them straight to the area which has a cellular deficiency.
The goal is to stimulate the repair of injured tissues. Stem cells aid in fibroblastic proliferation where cell growth, proteosynthesis, reparation, the remodeling of tissues and chondrocyte proliferation occurs. Our fat cells contain stem cells, also termed mesenchymal stem cells and progenitor cells, among other names. These immature cells have the ability to become tissues like cartilage, bone, and ligaments.
Consequently, researchers and clinicians are focusing on alternative methods for cartilage preservation and repair. Recently, cell-based therapy has become a key focus of tissue engineering research to achieve functional replacement of articular cartilage.
- "Regenerative medicine (stem cell therapy) offers the exciting potential of developing alternatives to total joint replacement for treating osteoarthritis.”
- Stem Cell Therapy shown to reverse joint disease in selected patients.
Stem Cell Therapy or Prolotherapy?
Not all injuries require stem cells to heal. For many patients the success rate with traditional Prolotherapy in this office is in the 90%+ range for all patients. However, for those cases of advanced arthritis, meniscus tears, labral tears, bone-on-bone, or aggressive injuries, our Prolotherapy practitioners may choose to use stem cell injections to enhance the healing, in combination with dextrose Prolotherapy to strengthen and stabilize the surrounding support structures for meniscus repair.
Typically the tissue that we are trying to stimulate to repair with Stem Cell Therapy or Cellular Prolotherapy is articular cartilage, but we can also proliferate soft tissues structures such as ligament and tendons. This is new technology so we are studying it as we use it to treat patients.
Improvement in technique Platelet Rich Plasma Therapy combined with Stem Cell Therapy
We agree that stem cell therapy has benefits but may not provide a full cure. This is why we recommend the use of Platelet Rich Plasma Therapy in conjunction with stem cell therapy. Stem cell therapy is more effective if the stem cells are given better direction. This is where the growth factors in blood platelets can be very effective. Platelets aid the stem cells in their various jobs including differentiation and then aid in the differentiated cells making the extracellular matrix to repair the injured tissue.
Platelet Rich Plasma contains a myriad of substances that stimulate healing:
- Platelet-Derived Growth Factor (PDGF) Attracts immune system cells to the area and stimulates them to proliferate. Has been shown to enhance ligament and tendon healing.
- Transforming Growth Factor-8 (TGF-8) Secreted by and affects all major cell types involved in healing. Similar affects as PDGF.
- Vascular Endothelial Growth Factor (VEGF) Helps new blood vessel formation, thereby increasing vascularity in injured areas.
- Fibroblast Growth Factor (FGF) promotes the growth of the cells involved in collagen and cartilage formation.
The goal of Stem Cell Therapy – Cellular Prolotherapy
Our ultimate goal with all forms of Prolotherapy is to get the patients back to doing the things that they want to do without pain. It is our hope that the Stem Cell Therapy (Cellular Prolotherapy) treatments will form functionally, structurally, and mechanically equal to, if not better than, living tissue which has been designed to replace (or work alongside of) damaged tissue. It is hard to prove the above statement because we cannot sacrifice human beings after Prolotherapy to see if the tissue looks and acts normally. We can, however, report that the majority of our patients who receive Stem Cell Therapy along with traditional Hackett-Hemwall Prolotherapy get back to activities and have dramatically decreased pain levels using this comprehensive approach.
Stem Cell Procedure
The stem cell therapy is an outpatient procedure performed by board certified physicians . The total procedure time is approximately 2 hours.
- Harvest: Using a liposuction procedure, 100-200cc of adipose tissue is harvested from the patient.
- Separate: Using advanced protocols, the Stromal Vascular Fraction (SVF) which contains Adult Stem Cells (ASCs) is separated from the fat cells.
- Isolate: Adult Stem Cells and other progenitor cells are then isolated from the SVF using advanced multi-filtration protocols.
- Activate: The isolated adult stem cells are added in the person’s own platelet rich plasma (PRP).
- The activated stem cells cells are then administered directly into injured structures.
- The advantages of adipose stem cell therapy, compared with other sources of regenerative cells, are:
- Adipose yields are much higher than most sources. It is not unusual to obtain hundreds of millions of dormant stem cells from 120-200cc’s. In comparison, the same amount of bone marrow may only yield tens of thousands of cells.
- Patients receive their own cells so there is no risk of immune rejection.
- Mesenchymal stem cells have been proven to differentiate and proliferate into many types of cells. Some patients have reported immediate symptom relief.
- Autologous stem cell therapy is a minimally invasive procedure with little to no down time.
- How do the stem cells work?
- Stem Cells are infused into the bloodstream and injected into localized tissues.
- The stem cells are attracted to signals from areas of inflammation.
- Distressed signals trigger stem cells to differentiate.
- Differentiating cells begin to integrate with target tissues or organs.