The use of stem cells (SCs) to treat arthritis remains controversial in many scientific circles. The reasons are many including lack of experience, lack of convincing data, a paucity of well-designed clinical trials, restricted federal funding for research, lack of proprietary methods limiting the amount of venture capital that could be obtained, and lack of consensus as to the best methods to administer SCs.
Since there are many different types of arthritis, it stands to reason that are going to be many opinions as to the best route of administration for SCs.
For example, there have been anecdotal reports of patients with rheumatoid arthritis receiving intravenous SCs. The problem, of course, is that there are no rigidly controlled studies to confirm the efficacy Clínica veterinária em Guarulhos.
For degenerative arthritis (osteoarthritis), it is still a subject of debate as to what constitutes the best type of tissue to obtain SCs. Many advocate the use of SCs derived from adipose tissue (fat). There a number of different approaches for obtaining the fat, the most common being a tumescent technique. This model was first described in veterinary medicine and is also used in human volunteers, according to multiple anecdotal reports. The second area, and probably the second most common site for SC harvest is the bone marrow. The number of SCs that can be obtained via this route exceeds the number one can obtain from fat.
There is ongoing discussion regarding whether donor SCs are better than autologous (from the patient) SCs. Right now, practically speaking, autologous SCs are the ones that are most readily available for use.
A question then comes up. What about the use of growth factors still stimulate the multiplication of stem cells outside the body? While this is being done in veterinary medicine, it is not yet being done in humans. There are many reasons for this including the possible introduction of infectious agents, contaminants, and other factors that could have negative impact on the safety of the patient.
Another issue is the best way to administer SCs.
Some suggest a simple injection technique. It is hard to imagine, though, that simply injecting SCs into a knee with any type of deformity related to osteoarthritis, could correct the problem.
It is quite likely, that removal of osteophytes (bone spurs), along with some type of cartilage injury that causes SCs to home in would be required. However, this is conjecture, in that experience in human arthritis is still in its infancy.
It is also likely that some type of matrix is required to provide “bulk.”
Finally, reducing the amount of deformity by using some type of unloading mechanism is going to be critical to the success of the procedure.