The Institute of Regenerative & Molecular Orthopaedics

Stem Cells Therapy

What are stem cells?

Although stem cells sounds innovative and cutting edge, this therapy has been around for quite some time. In the past, these cells were very difficult and expensive to procure. With newer techniques and equipment, stem cells can easily be obtained and concentrated by a simple office procedure.

Stem cells are in people of all ages. Stem cells are the repairmen of the body. The most common is known as hematopoietic stem cells (HSC-CD 34+).  The type of adult stem cell that is most often seen in research as being associated with tissue repair is a mesenchymal stem cell (MSC).  These cells usually travel to the injured areas via the blood stream.  If the injured area has a poor blood supply, this is called an area of hypoxia or low oxygen content. Areas of hypoxia include the joints, meniscus tissue, rotator cuff and other tendon injuries.  These are areas that typically do not heal on their own.  The body is not able to get enough of the repair cells to these injured areas.  Since there is a poor blood supply in this area, the body has trouble sensing an injury is present.  If the injury is not that severe, we are usually able to treat the area with platelet rich plasma.  We are in a sense mimicking a blood supply in that the platelets sense the injury, release growth factors which than signal the body to send in various types of stem cells to repair the body in this area.

Stem cells are collected by aspirating bone marrow from the back of the patient's pelvis. The bone marrow aspirate is a bloody substance that is removed from the pelvis through a small needle. There is usually minimal discomfort with this procedure since the area is well anesthetized with a local anesthetic. Most procedures require about 2oz. (60cc) of bone marrow aspirate. This aspirate contains mesenchymal stem cells, platelets, and other types of stem cells.

The bone marrow is placed in a special container. The container is then placed into a machine called a centrifuge. This machine spins the bone marrow at a very fast speed causing the stem cells and platelets to be separated from the rest of the blood products. It is this concentration of bone marrow that is injected back into the injured area.  The concentration is called BMAC or bone marrow aspiration concentrate.

Another method of obtaining stem cells is from the patient’s fat cells—known as adipose tissue.  Adipose tissue is a very rich source of stem cells.  There are far more stem cells in adipose tissue than bone marrow when one compares like amounts of tissue.  We usually obtain the adipose tissue by performing a simple liposuction technique.  In many of our cases, we will use this tissue as both a source of stem cells and as a scaffold for the various cells. Typically, we will inject it after a few minutes of processing.  In more severe cases, we will obtain more adipose tissue via a liposuction technique but then we extract the stem cells from the fat via a proprietary method.   Also, we will subject all stem cells to various light wave lengths to further activate the stem cells.  The light activation is a proprietary method.   These two new methods separate our clinic from others who have tried to copy our techniques.

Once introduced back into the body, the platelets release growth factors and signaling proteins that basically tells the stem cells what to become.  Stem cells by themselves are not capable of repairing the area. They need to be directed, and the platelets are the directors.  Think of stem cells as the construction workers and the platelets as their supervisors.  Once activated, the stem cells are capable of many remarkable things. In addition to repairing the damage, the stem cells encourage damaged cells to repair themselves and to take part in the repair process.

THIS IS A REPAIR PROCESS AND THUS IT TAKES WEEKS TO MONTHS TO HAPPEN.

The repair usually takes 2-3 months but improvement is usually noted before then.  Approximately 4-6 weeks after the stem cell injection, a platelet rich plasma injection is performed on the affected area followed by a second injection 4-6 weeks later.  These platelet injections allow the stem cells to continue growing and multiplying into cartilage tissue.

The stem cells can be affected by many different conditions some positively and some negatively. Alcohol seems to diminish the body's release of stem cells so when undergoing either stem cell treatments or platelet rich plasma treatments alcohol intake should be a minimum!  Certain supplements seem to positively affect the release of stem cells and actually increase their number.  These include vitamin D3, blueberry extract, carnosine, and green tea extract.   At present when undergoing a treatment, patients are advised to take a compound called Naturacell which has these aforementioned supplements.  Two prominent stem cell scientists performed the research on these supplements at the University of South Florida.

Additionally, we wish to address the potential problems stem cells may have with their telomeres.  The telomeres are the ends of the DNA strands which are lost when a cell reproduces.  There is now compelling evidence that the length of a person’s life span is dictated by the limited number of times a human cell can divide. Though the immortal reproductive cell can divide a limitless number of times, it eventually turns into a developmental cell.  As a result, the clock starts ticking and the cell’s fate is doomed to a limited 75-100 number of cell divisions (the Hayflick Limit). Once that limit has been reached, the cell and all of its progeny completely lose the ability to divide and then enter a phase called senescence. The ticking clock in this case is found at the tips of the cell’s chromosomes in a region called the telomere. Theory states that telomeres may have evolved to prevent the unlimited growth of cells by limiting their life span. Telomeres are made up of subunits (or bases) of DNA called A, C, G, and T. In the telomere, these bases are arranged in six base repeat units of TTAGGG. When a human is first conceived, the length of the telomeres averages about 15,000 bases (up to 2,500 TTAGGG repeat units) as measured by a process called terminal restriction fragment length analysis. The length then begins to decrease at a rate of about 100 bases per cell division. By the time a person is born, the average telomere length has already dwindled to about 10,000 bases and then throughout the rest of a person’s lifetime the average length of the telomeres gradually decreases to about 5,000 bases at which time the person’s cells lose the ability to divide. These cells are then senescent, and the person suffers and dies of old age. The human body is made up of 100 trillion cells. According to one theory, you age because your cells age. Hence if you can control the aging process in your cells, you should be able to control your aging.  

When dealing with stem cells, the telomeres and their consequences are quite significant.   All one has to do is think of Dolly the sheep that was cloned from an adult cell.  Dolly the cloned sheep died at a young age of old age because her telomeres were old.  With this fact in mind, we are attempting to slow down the telomere shortening by using certain key supplements which we think will have a positive effect on the stem cells and their function.  We think that stem cells do not age as quickly as the typical cell.  We are using a variety of hormone analogs to enhance stem cell production.