The exciting discoveries indicate that specialized cells can turn back the developmental clock under certain circumstances using the Induced Pluripotent Stem Cell (iPS). The journey of a cell from immature to specialized was previously considered to be irreversible. We now know that under certain circumstances, it is possible for the cell to return to an immature, pluripotent stage. The discoveries of Drs Gurdon and Yamanaka have shown that specialized cells can turn back the developmental clock. While it is hoped their technique will enable replacement tissues to be generated from a patient’s own cells, that remains a distant prospect.
In the meantime, our present application of adult mesenchymal stem cells from bone marrow aspirated concentrate has shown excellent preliminary clinical results. Question: What would be a “meaningful “ improvement” for a biologic treatment compared to an active control group? Does stem cell treatment outcomes need to be as good as or better than surgical intervention; the joint replacement?
My standards concerning outcome surveillance for a joint replacement and that of regenerative care are one and the same. I am applying the same methods of scrutiny in the new world of stem cell management as I used for over 38 years as a joint replacement surgeon. There is one member of my staff who responsible for gathering and recording outcome metrics on all the patients I treat over a lifetime. That database is expanding and in about six months, we will begin gathering preliminary results for scientific presentation and publication. Until that time, I am reporting in my blog on a case-by-case basis. Incidentally, the bicyclist who I featured last week, was in a big cross cycle race on Sunday, and came in 23rd out of 79 riders-amazing. Last night he posed this question: “ I went on a very short run at week 7,and felt practically no pain. Can I begin to jog now? Light, short distances to start?”
As my database is short lived and relatively small, and I continually update my knowledge base concerning stem cell orthopedic issues. What I discovered is that those of us working with bone marrow aspirate concentrate are the only ones who truly meet FDA guidelines and for whom there is a scientific foundation of information. Bone marrow nucleated cells, adipose stromal vascular fraction (SVF), adipose fat grafts, and amniotic fluid stem cells are the most common stem cell procedure types being used. A handful of Internet sites are also offering cultured bone marrow or adipose mesenchymal stem cells. Please keep in mind that the risk of stem cell therapy increases as the source changes. The safest cells are your own.
The published research or published FDA trials have the following number of patients treated for arthritis or bone disease:
Bone Marrow Cultured Mesenchymal Stem cells…………………………549
Bone Marrow Nucleated Cells……………………………………………………..624
SVF Adipose Stromal Vascular Fraction…………………………………………..4
Amniotic Fluid Stem Cells………………………………………………………………0
Synovial Fluid Stem Cells………………………………………………………………..0
Cord Stem Cells………………………………………………………………………………1
Embryonic Stem Cells……………………………………………………………………..0
Tags: bone marrow, FDA, stem cells