Last week, a science writer who wanted my thoughts regarding might stem cells help those with arthritis interviewed me. Then she ended the interview,” how might a patient best choose a clinician to do the stem cell procedure?”
There is great promise for stem cell therapies; there is little clinical evidence supporting it for arthritis. We know from animal studies that stem cell injections help reduce inflammation in the joint. Stem Cells have a natural capacity to produce anti-inflammatory molecules, and once injected in the joint, can slow down and even reverse the degenerative process in osteoarthritis. Recent clinical studies document the potential of stem cells to grow enough cartilage to resurface the entire joint or prevent further degeneration. One day, entire joint surfaces such as hips and knees could be grown in a lab but that’s for the future. The problem now is that many physicians today are offering Regenerative Medicine interventions before there has been sufficient scientific data collected to establish safety and efficacy. What about quality assurance; how might patients seeking to avoid a joint replacement protect themselves from irresponsible and potentially dangerous procedures? How will you know if the clinician has a full understanding of the possible risks and benefits of the stem cell intervention? How does a patient seek out those best qualified?
First of all, as I have previously written, make sure the clinician is Board Certified in a medical specialty. Then inquire about prior treatment experience; you don’t want to become a victim of the “learning curve”. Most important however is to find out if the treatment advocated falls under an IRB approval at that site.
What is an IRB? Wikipedia identifies an Institutional Review Board (IRB) as an independent ethics committee or ethical review board. Every intervention I perform with stem cells falls under the scrutiny of an IRB so I may best assure my patients and stand up to the criticism of my orthopedic colleagues. I readily acknowledge that more research is needed and that is why I have introduced the same guiding principles used during my joint replacement career into my cellular orthopedic practice; namely, the integration of patient care and clinical research. 20 months ago, when I undertook this stem cell sojourn, it was mostly based on anecdote. Today, the majority of what I do is based on the early results of outcomes surveillance under IRB oversight.