Last week, I happened on a patient for whom I had performed both a hip and a knee replacement some years back. The patient looked at my graying hair, the wrinkles on my face, sized me up and asked “are you retired?” It is an ever-increasing happening in my daily routine. Even though I am healthy and quite active, the usual and customary for an orthopedic surgeon after many years of practice is to burn out so the question is not without a precedent. My response, “ I have moved on and I now offer a minimally invasive technique through Cellular Orthopedics that might or could avoid a major orthopedic surgical procedure” What followed: “What is that?” I went on to explain as best I could.
Application of Mesenchymal Stem Cells in Regenerative Medicine
Cellular Orthopedics or Regenerative Medicine mainly includes two different strategies of cell-based therapy. In the first approach, cells are applied to substitute damaged cells within a tissue to reconstitute its integrity and function. During this procedure called “cell therapy” a cell suspension is simply injected into the damaged tissue. The second approach called “tissue engineering” is more complex. Here, cells are combined with a three-dimensional matrix to compose a tissue-like construct to substitute lost parts of the tissue, or even whole organs
Participation of Mesenchymal Stem Cells in Tissue Regeneration
Mesenchymal stem cells have the ability to migrate being attracted by cellular signals (chemo tactically) to tissues showing inflammation and injury in the body Besides their unique ability to differentiate into different cell types, mesenchymal stem cells secrete a variety of cytokines, showing anti-inflammatory activity and create an anabolic microenvironment. Furthermore, direct cell-cell contact (immunomodulation) also takes place. Thus, they participate in regeneration of injured tissues in different ways. On one hand, they directly differentiate into tissue-specific cells and thus substitute damaged or lost cells. On the other hand, they indirectly influence tissue regeneration by secretion of soluble factors. Thirdly, they are able to modulate the inflammatory response. Thus, they can promote new blood supply (vascularization,) cell proliferation, differentiation and modulate an inflammatory process As I have previously described in my Blog, Osteoarthritis is not limited to the joint cartilage but is an inflammatory cascade resulting in limited motion, swelling, loss of articular cartilage, pain, and altered functional capacity
I call attention to this new world of Cellular Orthopedics not because I can promise results but because non-surgical options are now available and may add dramatic advantages over a joint replacement. It is a process for deploying good treatment with ever improving smart strategies