What Are Stem Cells?
Most people know about embryonic stem cells. Our own tissues are rich in stem cells. Stem cells are naturally occurring cells in the body that help to create new cells in existing healthy tissues. They also help repair tissues that are injured or damaged. They are the basis for the specific cell types that make up each organ in the body.
Stem cells are distinguished from other cells by a few important characteristics:
- they have the ability to self-renew and they have the ability to divide for a long period of time
- under appropriate conditions, they can differentiate into other specialized cells including heart cells, liver cells, bone cells, cartilage cells, nerve cells and other cells.
“Autologous” means donor and recipient are the same person – these are your very own adult cells. ASC (Autologous Stem Cells) are NOT embryonic stem cells; they are “adult” stem cells, or more accurately, ‘tissue’ stem cells. The use of minimally manipulated autologous stem cells for orthopedic conditions is FDA-cleared; it is neither controversial nor dangerous.
The use of ASC is legal and safe.
Although adult stem cell therapy sounds innovative and cutting edge, this type of therapy has been around for quite some time. In the past, these cells were very difficult and expensive to procure, especailly in out-patient office settings. With newer techniques and equipment, stem cells can easily be obtained and concentrated by simple office procedure.
Stem cells are the repairmen of the body. The most common is derived from bone marrow and is known as hematopoietic stem cell. 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). MSC are readily avaiable in Fat and Bone Marrow. These mesenchymal stem cells usually travel to the injured areas via the blood stream.
If the injured area has a poor blood supply like joints, meniscus tissue, rotator cuff and other tendon injuries, then these areas typically do not heal well on their own. Since there is a poor blood supply in this area, the body has trouble sensing an injury is present. The body is not able to get enough of the repair cells to these injured areas.
ASC can be harvested and injected into our own degenerated joints and ligaments. Upon contact with the degenerated joint surfaces or other damaged tissues, the stem cells are able to determine the damaged cells (a process called ‘homing’) and in turn, become new, healthy versions of those cells (a process called ‘differentiation’). Injecting these injured areas with stem cells leads to healing, decreased pain and improvement in function.
Stem Cells need to be directed and this is done by Platelet-Rich Plasma (PRP). Once introduced back into the body, the growth factors, cytokines and signaling proteins from PRP tell the stem cells where to go and what to do and what to tranform into. The growth factors and cytokines from PRP are the directors. Think of stem cells as the construction workers and the PRP as their supervisors. Once activated, the stem cells are capable of remarkable healing and repair.
ADIPOSE DERIVED STEM CELLS (ADSC)
Fat is very rich in stem cells; primarily mesenchymal stem cells. Fat harvesting for ADSC therapy is done with a very simple process called lipoaspiration. It is important to understand that lipoaspiration is vastly different from liposuction. Liposuction is performed by a plastic surgeon in a surgical suite using general anesthesia or sedation. Liposuction removes a very large volume of fat and is intended for a cosmetic result.
BONE MARROW ASPIRATE CONCENTRATE (BMAC)
Bone marrow contains stem cells; both mesenchymal and hematopoietic stem cells. Bone marrow is harvested from the hip (and sometimes from the shin bone called the Tibia) using local anesthetic and a specialized needle.
It is important to understand that bone marrow harvesting for BMAC is vastly different from bone marrow harvesting for transfusion for cancer therapies. In bone marrow harvesting for transfusion, a hematologist, oncologist, or surgeon removes a very large amount of bone marrow. BMAC requires only a very small amount of bone marrow. Surprisingly, the procedure is not painful, takes under ten minutes, and causes only mild soreness afterward. It has an excellent safety profile.
Mesenchymal stem cells (from fat and bone marrow) differentiate into musculoskeletal tissues such as bone, ligament, muscle, tendon, and joint surface. Hematopoietic stem cells (from bone marrow) differentiate into blood vessels that are needed to nourish musculoskeletal structures and nerves. Platelet rich plasma contains key growth factors that activate the stem cells to generate new, healthy tissue. Therefore, for most procedures, we blend PRP, ADSC, and BMAC.