Regenerative Medicine Applications in Orthopaedic Care

Image Credit: The Mandarin

There is no medicine like hope, no incentive so great, and no tonic so powerful as expectation of something tomorrow. – Orison Swett Marden

Great sages have identified that the body is quite adroit at healing itself. At the baseline of health, whenever you have an injury such as a cut, the body goes through its healing processes and enables the skin to heal itself. Likewise, within the body itself, there is a constant regenerative process that takes place. The body is continuously generating new cells that replace the existing cells. In essence, every seven years you have a new body. However, with time some healing mechanisms are reduced in their capacity. Medical technology has enabled us to identify the key contributors to the regenerative abilities of the body. This realm of science and medicine is known as Regenerative Medicine. Via harnessing the body’s own cells, healing can be catalyzed. This takes place in a myriad of ways, via facilitating healing properties such as bone and cartilage regrowth.In the orthopaedic realm, it is now possible to restore ligaments, tendons, muscles and joints and actually prevent surgery in some instances. 

The discovery of regenerative medicine is one of those biological marvels that is changing the way that medicine is being practiced in almost all of the specialties. Research usually requires a team effort with an integrated interconnection of specialists such as bioengineers, physicians, robotic engineers, and stem cell biologists who will work together to understand the critical mechanisms that are involved in healing, and apply them to the body. The goals of research in regenerative medicine is to utilize new technologies and therapies in order to optimize or fill the gaps where the current therapies are unable to treat. Medicine, like all fields, does have its current limitations, and with the advent of new technologies, it is possible for us to overcome these barriers and improve the standard of healthcare that is being offered to the current patient pool. 

Bioengineering and stem cell therapies are gearing up to be next generation therapies that will be utilized in order to heal certain orthopaedic ailments. When it comes to existing treatments, conditions such as arthritis are currently being treated via the utilization of stem cells and growth factors. Bone is now being integrated with materials generated in a material science lab, that actually match its physical properties and can also grow and expand. Transplant medicine is benefitting from the fact that via certain critical biological procedures, new organs or even veins can be grown for an individual, and implanted into the body in order to integrate with the existing mechanism. 

Stem cell therapy as a regenerative medicine, is also emerging as a means to heal the body. The stem cells are those parts of our bodies that are able to create new cells as needed by the body. With time, our stem cell count diminishes. Via external injections however, healing can be restored to a site. In the regenerative realm, researchers are studying how stem cells can be used to replace, repair, reprogram and even renew diseased cells. When healthy cells abound, the appropriate mechanisms of healing will follow. 

As undifferentiated, yet intelligent cells, stem cells have the amazing ability to grow and develop into the cells the body needs for a healing mechanism. The sources of these stem cells vary from sites such as a placenta (embryonic stem cells), garnered from a labor and delivery exercise, to adult stem cells that are extracted from places like the fat of the body, and genetically reprogrammed to the desired purpose. The latter stem cells are known as induced pluripotent stem cells. Regardless of the source, studies have shown an improvement in healing time of patients who have utilized these therapies. The current challenge in medicine is identifying the appropriate healing mechanism, and the ability to specify the differentiating ability of the stem cells. The current medical studies are aiming to identify how reprogrammed stem cells specifically generate specialized stem cells that are able to repair cells in healing sites such as the heart, foot and ankle and also in the nervous system. Via these critical analyses, the root causes of many of our current ailments can be identified and even prevented. 

On a global scale, there is an emergence of stem cell research. If you search your local Universities, you will be able to find that research labs are starting to explore the ability to heal their patients via biologics such as stem cells, instead of resorting to mechanisms such as drug therapy as an initial instance. The wealth of medical problems that are being treated is expanding, and it is interesting to see how evolution will take place. In orthopaedics, many patients experience cases of degenerative joint conditions that are the perfect candidate for treatment. Foot conditions are also heavily tied to diabetes, and the treatment of diabetes can also help to facilitate the overall healing of any orthopaedic conditions that may develop.With many years of medical studies of stem cells in the laboratory, the process of translating the therapy from the laboratory into patients is something that is currently underway. 

With all research procedures, there is the desire to fully implement once the potential of these therapies is identified. However, because of the various unknown factors that are associated with the healing mechanisms of stem cells, regulations will not allow them to be fully available for commercial treatments just yet. There are some naturopath based doctors that do treatments, but you will have to ensure that you are aware of all the legal considerations before you begin the procedure. You will usually have some paperwork to sign before you begin your therapy. These will protect both you and your physician, in case there are complications. 

With the current hindrances to standardization of stem cell therapy currently being standardization of treatments, regulatory approval, adequate research funding, once overcome this will be the perfect opportunity for research and development. Patient therapy is always a priority. Until all the major details are known, there will be limits to how stem cells can be administered for healing therapies. Only in very dire circumstances such as the healing of leukemia, lymphoma or other serious cancers tend to be considered for extensive stem cell therapy as a trial. 

How To Access Stem Cell Therapies 

As a patient, it is very useful to be proactive. Many times, doctors will offer you therapies that are standard practice. If you feel that you want to try something new, you can personally push the envelope and ask them about these next generation therapies. As a transition from external treatments, to natural self healing methods, you may save yourself many months and years of pain. As the field embraces this evolving technology, it will be a joint decision between yourself and your doctor that determines how the therapy is progressed. 

As with all treatments, the first place to start if there’s a problem with your health is with your general practitioner. If you have an orthopaedic condition, you will then be referred to an orthopaedic surgeon, who will conduct a second assessment and determine what the path going forward will be. There are some healing centers that offer a specialty consult service for regenerative medicine. Once you attend a consultation, you will be referred to an appropriate stem cell healing site if your orthopaedic surgeon won’t be able to do that procedure at their practice. 

At a regenerative healing center, you will be assessed to determine whether you are the perfect candidate for a stem cell clinical trial. As an educational experience, you will better be able to understand your own treatment path. If you seek, you will find. 

Stem Cell Therapy and Arthritis

Arthritis is one of the most prevalent foot and ankle degenerative conditions. Depending on which stage of the arthritis severity curve you are on, you may be the perfect candidate for stem cell treatment. If your pain point is high enough, you’ll be better able, with the help of your orthopaedic surgeon to find a path that will result in the best restorative treatment. 

How does Stem Cell Therapy Heal My Arthritis?

With the advent of ortho-biologics, arthritis treatments with the facilitation of cartilage restoration is now a modern-day possibility. With options ranging from total joint replacement, to distraction arthroplasty, stem cell therapy and growth factors there are a myriad of evolving technologies and minimally invasive methods that can heal the arthritic site.

As a word of caution, many new therapies are not covered by insurance due to their recency, and the fact that the methods are still being approved by various medical bodies globally. In Australia, growth factors are rebated, whereas stem cell therapy is not. Talk to your orthopedic surgeon about the stem cell therapy procedure, and find out how the treatments can be financed. Your doctor may have their own payment options so investigate with them how your therapy can be financed. 

How do Stem Cells or Growth Factors Regenerate the Body? 

The stem cell has long been identified as the regenerative life force in our bodies. With their ability to divide and duplicate, as well as generate new and different stem cells that are relevant to a healing site, it is possible to regenerate cartilage cells and even bone cells. This is great news for the arthritic foot. Over time, the joint can wear away, and with the ability to rebuild it naturally, it will save the individual time from having to go through processes like harvesting. 

How are Stem Cells Administered? 

Stem cells are administered either surgically, or via injection into the arthritic joint. Much like the image above, your orthopaedic surgeon will utilize medical imaging in order to identify where on the body, the stem cells are to be administered. Depending on the severity of the injury, either of the two options will be applied. When the stem cells are being administered, your orthopaedic surgeon will more than likely utilize mesenchymal stem cells that have been harvested from the individual’s body. 

Additional Regenerative Medicine Applications: 

Additional utilization of stem cells include applications such as tissue engineering and biomaterials and medical devices and artificial organs. Tissue engineering is a strategy that involves the insertion of biologically active scaffolds. The scaffold provides a bridge for the new tissue to form on. With appropriate physical therapy applications, the body eventually is able to regenerate functional engineered tissues. 

Within the body, organs do actually fail, and the predominant method that is emerging to treat this condition is to grow a new organ. Originally, organ transfers were often relied on to supply new organs and the process for incorporating the donor organ into the body is a very complex one that requires the utilization of immunosuppressive drugs, and the post surgical risks. With grown organs, the risks associated with donor organs are minimized, as they are from the patient’s own cells. As science and technology evolves, it will be possible to facilitate various orthopaedic care requirements, via the utilization of regenerative medicine. 

Reference Articles: 

Mayo Clinic Transplant Center: 

https://www.mayoclinic.org/departments-centers/transplant-center/regenerative-medicine-consultation-service/gnc-20203917

Cartilage Restoration: http://www.cartilagerestoration.org/stem-cell-ortho-biologics-and-regenerative-medicine-program

Stem Cell Therapy for Arthritis: https://www.arthritis-health.com/treatment/injections/stem-cell-therapy-arthritis

Regenerative Stem Cell Therapy for Foot and Ankle Pain: https://www.stemcellctr.com/procedures/foot-ankle/

University of Pittsburgh: 

https://mirm-pitt.net/about-us/what-is-regenerative-medicine/

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Dr. Gordon Slater

Dr. Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions.

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Dr Gordon Slater is a highly-skilled surgeon specialising in foot and ankle conditions and sports injuries. Dr Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions. MIS  has many advantages including shorter operating times, reduced post-operative pain, reduced risk of infection, minimal scarring and better cosmetic outcomes.

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