Mesenchymal Stem Cells: Orthopaedic Applications in 2020 and Beyond

Ankle osteoarthritis is a condition that causes pain and stiffness in the ankle joint. Traditional treatments like joint fusion can limit mobility. An alternative procedure called ankle distraction arthroplasty has been gaining some traction, but how well does it hold up in the long term? 

A recent study by Greenfield et al. (2019) investigated this very question. They conducted a survival analysis of ankle distraction arthroplasty for ankle osteoarthritis. Their findings suggest that this procedure may be a viable option for some patients. 

Key takeaways from the study: 

  • Ankle distraction arthroplasty showed promising results, with an 84% survival rate at 5 years. This is better than some previously reported outcomes. 
  • The study also identified factors that can influence the success of the procedure. Avascular necrosis of the talus (bone death) was associated with a lower survival rate. Additionally, sex may play a role, with the study suggesting potential gender differences in long-term outcomes. 

What this means for patients: 

Ankle distraction arthroplasty offers a potential option for preserving joint mobility in patients with ankle osteoarthritis. This study provides valuable data for surgeons and patients to consider when making treatment decisions. 

Important to note: 

  • This was a retrospective study, meaning researchers analyzed past data. More robust research designs are needed to confirm these findings. 
  • The study involved a relatively small group of patients. Larger studies are necessary to draw more definitive conclusions. 

Overall, this research suggests that ankle distraction arthroplasty may be a valuable tool for treating ankle osteoarthritis. However, more research is needed to solidify its place as a standard treatment option. 

ReferenceGreenfield, S., Matta, K. M., McCoy, T. H., Rozbruch, S. R., & Fragomen, A. (2019). Ankle distraction arthroplasty for ankle osteoarthritis: a survival analysis. Strategies in trauma and limb reconstruction, 14(2), 65.,and%2037%25%20within%205%20years


This blog is for informational purposes only and should not be considered as medical advice. Always consult with a qualified healthcare professional to discuss your individual treatment options.

Mesenchymal Stem Cells
Image Credits: BoulderProlotherapy

Image Credits: BoulderProlotherapy

“Physical fitness is not only one of the most important keys to a healthy body, it is the basis of dynamic and creative intellectual activity.” – John F. Kennedy

Stem Cell Therapy is an ever evolving part of the orthobiologic movement. The human body generates different types of stem cells, including the mesenchymal stem cell group. Alternatively known as MSCs, these very specialized stem cells are able to make several types of cells that the human body will need for regeneration and repair. These new cells include cartilage cells, bone and fat cells, and other relevant tissues. In the orthopaedic realm, the importance of the utilization of stem cells to generate MSC for treatment of bone and cartilage conditions, is of great interest. As the knowledge of the processes involved in the healing mechanism of the body is known, the applications of MSCs to healing processes will increasingly be utilized and standardised in Orthopaedic care. 

Mesenchymal stem cells are classified as tissue cells. As the diagram above outlines, the stem cells are able to differentiate into a multitude of cells in the human body. This ability, known as multipotent ability, is one of the advantages of utilizing the stem cells in the healing process. As a source for a wide variety of skeletal tissues, the MSCs have found great utilization in regenerative medicine. By differentiating into cartilage cells (chondrocytes), bone cells (osteoblasts) and fat cells (adipocytes), tissue regeneration is possible. Where necessary, the ability of MSCs to generate nerve cells, heart muscle cells, liver cells and endothelial cells has been elucidated by medical research. 

Original studies of MSCs, indicated that the stem cells were sourced in the bone marrow. With time, other sources of the cells have been found in sources such as umbilical cord blood and fatty or adipose tissue. With this knowledge, medical science has successfully attempted to extract MSCs from the various sources in the body. With the ability to extract cells that are capable of self-renewal the proliferation of bone, cartilage and fat cells is currently underway. 

MSC Applications in Bone and Cartilage Repair

The multipotent ability of stem cells to differentiate into differing types of cells such as osteoblasts and chondrocytes, has led to their utilization in clinical trials that are dedicated to repair of bones. Where some patients are diagnosed with skeletal defects, clinical trial activities are testing the patients to identify if their conditions can be rectified with the utilization of stem cells. As a localized healing mechanism, evolutionary tests identifying the response of the healing site are often carefully administered. 

For patients with extensive cases of conditions such as MSCs, the process of repairing cartilage of importance in the healing of osteoarthritis. In instances where surgical procedures can be avoided, it is always a good idea to investigate and understand the healing mechanisms that can restore the body either by its own cells or via the incorporation of external cells. 

Cartilage degeneration is a painful condition experienced by adults. The cartilage degenerates in time, and does not repair itself due to the fact that the vascular system does not supply the joints with adequate blood flow that will result in the access of stem cells to the area for healing. If there is induced damage, very often, the cartilage that is generated by the body will be weaker than the cartilage that originally existed. 

MSC utilization in the healing of cartilage degeneration is a very promising regenerative medicine application. MSCs differentiate into chondrocytes, and can be injected into the healing site in order to provide the means that will catalyze the healing of cartilage. 

In alternate cases, it is also possible to transplant MSCs into a healing matrix that can release the required doses of healing substances that optimize and control the healing processes in the body. These 3-D matrices or scaffolds, not only reinforce the joints, but also facilitate the appropriate differentiation of the MSC into the chondrocyte cells that will complete the healing process.

MSC applications in Heart and Blood Vessel repair

Scaled clinical trials have indicated that MSCs are excellent candidates for the formation of new blood vessels via the process of neovascularization. The cells are support cells, and help to reinvigorate the existing vascular system in order to restore the capillary strength and regeneration. As the healing mechanisms are currently being elucidated, studies have shown that the MSCs monitor protein release, and catalyze endothelial precursor cell growth. These cells are able to control the development of the inner blood vessel lining. For patients with heart attacks or other vascular system limitations, the MSC presence will facilitate the restoration of the cardiovascular system, when they are introduced to the sites of healing. 

MSC application in Inflammatory or Autoimmune Diseases

The immune system is a very complex mechanism that is able to identify foreign bodies and eliminate them. While in the majority of instances, the ability of the immune system to protect the body is warranted, the immune system can often be a hindrance to implant process or any process that involves the introduction of healing cells from external sources. When MSCs are introduced into the body, in some instances the body may attack the cells because it does not readily identify the cells  as a healing agent. The body does take some time to accept new healing agents into its systems. Where possible, it is always helpful for the patient’s own cells to be introduced into their system. 

For very sensitive patients, it will be very important for detailed medical research to be investigated, in order to ensure that safe utilization for a broad spectrum of patients will be possible in the near future. How to control stem cell proliferation and behavior is a critical point of concern in the medical community. If behaviour is well understood, the utilization of stem cells in the hematopoietic and vascular cell systems will be more prevalent. New and effective treatments can be developed in the future.

Orthopaedic Applications of MSCs 

As the science and experimental validation of stem cells is better understood, the ability to treat orthopaedic conditions via this treatment path will be increasingly applied. Allowing the body to heal its own self, is one of the best ways to ensure that patient health is achieved and sustained. As stem cell biology knowledge expands, orthopaedic practice is also adapting to the changes. According to a noted medical journal: 

“These cells can be easily isolated, processed and made available for clinical use. From healing of bone defects caused by trauma, tumor or infection to cartilage defects, nerve, tendon and ligament healing, stem cell use has the potential to revolutionize orthopaedic practice.” [3]

As the future of medicine evolves, rest assured that you will one day be able to heal yourself, from within your own body’s healing mechanisms. Stem cells are the wave of the medical future. 


  1. Mesenchymal Stem Cells:
  2. Stem Cell Based Regenerative Energy:
  3. The Current Role of Stem Cells In Orthopaedic Surgery:

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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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