July 11, 2018

Stem Cells, Allograft Tissue and Platelet-Rich Plasma

By Bryt Christensen, MD – Board Certified Physical Medicine and Interventional Pain Physician

Most pain conditions involve injury, overuse, or typical wear and tear on the musculoskeletal system (i.e. the bones, joints, tendons, ligaments, and spine). Stem cell, tissue allograft, and platelet-rich plasma (PRP) therapies are all being used more frequently for the treatment of these common conditions. Each of these therapies is explained below.

Prior to the use of stem cell, tissue allograft, and PRP therapies, most musculoskeletal conditions were treated with a combination of rest, rehabilitation, medications, cortisone injections, and surgery. We now have additional options for many of these conditions. Stem cell, tissue allograft, and PRP have the ability to help reduce pain, increase function, and potentially heal damaged tissues. Many conditions can be treated with simple in-office procedures, using image guided injections. These treatments should be provided by only a board certified physician, and never be offered without image guidance to ensure proper placement.

Bone marrow derived mesenchymal stem cells have been used for several years now and are FDA approved. These stem cells are typically harvested from the bone marrow and then reintroduced to the site of interest, during a fairly simple office procedure. Bone marrow mesenchymal stem cells are also being used during orthopedic and spine surgeries to help with bone fusions, ligament repairs, and cartilage defects. Their use has been shown to be safe and can potentially help reduce pain, increase healing and help to increase function.

Allograft tissues are tissues and cells that are donated from one human being to another. Allograft tissue can be used under FDA approval when used under certain conditions. Allograft tissues that are being used for the treatment of musculoskeletal conditions are typically donated from amniotic, placental, and cord tissue from live births. These tissues are then screened for infection and cleared for use in others. These products contain various amounts of cells, growth factors, and tissue scaffolding that can effectively treat many musculoskeletal pain conditions.

Platelet-Rich Plasma (PRP) is plasma that is isolated from the patient’s own blood. This plasma contains a highly concentrated amount of platelets not normally present. Platelets naturally flow throughout the blood stream and function to help stop bleeding. They also signal to the other immune cells to help heal damaged tissue and can help reduce pain. PRP is prepared by a centrifugation process, after a simple blood draw. The plasma is then immediately used to treat the area of interest. PRP has been shown to be effective at treating various tendon, muscle, and some joint conditions. Here is a recent patient’s experience with PRP:

“For the past five years I have experienced pain in my left knee and leg.  Over time, the pain kept getting worse.  My knee would also give out when walking.  I saw an orthopedic surgeon who performed laparoscopic surgery to see if he could find the cause.  He removed my fat pad thinking this was the cause.  The giving out of my knee went away but the pain continued on for 4 more years. An ultrasound found that I had a patellar tendon tear.  I opted to try PRP hoping this would fix the tear without having to go through another surgery.  After the procedure it took about six weeks for the pain to go away and I was able to be more active.  I am now able to hike and climb stairs without pain.”

The use of stem cells, allograft tissues, and PRP to treat musculoskeletal conditions should be considered only after a thorough history and physical exam performed by a physician trained to diagnose and treat the conditions of interest and after proper patient consent. For best results, the physician should also use image guidance during the treatment to ensure proper placement to the desired location.

The physicians at Southwest Spine and Pain have been using regenerative therapies for years and continue to stay at the forefront of stem cell and platelet-rich plasma research and techniques. If you have questions regarding these therapies or any other pain complaints, the highly trained physicians at Southwest Spine and Pain Treatment Center are willing to help.

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