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The Sports Doctor

‘Stem Cell’ Therapy for Osteoarthritis

Posted on 1st March, 2012   •  

I was interested to hear the glowing report from Anthony Toupou of the Sharks after an injection of ‘stem cells’ into what I can assume is an arthritic knee complaint (Daily Telegraph 29th March). This is a very new and clearly experimental technique where fat cells are harvested from the stomach and then re-injected into an area of joint degeneration. It has recently come into some prominence, especially in the field of Sports Medicine. The theory is that the fat layer contains mesenchymal stem cells which will improve pain by ‘replacing lost or damaged cells, reducing inflammation, improving the function of cells at the site and attracting cells from other parts of the body to assist in these processes’. (Regenerus HiQ brochure)

 

Like many techniques in medicine it sounds like a plausible idea, but do we have any evidence that what we are doing is anything more than an expensive placebo? Sports medicine in particular is criticised for the use of non-scientifically validated techniques as they ‘might be helpful’. As long as there are no specific side-effects from the procedure then this can be justified as ‘might not help, but at least will do no harm’ way of thinking. Unfortunately what happens is that an un-validated process gets mainstream traction via the media (such as this newspaper article) and the general population gets the idea that it may be helpful to them. Like ‘magic water’ in Cronulla for arthritis, a lot of patients may have parted with their money before it is shown not to be an effective treatment.

There are many potential reasons this procedure may of benefit to some patients, including the ‘placebo effect’, the normal fluctuation of arthritic disease or some mechanical effect of the injection itself. Anthony’s knee may just feel better as he had an off-season without running!

The ethical way of getting around this is for the proponents of this technique to perform some randomised double-blind clinical trials (the ‘gold standard’ of studies) to rigorously confirm the relative benefits of the injection. As always this issue will be followed with interest to see what develops and may certainly prove to be helpful in the future. Only at this time can it be offered with any confidence to our patients.

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General

Dr John Molloy

Ankle

Plantar Fascitis

General

Platelet Rich Plasma Protein Injection



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