Stem Cells Used as Prolotherapy Proliferant
Study conducted, “Transplanted bone marrow mesenchymal stem cells with platelet-rich fibrin glue scaffold stimulates full-thickness cartilage defects to heal.”
 We chose to review this study to inform people about the human studies using bone marrow stem cells for articular cartilage lesions. Articular cartilage is a type of cartilage that covers joint surfaces and is most susceptible to injury compared to other types of cartilage. Researchers at Cairo University School of Medicine and the University of Pittsburg School of Medicine reported on the use of bone marrow mesenchymal stem cells and a platelet-rich fibrin scaffold to heal full-thickness cartilage defects in five patients (mean age 25.4). The researchers studied the treatment results from transplantation of autologous bone marrow mesenchymal stem cells. These stem cells were expanded on platelet rich fibrin glue, placed on the defect and covered with an autologous periosteal flap.
Why Bone Marrow Stem Cells
Articular Cartilage has limited repair capacity and marrow-stimulation procedures such as microfracture, osteochondral grafts and autologous cartilage implantations have had limited success in articular cartilage defects.1 The researchers from this study chose mesenchymal stem cells from bone marrow because these have the ability to differentiate into cartilage cells. In the case of these five patients the bone marrow was harvested from the iliac crest (hip bone). Platelets were used as a scaffold because platelets contain various growth factors that stimulate cartilage regeneration. The researchers expected that the biological effect of multiple growth factors on tissue regeneration is greater that of a single growth factor.
Results
The patients showed significant functional improvement. Two of the patients underwent arthroscopy after the transplantation and showed near normal articular cartilage. Three postoperative MRIs revealed complete healing and congruent cartilage tissue, whereas two patient MRIs showed incomplete congruity in the cartilage tissue.
Conclusion
The researchers concluded that the transplantation of autologous culture-expanded bone marrow-mesenchymal stem cells in platelet rich-fibrin glue shows great promise in the treatment of full-thickness articular cartilage defects, particularly large-sized defects (>4 cm). The positive 1 year clinical outcomes support further randomized controlled clinical trials of this treatment modality with larger numbers of patients and longer follow-up periods.
Bone Marrow at Caring Medical
 At Caring Medical, Dr. Ross Hauser uses bone marrow in a more direct way to regenerate cartilage, Bone Marrow Prolotherapy involves direct bone marrow aspiration (and concentrated) to get the stem cells to the site of the injury. Does the study above suggest that direct bone marrow injections without culture expanded and without the scaffold would work? Possibly, but only time will tell as research progresses. But in our experience we have discovered that these stem cells act as a great proliferant solution for Prolotherapy. At Caring Medical we use bone marrow stem cells in conjunction with other Prolotherapy Solutions to treat large articular defects in the labrum and meniscus areas. Typically, patients are seen every two months. Most patients need 3-6 visits. The good news is during the time of healing, the patient can exercise and start getting back into great shape! Bone Marrow ad stem cell therapies are gaining in recognition and Caring Medical offers them as an option for treating chronic injuries and sports injuries. So what are you waiting for? Contact us today at 708-848-7789 or scheduling@caringmedical.com.
1 Haleem Am,singergy AA, Sabry D. the clinical use of human culture – expanded autologous bone marrow mesenchymal stem cells transplanted on platelet – rich fibrin glue in the treatment of articular cartilage defects ; a pilot study and preliminary results. Cartilige. October 1: 253-261.
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