While cell-based treatments are ‘‘promising’’, as yet ‘‘there is no high-quality evidence base to be confident of the safety and efficacy of this treatment’’.
There is, however, an increasing push across the world to legitimise stem cell use for crippling orthopaedic shoulder, knee and hip pain.
The first FDA-approved stem cell study for rotator cuff tears is under way in the United States and early results indicate that adipose tissue (fat) may be effective in regenerating damaged shoulder tissue.
In Australia, Macquarie Stem Cells maintains that stem cell therapy is a viable regenerative treatment for arthritis.
‘‘In several peer-reviewed studies including the Journal of Bio Medical Science, results show long-term patient relief from severe arthritis pain after harvesting their own adipose cells during a liposuction procedure,’’ says stem cell physician Dr Ralph Bright, who has performed close to 1000 procedures.
‘‘The best results are usually with knees, hips, shoulders and fingers, although not so much with the ankle. That’s possibly because it’s such a small joint and takes the body’s full weight,’’ he says.
A five-hour medical procedure involves a twilight sedation, during which fat is taken from the abdomen, thighs or buttocks, separated and then injected into the joint on the same day.
Patients are usually able to walk the next day but discouraged from undertaking vigorous work or activity for four weeks.
So, does the (ballpark) $9000 procedure work?
‘‘A multi-centre study in the International Journal of Research Orthopaedics, involving 1114 patients with osteoarthritis of the knees and hips from four different countries (the US, Czech Republic, Slovakia and Lithuania) were followed for 17 months after stem cell injection,’’ says Bright.
‘‘No serious side effects were reported and clinical effects, measured on the basis of pain, non-steroid analgesic usage, limping, extent of joint movement, and stiffness, all improved.
‘‘At 12 months after treatment, 63 per cent of all patients reported approximately 75 per cent symptom improvement and 91 per cent of all patients reported approximately 50 per cent of symptom improvement.’’
Bright is conducting his own double blind, placebo-controlled trial on about 150 patients – half receiving stem cells, the other half a placebo, with the results to be released in 2019.
As we live longer, so does a potential need grow for multiple joint replacements.
‘‘In 1965 the average life expectancy of an Australian male in Australia was about 67 years. In 2017 it was 80.3 years,’’ says Bright.
‘‘So if you’re an older patient living longer or a younger patient with early arthritis, stem cells are a viable option because there is a limit to the number of joint replacements you can have in a lifetime.
‘‘One or two may be all right, but come the third time the body exhausts its ability to attach metal parts,’’ he says.