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Treating osteoarthritis with Biological Therapy for the elderly

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Treating osteoarthritis with Biological Therapy for the elderly

December 18,2018

Macquarie Stem Cells has provided this information to educate the public based on peer reviewed, published scientific and medical documents. We don’t aim to encourage consumers to seek out such treatments prior to an assessment by a health professional to determine your suitability for treatment. This is obtained directly from the Journal of Clinical Orthopaedics and Trauma. This study was supported in part by grant FV20422 Czech Ministry of Industry and Trade and European Regional Development Fund , Czech Ministry of Industry and Trade CZ.01.1.02/0.0/0.0/16_084/0010379 . We aim to provide you with an unbiased range of treatments that are available aside from biological therapy, This is discussed in ‘other-options’  page on our website.

TITLE: “Stromal vascular fraction cell therapy for osteoarthritis in elderly” (Michalek et al., 2018)

Published: 22 Nov 2018
Journal of Clinical Orthopaedics and Trauma

Introduction

“Osteoarthritis (OA) is the most common type of degenerative joint disease often requiring joint replacement as a current available therapeutic option. A basis of OA is degeneration and chronic inflammation of the connective tissues of joints, including the cartilage due to a long-term damaging of chondroblasts, chondrocytes and extracellular matrix caused by oxidative stress, inflammatory factors and mitochondrial dysfunction causing DNA damage. Elderly people are the most vulnerable population as effects of ageing including degenerative changes and chronic inflammation of joints are more pronounced” (Michalek et al., 2018)

“In this article we focus on elderly population from our large clinical study, people older than 80 years as they are the most frailty. They are seeking for safe, effective and minimally invasive solution for their OA in order to improve quality of life without possible side effects which are more pronounced in this age group. We also focused on long-term 36 months follow-up of this unique and vulnerable population which was not previously documented or described in such extent elsewhere.” (Michalek et al., 2018)

Treatment

“Certified orthopedic surgeons and/or traumatology surgeons recruited patients with OA as agreed with the following criteria: (1) chronic or degenerative joint OA grade 2–4 (Kellgren-Lawrence) of 1–4 large weight bearing joints (including hip and knee) and additionally 0–8 other joints (shoulder, elbow, wrist, hand, ankle and foot) causing significant functional disability detected by clinical examination, X-ray and/or magnetic resonance imaging (MRI); (2) failure of conservative therapy; (3) signed informed consent form.” (Michalek et al., 2018)

“All patients underwent standard tumescent liposuction under the local anesthesia to obtain 20–200 ml of lipoaspirate. Lipoaspirate was processed by Cellthera, s.r.o., Brno, Czech Republic in order to obtain at least 15 million nucleated SVF cells. All nucleated SVF cells were counted on Burker chamber.  SVF cells resuspended in autologous plasma and to 4 large joints (hip, knee) or up to 8 other joints (shoulder, elbow, wrist, hand, ankle, foot) intra-articularly or peri-articularly to the synovial stromal loose connective tissue closely to the joint. If necessary, ultrasound or C-arm X-ray navigation of the needle was employed. SVF therapy was recorded and evaluated before therapy and after 1, 3, 6, 12, 24 and 36 months after the SVF treatment.” (Michalek et al., 2018)

Results

“A total of 29 patients aged 80–94 years (average age 83.3 years, 4 of them older than 90 years) were treated by SVF cells isolated from adipose tissue. 31.1% of patients were males and 68.9% were females. 10.3% patients were diagnosed with grade 2, 48.3% with grade 3 and 41.4% with grade 4 of degenerative osteoarthritis monitored by clinical and X-ray examination. There were 24.1% patients with normal weight (BMI 18–24.9), 41.4% overweight patients (BMI 25–29.9) and 34.5% obese patients (BMI 30 or over). Adipose tissue was processed leading to at least 15 million nucleated SVF cells per joint applied. No complications associated with processing of adipose tissue or preparation of SVF cells was noticed. Local pain and minor swelling at the site of injection were observed for 24–48 h after the SVF application in 2 cases. No long-term side effects or complications after the procedure were noticed during 36 months follow-up period. Three patients have died during the follow-up period (21–33 months after their SVF therapy) due to aging and causes not related to SVF therapy.” (Michalek et al., 2018)

“Regarding clinical effects of SVF therapy, semiquantitative evaluation of pain as well as total amount of NSAIDs or analgesic drugs were significantly decreased from the first month after the SVF therapy and were significantly decreased further during the next 36 months in comparison to the clinical situation before SVF therapy. Similar results were obtained by evaluation of limping at walk, extent of joint movement and joint stiffness. Complex Score evaluation of all 5 parameters (pain, number of analgesics/NSAIDs per week, limping at walk, joint stiffness, and extent of joint movement) including statistical analysis is summarized in  Figure 2 (available from formal publication). A significant and constant improvement in Score was observed for 36 months after SVF therapy compared to the status before SVF therapy. Score was constantly decreasing for 24 months. Last follow-up at 36 months reveals mild non-significant Score increase. Only 2 patients (6.9%) required total hip replacement during the analyzed period (21 and 24 months after SVF therapy), both with grade 4 OA. One of these patients died 12 months after total joint replacement.” (Michalek et al., 2018)

“In summary, SVF therapy represents important tool in regeneration of joints in elderly patients. Such a novel method can be provided very safely and gently during one surgical procedure with a respect to frailty of this patient population thus significantly improving their quality of life without the risk of serious side effects or complications.” (Michalek et al., 2018)

REF:Michalek, J., Vrablikova, A., Darinskas, A., Lukac, L., Prucha, J., Skopalik, J., Travnik, J., Cibulka, M. and Dudasova, Z. (2018). Stromal vascular fraction cell therapy for osteoarthritis in elderly: Multicenter case-control study. Journal of Clinical Orthopaedics and Trauma. (Michalek et al., 2018)

TAGS: Macquarie Stem Cells, Possibilities of Biological Treatments, Focusing on Osteoarthritis, Macquarie Stem Cells treating osteoarthritis, Dr. Ralph Bright biological treatment, Osteoarthritis in the elderly, arthritis and biological medicine in elderly, biological therapy for patients over 80 years of age

 

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