Systematic Review by Dr. J. Pak 2017

September 28,2017

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 NCBI Pubmed Literature. There were no financial sponsors identified for this study. We aim to provide you with an unbiased range of treatments that are available aside from biological therapy, this is discussed in ‘supporting information>other-options’  page on our website

Published: 1st June 2018
Go55’s News Paper

TITLE: Systematic Review of Biological Treatments for Osteoarthritis

The Latest literature review in the Journal of Biomedical Science covers over 1500 patients treated for osteoarthritis with new biological interventions.

We understand clinical papers can be difficult to read through, therefore we have re-organised these publications by date order and simply extracted the results of the study directly from the publication.

In addition, Dr. Ralph Bright of Macquarie Stem Cells’ publication, “Adipose Derived Stromal Cells to Treat Joint Disease” published in the journal of cosmetic surgery & medicine, pre-dates the earliest publication in this review, therefore we have placed the results directly at the beginning of this article. The conclusion of this systematic review can be found at the end of this article.

In 2009, Dr. Ralph Bright (Macquarie Stem Cells) treated our first patient. “In April 2009, Dr. Ralph Bright (Macquarie Stem Cells) treated our first patient. “She had moderate osteoarthritis which had given her continuous pain for the past five years. The pain ranged from a 2.5 to a 10, with 10 being pain equivalent to her child delivery pain. Twelve days after her injection she was pain-free and has remained so. This lady also had a rotator cuff syndrome in her right shoulder. This shoulder has remained pain-free also. In both her wrists she had rheumatoid arthritis with pain and swelling. For this she had been taking severe amounts of immune suppressing and anti-inflammatory medications. After Day 12 she was only taking immune suppressing medications. At eight weeks we stopped the immune suppressing medications such that she was now taking no medication whatsoever. Blood testing revealed that her cold reactive proteins (CRP) dropped from 23mg/ml to 7.7mg/ml at 10 weeks. However at 13 weeks we noted that her CRP had started to rise again although she remained asymptomatic. At 20 weeks she had a flare-up of her rheumatoid arthritis in her left wrist for which she took anti-inflammatories. She remains pain-free and asymptomatic in her knee and shoulder. In 2010, we treated our next six patients. They all showed significant improvement, most marked in the first month and plateauing after four months, as demonstrated by the WOMAC questionnaire scores. We have not been able to demonstrate any improvement radiographically. Three patients had other disease processes in other areas of the body which improved with injections into the knee. One has not needed to use his asthma medication since having the injection. Two showed a 90% improvement in spine pain. Two patients had some swelling in the joints after injection, but this cleared within two weeks. There had been no permanent adverse events. There have been no infections.” (Bright, R. 2010)

Dr. Pak’s review observed patients treated between the years of 2011 through to 2016. Doctors from a variety of clinics around the world released a series of publications for the treatment of osteoarthritis using biological interventions as opposed to the common methods available in medicine now. The treatment biological treatment was taken from the patient’s own body fat, medically referred to as “Autologous Adipose Tissue”.

The very first publication Dr. Pak reviewed, discussed the results of 4 patients that were treated In 2011. Dr. Pak stated, the “score for pain, functional rating index, and range of motion of the patients were assessed and shown to be improved along with MRI evidence of cartilage regeneration.” (Pak J., et al. 2017)

77 more patient treatments were reported in 2012, their results presented, “knee scoring scales, Tegner activity level scales, and VAS scores improved significantly in the treated group compared to the control group. No imaging studies were carried out. No major side effects were reported.” (Pak J., et al. 2017)

Furthermore, 112 patients treated in 2013 were reported by doctor Pak, he states “The patients improved on all criteria, including the cartilage whole-organ MRI scores. No serious complications were reported. They also reported the average efficacy of the regenerative treatment to be 65% at 3 months without any serious side effects and without any development of tumours. Some of the side effects reported were swelling and tendonitis.” (Pak J., et al. 2017)

In 2014, a total of 102 patient treatments were covered in his review. The patient’s “arthroscopic exams showed fibrocartilage regeneration”, the “Knee Documentation Committee and Tegner activity level scales significantly improved, but 76% of the patients had abnormal repair tissue observed during arthroscopy.” (Pak J., et al. 2017)

Another study performed in 2014 revealed “after 8.5 months of treatment, all 21 patients showed improved VAS pain score and the Lysholm score.” (Pak J., et al. 2017)

The largest study took place by professor Michalek in 2015, focusing on 1114 patients. The results of this study written by Dr. Pak stated, “No serious side effects were reported, and no incidents of cancer were reported. The 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% of all patients reported approximately 75% symptom improvement and 91% of all patients reported approximately 50% of symptom improvement.” (Pak J., et al. 2017)

The final observation focuses on a further 73 patients that were treated in 2016. The results state “Three months after treatment, all three patients’ symptoms, measured using FRI, ROM, and VAS pain score, improved. In addition, comparison of pre-treatment and post-treatment MRI data of all three patients demonstrated cartilage-like tissue regeneration”. The patient improvement results based on their WOMAC and VAS questionnaires “were maintained at 1 year”. “No major side effects were observed.” (Pak J., et al. 2017)

Conclusion provided by Dr. Jaewoo Pak’s systematic review reveals biological methods of treatment possess “a great clinical potential to treat various orthopedic disorders as seen in human studies”.  Dr. Pak finalises his paper by stating, biological treatment approaches “may be worthwhile to try in individuals for whom medical treatment has failed and for whom surgical options are not available.” (Pak J., et al. 2017)

REF1: Bright, R. (2010). Adipose Derived Stromal Cells to Treat Joint Disease. Journal of Cosmetic Surgery & Medicine, Volume 5(Issue 3).

REF2: Pak, J., Lee, J., Park, K., Park, M., Kang, L. and Lee, S. (2017). Current use of autologous adipose tissue-derived stromal vascular fraction cells for orthopedic applications. Journal of Biomedical Science, 24(1).


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