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Osteoarthritis

Common Questions

Macquarie Stem Cells has provided the information below so consumers can understand the services we provide. 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.  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.

 

Here at Macquarie Stem Cells, Dr. Bright and our scientific team aims to reduce the symptoms of osteoarthritis such as pain, stiffness and loss of strength in the joints. After your treatment, our goal is to keep in contact with you so we can guide you to achieve the best results and get you moving comfortably again. Patient care and knowledge is what is expected of us and it is exactly what you would expect to gain from our expertise.

The first bone marrow transplant was performed in 1968. Osteoarthritis treatments in horses and dogs started in 2004. This may be your first contact with “biological treatments” but they have been in development for a very long time.

Understanding Osteoarthritis (very important)

Osteoarthritis is a very complex condition, many people assume cartilage is everything but this is wrong. Your pain starts due to loss of cartilage, however it continues to be a problem due to inflammation. Inflammation is destructive to all of the tissues in your joint.  Let’s look in detail below.

  • The cartilage (cushioning) in between the bones starts to wear away, cartilage is mainly avascular, meaning it has no blood supply. Without blood supply repairs do not happen. Since your cartilage can’t repair itself inflammation starts to occur, this causes pain in your joints.
  • Ongoing or “chronic” inflammation damages all the surrounding tissues and structures of the joint including veins, arteries, nerves, synovial membrane and tendons.
  • Blood vessels inside the joints will become inflamed Blood carries nutrients. When the vessels are inflamed, delivery of nutrients becomes very poor. Overall health of the joint will decrease dramatically, continuing the domino effect.
  • Synovial membrane & bursal sacks become inflamed, then damaged over time.
  • When the synovial membrane becomes inflamed it is not able to produce good quality lubrication. This will lead to further aggravation. (similar to an engine running without any oil)
  • Pain restricts movement, inflammation and swelling causes stiffness.
  • Restricted movement means the muscles and tendons supporting your joint become weaker and lose their flexibility
  • Many people with osteoarthritis will develop tendonitis (inflamed and painful tendons).
  • The nerve endings around the bone and general joint structure will become inflamed. This is what causes your night pains or resting pain.
  • Your body may try to repair the areas where cartilage has been lost, it will fail. This can cause small bony formations known as osteophytes. These osteophytes can cause severe pain if they press against tendons or nerves.
  • Ongoing impact on your bones may cause bone oedema (swelling). Weight bearing on bone oedema will cause significant pain.
  • The lack of cartilage and ongoing movement in your joint allows the bones to rub against each other. This leads to bone sclerosis (hardening) of the bone.
  • Over time, the nerve endings to the sclerosed bones will lose their sensation. (this is not always bad)
  • The lack of movement along with the ongoing  wear and tear of the joint will push you to a point where you have no choice but to replace your joints….. OR PERHAPS NOT?

(Netzer et al., 2016) (Finnilä et al., 2016) (Michalek etal,. 2015) (Hayes et al., 2005) (Cassar-Pullicino, Darby and Davies, 2004) (van Ochten et al., 2014) (Li et al., 2013)

Your body has the potential to heal itself, sometimes it just needs guidance.

We can clearly see inflammation is the root cause of your problems, if we could resolve the inflammation and reinstate  healthy blood vessels, your joints would go into a state where repairs can be carried out.

THIS IS EXACTLY HOW OUR BIOLOGICAL TREATMENT STARTS.

  • We can use your body to target and fight off the inflammation that is causing you pain.
  • Your blood vessels, no longer inflamed. Nutrient delivery resumes as it always should have.
  • Your body makes lubrication for your joints (synovial fluid). When the inflammation is reduced it can continue making good quality lubricant inside your joints. Therefore allowing free flowing movement within the joint.
  • Nerve pain, the pain that is keeping you awake at night. This can be taken care of, it’s root cause….? Inflammation of the nerves.
    • Don’t forget, sensations such as burning, tingling and numbness are types of nerve pain.
  • Bone oedema will resolve , it does take a very long time. We can speed up this process significantly.
  • The cartilage, yes this can re-grow. (if you are bone on bone please read the next section)

(Wu et al., 2013) (Gibbs et al., 2015) (Jo et al., 2014)(Michalek, 2015)

THIS IS WHERE THE TREATMENT CONTINUES WITH YOU.

As your inflammation reduces, naturally you will start moving as normal. You may notice your muscles are weaker than usual We can reverse and gain strength very quickly since muscles have very good blood supply. However if they gain strength too quickly your tendons may not keep up. You will notice this when you feel your pain “shifts”.

  • At this stage, you may develop tendonitis, this is not a side effect of the treatment. It is simply your joint trying to get back to normal but it is encountering “growing pains”.

This occurs because your tendons have a very poor blood supply, blood is the key here. Tendonitis will pass naturally, but it will take a very long time. In some cases up to 2 years. You must continue with consistent physiotherapy to speed up this process.

Don’t forget, we are here to assist. We can also use your body resolve tendonitis quickly, and without the need for any surgery.

Can Macquarie Stem Cells Help Osteoarthritis?

Your cells have the potential to carry out repairs, as indicated below:

  1. Target and fight off inflammation (reduce the pain you have)
  2. Increase the productivity of synovial fluid (increase lubrication of your joints)
  3. Differentiate into specific tissue types and repair the damaged layer of cartilage as well as connective tissue such as tendons, muscles and ligaments
  4. Resolve nerve related pain such as burning, tingling and numbness

(Wu et al., 2013) (Gibbs et al., 2015) (Jo et al., 2014) , (Michalek, 2015)

What if I am Bone on Bone?

When you lose all the cartilage in the centre of the joint bone is exposed. This treatment will stimulate the cartilage and it will start to regrow from the edges in the same way that skin around the edge of an ulcer will grow and eventually spread across the gap to close the defect. In the knee joint if the hole is small it can close. If the hole is large, the cartilage still grows inward towards the centre of the hole. However, as we walk, run, exercise, we are performing movements that can grind that new cartilage off. Even if you are not able to close the hole, you are able to remove all the inflammation, swelling and oedema, this is how your pain will go. The surface of the bone will become sclerosed and smooth like ivory, this hard sclerosed bone will have no nerve endings just like the enamel on your teeth so there will be no feeling. Like water on a marble floor, ivory with oil, polished bone with synovial fluid is very slippery. So you still have the ability to become pain free and completely mobile, even if you are bone on bone in your joints.

Does Biological Medicine Work for Knees?

Yes, biological medicine is a suitable treatment for knee pain, inflammation and cartilage loss caused by osteoarthritis. The very first patient we treated in 2009 suffered from arthritic knees. Following the success of this treatment, we have seen very good results for many other patients. The knee joint is the most common joint treated here at Macquarie Stem Cells and it does respond very well.

Which joints can be treated?

At Macquarie Stem Cells, we’ve used biological treatments on just about every joint in the body. It is extremely common for us to treat multiple joints at the same time, as osteoarthritis can unfortunately cause wear and tear in more than one joint.
Here are some of the joints we have treated which have shown very good improvement;

  • Fingers and toes, including thumb joints
  • Wrists
  • Shoulders
  • Spine, inclusive from the neck to the lower back
  • Hips
  • Knees
  • Ankles
  • Feet

Does Weight and Age Make a Difference?

Your body fat does not age as rapidly as some of the other parts of your body such as bone marrow. There have been studies confirming this. The most recent study was performed in 2017, conducted by Kokai et al.  View the study here.

We have treated patients who weigh under 50kgs as well as patients who weight in excess of 130kg and have determined that weight does not appear to change the patient’s response to this treatment. We see very good improvements in patients regardless of weight.

Whilst your weight may not affect your response to this treatment, you will need to keep in mind that weight can impact wear and tear. The correlation with obesity has been observed for knees, hips and other weight bearing joints in addition to non-weight bearing joints. This means the loss of body fat is more closely related to symptom relief than the loss of actual weight induced physical stress. It has been suggested that there may be a metabolic link to body fat as opposed to just mechanical loading. (Michalek et al,. 2015)

As for age, we have treated patients as young as 18 and as old as 94. We have not seen any correlation in an aged population as opposed to a younger population when using biological interventions.

What is the Success Rate of the Treatment?

In 2017, Dr. Pak published a systematic review in the Journal of Biomedical Science that covers over 1500 patients treated for osteoarthritis with new biological interventions. In his literature review, he covered results published previously by Professor Michalek, where he observed 1114 patients, and the results revealed “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)

At Macquarie Stem Cells, we’ve treated over 1000 patients suffering from arthritis and similar musculo-skeletal issues. The service we provide matches closely, if not superior to the results published above. Our high success rate is a result of Dr. Bright’s expertise along with our scientific team.

Our very first publication pre-dates many other journal articles. Below is a direct snippet from the publication.

Treating Joint Disease using a Biological Process

Published: Journal of cosmetic surgery & medicine – VOL 5 NO 3 2010 – There were no financial sponsors for this study.

“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) – complete reference available in the references page.

It is important to remember every patient will respond differently to these treatments. We have provided this publication as an educational piece, not to encourage you to undertake this treatment.

Treating Tears to Cartilage and Ligaments?

It can be very common for osteoarthritis sufferers to have comorbidities such as cartilage tears (labrum, meniscus, etc.) or ligament tears. While this does stray away a little from this page, the treatment does work very well. In our main page about treating tears, you can find a lot more information. Click here to learn more about treating tears using a biological approach.

The knees, most commonly treated joint.

This treatment is suitable for knee pain, inflammation and cartilage loss caused by osteoarthritis. The very first patient we treated in 2009 suffered from arthritic knees. Following the success of this treatment, we have seen very good results for many other patients. The knee joint is the most common joint treated here at Macquarie Stem Cells and it does respond very well.

Hip Joint, does the biological treatment work?

We have observed significant improvements in the arthritic hips of our patients. Since 2012, we have formally been treating the hip joints. In the early days we used to notice slow improvement, however we are now noticing hip joint results that are comparable to the results we see in knees.

Spine Related Arthritis, is a biological treatment suitable?

Spine related arthritis refers to osteoarthritis in the spine, inclusive of the neck down to your lower back. Our in-house observations indicate the spine does respond to the treatment, but patients need to keep in mind that in many cases the results will be far greater with multiple treatments. We do have the option to offer multiple treatments for you.

Osteoarthritis in the Shoulder? Can my biological process be used here?

Whether it affects one shoulder or both, arthritis of the shoulder can be a particularly painful condition. Macquarie Stem Cells biological treatment has shown great promise for shoulder arthritis.  We’ve seen extremely successful results for shoulders, including certain cases of frozen shoulder.

Smaller joints such as the Fingers, Toes and Thumbs?

Interestingly, these smaller joints can cause big issues in limiting a patient’s quality of life. Handling objects, writing, walking and even leaning can become debilitating. Fortunately, biological approaches apply very well for these smaller joints.

TO OBTAIN FURTHER INFORMATION
Download Our Information Pack

Remember, any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

More Medical & Scientific Publications?

  • The link below is a publication for treating osteoarthritis with a biological intervention. This study is utilising a patented biological process by Dr. Ralph Bright, et al. It has been published in the Journal of Evidence Based Medicine & Healthcare Oct. 2015.
    Click here to read the publication.
  • You can also read through the literature review for treating osteoarthritis, published in January 2017. This study is observing multiple countries, multiple clinics and over 1500 patients treated using biological interventions. This is a very valuable publication, it is well worth reading.
    Click here to read the systematic review.

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