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Osteoarthritis

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)

Long gone are the days when we used to think osteoarthritis was all about the loss of cartilage. We now know osteoarthritis starts due to loss of cartilage and this leads to inflammation throughout the entire joint. Inflammation is the problem, it is destructive to all the tissues in your joint.

  • 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 cannot repair itself, inflammation starts to occur and this causes pain in your joints.
  • Ongoing or “chronic” inflammation damages all the surrounding tissues and structures of the joint including veins, nerves, synovial membrane, ligaments, cartilage inclusive of muscles and tendons.
  • Blood vessels inside and around the joints will become inflamed. Blood vessels carry nutrients, when the vessels are inflamed, delivery of nutrients becomes very poor. Inflamed blood vessels start to leak. This extra fluid leaking out of the blood vessels causes oedema. This oedema is felt as stiffness.
  • Inflammation builds, causing the synovial membrane & bursal sacks to become inflamed.
  • When the synovial membrane becomes inflamed, it starts to produce excess amounts of poor quality lubrication (synovial fluid) lubrication. This is excess fluid does not help movement, it is of poor quality and it leads to swelling, therefore restricting.
  • Pain restricts movement and decreased movement means the muscle will waste away. Strong muscles provide stability and help to protect the joint.
  • Tendon’s attach the muscle to bone. Due to lack of movement they start to degenerate, leading to 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). Walking with joints that suffer from bone oedema can 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.
  • Once you have lost all the cartilage in the centre of the joint and your bones are rubbing on each other. Each time you walk, you will grind down the surface of the bone like polishing a stone.
  • Eventually the polished bone will look like ivory; smooth, hard and slippery. This dense bone has no nerve endings and no feeling, just like the enamel on your teeth. When the dentist drills through the enamel then you feel everything. For some people being bone on bone is not painful.
  • The lack of movement along with the ongoing wear and tear of the joint may push you to a point where you have no choice but to replace your joints.

(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 a helping hand.

 

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.

Our Biological Treatment

At Macquarie Stem Cells, our treatment can target and resolve the inflammation that is causing you pain and repair damage.

  • When the blood vessels are no longer inflamed, nutrient delivery can return to normal, the blood vessels stop leaking and this will reduce the swelling, oedema and stiffness.
  • Your body makes lubrication for your joints (synovial fluid). When the inflammation is reduced it can continue making good quality lubricant inside your joints. Thereby, allowing free flowing movement within the joint.
  • Nerve pain will go as the nerve inflammation settles. Sensations such as burning, tingling and numbness are symptoms of nerve pain.
  • Bone oedema will resolve as repairs are carried out, it does take longer.
  • The cartilage, yes this can re-grow. (if you are bone on bone please read the “bone on bone” section below)

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

Our Treatment Continues With You

As your inflammation reduces, you will start moving better. You may notice your muscles are weaker than usual. It is possible to reverse this 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 because their blood supply is not as good. You will notice this when you feel your pain “shifts”. At this stage, you may develop tendonitis.  It is important to note that 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”.

The pain of osteoarthritis can resolve in 2 to 6 weeks but tendonitis can take up to two years for some patients. The more degenerate your tendons are before treatment the longer they will take to heal.

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

 

Can Macquarie Stem Cells Help Osteoarthritis?

Treatment by Macquarie Stem Cells has 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 away. 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 good quality 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 have used this biological treatment on just about every joint in the body. Osteoarthritis can, unfortunately, cause wear and tear in more than one joint hence the reason why it is extremely common for us to treat multiple joints at the same time. Below are some of the joints we have treated which have shown very good improvement:

  • Fingers and toes, including thumb joints
  • Wrists
  • Shoulders
  • Spine (the neck down 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 weigh 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 their 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, your biologicals obtained from adipose tissue (body fat) do not age as rapidly as some of the other tissues in your body.  There have been studies confirming this. The most recent study was performed in 2017, conducted by Kokai et al.

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 this biological intervention.

What is the Success Rate of the Treatment?

At Macquarie Stem Cells, we’ve been operational for almost 10 years, treating patients suffering from osteoarthritis. Our success or “response rate” is approximately 97%. The non-response rate for our treatment is very low; only 3%. We pride our selves of honesty, therefore this is a number you will need to be aware of, since that non-responding patient may be you.

Our patients generally notice very good improvements to their pain levels, joint function and quality of life. Our previous in-house studies indicate average improvements around 75%. You just need to keep in mind, no two people are exactly alike and results vary from one patient to the next.

When we look into published results in the literature of biological treatments, a great study to compare our results to is the systematic review that was written in 2017 by Dr. Pak in the Journal of Biomedical Science.

In his literature review, he discussed the results of 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 et al., 2017)

The results we see at Macquarie Stem Cells are now greater than those published results. We can achieve great results since we continually fund our own research to help all of our patients. We pride our selves of not only Dr. Bright’s expertise, but the work our entire medical and biological team performs together.

 

No one else performs this treatment as we do, our processes and protocols are patented.

 

Moving forward, our very first publication pre-dates many other journal articles. On the next page you will find 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.

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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