Stem cell research and application of therapies has the potential to become one of the most promising areas of medicine. There are a number of areas where stem cells are being targeted for use in treating musculoskeletal disease.
The term “stem cells” is somewhat misunderstood by many. In simplest form, stem cells are unique unspecialized cells within the human body that have the ability to differentiate into different adult cell types. For example, mesenchymal stem cells which are used in orthopaedics, have the ability to differentiate into cartilage, bone, fat, and fibroblasts.
The relationship between Prolotherapy, Platelet Rich Plasma (PRP), and stem cell treatments is complex. Both Prolotherapy and PRP treatments activate the body’s own natural healing response. Platelets release cells that are considered inflammatory mediators, along with proteins and growth factors. The platelets provide the necessary scaffolding from which mesenchymal stem cells proliferate. In theory, Prolotherapy and PRP provide the means to attract stem cells to the injured area where they will differentiate and develop into new cells, leading to restoration and repair of the affected area.
In the field of musculoskeletal medicine, stem cell therapies are being combined with tissue engineering to form the basis of regenerative medicine. In one approach, a patient’s own harvested stem cells are being injected or applied to areas of damaged or diseased tissues to promote healing. The other approach involves taking stem cells from the patient or from another human (“allogenic transplantation”) and combining with different types of engineered scaffolds to fill tissue or bony defects. These applications are being targeted at treating tendon and ligament injuries, healing of bone fractures, and filling of bony defects caused by injury or disease.
As we are just beginning to gain understanding of the many ways stem cells can be used, there are many unknowns and many questions without answers. The use of stem cells is still experimental. Many applications are being evaluated through clinical research trials and animal models. The hope is to be able to one day treat and cure diseases like osteoarthritis and rheumatoid arthritis, avascular necrosis, and spinal cord injuries using stem cell therapies.