Stem Cell Therapy for Knee Pain, Arthritis, Tendonitis & More
For many patients with debilitating knee osteoarthritis, treatment options are limited and include steroid injections, hyaluronic acid injections (viscosupplementation), physical therapy, and joint replacement surgery. Rotator cuff tendonitis is also a common problem and again, treatment is often limited to intermittent steroid injections, physical therapy and possibly surgery when conservative management fails. Steroid injections have frequently been met with either ineffectiveness, short-term pain relief and the risk of tendon atrophy and rupture. Currently, Dr. Badman offers new cutting-edge treatment options like amniotic membrane stem cell injections which can be used to as an alternative to surgery to successfully treat patients with degenerative arthritis (knee and shoulder), rotator cuff tendonitis, lateral epicondylitis (tennis elbow) and other tendon and joint disorders.
For clarification, this type of stem cell comes from the amniotic sac of donated placentas following childbirth – it is not embryotic. The amnion is removed and harvested from the placenta of prescreened and tested donors. It is then sterilely processed and undergoes further rigorous testing to assure safety and efficacy. While some people may have ethical issues with embryonic stem cell therapy, most everyone agrees that the use of amniotic stem cell therapy raises no ethical or moral questions.
How does amniotic stem cell therapy work?
Stem cell treatment takes advantage of the body’s ability to repair itself. A stem cell is a type of cell the body uses to create new tissues and structures. Stem cells have the ability to differentiate into any kind of cell that the body might need: skin, bone, blood, cartilage, etc. They also remain stable for many years and have the ability to divide and regenerate.
With amniotic stem cell therapy, Dr. Badman injects stem cells from amniotic tissue into your affected area. This has been sterilely processed and converted into a flowable injectable form. For the knee, this is placed sterilely within the joint. For the shoulder it is either placed subacromially (above the rotator cuff) for tendonitis or into the joint under ultrasound if treating osteoarthritis. These stem cells have potent anti-inflammatory properties. Amniotic tissues are also a rich source of collagen, elastin, fibronectin, mesenchymal stem cells and growth factors that can support tissue repair and regeneration. This is the tissue that protects the baby in utero during pregnancy. While similar in concept to steroid injections, stem cell therapy is thought to have a longer and greater impact. At this stage we do not know if this will actually repair or restore damaged cartilage but preliminary data has been promising. A recent scientific paper published in January of 2014 out of University of Southern California showed a benefit in pain control and possibly in regeneration of meniscus tissue after knee arthroscopy for meniscus tears. Applications of this therapy are still being researched and implemented around the world. Ask Dr. Badman about any ongoing study you may be a candidate for.
While cortisone and other drugs only provide temporary pain relief, stem cells have the ability to restore degenerated tissue while providing pain relief. The growth factors in amniotic stem cells may replace damaged cells in your body. Additionally, stem cell injections contain hyaluronic acid, which lubricates joints and tendons, easing the pain and helping restore mobility. The hope and thought is that because of their regenerative capacity and stability, the impact and pain relief may be much longer than previously obtained with past treatments (steroid, viscosupplmentation, etc.).
Are stem cell injections safe?
Yes. Amniotic stem cell treatment has been used by ophthalmologists to aid with corneal surgery for over 20 years. It also has applications in plastic surgery assisting in burn patient healing. To date, more than 10,000 injections have been performed without a single reported adverse side effect. As with all treatment options, the biggest risk of a stem cell injection is that it does not alleviate all your pain but does afford one more option prior to surgical intervention.
- Amniotic stem cell therapy is a preferred type of stem cell therapy because the cells come from an immunoprivileged site (newborn babies). This means that patient-rejection is extremely rare.
- The use of amniotic stem cells is well researched, safe, and effective.
- All amniotic stem cell donors go through a rigorous screening process, as determined by the Food and Drug Administration (FDA) and American Association of Tissue Banks (AATB).
What benefits does amniotic stem cell therapy offer?
Amniotic stem cell therapy is very safe and effective. Learn more about several benefits this treatment has to offer:
- Amniotic stem cells contain no steroids. Instead, the injections rely on naturally occurring anti-inflammatory agents, such as cytokines.
- Amniotic stem cells contain hyaluronic acid, which lubricates cartilage and promotes new cartilage growth.
- Amniotic stem cells contain growth factors, which stimulate tissue growth.
- With amniotic stem cells, there is no threat of patient rejection.
- Lastly, amniotic fluid is a highly concentrated source of stem cells, which makes this type of stem cell injection preferable over embryonic stem cells and the patient’s own stem cells (from fat or bone marrow).
Am I a candidate for stem cell therapy?
Patients suffering from any kind of joint, tendon, or ligament pain may be considered as candidates for amniotic stem cell therapy. Patients with severe degenerative osteoarthritis may not be eligible for stem cell therapy. Upon evaluation, Dr. Badman may be able to provide you with recommendations for other types of treatment options.
Does insurance cover stem cell therapy?
Most insurance companies do not cover Amniotic Tissue injections at this time. As such, this is fee for service due at the time of treatment. Many insurance companies, however, may cover the initial consultation as well as some aspects of the treatment, such as the injection fee, radiographs, and use of ultrasound guidance if necessary during your appointment.
Dr. Badman can help review the advantages, costs, and indications for amniotic stem cell treatments to help you select which is best for you.
How much do amniotic stem cell injections cost?
Amniotic Tissue Graft prices range between $1500 – $5000 depending on the site of injury and the amount of graft material required. Because of this, final prices can be determined only after an initial consultation with Dr. Badman.
Dr. Badman strives to provide this treatment as cost-effectively as possible, with costs comparing favorably with other nationally prominent specialists.
Platelet-rich Plasma (PRP)
Platelet-rich plasma (PRP) is a newer modality of treatment for the management of many orthopedic conditions including sports injuries. RBC (red blood cells), WBC (white blood cells), plasma, and platelets are the major components of blood. Platelets are small discoid blood cells with granules containing clotting and growth factors which are released during the healing process. On activation, the platelets accelerate the inflammatory cascade as well as healing by the release of the granules containing growth factors. Platelets have an average lifespan of 7–10 days.
A normal blood specimen contains only 6% platelets whereas platelet-rich plasma (PRP) contains a much higher concentration of platelets. A PRP injection is generally recommended in the treatment of tendon or muscle injuries with a success rate of about 70% to 80%. Four to six weeks may be required for complete healing.
Special precautions are required in individuals with low platelet count, bleeding disorders, those on blood thinning medications or anti-inflammatory medications, individuals allergic to local anesthetic agents, those with active infections and women who are pregnant or breastfeeding.
Your doctor will first draw 10 ml of blood from the large vein in your elbow. The blood will be centrifuged or spun to separate the platelets from other blood components. The entire process takes about 10 minutes. The platelet rich portion of the blood is then extracted.
The injured part of the body is anesthetized with a local anesthetic and PRP is injected into the affected area under ultrasound guidance.
After the procedure
Following the procedure, you can resume your daily routine activities but avoid strenuous activities such as heavy exercise or lifting. You may experience some pain during the injection which may last for a couple of days. Cold compresses and pain medication may be prescribed for pain relief. Anti-inflammatory medications are to be avoided for up to 48 hours after the injection, as they can affect the platelet function.
Risks and Complications of PRP
Risks and complications are rare but can include infection, nerve or blood vessel injury, scar tissue formation, and calcification at the injection site following a PRP injection. Call your doctor immediately in case of persistent pain or the development of any adverse reaction after the injection.