Ask Dr. Boettcher: Should I Consider Knee Stem Cell Therapy?
Research guides the use of knee stem cell therapy to manage arthritis pain.
Emerging therapies based on stem cells offer the promise of pain relief for those with arthritis. Understandably, the potential to treat medical conditions with our own stem cells generates a lot of public interest. Arthritis and stem cell therapy specialist Dr. Brennan Boettcher explains what we know about knee stem cell therapy and addresses frequently asked questions.
Conditions treated with knee stem cell therapy
Research studies are gradually expanding understanding about how stem cells work to encourage healing. “Our arthritis specialists track current stem cell studies,” says Dr. Boettcher. “We confer together, sharing our collective knowledge and experience with stem cell treatments for knee conditions. Currently, two main knee conditions benefit from stem cell therapies.”
- “Arthritis is the No. 1 condition we treat with stem cell therapy,” says Dr. Boettcher. “It can be particularly helpful to treat younger arthritis patients who aren’t ready to have a total knee replacement and haven’t had the symptom relief they desire from standard treatments.”
- Meniscal tears. The second most common use for knee stem cell therapy is treatment of meniscal tears. “The appropriateness of knee stem cell therapy for a meniscal tear depends upon the nature of the tear,” explains Dr. Boettcher. “In some cases, surgery can restore the alignment of the meniscus and repair the tear. And that’s when surgery is preferable to stem cell therapy. However, sometimes a tear can’t be repaired. Then, treatment options include surgically removing part of the meniscus. Alternately we can use stem cells to encourage repair in combination with other treatments to relieve pain.
What type of stem cell preparations does Summit use?
“Stem cells reside in most tissues throughout the body,” notes Dr. Boettcher. “But they can really only be harvested successfully from bone marrow and adipose tissue for orthopedic conditions such as knee arthritis. At Summit Orthopedics, our regenerative medicine specialists harvest stem cells from a patient’s own bone marrow. When this bone marrow is concentrated, it is known as bone marrow aspirate concentrate (BMAC). Stem cells obtained from BMAC are the most commonly used type of stem cell to treat arthritis. When compared to other regenerative medicine treatment options such as platelet rich plasma (PRP), some BMAC studies suggest that BMAC results may last longer than PRP and may work better for higher grades of arthritis. Although this is promising, we need more studies in order to be sure.”
Does Summit use amniotic or cord blood stem cells?
“My patients frequently ask me about allograft stem cell products like Wharton’s jelly, amniotic fluid, and umbilical cord blood stem cell treatments.” says Dr. Boettcher. “It’s really a misnomer to call these ‘stem cell’ products, since the current research indicates there are actually no live or viable stem cells in the tested products. They are often unregulated or under-regulated and marketed as highly effective for a variety of maladies. But marketing claims can be misleading and untruthful. Some clinics claim that amniotic products contain live stem cells. The difficulty with this claim is that the FDA considers products containing live stem cells from another person to be drugs that must be registered, and proven safe and effective in large clinical trials, while these products have not been. Because amniotic products are not registered as drugs, it would actually be illegal to sell them if they did contain live stem cells.”
Additionally, some amniotic products are marketed as containing a high concentration of growth factors. “Research does not entirely support these claims,” states Dr. Boettcher. “In fact, many amniotic products have far fewer growth factors than PRP or BMAC products do. Also, there’s very little orthopedic research on these products. That’s why it’s important to consult with an orthopedic physician with an excellent understanding of the current research if you are considering stem cell treatment for an orthopedic condition.”
Without proper regulation, product safety is also an issue. There have been several individuals recently who have acquired serious E. coli infections as the result of poor product processing and substandard manufacturing protocols.
Does Summit use adipose stem cells?
Adipose stem cells are harvested from fat cells either in the belly or thigh. “Although we see adipose stem cells as holding promise in the future, most adipose stem cell research has been done using enzymatically digested adipose tissue or cultured adipose stem cells,” explains Dr. Boettcher. “Under FDA regulations, these processes are not currently legal to use in the U.S. outside of a research protocol because they require more than “minimal manipulation” once the tissue is outside of the body. Though techniques now exist to harvest and process adipose stem cells within FDA regulations using simple mechanical disruption, there remains the question of whether they will be as effective. We continue to monitor new research in this area and may consider using adipose derived stem cells in the future, but for now we feel that BMAC for knee stem cell therapy is best. It is effective, minimally manipulated, and sanctioned for orthopedic conditions.”
Imaging guidance is critical to the safety of stem cell procedures
“While supported by the current literature, knee stem cell therapy is still considered experimental,” says Dr. Boettcher. “Whenever you use an invasive treatment in a joint, safety is a concern. That’s why I advise people to seek treatment from an orthopedic physician with specialized training in image-guided stem cell therapy. Imaging is important from a safety standpoint. X-ray- and ultrasound-guided procedures minimize the risk of damaging nerves or joint structures during harvesting and injections. Also, an orthopedic specialist ensures a comprehensive diagnosis and consideration of all appropriate evidence-based treatments for your condition. All of Summit’s regenerative medicine specialists have fellowship training. In addition, we have advanced training in regenerative medicine procedures using imaging guidance. We use all available safeguards so that procedures are done safely, sterilely, and with the most advanced technology and techniques available.”
Stem cell therapy is one option in a comprehensive treatment plan
“Like most medical therapies, stem cell treatments are not a cure-all,” Dr. Boettcher points out. “And not everyone is a good candidate for these therapies. Think of them as one aspect of a comprehensive plan to manage arthritis. If you are wondering if you are a candidate for a stem cell treatment, I am happy to talk with you. Knee stem cell therapy is a valuable treatment option, but it isn’t ideal for everyone. Your doctor should be willing to tell you if and why you are a good or excellent candidate. Just as important, your doctor should speak frankly with you if stem cells are unlikely to help.”
At Summit, we offer comprehensive treatment for knee conditions. “We don’t focus exclusively on one therapy,” explains Dr. Boettcher. “That’s because multiple treatments, used together, may deliver the best outcome. If you are a good candidate, stem cells may give you substantial pain relief. But physical therapy and a brace could relieve your pain by another 20 percent. And losing 10 pounds might provide 15 percent more relief. With a comprehensive plan, you could realize significantly more benefit than you’d get from stem cell therapy alone. We are committed to help you maximize pain-free function so you can continue to enjoy your favorite activities.”
Summit Orthopedics offers regenerative medicine expertise
Summit’s team of experts provide innovative regenerative medicine therapies for those looking for an alternative to traditional treatments. They can treat arthritic joint pain, sports injuries, neck and back conditions—creating an environment to trigger tissue repair and healing.
Start your journey to better function and less pain. Visit our regenerative medicine services hub and find your expert, request an appointment online, or call us at (651) 968–5201 to schedule a consultation.
Summit has convenient locations across the Minneapolis-St. Paul metro area, serving Minnesota and western Wisconsin. We have state-of-the-art centers for comprehensive orthopedic care in Eagan, MN, Plymouth, MN, Vadnais Heights, MN, and Woodbury, MN, as well as additional community clinics throughout the metro and southern Minnesota.
More resources for you
- Meet Brennan Boettcher
- Learn more about regenerative medicine safety
- Watch the video: What is a stem cell?
- Watch the video: What is stem cell (BMAC) injection therapy?
- Ask Dr. Boettcher: What to Expect During Stem Cell Treatment
“My goal is simple; getting you back to the activities you love. At Summit, we help you achieve your healthiest version of yourself by rehabilitating injuries, utilizing cutting-edge treatments such as minimally-invasive ultrasound guided procedures and regenerative medicine, and reserving surgery as a last resort.”
Ask the Expert: Regenerative Medicine Video Series
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