Degenerative Joint Disease
Commonly called “degenerative joint disease,” (DJD), osteoarthrosis or osteoarthritis (OA) is the commonest form of arthritis. It is ubiquitous and causes the afflicted joints to deteriorate or “degenerate” progressively, losing articular cartilage, eroding into bone, often accompanied by ligament laxity. The disease affects approximately 27 million Americans and hundreds of millions more worldwide. In the United States alone, Osteoarthritis is historically reported in 13% of adults over the age of 25 and 33% of those over 65. In normal joints, hyaline (glass-like) cartilage covers the articular end of each bone, providing a smooth, slippery surface for ease-of-motion. This firm, rubbery material acts as a cushion between the bones and enables painless movement without friction. In osteoarthritis, the cartilage breaks down and erodes causing inflammation and pain, which can lead to swelling and difficulty with movement. As the progressive disease breaks down cartilage further, bone rubs on bone resulting in loss of joint space, laxity, and weakness of ligaments and formation of painful growths called spurs. These spurs can eventually break off and freely float within the joint, causing further discomfort. The body’s natural immune response to this process releases proteins and enzymes to try and help heal the damage, but it only leads to further degeneration of the fragile joint elements.
Over time, with progressive loss of cartilage and bone, the direct rubbing of bone on bone during regular, essential daily movements, leads to further damage, pain, and decreased quality-of-life. The most common symptoms of OA are joint pain in the hands (especially thumb), neck, lower back, knees, and hips. Osteoarthritis symptoms in “weight bearing” joints such as the hips and knees equate to devastating pain, stiffness, decreased range of motion, and joint deformities. OA is one of the leading causes of loss of functionality and ability to work in the elderly population and translates into a decreased quality of life in those afflicted regardless of age. In patients reporting concomitant diagnosis of osteoarthritis and obesity, the damage done to the weight-bearing joints increases in proportion to the over-weight, because of the increased stress and shear forces on the joints. This leads to an increased rate of degeneration and greater loss of functionality over a shorter period.
In the early stages of OA, symptom of pain and stiffness can be partially-alleviated by lifestyle changes such as those which promote healthy diet, exercise and weight loss. Used in conjunction with mild analgesic drugs, symptoms can be readily managed, and quality of life can be maintained. While these treatment options can help temporarily alleviate physical symptoms such as minor pain and stiffness, none of these treatments lead to any meaningful regeneration of the essential articular cartilage. There are further pharmacological options for managing worsening symptom, such as prescription anti-inflammatory, immunosuppressants, and pain management drugs including narcotics. Medication-related interventions can also treat secondary symptoms such as the use of chondroprotective chemical compounds to slow down progressive joint-space narrowing resulting from the actual cartilage breakdown. Unfortunately, long term use (as necessary in an incurable and progressive degenerative condition) can result in adverse effects and complications such as gastrointestinal tract ulceration, and damage to the liver, kidneys or heart.
Once the disease has progressed beyond the manageable mild to moderate stages, the only viable treatment option for many is total and complete joint replacement, where the entire joint is surgically removed and replaced with prosthesis. This procedure is costly, painful, and requires full surgical anesthesia. Total joint replacement carries a multitude of risks and complications such as an increased risk of infection, thromboembolism (which may be life-threatening), stroke, heart attack, and a greater risk of death within the first 90 days following surgery (most within the first 30). But even if a patient is lucky enough to avoid all serious complications, the lifespan of the prosthesis itself is limited, hence being denied to the younger adults. Furthermore, owing to the risk of serious complications it is generally not recommended for the older patients to undergo surgical procedures such as total joint replacement if they have co-morbidities. The sad truth is that, in the case of a progressive, degenerative disease affecting largely the older population with functional loss, these patients are precisely the ones most in need of the procedure of joint replacement.
Groundbreaking Therapeutic Benefits with Little Operative Risk
Recent studies done on the efficacy of mesenchymal stromal stem cells (MSCs) show the potential for groundbreaking therapeutic benefits and great promise to the field of regenerative medicine. Mesenchymal cells are multifaceted, able to differentiate into a variety of cell types, including cartilage and bone. For example, in the case of arthritis treatment, MSCs have the ability to differentiate into a variety of connective tissues, such as cartilage, tendon, or ligament. “Stromal” is simply a broad term referring to the loose connective tissue in adipose (fat) which contains these mesenchymal stem cells. The isolated SVF contains various regenerative cells in addition to hundreds of cytokines and growth factors. These appear to be anti-inflammatory and immunomodulatory as well as regenerative, which further contributes to regeneration of connective tissue structures and creates an environment for the adaptive stem cells to repair damaged cells and tissues, often resulting in cartilage growth.
While MSCs are found in culture-expanded bone marrow cells as well, this procedure carries its own risks and complications as well as added costs. These complications are similar to those found in bone marrow donation or transplantation, whereas adipose stem cell extraction carries none of these risks. Both are “autologous” stem cell extractions, meaning the patient is utilizing their own stem cells to provide a regenerative therapy to alleviate their condition, and the beneficial nature of MSCs is mostly similar in the two sources, and the two do share many biological features and benefits, there are fundamental differences.
Adipose-derived stem cells are more stable for long-term cultures, although for maximum benefit freshly harvested stem cells are the best therapeutic option because it contains different populations of stem cells; and culture favors certain species of cell. Adipose-derived MSCs display lower senescence, meaning production neither decreases significantly with age nor loses its innate power to divide, grow, and differentiate. Additionally, adipose stem cells have higher numbers and concentrations by a factor of around 1000 times, for the same amount of tissue. Hence, the numbers of beneficial MSCs, using the same amount of tissue, is much higher when compared with bone marrow, for immediate treatment. Adipose retrieval is done under local anesthesia in an outpatient setting utilizing standard mini-liposuction procedures, resulting in less risk as well as less down time for the patient. While the amount of MSCs found in bone marrow decrease considerably with age, adipose-derived MSCs do not, which is good news for the elderly patients who are not able to be medically cleared for total joint replacement. To review, a less painful procedure yields 1000x the beneficial cells without surgery, costly and time-consuming medications and procedures, or fear of unforeseen complications. The benefits are available to patients regardless of age or level of function, to utilize the patient’s own naturally-occurring fat-tissue stem cells to actively regenerate necessary connective tissue structures and increase quality of life.
Proof in the Research
Between the years 2000 and 2010, more than 17,000 articles have been published in peer-reviewed academic and scientific journals about Stromal Vascular Fraction and Autologous Adipose-derived Mesenchymal stem cells. These articles comprise 2724 separate clinical trials and approximately 323,000 patients. The results point to the efficacy of autologous stem cell therapy to treat a variety of diseases such as Crohn’s disease, stroke, Multiple Sclerosis, Rheumatoid Arthritis, ulcers, post-radiation fibrosis, heart disease, and as an aftercare procedure following breast augmentation and reconstruction. The therapeutic benefits of mesenchymal stem cells in osteoarthritis are similarly proven through research and clinical trials. Additionally, fat-derived stem cells have saved thousands of large animals from certain disability and death. These include dogs, horses, kettle and zoo animals like giraffes, hippos, and rhinos. The procedure is safe, effective, cost-effective, and relies only on the safe extraction of autologous cells. When used to treat degenerative conditions such as osteoarthritis, this procedure can also lead to a decreased reliance on addictive pain killers or dangerous drug regimens. The potential of this aspect of regenerative medicine is seemingly limitless and has the possibility to improve the quality of life and health worldwide.
Gulf Coast Stem Cell & Regenerative Medicine
At the Gulf Coast Stem Cell and Regenerative Medicine Center, which is an affiliate partner of the Cell Surgical Network of California, we are actively conducting patient-funded research programs with the intention of giving patients their own autologous stem cells. We aid in the management of autoimmune, degenerative, inflammatory, and ischemic conditions, and our highly skilled team of providers is committed to the goal of alleviating symptoms, enhancing functionality, and improving overall quality-of-life for our patients.
Contact Gulf Coast Stem Cell and Regenerative Medicine Center and let us show you what value and “Excellence with a Human Touch” mean. For more information on the full list of diseases and disorders that we currently address, please call (866) 865-4823 or contact us via our website, today.
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