For many years, the inevitable outcome of osteoarthritis and some other osteopathic disorders has been either permanent pain and disability or a spell on the operating table followed by a lengthy period of rehab. Common joint replacement surgeries involve replacing the articular ends of the original bone and cartilage with metal prostheses in the knees and the hips, or less commonly, other joints. However, just because joint replacement is the most established treatment for these conditions it doesn’t necessarily mean that it is the best option, especially with the recent progress being made in regenerative medicine. Further, it must be remembered that the criteria for joint replacement are very stringent and include severe symptoms, an advanced stage of disease, not being young or too old and being able to undergo general anesthesia safely. There should not be another concomitant disease that may complicate surgery, like a recent heart attack, severe COPD and heart failure.
In fact, regenerative medicine, which includes stem cell therapies, are about to shake up the field in a big way, offering minimally-invasive alternatives to major surgeries, including hip replacements and hip resurfacing work. Around the world, in state-of-the-art laboratories and medical facilities, there are numerous ongoing clinical trials at various stages of progress, each searching for that breakthrough discovery that may contract the era of joint replacement surgery for good.
Why Patients Opt for Hip Surgery
Despite it being a major surgery, and a significant source of stress for the body, hip replacement surgery is still often presented as the patient’s only option for a normal quality of life following the ravages of osteoarthrosis. If patients are deemed medically fit enough, they may even be offered outpatient hip arthroplasty although most hip replacements still occur on the hospital operating table.
In the absence of FDA-approved stem cell injectables, some doctors are reluctant to look into existing stem cell therapy. They may be unconvinced by the evidence and case studies provided by stem cell therapy centers, unwilling to give their patients false hope or afraid that they will be held to account if results are not as desired. There is also a lot of marketing clout behind hip replacement technology which can be presented in a slick and persuasive way, promising that the latest prosthesis will outperform anything else on the market. Sadly, manufacturers’ claims often prove to be exaggerated.
The Problem with Hip Replacement Surgery
Just because hip replacement surgery is now commonplace, it does not follow that it is a minor procedure. If everything goes to plan – and that is a big if – the lucky few may be able to undergo a minimally-invasive outpatient hip arthroplasty, but it is still the case that most hip replacements involve open surgery which carries an increased risk of hospital-acquired infections and an extended spell of inpatient recovery. This level of surgery which, of course, requires general anesthesia, is incredibly traumatic for the body and is likely to leave the patient with months of pain and discomfort.
This may seem a worthwhile sacrifice to make if the operation were almost always guaranteed to result in a pain-free and activity-filled future. But this prognosis is by no means guaranteed according to recent research which highlights a discord between patient expectation and reality. For example, 90% of hip surgery candidates expect reduced pain following the procedure. In fact, it was found that 67% of patients surveyed four to six months later were still afflicted by significant pain with 27% still suffering after three to four years. Some experts have suggested that these disappointing figures could be down to the source of the pain being misidentified with much joint pain actually being referred pain from trapped nerve damage in the lower back; this is a worrying thought since the tests to rule out localized joint pain are quite simple. Given the above, it is not surprising that around a quarter of those who have their hips replaced can expect to go under the knife again within two years. In terms of activity levels, there has been criticism that prosthesis marketing companies have boosted sales by implying a greater level of activity than is often achieved in reality. They achieve this effect by including uplifting videos of people riding bikes and hiking in beautiful scenery. Studies making use of accelerometers (measuring actual versus subjective levels of activity) have demonstrated that few patients go on to lead a more active life than before their operations.
Then there are the risk factors that come with a hip replacement or major hip surgery; these make for eye-opening reading! It has been found that, for those aged 60 or above, the risk of heart attack in the two weeks following a hip replacement operation soars by over 25 times when compared with the general population. This is thought to be largely due to a combination of stress and an increased risk of dangerous blood clots following trauma to blood vessels. In fact, tens of thousands of hip replacement patients experience complications each year with thousands dying as a result.
Another potential problem with hip replacements comes from the natural wearing of metal prostheses. This can cause shards to become lodged in the joint leading to inflammation and bone death. In addition, there is evidence of raised levels of metal in the blood with long-term effects that are as yet unknown. There are also many cases of rejection and allergic reaction to the artificial materials used in prostheses. Some evidence suggests that the newer types of prosthesis are even more problematic in this respect due to the combination of different plastics and metals.
How Stem Cells Can Help
Given the above risk factors, it is not surprising that many orthopedic patients are now exploring their options and turning to treatment centers offering stem cell therapy. Stem cells are naturally present in the body and are responsible for the regeneration of tissues following an injury. However, there are certain tissues that regenerate very slowly – if at all– and these include the articular cartilage that allows joints to operate smoothly, efficiently and painlessly. It is the breakdown of cartilage that is at the root of osteoarthritis with the associated inflammation of the joint cavity and bone deformations leading to worsening pain and immobility.
Various clinical trials are focusing on identifying the most effective source of stem cells and the growth factors which can act on them to reliably produce high quality and cost-effective cartilage growth. Eventually this will lead to marketable treatments that can be injected into damaged tissues. Elsewhere, specialist clinics such as the Gulf Coast Stem Cell & Regenerative Medicine Center are currently offering treatments using the stem cells already present in the fat reserves of the patient’s body. The procedure is, in effect, autologous transplantation. Such routine procedures do not require manipulation of the cells or culturing them and are done under strict aseptic, surgically sterile conditions. They are carried out by experienced and skilled medics under local anesthesia, by a process of mini-liposuction; and the entire procedure is completed in less than three hours.
The benefits of autologous stem cell transplantation are many. First, there is no surgery involved which immediately takes away the risk of infection and blood clots which can lead to serious outcomes from sepsis to heart attack and stroke. Second, there is no lengthy stay in hospital; the stem cell harvesting and deployment procedure is carried out in a single morning or afternoon, leaving the patient free to continue with their lives with minimal downtime. In addition, since the procedure involves the patient’s own cells, there is no danger of rejection and no controversy, unlike procedures involving embryonic stem cells (ESCs).
Making an Informed Decision
The most important ‘take home’ message for those suffering with osteoarthritis or other hip conditions (e.g. hip bursitis, hip trauma) and who may be contemplating hip replacement surgery is that there may be other options. Doctors and other health professionals are not all-knowing and can be tempted to stick with the tried and tested, rather than explore more pioneering treatments; they are also– to a greater or lesser extent– affected by product marketing and need to work. Given the increased risks of heart attack, prosthesis rejection and metal contamination following hip surgery, combined with less than convincing outcomes in studies focusing on pain and activity levels, it is definitely worth taking time and collecting as much information and advice as possible before making any final decisions. It may be that trying a course of autologous stem cell injections is the more prudent option for those willing and able to do so, remembering that stem cell therapy carries no down side. Patients never, ever get worse as a result; and joint replacement always remains and option.
Osteoarthritis is just one of the many orthopedic conditions for which autologous stem cell therapy could provide benefit; others include degenerative spine disease and fibromyalgia. To find out more about the Gulf Coast Stem Cell & Regenerative Medicine Center, including whether you could be an eligible patient, please call (886) 855 4823 or visit our website at http://www.gulfcoaststemcell.com.