Stem cell treatment involves the use of unspecialised cells that can self-renew indefinitely and can differentiate into any type of body tissue.
They can be obtained from the umbilical cord, an embryo or from an adult.
There are two ways stem cells can be used to benefit people with hip problems. Repairing cartilage and repairing bone. Here we will look at using stem cells to repair and replace cartilage. It should be emphasised that this technique is still very much under development.
There are no restrictions for this treatment in terms of either age or gender. However as it means avoiding a general anaesthetic it may have additional benefits for older patients who are more at risk from anaesthesia. How is it done?In orthopaedic surgery the patient's own stem cells are normally used (referred to as autologus stem cell transplant).
Thee to four weeks before surgery the patient will be started on a course of anti-inflammatory and immunosuppressive medication. It may seem strange but immunosuppressive medication is needed even when the stem cells are the patient's own. Although it is rare to reject one's own stem cells some studies have indicated that stem cells taken from a different part of the body may cause an autoimmune reaction.
On the day of surgery the patient is placed on the operating table, face down and the area around the iliac crest (part of the hip bone) is anesthetised. Using a biopsy needle and ultrasound for guidance a small amount of bone marrow is extracted. The stem cells are then taken from the bone marrow and centrifuged which results in a higher concentration of stem cells. These are then injected into the hip joint using a special needle. This is followed by another injection into the hip joint of platelet rich plasma which is needed to support cartilage growth.
The entire procedure (including extraction, centrifugation and implantation) takes about one hour and the only precaution the patient needs to keep is to be low weight bearing on the joint for about three days.
Growth of new cartilage will take a few months and is usually monitored using a MRI at two months and six months post-op.
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