This review is about treatment of osteoarthritis with stem cells and platelet rich plasma (PRP). In addition it is about the effect of treating both hip and knee osteoarthritis with hyaluronic acid vs. PRP.
Treatment of Hip Osteoarthritis with Hyaluronic Acid vs. Platelet Rich Plasma
A pilot study dated January 2021 investigated treatment of hip osteoarthritis with hyaluronic acid vs. platelet rich plasma (PRP). The goal of this study was to determine whether hyaluronic acid injection or PRP would be better to treat the symptoms of osteoarthritis. The overall observation time was 1 year. Patients received injections at 16 weeks, 3, 6, 12, and 24 months. 14 patients received hyaluronic acid injections. 19 patients received PRP injections. There were no objective improvements in the hyaluronic acid injection group. The PRP injection group showed significant pain reduction and improvement of internal rotation of the affected hip. It was obvious that 50% of the hyaluronic acid injection group ended up with either a total hip replacement or hip resurfacing surgery. In the PRP group only 15.8% required these surgical procedures. The pain scores in the PRP group showed significantly improvement in comparison to the other group.
Another publication about osteoarthritis of the knee (hyaluronic acid vs. PRP)
A similar study was published in February of 2017 regarding knee osteoarthritis. 111 patients with osteoarthritis in one knee entered the trial and researchers followed them for 1 year. At the time of stratification of the trial 49 patients received PRP treatments. 50 patients had treatments with hyaluronic acid. At 24 weeks and 52 weeks the researchers scored for pain and measured range of motion. Also, the researchers determined proinflammatory kinins in the blood of both groups. Both interleukin-1-beta and tumor necrosis factor alpha were lower in the PRP treated group in comparison to the group that received hyaluronic acid. In addition, the pain scores were significantly lower in the PRP group. This was measured at 24 and 52 weeks, but there was no reduction in the hyaluronic acid treated group.
Comparison with mesenchymal stem cell treatment for osteoarthritis in the knee
Physicians can use mesenchymal stem cells from fat cells to inject into a knee or hip joint to cure mild to moderate osteoarthritis. This review article describes several clinical trials where stem cell therapy was done. One of them consisted of 64 patients with knee osteoarthritis. 1 year following the stem cell therapy repeat arthroscopy verified that new cartilage had formed and osteoarthritis had improved. Clinically, joint pain and range of motion were improved.
Another clinical trial involved 6 patients with hip osteoarthritis. They were evaluated prior to mesenchymal stem cell therapy and again 6 months after the treatment.
Results of stem cell therapy in patients with osteoarthritis in the hip
The researchers noted that the patients had much less pain 6 months after stem cell therapy. The Harris hip score was 67.2 preoperatively for all patients on average. The higher the score, the better the hip function. 6 months after the procedure their hip score improved to 84.6. None of the patients deteriorated.
Details of mesenchymal stem cell therapy
Mesenchymal stem cells have the capability of turning into hyaline producing cells in joints. In addition, they can reduce cytokines associated with osteoarthritis. They also stimulate the synovial membrane to produce synovial fluid, which provides lubrication of the joint. These effects are amplified by growth factors from platelet rich plasma (PRP). Adding PRP to the stem cell preparation is routine when it comes to stem cell therapy. Some laboratories add a blue-green algae product to make mesenchymal stem cells pluripotent again.
Low-dose laser therapy is another method to increase the healing power of stem cells. The physician can combine all of this to help improve the clinical condition of patients with osteoarthritis. Here is a link to an article that tells you more about treatment of osteoarthritis and the use of stem cell therapy.
Regenerative medicine includes the use of mesenchymal stem cells to help patients with osteoarthritis. This is now a routine method in the treatment of osteoarthritis. The advantage is that there is no surgery requirement for this treatment modality. As the therapist uses only needles, there are no scars from the procedure. Swelling of the joints subsides, range of movement improves and the pain disappears or diminishes significantly. Mesenchymal stem cell therapy for knee and hip osteoarthritis is already a treatment modality that orthopedic surgeons use. However, this method is also useful for degenerative arthritis of the facet joints in the spine. In this context it can prevent disc herniation from occurring. Not enough orthopedic surgeons and pain specialists have training in the use of mesenchymal stem cell therapy, but as the treatment shows success, the interest will grow.