Effective joint regeneration using regenerating treatments and surgery

Stem cells

What are stem cells?

These are human cells able to differentiate to other types of cells and undergo a potentially unlimited number of cell division cycles. A common characteristic of all stem cells is their self-renewal ability. Stem cells are injected into the injured/ degenerated site expecting them to restore the damaged tissue over time.

Where can you get stem cells from?

Stem cells can be derived from mobilised peripheral blood, bone marrow and adipose tissue. However, each source differs in stem cell composition and their regenerative properties.

What is the difference between peripheral blood derived stem cells and bone marrow derived stem cells?

1. Peripheral blood does not contain many stem cells, since mostly the mature and differentiated cells ready to perform their highly specialist functions are released to circulation. In order to increase the stem cell count in peripheral blood, growth factors (GCSF or GMCSF) can be administered a few days prior to scheduled cell harvesting. After the blood sample is collected, the cells are separated according to their type. Stem cells can also be multiplied in vitro in laboratory conditions. However, even this process does not ensure a sufficient number of stem cells. The method does not yield the stromal vascular fraction (SVF).
2. Bone marrow was considered the richest source of stem cells for a number of years. It contains more stem cells than peripheral blood. However, it contains mostly hematopoietic cells, i.e. cells which ultimately become specialist blood cells. Stem cell harvesting from bone marrow requires specialist separation process carried out in laboratory conditions followed by cell cultures and multiplication in order to obtain sufficient number of cells. The process takes 7-14-21 days.
Therefore, there is some (not short) time interval between cell harvesting and administration.
The method does not yield the stromal vascular fraction (SVF).

What is SVF (stromal vascular fraction)?

Stromal vascular fraction is contained in adipose tissue is obtained through adipose derived stem cell (ADRC) harvesting in a Cytori system. Apart from stem cells, it also contain a number of immunomodulatory factors (which control tissue and whole body immune response), paracrines (chemicals mediating cell-to-cell communication), chemicals which stimulate cell differentiation, longevity and activity, as well as substances of angiogenic (responsible for forming new blood vessels) and anti-apoptotic (preventing death of normal, healthy cells) properties.

What are ADRCs?

Adipose-Derived Regenerative Cells (ADRCs).

Why are ADRCs the most valuable?

Adipose tissue contains 2500-fold more stem cells than bone marrow. Furthermore, it contains stromal vascular fraction (SVF), which constitutes natural environment for regenerative cells.
However, to ensure full potential of ADRCs, several requirements must be met. Enzymatic process is a prerequisite for stem and regenerative cells to be harvested from adipose tissue. It is not enough for the adipose tissue to undergo a standard wash and centrifugation cycle. Furthermore, tissue centrifugation damages the cells, including the ADRCs. Therefore, ADIPOSE TISSUE SHOULD NOT BE PROCESSED BY CENTRIFUGATION PRIOR TO ADRC HARVESTING. Washing, centrifugation and emulsification of adipose tissue does not ensure harvesting stem and regenerative cells.

What does the procedure look like?

The first stage is lipoaspiration using specialist equipment.
The next stage is specialist, enzymatic processing of harvested adipose tissue using Cytori system. Its final produce is a unique cell component.
The third - last - stage involves administering the harvested stem and regenerative cells to the joint.

What are the indications for stem cell treatment?

degenerative joint disease
Muscle and tendon injury
Bone nonunion
Complicated bone fractures (pseudoarthroses)
Problematic wounds
autoimmune diseases

What does the after-treatment care involve?

Continue wearing your compression garments as prescribed for at least 4 weeks.
Manual lymphatic drainage (MLD) should be performed from the second day after treatment onwards.
Ensure the liposuction and stem cell injection site are clean.
If stem cells were administered into the joint, please avoid physical activity for two weeks.

How should I prepare for my stem cell treatment?

First, you need an orthopaedic consultation and the MRI. Your orthopaedist will also order appropriate blood tests.