North Texas Musculoskeletal Medicine

Enhancing the body's innate ability to heal

Regenerative Orthopedics Osteopathic Manipulation



What is Regenerative Orthopedics?

What is Regenerative Orthopedics?
Mesenchymal stem cells (MSCs) are an especially good option for treating musculoskeletal conditions involving lost or injured tissue, such: as bone-on-bone arthritis, injury and tears to tendons, ligaments, and cartilage, degenerative disc disease. MSCs not only can differentiate into all the different cell types within a joint, they also control the local inflammatory response.

What is Regenerative Orthopedics?

Physicians at North Texas Musculoskeletal Medicine are frequently asked the question, “What exactly is Regenerative Orthopedics?”  The answer is both profoundly simple and mind-boggling complex.  Patients come to us because we provide an approach to medicine that is often overlooked… we look to the body to provide its own answers.  Osteopathic Manipulative Medicine certainly uses this approach with diagnostic insight provided through messages from the body: restrictions in range of motion, tender areas in soft tissue, and painful trigger points.  These indications allow the physician to assist in realignment and removal of structural dysfunction to help the body attain optimal function.

Regenerative Stem CellsRegenerative Orthopedics assists the natural healing process by stimulating the regeneration of cells in the musculoskeletal system. With increased age or injury, sometimes the optimum amount of stem cells needed to maintain healthy function is not delivered to the area. The goal of Regenerative Medicine is to amplify this natural repair system to keep pace with these demands. 

Stem cell injection therapy utilizing mesenchymal stem cells (MSCs), is an exciting recent development in musculoskeletal medicine.  These multipotent stem cells are undifferentiated cells that have the potential to become specialized types of cells, such as osteoblasts (bone cells), chondrocytes (cartilage cells), myocytes (muscle cells), and fibroblasts (ligament and tendon cells).  MSCs are considered to be exceptionally potent stem cells with outstanding regeneration abilities.  MSCs can be sourced from the umbilical cord blood of healthy donors in hospitals regulated by the American Association of Tissue Banks for quality, safety and ethics.  MSCs can also be obtained from the patient's bone marrow and/or adipose (fat) cells.  

MSC treatment is an especially good option for treating musculoskeletal conditions involving lost or injured tissue, such as bone-on-bone arthritis; injury and tears to tendons, ligaments, and cartilage and degenerative disc disease. MSCs not only can differentiate into all the different cell types within a joint, they also control the local inflammatory response.

Platelet Rich Plasma Injections are an increasingly popular procedure that utilizes the patient's own blood to form a concentration of blood cells called platelets.  Platelets are among the many blood cells in plasma that not only play an important role in forming blood clots, but also contain growth factors, alpha-granules, that are central to the body's healing process.  When injected into damaged tissue, existing stem cells are stimulated and released to accelerate healing.  

In PRP, the patient's own blood is drawn and spun in a centrifuge to isolate the platelets and their associated growth factors. Centrifuging then increases the level of platelets from a concentration of 6% to 94%. This concentration of cells is added to the patient's plasma which contains a variety of proteins that are essential to connective tissue healing.

Applications

Conditions responding well to Regenerative Medicine include:

  • Osteoarthritis of the joints
  • Meniscal (cartilage) tears in the knee
  • Partial rotator cuff tears
  • Persistent partial tendon tears and injuries, such as tennis elbow, plantar fasciitis, quadriceps and patellar tendon tears.
  • Chondromalacia patella (patellofemoral syndrome/runner’s knee)
  • Partial muscle tears, such as hamstring strains

Clinical use of cellular regeneration has currently outpaced research.  Studies, however, are positive and point to an increasing use of regeneration of tissues as an alternative to medication and/or surgery.  The following links provide in depth information of the use of stem cells in musculoskeletal degeneration and injury:

Osteoarthritis-derived chondrocytes are a potential source of multipotent progenitor cells for cartilage tissue engineering.

https://www.ncbi.nlm.nih.gov/pubmed/27644879

Osteoarthritis prevention through meniscal regeneration induced by intra-articular injection of meniscus stem cells.

https://www.ncbi.nlm.nih.gov/pubmed/23461527

Mesenchymal stem cells as a potent cell source for articular cartilage regeneration

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4559256

Basic science of osteoarthritis.

https://www.ncbi.nlm.nih.gov/pubmed/27624438

Mesenchymal stem cells as a potent cell source for articular cartilage regeneration

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4131275/