Introduction:
Regenerative therapy for osteoarthritis (OA) originated with the idea that given cells would implant to lesion sites and develop into chondrocytes. However, recent research has demonstrated that cells incur apoptosis following a brief paracrine action, especially when injected in suspension. The chondrogenic effect of innate immunity has been demonstrated to be less substantial than the anti-inflammatory effect of innate immunity, even though paracrine activity may involve the activation of endogenous stem cells that aid in developing regenerative neo-cartilage.
The expensive nature of cell therapy for OA cannot be justified if injected stem cells do not result in structural improvements, such as regeneration of articular cartilage (AC), and vanish after a brief anti-inflammatory effect. This is especially true when compared to other injection therapeutics like corticosteroids and hyaluronic acid. The extended survival of implanted cells that provide a prolonged paracrine action or maybe engraftment is important for a successful cell therapy in Osteoarthritis that provides long-term structural changes.
What Is Osteoarthritis and Why Does It Need Regeneration?
The most prevalent kind of arthritis is called OA. Loss of AC, subchondral sclerosis, osteophytes' development, and joint destruction are its defining features. Patients with OA experience a marked decline in quality of life due to elevated pain and reduction in joint function. Weight loss, exercise, braces, nonsteroidal anti-inflammatory medications, and intra-articular (IA) injections of glucocorticoids or hyaluronic acid (HA) are the current treatments for early OA; for more advanced circumstances, joint replacement has been the cornerstone therapy for decades.
Symptoms like pain and inflammation are reduced by pharmaceutical treatment. As of right now, there are no medications that modify the normal course of OA or provide structural enhancements for damaged AC. Serious, perhaps fatal consequences following joint replacements include periprosthetic infection and thrombosis.
Because OA is so common and there are currently no medications that might slow down the disease's progression, medical professionals and researchers are looking into regenerative medicine as a potential therapy option that could slow the progression of OA by changing the structural makeup of damaged AC.
What Are the Regenerative Therapies for Osteoarthritis?
The regenerative therapies include:
Stem Cell Therapy:
Stem cell therapy, the most well-known regenerative medicine use, has recently received much attention. Physicians have successfully used it to heal joint and tissue injuries. One researcher examined patients with osteoarthritis in their knees and found that their condition improved even five years after starting treatment.
It functions well because stem cells are involved and have the rare capacity to change into any kind of cell in their immediate environment. Stem cells can be injected into the knee or shoulder to cure the degenerated cartilage and ligaments since they can change and rebuild those tissues. The process involves removing stem cells, usually the iliac crest bone marrow (hipbone), from another body part. Then, inject them into the joint to initiate the body’s healing process.
Platelet-Rich Plasma (PRP):
Platelet-rich plasma is becoming an increasingly popular treatment for osteoarthritis in the knee. While it has been used for tendinopathy for over thirty years, its effectiveness in treating arthritis has made it more well-known since the beginning of this century.
In this procedure, a small blood sample is drawn from the arm- similar to a routine blood draw in a lab. The doctor puts that blood into a device called a centrifuge, separating the platelets from the red and white blood cells by spinning it quickly. When ready, the doctor injects the aching joint with the concentrated fluid. Growth factors secreted by the platelets promote cell proliferation, stimulate tissue regeneration, and expedite the healing process. According to studies, PRP for osteoarthritis in the knee frequently halts the disease's progression and lessens pain.
Prolotherapy:
Prolotherapy is a different kind of regenerative medicine that also requires injections but does not call for the extraction of stem cells or a blood sample. The foundation of prolotherapy is the idea that the human body will always transfer resources to an area needing treatment. Thus, during this process, the physician will inject a harmless glucose solution, also known as sugar water, into the joint, which will serve as an irritant and activate the body's natural healing and defensive processes.
Although the treating physician may add a dose of lidocaine to assist in numbing the area and make the patient comfortable during the treatment, the injection typically doesn't contain any medications or steroids. Prolotherapy is intended to lessen pain and inflammation while encouraging the healing of injured tissues, such as tendons and ligaments. Numerous patients claim improved mobility and less pain.
Amniotic Membrane Injections:
The fourth kind of regenerative medicine involves using amniotic membrane tissue from a fully consented mother's placenta during delivery. This tissue, normally thrown away with the placenta after birth, has strong qualities that can be used in regenerative medicine in several ways.
The doctor injects an amniotic membrane solution into the joint, releasing healing components such as growth factors, cytokines, hyaluronic acid, collagen, and fibrinogen. Injections of amniotic membranes have been proven to aid in healing wounds and surgical sites, in addition to providing relief from joint discomfort and other sports medicine and orthopedic conditions.
Conclusion:
If traditional approaches fail to relieve your pain, examine regenerative medicine options to see which would suit your symptoms. Compared to surgical procedures, regenerative medicine promises speedier healing, recovery, and long-term pain alleviation. There is no infection or blood loss risk, and the procedures are quick and easy.
Regenerative treatments work best on joints like the shoulders, elbows, and knees. In light of the lack of clear mechanisms separating implanted stem cells from those that necrotize them, future research should examine the effects of adjuvant biomaterials, implantation mode, and cell physical state on the fate of stem cells supplied with intraarticular injections. Gene editing and gene treatments are emerging fast in regenerative medicine.
