Stem Cell Therapy for Sports Injuries

Answer: Yes in many cases. Stem cells are being used increasingly to enhance healing both with and without surgical intervention. Although the best way to use the cells is still being tested, stem cells can definitely improve healing.

Answer: Sports injuries vary greatly in location, cause, and extent of injury. Studies are available showing help with the following injuries:

1. Shoulder and rotator cuff injuries
2. Knee ligament and cartilage injuries
3. Elbow injuries
4. Achilles tendon injuries
5. Foot and ankle injuries
6. Back injuries

Answer: Yes. Multiple sports injuries have been shown to heal and recover more quickly when stem cells are used.

Answer: Yes. Multiple studies now show that both pain and mobility can be improved by stem cells used in the areas of old injuries.

We can group most sports injuries into five categories:

1. Bone injuries: Including breaks or fractures and “bruising”
2. Soft tissue injuries: Including muscle, ligaments, tendons, cartilage, skin scrapes, and bruises
3. Joint injuries: Including dislocations, separations, and post-injury arthritis
4. Head injuries: Primarily concussions
5. Overuse injuries: Usually involve soft tissue or joints but are caused by repetitive activities

Stem cells are being investigated in each of these areas. Some investigations are determining if stem cells speed healing and recovery. These include:

• Muscle injuries
• Bone fractures
• Some joint injuries
• Head injuries
• Overuse injuries

Others are investigating the ability of stem cells to promote recovery in areas that historically heal poorly or not at all. These include:

• Tendon and ligament injuries
• Cartilage injuries
• Repeated concussions
• Some overuse and muscle injuries

Investigators are also looking at both; speeding recovery and enabling recovery in historically poorly recovering injuries.

A: Sports injuries are treated differently depending on the category mentioned above. For example, bone fractures are currently treated to place the broken edges together and immobilize them for several weeks.

Soft tissue injuries and joint injuries are treated variously with rest, physical therapy/rehab, injections (steroids and others like Platelet Rich Plasma (PRP)), and sometimes surgical repair.

The importance of treating concussions with physical and mental rest is becoming increasingly emphasized. Overuse injuries typically require long-term rest from the offending activity, rehab, and sometimes injections.

Many of these therapies, like those for fractures and minor soft tissue injuries like sprains, are highly effective. Any use of stem cells in these areas would have the goal of speeding recovery since complete recovery is the typical outcome of conventional therapy.

Other treatments, like some muscle or ligament tears, overuse injuries, and repeated concussions, often result in less than complete recovery. These are areas where stem cells may offer more complete recovery as well as faster recovery.

A: Stem cells are special cells in our bodies that have two important characteristics:

Stem cells have the ability to replicate. In other words, they can make new copies of themselves. Because of this ability, an infinite number of copies can be made from the same cell.

Stem cells also have the ability to become other types of cells. Research labs have used fat-derived stem cells to make cartilage, muscle, skin, and bone cells. This ability means that in theory the transformed cells can make an infinite number of the new cell type.

Stem cells can come from various sources, including embryos, umbilical cord blood, and adult cells. Adult stem cells come from adult individuals, not embryos or umbilical cord blood. Stem cells obtained from mature adult tissues are referred to as adult stem cells. Adult stem cells are believed to have the potential to become any type of cell.

The two most commonly used sources of adult stem cells are fat and bone marrow.

Adult stem cells from fat are called adipose-derived adult stem cells. For most purposes, stem cells from fat are easier to obtain and more abundant than those from other tissues.

A: Harvesting adult stem cells from fat is very safe. The procedure has little discomfort and a fairly easy recovery. First, an area such as the stomach or leg is picked to remove the fat. We then take you to the procedure room and sterilize the area. A local anesthetic is then injected into the area. Fat is suctioned using a special syringe and cannula. Typically we suction about 50 ml (about 1 1.2 oz.) of fat.

Swelling and bruising are common following the procedure at the harvest site. Swelling and bruising typically resolve within 2-3 weeks after the procedure. Most patients receive a prescription for pain medications for use as needed. We give a dose of antibiotics before the procedure but no antibiotics are needed afterward.

Next we take the harvested cells and use a centrifuge and incubator to do some simple processing. The processing isolates the adult stem cells from the other fat cells. The final product is called Stromal Vascular Fraction (SVF). SVF obtained from fat can contain up to about 25 million adult stem cells from 50 ml of fat. SVF also contains a large amount of growth factors. Growth factors are chemical “text messages” our cells use to communicate with each other. After we have obtained the SVF, the next step is to deploy the SVF for your peripheral neuropathy.

A: Stem cells are typically deployed by injection into the affected area(s) and intravenously (IV). Early investigations suggest that using both local injections and IV deployment enhances the outcomes. Most of the injection sites such as most soft tissue and joints can be done directly at Innovations Medical.

Some such as injections in the back or neck require special imaging and are done at a separate location where radiologic imaging like a CT scan is available. Typically all of these injections and the IV are done under local anesthesia without the need for sedation.

A: Currently the treatment group is not large enough to give a conclusive answer to this question.

Fortunately, we have enough early experience to talk about trends in therapy. Improvement in one or two days is common. We believe this is due to the strong anti-inflammatory effect of the growth factors associated with adult stem cells/SVF. This anti-inflammatory effect lasts from 2-3 months.

From there, we most commonly see continued gradual improvement as the adult stem cells help provide healing to the injured area. Bone fractures may heal a bit faster and tend to hurt less and recover faster once fused.

It is too early to say conclusively that adult stem cell treatment promotes the growth of new cartilage or repairs damaged ligaments or tendons. However, some early evidence is pointing in that direction.

Sports injuries may or may not require repeat deployment. Typically it is best to wait 3-6 months before considering repeat deployment. Most of the time repeat deployment is done because some improvement has been seen and more is sought. Occasionally, repeat deployment is done because the patient has lost some benefit previously gained.

The question of how many and how often is an area of intense interest and close study at this time.

A: Many people believe that stem cells hold great potential for treating and reversing the effects of sports injuries, including repeated concussions.

The type of stem cells best to use (embryonic, bone marrow, or fat derived) and how to best utilize them is heavily researched and debated.

Adult stem cells have a good chance of becoming the treatment of choice because of their safety, availability, and lack of controversy. It is likely that in the future, we will see further preparation done to the adult stem cells/SVF in order to prepare them to more readily become tendons, ligaments, and cartilage.

Over the next few years, we have some real hope in seeing therapy develop that could restore large amounts of function to patients with sports injuries and hasten their recovery.