Platelet Rich Plasma provides a potent delivery of the body's healing properties, called growth factors. However in some patients with severe cartilage loss and less viable cells, a stronger pool of healing properties lies in obtaining adult "mesenchymal stem cells" from the hip (iliac crest). In this procedure, Bone marrow is taken from the hip and like PRP is prepared for injection into an arthritic hip or knee. While further studies are needed, preliminary reports are encouraging. PRP is probably a more reasonable first line treatment, given it's ease of use. However particularly challenging cases may consider the marrow application. A blog on bone marrow aspirate is: http://www.autologousadultstemcells.org/blogs.html
2 comments:
How advanced, should or shouldn't the OA be before considering treatment. Would this apply to all joints or better in non weigth bearing joint like the shoudler, elbow and thumb, versus knee hip of ankle?
Thanks for your comment. For PRP, generally, the earlier the OA/"chondropenia" the better. The group in Italy performing injections of the knee with PRP found that 85% of those under 60 had significant improvements versus 30% over 60. However, this can be misleading as younger patients can have varying levels of arthritis depending on their activity level/injury.
Stem cells from marrow aspirate is applied after PRP has failed, or if there is dramatic cartilage loss with less viable cartilage cells to begin with. I can't comment on stem cell usage in smaller non-weat bearing joints as I'm not aware of examples. However, PRP has been applied to amy joints under ultrasound guidance.
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