Stem Cell Therapy following Meniscus Knee Surgery

Stem Cell Therapy Following Meniscus Knee Surgery
                                                                     May Reduce Pain and Restore Meniscus

While certain authorities, like the FDA, are regulating each time more tightly Stem Cell treatment, countries like Japan are supporting the fast application of technological advances in stem cell research as there is each time more international research evidence, that stem cell treatment is not only safe, but can improve the quality of life of patients considerably.

In the January issue of the Journal of Bone and Joint Surgery (JBJS – Jan. 16, 2014) it is reported that according to a novel study a single stem cell injection following meniscus knee surgery may provide pain relief and aid in meniscus regrowth. Please see below the remarks about the study being not so novel.

More than one million knee arthroscopy procedures are performed each year in the U.S. primarily for the treatment of tears to the meniscus — the wedge-shaped pieces of cartilage that act as “shock absorbers” between the thighbone and shinbone in the knee joint.

Beside the below mentioned study confirming “also” safety there are already clinics doing this experimental treatment with great success …… in several parts of this world, like Panama, Malaysia, India but also……

In AUSTRALIA……………..Published 19. October 2012 

Even in the US…… Published 19. September 2013 (!!?? – Practice of Medicine)

In the first-of-its-kind study, “Adult Human Mesenchymal Stem Cells (MSC) delivered via Intra-Articular Injection to the Knee, Following Partial Medial Meniscectomy,” most patients who received a single injection of adult stem cells following the surgical removal of all or part of a torn meniscus, reported a significant reduction in pain. Some patients; 24 percent of one MSC group and 6 percent of another experienced at least a 15 percent increase in meniscal volume at one year. There was no additional increase in meniscal volume at year two.

“The results demonstrated that high doses of mesenchymal stem cells can be safely delivered in a concentrated manner to a knee joint without abnormal tissue formation,” said lead study author C. Thomas Vangsness, Jr., MD. “No one has ever done that before.” In addition, “the patients with arthritis got strong improvement in pain” and some experienced meniscal regrowth.

Specific Study Details 

The study involved 55 patients, ages 18 to 60, who underwent a partial medial meniscectomy (the surgical removal of all or part of a torn meniscus) at seven medical institutions. Patients were randomly placed in one of three treatment groups: Group A patients (18) received a “low-dose” injection of 50 million stem cells within seven to 10 days after meniscus surgery; Group B patients (18), a higher dose of 100 million stem cells; and the “control group (19),” sodium hyaluronate only. Patients were assessed to evaluate the safety, meniscus regeneration through MRI and X-ray images, overall condition of the knee joint and clinical outcomes through two years. While most of the patients had some arthritis, patients with severe (level three or four) arthritis, in the same compartment as the meniscectomy, were excluded from the study.

Key Study Findings

    • There was no abnormal (ectopic) tissue formation or “clinically important” safety issues identified.
    • There was “significantly increased meniscal volume,” determined by an MRI in 24 percent of the patients in the low-dose injection group (A) and six percent of the high-dose injection group (B) at one year. There was no statistical increase in meniscal volume at two years.
    • No patients in the control group (non-MSC group) met the 15 percent threshold for increased meniscal volume.
    • Patients with osteoarthritis experienced a reduction in pain in the stem cell treatment groups; there was no reduction in pain in the control (non-MSC group).

“The results of this study suggest that mesenchymal stem cells have the potential to improve the overall condition of the knee joint,” said Dr. Vangsness. “I am very excited and encouraged” by the results. With the success of a single injection, “it begs the question: What if we give a series of injections?”

Remarks and Clarification:
I personally believe there is quite some progress in the field of knee joints and stem cells as shown in the videos from other sources. Since this information about the novel stem cell treatment for joints made quite a news all over, it appears however, to be necessary to add some clarifications to the information.

See also: http://jbjs.org/article.aspx?articleid=1809960

First of all, this study appears to be not so novel! Obviously this information is based on the Osiris trial results of Chondrogen, which was completed in 2008. It took 5 years to publish 2-year outcome. Since Mesoblast now owns cultured MSC’s programs from Osiris, it remains to be seen that they will continue Chondrogen. Quite some sources we know, believe the product is dead, as since 2008 Phase 3 of the trial did not happen! — But stem cell treatment for joints as a practice of medicine is already quite successful in various countries!

SOURCES:
OSIRIS Investors Information:
http://investor.osiris.com/releasedetail.cfm?ReleaseID=229686http://investor.osiris.com/releasedetail.cfm?releaseid=278696

http://clinicaltrials.gov/show/NCT00225095

C. Thomas Vangsness, Jr., MD. et al. Adult Human Mesenchymal Stem Cells (MSC) Delivered via Intra-Articular Injection to the Knee, Following Partial Medial Meniscectomy. Journal of Bone and Joint Surgery, January 2014

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