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Stem Cell Injection

What is a Stem Cell?

Stem cells help to create new cells in existing healthy tissues, and may help repair tissues in areas that are injured or damaged. They are the basis for the specific cell types that make up each organ in the body.

Stem cells are distinguished from other cells by a few important characteristics: they have the ability to self-renew; they have the ability to divide for a long period of Stem Celltime; and, under certain conditions, they can be induced to differentiate into specialized cells with distinct functions (phenotypes) including, but not limited to, cardiac cells, liver cells, fat cells, bone cells, cartilage cells, nerve cells, and connective tissue cells. The ability of cells to differentiate into a variety of other cells is termed multipotency.

What scientists learn about controlling stem cell differentiation can become the basis for new treatments of many serious diseases and injuries.


What types of Stem Cells Exist?

Scientists primarily work with two main types of stem cells: adult stem cells and embryonic stem cells. Adult stem cells are used in research for orthopedic conditions.
Embryonic stem cells are more basic cells obtained in the laboratory. Unlike adult stem cells, which are obtained from living human tissue, embryonic stem cells are removed from human embryos that have been fertilized in the laboratory or in vitro. They are typically removed 4 to 5 days after fertilization and then grown in culture.
Embryonic cells are pluripotent and can develop into almost any type of cell in the body. Adult stem cells are more tissue-specific and are therefore more useful to orthopedic surgeons who are attempting to repair bone, muscle, and cartilage. Orthopedic surgeons who use cell therapy typically work with adult stem cells.

The most common (and probably the most studied) source for adult stem cells is the bone marrow, which contains two types: hematopoietic (blood forming cells) and mesenchymal stem cells. Of particular interest in orthopedic research are bone marrow stromal cells. These are mesenchymal stem cells that, in the proper environment, can differentiate into cells that are part of the musculoskeletal system. They can help to form trabecular bone, tendon, articular cartilage, ligaments, and part of the bone marrow.

Researchers in the last 10 years have reported the presence of adult stem cells in several other tissues aside from bone marrow, including the brain, hair follicles, dental pulp, skin, liver, skeletal muscle, blood vessel walls, pancreas, and intestine.
Another stem cell that has been studied recently is the cancer stem cell. Researchers believe that a stem cell proliferates to give rise to tumors in a growing list of cancers. Such cells regenerate the tumor after cycles of cancer therapy and surgery. Comparative studies of the signaling pathways of normal and cancer stem cells could provide information on what specific molecules can be targeted to screen for and to prevent the formation of cancers.

How are Adult Stem Cells Obtained?

Adult stem cells are most commonly obtained from the outside part of the pelvis, the iliac crest. A needle is inserted in the iliac bone and bone marrow is withdrawn or aspirated through the needle. Several samples may be obtained from one area in this manner.
The stem cells may then be separated from other cells in the marrow and grown or expanded in the laboratory. This may take from 7 to 21 days.
When stem cells are placed in a specific tissue environment, such as bone, they become activated. As they divide, they create new stem cells and second generation, progenitor cells. It is the progenitor cells which may differentiate into newer cells with the same phenotype as the host tissue.

How are Musculoskeletal Injuries Treated with Stem Cells?

At this point, most musculoskeletal treatments using stem cells are performed at research centers as part of controlled clinical trials. Stem cell procedures are being developed to treat bone fractures and nonunions, regenerate articular cartilage in arthritic joints, and heal ligaments or tendons. These are detailed below.
Bone fractures and nonunions: In bone, progenitor cells may give rise to osteoblasts, which become mature bone cells, or osteocytes. Osteocytes are the living cells in mature bone tissue. Stem cells may stimulate bone growth and promote healing of injured bone.
Traditionally, bone defects have been treated with solid bone graft material placed at the site of the fracture or nonunion. Stem cells and progenitor cells are now placed along with the bone graft to stimulate and speed the healing.
Articular cartilage: The lining of joints is called the articular cartilage. Damage to the articular cartilage can frequently lead to degeneration of the joint and painful arthritis. Current techniques to treat articular cartilage damage use grafting and transplantation of cartilage to fill the defects. It is hoped that stem cells will create growth of primary hyaline cartilage to restore the normal joint surface.
Ligaments and tendons: Mesenchymal stem cells may also develop into cells that are specific for connective tissue. This would allow faster healing of ligament and tendon injuries, such as quadriceps or Achilles tendon ruptures. In this instance, stem cells would be included as part of a primary repair process.

What Happens During a Stem Cell Injection

Where is a Stem Cell Injection Performed?

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