Stem cell use in orthopedic treatment

What is stem cell : Stem cells are cells located around the vessels in our tissues. These cells have the ability to transform into necessary cells that participate in the healing process when tissue damage occurs. Stem cells can transform into cells such as muscle, bone, cartilage and fat in our body. Thanks to this potential, stem cells emerge as a treatment method that can be used to repair all kinds of tissue damage. However, the fact that the method is very new is the disadvantage that its long-term results are not known yet. There are 2 types of stem cells. Although stem cells obtained from fetuses have high transformation potential, they have no practical use due to difficulties in obtaining and ethical problems. Adult stem cells, which are widely used today, are preferred because of their ease of obtaining, although their transformation potential is more limited.

How to obtain stem cells : stem cells are found in many tissues in our body. Studies have shown that they are mostly found in the adipose tissue called stromal tissue, muscle and tissues around the joint. In order for the obtained stem cells to be sufficient, they must be multiplied or concentrated. Since stem cell reproduction requires an advanced technological laboratory, its practical use is limited. It is easier and more practical to obtain by centrifugation method. The method of obtaining stem cells, which is widely used today, is the condensation of stem cells obtained from adipose tissue by passing them through special filters. In simple terms, approximately 200-300 cc of adipose tissue is taken by injecting a solution into the abdominal adipose tissue under local anesthesia, and a solution rich in approximately 5-6 cc stem cells is obtained by filtering. This solution is injected into the patient’s area to be used in the same session. The process takes 20 minutes in total. It continues and can be performed under local anesthesia and light sedation (sedative). Preferably, it is more suitable to be done in an intervention room or operating room where the patient can be monitored after the procedure. It is not necessary to stay in the hospital, and it is appropriate to rest for a few days after the procedure.

To whom stem cells are made : Although stem cell therapy can potentially be used in almost all cases of tissue damage, its widespread use today is in patients with articular cartilage damage. Stem cell application can be performed for cartilage regeneration, especially in patients with cartilage damage in the knee, shoulder, ankle, hip joint. It is important that the cartilage damage in the joint to be treated is at an early stage and that degenerative bony changes have not started in the joint. The activities of stem cells do not decrease with age, so there is no age limit for stem cell application.

Who can’t get stem cells : Obesity is the most important obstacle in stem cell application. The chance of success decreases in patients with a BMD (body mass index) of 35 and above. The application of the method is definitely not recommended for patients with BMD above 40. Patients with severe joint damage, whose only alternative is surgery, are not suitable for stem cell therapy. Stem cells are not an alternative treatment for patients who have developed osteoarthritis due to joint cartilage damage and need surgery. It is an option especially for patients who are still early for surgery and where it is possible to save the joint.

Risks of stem cell therapy : There is a possibility that stem cells can potentially develop into any type of cell. It has been reported that stem cells given to the joint for cartilage formation turn into bone cells. It is also possible for overgrowth to occur in the target area. Excess tissue may need to be shaved. There is a possibility that stem cells from fetuses may develop into tumors, but adult stem cells have not been reported to develop into tumors.

Conclusion: Today, the use of stem cells is an increasingly common treatment method. Good results are seen with the treatments to be done with the right patient selection. The target audience of the method is especially young patients who have articular cartilage damage at an early stage, who do not have bony degenerative changes, whose joint structure is not impaired, and who are not overweight.

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