Column: Regenerative medicine: Snake oil or elixir?


Commentary by Joseph Hui

A few years ago, while riding an airplane, I came across an airline magazine adverstisement. It was for an orthopedic/dermatology clinic in Boca Raton, Fla., and splashed across the headline was, “Regenerative Medicine Stem Cell Specialists.” It claimed that while preparing your stem cells for the treatment of your joint pain, you could get its trademark vampire facelift while overlooking serene ocean views in the treatment room. At first I balked. Then, intrigued, I began to look into evidence behind such claims.

In the past few years, the data behind regenerative medicine to treat arthritis, cartilage degeneration and chronic tendon/ligament problems appears quite fruitful. Regenerative medicine is typically broken down into either using mesenchymal stem cells (MSCs) or platelet-rich plasma (PRP). Both are typically derived from your own body, so no embryos are involved. MSCs can differentiate—a process where a cell changes from one cell type to another—into  bone, muscle, cartilage, tendon and are typically found in fat and bone marrow. PRP is derived from taking 60 ml of a person’s blood and isolating the platelets. The plasma, with higher concentrated platelets than normal blood, is then injected using ultrasound guidance into problematic tendons or joints. Although MSCs hold more promise and will likely revolutionize the treatment of orthopedic problems in the future, at this time the treatment is still too costly, and long-term data is lacking.

PRP is simple and relatively cost-effective and is often used to treat joint and tendon problems. It also has strong data to support its use to treat mild to moderate hip and knee osteoarthritis. For those looking for an alternative to surgery, PRP can be helpful. Although I will not be performing vampire facelifts at my clinic, the use of regenerative medicine for musculoskeletal issues is likely here to stay.


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