In the past, patients were often forced to choose between living with the pain, taking pain medication or having radical, invasive surgery for their injuries or degenerative conditions. Today, orthobiologic treatments such as bone marrow-derived stem cell and platelet-rich plasma (PRP) injections provide a minimally invasive option for overcoming the pain and disability that orthopedic injuries can cause.
However, patients have many questions — and sometimes, confusion — about stem cell injections.
What Are Stem Cell Injections?
In this context, we are referring to bone marrow-derived stem cell therapy using guided injections.
A stem cell is any cell capable of becoming one of many types of cells and of renewing itself. In other words, a stem cell creates others like itself as well as “daughter cells” of differing types. Generally, these cells are inactive in the body once fetal development is complete. However, they become active again in the case of injury or disease.
For severe injuries or chronic conditions, the body’s natural regenerative processes are insufficient to achieve healing. This is why orthopedic doctors and sports medicine specialists use orthobiologic injections — to enhance the body’s natural healing processes to tackle more significant problems.
This treatment specifically uses adult cells known as mesenchymal stem cells, or MSCs. MSCs provide significant benefit because they can differentiate between bone and cartilage. Research indicates that MSCs may also be able to differentiate cardiac, skin, ligament, tendon and muscle tissue.
MSCs for injection therapy are extracted by the doctor from the patient’s bone marrow.
How Are Stem Cells Obtained?
On the day of your scheduled procedure, the orthopedic doctor begins by performing a bone marrow aspiration. The stem cells will be extracted from this marrow.
This procedure is most commonly done on the back of the pelvis, specifically the iliac crest. You will be positioned comfortably on your side. The doctor will numb the skin and underlying tissue to ensure your comfort. Most patients report little to no discomfort during the bone marrow aspiration.
Once the doctor completes the aspiration, the bone marrow is centrifuged, causing the marrow to separate into layers, one of which is the all-important stem cells.
Once these cells are isolated, it will be time for the guided injections.
How Are Stem Cell Injections Performed?
Prior to your appointment, the orthopedic doctor will have determined where the injections must go to provide maximum effectiveness.
The doctor will use image guidance, either with ultrasound or fluoroscopic technology, to identify this location and guide and deliver the injections to the precise area. Fluoroscopy (active X-ray) is used for injections in the joint, whereas ultrasound is used to guide injections into tendons or ligaments.
Depending on the nature of your injury or condition, you may require only one treatment, or the doctor may recommend a series of treatments.
Because this treatment works by stimulating your body’s natural healing processes, you will not see results immediately. The doctor may also incorporate rehab, physical therapy and strength training to help you overcome the original cause of the problem. Although each patient’s results may vary, stem cell injections can offer an effective approach that is safer than surgery and long-term pain medication use.