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Stem Cell Therapy for Orthopedic Conditions

By

Megan Freedman

What is stem cell therapy for orthopedic conditions?

Stem cell therapy is a medical treatment for a wide range of diseases and injuries. Stem cell therapy for orthopedic conditions involves injecting your own processed bone marrow into an injured bone or joint. Bone marrow contains a certain type of stem cell that may help reduce inflammation, promote healing, and create healthy new tissue. 

A stem cell is a type of “simple” cell. The stem cell can produce many different types of more complex and specialized cells in the body when it divides. Stem cells can help create healthy new tissue where tissues have died. Stem cells also appear to help repair cells in tissues that are injured or have been damaged by disease.

Stem cell therapy for orthopedic conditions is a relatively new medical treatment that researchers are actively investigating. Some treatments may only be available through a clinical trial at this time. The procedure is only one method used to treat orthopedic conditions. Discuss all of your treatment options with your doctor to understand which options are right for you.

Other procedures that may be performed

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Doctors use stem cell therapy by itself or with other procedures to treat certain orthopedic injuries or diseases. These will vary depending on the specific disease or injury, and upon your doctor’s preferred techniques. Other procedures include:

  • Bone grafts to replace missing bone with a piece of healthy bone from another part of the body

  • Fat grafts to inject fat from another place in the body into the injured area. Fat grafts help prevent some joint complications. Fat also contains some types of stem cells.

  • Physical therapy to improve joint mobility and function and quality of life

  • Platelet-rich plasma (PRP) injection to promote tissue healing

  • Prolotherapy injection to stimulate healing

Why is stem cell therapy for orthopedic conditions performed? 

Your doctor may recommend stem cell therapy to treat orthopedic diseases, conditions and injuries including: 

  • Bone fractures that have not healed with traditional treatment

  • Ligament injuries including sprains

  • Osteoarthritis, a breakdown of the protective cartilage on the ends of the bones

  • Osteonecrosis, bone tissue that has been deprived of oxygen and died. It most often occurs in the thighbone (femur) upper arm bone, knees, shoulders, and ankles.

  • Tendon injuries and conditions including rotator cuff tears, meniscus tears, plantar fasciitis, Achilles tendon rupture, and tennis elbow

Who performs stem cell therapy for orthopedic conditions?

Orthopedic surgeons perform stem cell therapy for orthopedic conditions. An orthopedic surgeon specializes in surgical treatment of diseases and conditions of the bones, joints, and connective tissues.

How is stem cell therapy for orthopedic conditions performed?

Your stem cell therapy for an orthopedic condition will be performed in an outpatient setting. Your doctor may recommend a few treatments spaced several weeks to a few months apart. The number and timing of treatments will depend on how much your condition improves over time and other factors. 

Stem cell therapy involves two separate procedures that may or may not take place the same day. The procedures generally include these steps:

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  1. Your doctor will numb the back of your hip with an injection of local anesthetic, such as procaine (Novocain).

  2. Your doctor will pass a needle into your hipbone and withdraw a small amount of bone marrow tissue. Bone marrow contains stem cells that can become muscle and bone cells.

  3. A technician will spin and concentrate your bone marrow fluid in a machine called a centrifuge.  This creates a substance called bone marrow aspiration concentrate (BMAC).

  4. Your doctor will numb the skin near your injury with an injection of local anesthetic. Then your doctor will inject the BMAC in the area near your injury. Your doctor will likely use ultrasound to guide the BMAC injection.

  5. You will go home the same day soon after your stem cell therapy treatment.

Will I feel pain?

Your comfort and relaxation is important to you and your care team. You will feel a brief pinch or prick during the local anesthetic injection. You may feel some pressure during removal of bone marrow and the BMAC injection. Afterwards, you may have mild soreness at both the extraction and injection sites. Your healthcare team will give you sufficient pain and sedative medications if you need them to stay comfortable. Tell a member of your healthcare team if you are uncomfortable in any way.

What are the risks and potential complications of stem cell therapy for orthopedic conditions?  

Complications after stem cell therapy for orthopedic conditions are not common, but any procedure involves risks and potential complications. Complications may become serious in some cases. Complications can develop during the procedure or your recovery. Risks and potential complications of stem cell therapy include: 

  • Adverse reaction or problems related to local anesthetic, such as an allergic reaction and problems with breathing

  • Bleeding or bruising

  • Damage to nerves and blood vessels

  • Infection

  • Injection site reactions including swelling, tenderness and warmth

  • Pain

Reducing your risk of complications

You can reduce the risk of certain complications by: 

  • Following activity, dietary and lifestyle restrictions and recommendations before your injection and during recovery

  • Notifying your doctor immediately of any concerns, such as bleeding, fever, or increase in pain

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies

How do I prepare for stem cell therapy for orthopedic conditions?

You are an important member of your own healthcare team. The steps you take before stem cell therapy for an orthopedic condition can improve your comfort and outcome. You can prepare yourself stem cell therapy by:

  • Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and help the healing process.

  • Taking or stopping medications exactly as directed. Your doctor will give you instructions for taking your medications and supplements.

Questions to ask your doctor

You may have many questions and concerns. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before your treatment and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need stem cell therapy? Are there any other options for treating my condition?

  • How long will the treatment take? When Can I go home?

  • What restrictions will I have after the procedure? When can I return to work and other activities?

  • How often will I need stem cell therapy? How far apart will you give treatments?

  • What kind of assistance will I need at home? Will I need a ride home?

  • What medication and dietary plan should I follow before and after the procedure? 

  • How will you treat my pain?

  • When and how will we know if the treatment is working?

  • How should I contact you? Ask for numbers to call during and after regular hours.

What can I expect after a stem cell therapy treatment for orthopedic conditions?

Knowing what to expect after a stem cell therapy treatment for an orthopedic condition can help you get back to your everyday life as soon as possible.

How will I feel after the stem cell therapy treatment?

You may discomfort and swelling near your extraction and injection sites for the first two to three days after the procedure. Your doctor will prescribe medication to control your pain. Tell your doctor or care team if your pain is not well controlled by your medication. 

You may have less pain and better mobility and strength in the affected area in about four weeks after your treatment. Results of stem cell therapy vary depending on your diagnosis and other factors. Ask your doctor what to expect from your therapy. Your doctor will also advise you on the next step, such as complementary treatments.

When can I go home?

You will likely go home the same day soon after your stem cell injection. 

When should I call my doctor?

It is important to keep your follow-up appointments after stem cell therapy. Contact your doctor for questions or concerns between appointments. Call your doctor right away if you have:

  • Bleeding

  • Drainage from the injection site

  • Fever

  • New or unexplained symptoms

  • Pain that is not controlled by pain medication

  • Skin changes, such as rash or skin irritation

  • Swelling, warmth or redness

Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Sep 6, 2016

© 2017 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

View Sources

Medical References

  1. FAQ’s. Centeno-Schultz Clinic. http://www.regenexx.com/common-questions/
  2. Frequently Asked Questions About Stem Cells. American Academy of Orthopedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00509.
  3. Platelet-Rich Plasma (PRP) Injections. Hospital for Special Surgery. http://www.hss.edu/condition-list_prp-injections.asp.
  4. Prolotherapy. Hemwall Center for Orthopedic Regenerative Medicine. http://www.prolotherapy.com/.
  5. Questions and Answers about Osteonecrosis (Avascular Necrosis). National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). http://www.niams.nih.gov/Health_Info/Osteonecrosis/.
  6. Regenexx-AD Fat Graft Survival. Centeno-Schultz Clinic. http://www.regenexx.com/regenexx-ad-fat-graft-survival/.
  7. Regenexx-SD (Same-Day) Stem Cell Procedure Overview. Centeno-Schultz Clinic. http://www.regenexx.com/regenexx-procedures-family/the-regenexx-procedure-explained/.
  8. Stem Cell Basics/What are adult stem cells? National Institutes of Health. http://stemcells.nih.gov/info/basics/pages/basics4.aspx.
  9. Stem Cell Injection Therapy. Valley Sports Physicians and Orthopedic Medicine. http://www.jockdoctors.com/page.asp?id=51&name=Stem%20Cell%20Injections.
  10. Stem Cell Therapy in Orthopaedics. American Academy of Orthopedic Surgeons. http://www.aaos.org/news/aaosnow/feb12/research2.asp.
  11. Stem Cells and Orthopaedics. American Academy of Orthopedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00501.

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