Treatment of injuries and degenerative diseases of the knee joint with the help of stem cells

The knee joint performs an important function, providing our movement. At the same time, the knee has to withstand the weight of the entire trunk, undergo regular flexion and extension, and perform work under conditions of physical exertion (when running, walking uphill or lifting weights). Given the regularity and strength of the loads to which the knee joint is subjected, most people face violations of its work. Such disorders are divided into two large groups — injuries and degenerative diseases. Let’s look at each of them in more detail.

Knee joint injuries

Stem cell therapy is effective in treatment of problems with the knee joint. Stem cells are
undifferentiated cells that have the potential differentiate into different types of body cells, including cells cartilage, bone cells and muscle cells.
The most common types of knee joint injuries:

• Sprains and torn ligaments. A strong sprain or a sharp blow can lead to a sprain or rupture
  of the ligaments of the knee joint. This can lead to pain, swelling and restricted movement.
• Damage to the meniscus: The meniscus is located between the bones of the thigh and lower leg, and its role is to improve joint mobility and absorb shocks. Damage to the meniscus can occur with a strong knee twist or injury, and can cause pain, swelling and instability in the knee.
• Cartilage damage: The cartilage at the ends of the knee joint bones allows them to slide
  freely over each other when moving. Injury can cause cartilage damage, resulting in pain and restricted movement.
• Fractures. The knee joint can be fractured with severe trauma, which leads to pain, swelling and inability to unbend the knee.

Such injuries severely restrict movement and reduce the quality of life. Recovery can take from 10-14 days to 3-4 months, and in severe cases (fractures with dislocations, complex fractures, fractures in the elderly), surgery or several operations, therapeutic treatment and rehabilitation may be required. Such treatment may take one and a half to two years and will not lead to a full recovery — the joint may remain restricted in movement, react to weather changes, cause pain with prolonged exertion, and so on.

A similar situation is also observed with respect to degenerative diseases of the knee joint.
Degenerative diseases of the knee joint are a group of diseases associated with the wear of articular cartilage, bone tissue and ligaments that support the stability of the joint. These diseases can lead to pain, restriction of movement, deterioration of quality of life and disability.

The most common degenerative diseases of the knee joint are:

• Osteoarthritis is a disease associated with the wear of the cartilage of the joint. It can
  manifest as pain, creaking or cracking in the joint when moving.
• Rheumatoid arthritis is a chronic inflammatory disease that can lead to the destruction of
  joints, including the knee. It can be manifested by pain, swelling, stiffness and restriction of
  movement in the joints. At common stages, rheumatoid arthritis can lead to irreversible
  deformation of the joint.
• Bursitis is an inflammation of the mucous bags that are located near the knee joint. This can lead to pain, limited mobility and fluid accumulation in the joint.

Degenerative diseases are difficult to treat with conservative methods. Standard therapeutic treatment includes anti-inflammatory drugs that have to be taken in long courses or constantly, which is toxic to the liver and stomach. Such treatment is able to remove or reduce pain, swelling, fluid discharge and redness of the joint, but does not contribute to regeneration in any way. Physiotherapy is used to restore knee tissue in its natural form, the effect of physiotherapy procedures in this regard exists, but such treatment is not able to lead to significant changes. A separate therapeutic option in some cases is surgery. In case of knee joint fractures in young patients, this option is often enough, in elderly patients, the regenerative properties of the body are often insufficient to ensure the possibility of full- fledged movement after surgery.
If other methods of treatment are ineffective, patients may need joint replacement.

Treatment with stem cells

In recent years, stem cell therapy has been a popular method of treatment. The predecessor of this method was plasma therapy, which has been successfully existing on the medical market for about 20 years and is still widely used in beauty salons and medical clinics, including in orthopedics. The essence of plasma therapy is to extract venous blood from the patient, which is then centrifuged, after which the necessary shaped blood elements that promote regeneration (platelets) are injected into the damaged area. During such procedures, the first effects of natural regeneration of knee tissues were noticeable without significant side effects for the patient`s health.

Stem cells are specialized cells that can develop into many different types of cells in the body. They possess the potential to repair damaged tissues, including cartilage and bone in the knee joint.
In the treatment of the knee joint, stem cells can be injected directly into the knee joint to help regenerate damaged tissues, reduce inflammation and pain, and improve joint function. Stem cells can be obtained from their own the patient`s body (autologous) or from a donor (allogeneic).
After administration, the stem cells differentiate into chondrocytes, which are cartilage- producing cells. This may help to restore damaged cartilage and reduce inflammation in the joint.

What types of stem cells are there?

For the treatment of the knee joint , several types can be used stem cells, including mesenchymal stem cells (MSCs) and induced pluripotent stem cells (iPSCs). MSK can be obtained from the patient`s own bone marrow, adipose tissue or cord blood, as well as from a donor. iPSCs are generated by reprogramming of adult cells into a pluripotent state, which this means that they can potentially become cells of any type in the body.
The most commonly used types of stem cells for treatment knee joint are mesenchymal stem cells (MSCs), which can differentiate into bone, cartilage and fat cells.
These cells can be obtained from bone marrow, adipose tissue or cord blood.

Rehabilitation with the help of stem cells

Rehabilitation after knee surgery using stem cells may vary depending on the type of surgery and the degree of injury. Stem cells are special cells that have the ability to
differentiate into different types of cells in the body, including cells, which make up cartilage and bones.

If stem cells are used as part of knee surgery, the process rehabilitation may include physical therapy and exercises that promote the healing and restoration of strength and flexibility of the knee joint. The specific exercises and physiotherapy program will depend on the patient`s condition and the volume of the operation.

A successful method of stem cell treatment of a repeatedly injured knee joint was described in the treatment of the famous Ukrainian football player Andriy Shevchenko. In his clinical case, there was a risk of joint replacement, but after stem cell therapy, this operation was avoided, some of the significant and reducing quality of life also disappeared. After effective treatment, Andriy Shevchenko agreed to talk about his experience in order to help other people in a similar situation. https://www.youtube.com/watch?v=LF7fOC1hxJs

The treatment took place at the Institute of Cell Therapy.

What course of treatment is required in this case?

It depends on the pathology and the degree of damage. Many patients undergo a course of 3-4 injections per year.

What side effects are observed in patients undergoing stem cell therapy in the treatment of
the knee joint?

As a rule, the first course of therapy is the worst tolerated in the case of donor cell therapy.
There may be increased swelling, fever, soreness at the injection site. These side effects are normal for this type of treatment. For their relief, standard anti-inflammatory drugs are taken.

How to choose the type of stem cells?

This is done by the attending physician based on data on the degree of joint damage and
extended blood tests. The general rule is often observed — younger patients receive their own stem cells, patients after 65 years of age receive donor cells.