Stem cells are pericytes, or cells that live on the walls of vessels. The more vascular a tissue is the more stem cells it has, so fat and bone marrow have the highest concentration. While embryonic stems cells can transform into any tissue, adult stem cells are primarily “medicinal cells” in that they produce growth factors, anti-inflammatory agents, antibiotics, and other tissue stimulating proteins..A specialized group of adult stem cells called mesenchymal stem cells are of particular interest in orthopedics because they can differentiate into high-quality bone and cartilage to restore damaged or missing tissue, often the result of acute trauma injuries or chronic disease such as arthritis. Essentially, stem cells deliver the growth factors to the repair site. There, the stem cell either produces or recruits the growth factors that speed up the rate of repair and increase the quality of tissue regenerated.

The natural lubricant of the joints is called hyaluronic acid (HA).

This lubricant in concentrated form can be injected into a joint to increase lubrication.

The lubricant tends to stimulate cartilage cells in order to assist in the natural cartilage repair process, decreasing inflammation and reducing the breakdown of damaged cartilage by degradative enzymes. In arthritic joints, HA tends to provide a smoother feeling joint, less pain, and less inflammation. While most practices require a series of injections, we’ve found that a single concentrated injection works just as well, with benefits from three months to a year. We may add PRP to the HA injection to stimulate tissue healing.

Cell-Based Cartilage Repair Techniques
*Autologous Chondrocyte Implantation (ACT)/Matrix Autologous Chondrocyte Implantation (MACI):
ACI/MACI is suitable for athletes 20-50 years old with an isolated femoral condyle defect greater then 2-4 cm, less than 3-6mm deep.

Neocartilage Implantation
Neocartilage implantation involves sophisticated tissue engineering technology. The chondrocytes are harvested in a similar way to ACI, the cells are then expanded in a 2-D culture and seeded in a bovine collagen gel/sponge construct.

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    By : Dr. Mohammad Ashfaq Konchwalla

    Consultant Orthopaedic & Sports Surgeon

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