Stem Cell Treatment
Glucosamine & Chondroitin Tablets FAI (impingement) surgery
What is it and why?
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A bone marrow harvest that’s centrifuged and immediately injected into the joint that has worn out.
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Alternative sources include fat cells and subchondral bone cells. These may be grown in a lab before injection.
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Typically, a course of treatment involves between 1 and 3 injections.
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Evidence is still not clear on which is the best type of stem cell to use.
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Not NICE approved.
- Applicable stages 4 & 5
- Best stages 5
- Cost High cost
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Home/self-help
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Hospital
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Daycase procedure
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Inpatient procedure
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Local anaesthetic
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General anaesthetic
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Regional block / Spina
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Pain
Painful for 2+ weeks
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Mobility
Affected 2+ weeks
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Daily activities
Affected for 2+ weeks
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Driving
No - 6+ weeks
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Leisure activities
Minor
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Light exercise
Affected 2+ weeks
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Heavy exercise
Affected 6+ weeks
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Light work
Affected 2+ weeks
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Heavy work
Affected 4+ months
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Intimate
Affected 2+ weeks
Overview
What does it involve?
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Stem cells can transform into another type of cell under certain circumstances.
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They're harvested from bone marrow, blood, subchondral bone cells or from fat tissues.
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After harvest, they need to be centrifuged and are immediately injected into the joint. However, some types cannot be injected straight away and need to be grown in a lab before injection.
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You may need a series of injections for this treatment to be effective.
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The evidence is still not clear regarding which type of stem cells are better.
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This is not a supported treatment by NICE and therefore may not be available in many NHS hospitals.
Effort/burden
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Outpatient or a day-case type procedure.
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Repeated injections will be required.
Benefits
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Some studies show that stem cell injections may decrease pain for a select group of patients.
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In some patients, this treatment may slow down joint wear. However, it's difficult to identify who will benefit from this.
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This may delay the need for more invasive surgery.
Limitations and side effects
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Your knee pain may not diminish completely.
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The pain may actually get worse after the injection for some patients. It's not possible to predict who will become worse after the injection.
Risks
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Severe risks include pain, infection, redness and persistent swelling.
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There are anecdotal serious complications like macular degeneration and blindness, stroke and concerns about potentially stimulating cancer cell overgrowth.
Cost
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There is a high cost for both the patient and the NHS.
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Patient: Cost may vary depending on local arrangements. Some commissioning bodies do not authorise the use of these injections, so the treatment may have to be done under a private setting. This can cost up to £8000 per course, not including the cost of a private consultation. Some insurance companies will not cover this cost.
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NHS: The exact cost is not known; however, it's likely to be as much as the cost in the private sector.
What if no treatment is done?
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Ongoing pain.
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Arthritis may deteriorate and affect your activities of daily living (ADL), family life, work environment and leisure activities.
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If the condition progresses, you may require more complex and demanding procedures.
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If your arthritis progresses significantly, you may not be able to have further treatment.
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You may regret not opting for treatment earlier.
