Stem Cell Treatment

Glucosamine & Chondroitin Tablets FAI (impingement) surgery


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What is it and why?

  • A bone marrow harvest that’s centrifuged and immediately injected into the joint that has worn out.

  • Alternative sources include fat cells and subchondral bone cells. These may be grown in a lab before injection.

  • Typically, a course of treatment involves between 1 and 3 injections.

  • Evidence is still not clear on which is the best type of stem cell to use.

  • Not NICE approved.


  • Treatment does not involve Home/self-help
    Home/self-help
  • Treatment involves Hospital
    Hospital
  • Treatment involves Daycase procedure
    Daycase procedure
  • Treatment does not involve Inpatient procedure
    Inpatient procedure
  • Treatment involves Local anaesthetic
    Local anaesthetic
  • Treatment does not involve General anaesthetic
    General anaesthetic
  • Treatment does not involve Regional block / Spina
    Regional block / Spina
  • Pain
    Pain

    Painful for 2+ weeks

  • Mobility
    Mobility

    Affected 2+ weeks

  • Daily activities
    Daily activities

    Affected for 2+ weeks

  • Driving
    Driving

    No - 6+ weeks

  • Leisure activities
    Leisure activities

    Minor

  • Light exercise
    Light exercise

    Affected 2+ weeks

  • Heavy exercise
    Heavy exercise

    Affected 6+ weeks

  • Light work
    Light work

    Affected 2+ weeks

  • Heavy work
    Heavy work

    Affected 4+ months

  • Intimate
    Intimate

    Affected 2+ weeks


Overview

What does it involve?

  • Stem cells can transform into another type of cell under certain circumstances.

  • They're harvested from bone marrow, blood, subchondral bone cells or from fat tissues.

  • 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.

  • You may need a series of injections for this treatment to be effective.

  • The evidence is still not clear regarding which type of stem cells are better.

  • This is not a supported treatment by NICE and therefore may not be available in many NHS hospitals.

Effort/burden

  • Outpatient or a day-case type procedure.

  • Repeated injections will be required.

Benefits

  • Some studies show that stem cell injections may decrease pain for a select group of patients.

  • In some patients, this treatment may slow down joint wear. However, it's difficult to identify who will benefit from this.

  • This may delay the need for more invasive surgery.

Limitations and side effects

  • Your knee pain may not diminish completely.

  • 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

  • Severe risks include pain, infection, redness and persistent swelling.

  • There are anecdotal serious complications like macular degeneration and blindness, stroke and concerns about potentially stimulating cancer cell overgrowth.

Cost

  • There is a high cost for both the patient and the NHS.

  • 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.

  • 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?

  • Ongoing pain.

  • Arthritis may deteriorate and affect your activities of daily living (ADL), family life, work environment and leisure activities.

  • If the condition progresses, you may require more complex and demanding procedures.

  • If your arthritis progresses significantly, you may not be able to have further treatment.

  • You may regret not opting for treatment earlier.


Glucosamine & Chondroitin Tablets FAI (impingement) surgery