How long does it take stem cell therapy to work?



At Advanced Regenerative Orthopedics, we encounter patients who have visited other “stem cell” clinics. They’ve been disappointed by unrealistic promises and expectations. It is important to understand how stem cells actually do what they do in order to understand how much time the treatment will take to prove effective.

When you inject the joint with stem cells (assuming you are using the proper type of cell and treating the proper pathology), those cells engraft, or bind, to a blood supply and secrete factors. These factors are proteins that stimulate the growth of the tissues and healthy cells in the injured area. In the knee, we’re talking about chondrocytes (cartilage cells). Stem cells secrete factors to activate the chondrocytes to proliferate. The chondrocytes multiply and theoretically grow to fill in the defects in the damaged cartilage, healing the source of the pain.

This takes time! Chondrocytes are microscopic cells. Even if you get the right dose of cells, you are not going to wake up three days later and feel great. If you do, it has more to do with temporary anti-inflammatory and lubricating factors, which are the side effects of the cells being in the joint. We have studies from South Korea, Japan, and Europe that show that before eight to ten months, you will not notice any significant decreases in what is called the “WOMAC” score, or any other orthopedic pain/function/inflammation scores (when the pain improves, the numbers drop). Studies show that physician directed stem cell therapy does reduce these symptom scores, but it takes months, or sometimes up to a year..

If you’re looking to have stem cell therapy for a joint, it means you’re having pain and often stiffness, you’re not happy with your medication or your other treatments, and you’re wary of undergoing joint replacement surgery. At Advanced Regenerative Orthopedics, we are addressing the underlying cause of your symptoms. This involves the whole joint and the synovial microenvironment.

Hyaline cartilage makes up a hard, glass-like covering over the ends of the bone in a joint. Over time, wear and tear leads to degenerative arthritis and pain from thinning of this glass-like cartilage protecting the bone. Remember, bone is alive! It has blood vessels and nerve endings. So when there is pressure on a thinned area of cartilage, the nerves are irritated. These sensory nerves tell our brain when something is amiss by sending pain signals. These pain signals stimulate inflammatory proteins called cytokines into the synovial or joint capsule, causing your joint swell and perpetuating a hostile joint microenvironment. Pain is the underlying part of the arthritis that perpetuates the disease. Our goal is to stop the pain! We need to protect the nerve endings or stop the pain signal from being sent. Because stem cell therapy takes time to work, we do a second procedure with all of our patients called radiofrequency ablation. This has been around since the 70s, and it is accepted by Medicare. It is used primarily by physicians in the spine for arthritis in the facets (the little knuckles of the spine). It is needle-based technology that uses radiofrequency or heat to disrupt the targeted sensory nerve. The nerve cannot be completely ablated by heat, but you can effectively disrupt the little “wires” inside the “cable” of the nerve so that the pain will disappear for about a year.

Every joint is different, but within days or weeks, that pain inside your hip, knee, or shoulder joint is mitigated. This accomplishes two good things. First, by improving the pain, you are able to start rehabilitating and strengthening the muscles and ligaments around your joint, so that they can move the way they were intended to function. Second, the nerves sending pain signals are also secreting inflammatory proteins (cytokines) into the synovial capsule, which is making your joint swell and perpetuating a hostile microenvironment. When we “turn off” these nerves, they stop producing the inflammation. This creates a healthier environment for the injected regenerative tissue matrix and its healing factors, lubricating proteins, and stem cells to promote healing.

The combination of radiofrequency ablation and stem cell therapy takes time to work. Because it is primarily needle-based and not a large open surgery, the healing takes place faster and less disruptively than a joint replacement. The radiofrequency ablation mitigates the condyle pain so that while your joint is healing, you can strengthen and recondition the muscles and ligaments that move the joint. This unique process allows you to get back to your active life quickly.

For more information on stem cell therapy or radiofrequency ablation, and to find out if you are a candidate, contact the team at Advanced Regenerative Orthopedics for a complimentary consultation!