Stem Cell Injections

by DR. TREVOR L. HALL
MD, CCFP(SEM), Dip. SEM

Stem Cell (SC) transplantation has garnered a lot of attention in the past few years as a treatment option for many medical conditions.  There is a lot of excitement about SC transplantations because of its potential to regenerate body tissue and to reverse disease processes.  Not surprisingly, SC transplantation is also being used successfully for treating osteoarthritis because of its potential for regenerating the cartilage that wears down due to the osteoarthritic process.

What is a Stem Cell Transplantation?

SC transplantation is a procedure in which “stem cells” are extracted from one part of your body and then injected into another body part that is injured or affected by osteoarthritis.  These stem cells are “pluripotential”, meaning that they can develop into various cell and tissue types such as bone, cartilage, ligament and tendon.  The most common sites from which Stem Cells are taken (“harvested”) include your own fat tissue (e.g., from your buttock or abdomen) and bone marrow.

The harvested fat (adipose) tissue is then processed so that millions of stem cells are extracted and concentrated.  The stem cells are then combined with platelet-rich plasma (PRP) which consists of concentrated growth factors that are extracted from your blood.  The Stem Cells and PRP combination forms a potent therapy to heal tissue.  This combination is then injected into the injured body part or osteoarthritic joint.

How does a SC Transplantation help your osteoarthritis?

For osteoarthritis, the theory behind a SC Transplantation process is that the stem cells that are injected into an osteoarthritic joint will then develop into new cartilage cells, thereby resulting in healing and growth of new cartilage.  This is very relevant for osteoarthritis (OA) which is a condition that involves degeneration and thinning of the articular (surface) cartilage layer in the joint.
SC transplantation, therefore, is viewed as a “regenerative” treatment with potential for healing and possibly reversing the degenerative process of OA.   Also, SC transplantation is a very “natural” treatment that is derived from your own body tissue, and does not involve the injection of any medication (none besides a small amount of anti-coagulant to ensure the harvested tissue does not clot).  Stem cell transplantation can also be used to treat other musculoskeletal injuries such as chronic tendon tears and tendon degeneration.

How does GRSM do SC procedures?

At GRSM, the SC transplantation process involves harvesting the SCs from fat (adipose) tissue in your buttock, flank or thighs.   Adipose tissue is very rich in stem cells, containing 100 to 1000 times the concentration of stem cells in bone marrow.  Harvesting SC’s from the buttock is one of the safest ways of obtaining SC’s, minimizing complications and side effects.  This process is similar to a “mini” liposuction procedure in which only 30 mls of adipose tissue are harvested.  A very small incision is made in the skin and a cannula is used to harvest the adipose tissue.  A local anaesthetic is used during the procedure to make the process more comfortable.  The harvesting process usually takes about 15mins.  A blood sample is then drawn, which is then processed so that the growth factors are concentrated and extracted, resulting in a Platelet-Rich Plasma (PRP) sample.  This PRP is then combined with the millions of stem cells that were harvested from you adipose tissue, and then this mixture is injected into your osteoarthritic joint.   You will then return 1-2 weeks later for a “booster” PRP injection which is all included as part of your SC transplantation procedure.

What are the potential side effects or complications?

Stem cell transplantation is generally very safe and well tolerated.  However, as with any medical procedure, there are possible side effects or complications that can occur.  Of note, the mini-liposuction procedure that is used in adipose-derived SC transplantation involves harvesting a very small amount of adipose tissue compared to a typical liposuction procedure that is used to remove fat from the body for cosmetic purposes.  As a result, the SC transplantation procedure does not involve the sometimes serious complications that are associated with typical liposuction procedures.   In addition, the SC transplantation procedure involves the use of local anaesthetic only and so does not involve the sometimes serious complications of using a general anaesthetic.

Some of the possible complications that can occur with adipose-derived SC transplantation include:

  • Pain or discomfort during the stem cell harvesting process at the site of harvesting (e.g. buttock)
  • Pain or discomfort during the injection process at the site of injection/transplantation
  • Pain or discomfort persisting for up to 1-2 weeks at the harvesting site and/or the transplantation site
  • Injury to the surrounding tissue during the harvesting process
  • As with any medical procedure that penetrates the skin, there is a low risk of infection which is minimized due to proper aseptic technique being used.

Possible Side Effects with All Injections

Injections that are performed by a properly trained physician tend to be a relatively safe procedure.  However, there are possible side effects that are possible with any type of injection.   These include the following:

  • Local pain or discomfort during or after the injection (e.g., needle discomfort, temporary tightness or fullness after the injection).
  • Skin bruising, bleeding or discoloration
  • Local tissue irritation and/or swelling
  • Allergy to the local analgesic (“freezing”) agent (topical xylocaine)
  • Suffering a “vasovagal reaction” (fainting or feeling weak/faint/dizzy)
  • Infection (risk is estimated statistically to be between 1:10,000 to 1:50,000)
  • Needle break
  • Nerve injury
  • Blood vessel injury
  • Lack of improvement
  • Worsened pain or function

Grand River Sports Medicine Centre is an accredited RegenerVate clinic.