From the Guidelines
Mesenchymal stem cell therapy from umbilical cord tissue is not currently recommended for orthopedic applications due to limited proven clinical efficacy and lack of FDA clearance. The International Society for Cell and Gene Therapy (ISCT) defines mesenchymal stem cells (MSCs) as plastic-adherent, culture-expanded cells that express specific cell surface markers and have the ability to differentiate into osteoblasts, adipocytes, and chondrocytes in vitro 1. Although MSCs have shown promise in preclinical studies, no MSC therapies have been cleared by the FDA for human clinical application to musculoskeletal diseases 1.
Some key points to consider about MSC therapy for orthopedic applications include:
- The therapy involves administering MSCs through direct injection into the affected joint or tissue, sometimes combined with platelet-rich plasma or hyaluronic acid
- Treatment protocols typically involve a single injection or series of injections over several weeks, with potential benefits lasting 6-12 months in responsive patients
- The therapy may work by reducing inflammation, secreting growth factors that promote healing, and possibly differentiating into cartilage or bone cells
- However, clinical evidence remains inconsistent, with many studies showing modest or temporary improvements rather than definitive tissue regeneration 1
It is essential to note that this treatment is often not covered by insurance, can cost several thousand dollars per treatment, and results vary significantly between individuals. As such, patients should exercise caution and carefully consider the potential benefits and risks before undergoing MSC therapy for orthopedic applications. More rigorous clinical trials are needed to establish standardized protocols and determine which patients might benefit most from this approach 1.
From the Research
Mesenchymal Stem Cell Therapy from Umbilical Cord
- Mesenchymal stem cells (MSCs) from umbilical cord tissue can be used in regenerative medicine and tissue engineering applications, including orthopedic applications 2.
- Umbilical cord tissue MSCs have the ability to differentiate into various cell lineages, including bone, cartilage, and fat, making them a potential candidate for treating orthopedic diseases 2.
Efficacy in Orthopedic Applications
- Studies have shown that MSC therapy may slightly improve pain and function in patients with osteoarthritis of the knee, although the evidence is of low certainty due to indirectness and suspected publication bias 3.
- MSC injections may also improve quality of life and treatment success in patients with osteoarthritis, but the evidence is of very low certainty due to imprecision and indirectness 3.
- Umbilical cord mesenchymal stem cell therapy has been proposed as a potential treatment for rheumatoid arthritis, with advantages including convenient collection of materials and no ethical disputes 4.
- MSC therapy has been successfully utilized in pre-clinical OA animal models and clinical studies, with the aim of cartilage repair and disease modification 5.
Challenges and Future Directions
- Despite the potential of MSC therapy, there are challenges to be addressed, including building regulatory guidelines, establishing donor genetic testing and long-term monitoring systems, and conducting further clinical trials to determine optimal dosage and treatment protocols 6.
- Future studies should focus on determining the efficacy and safety of MSC therapy in orthopedic applications, as well as exploring the mechanisms of action and optimal treatment strategies 3, 5.