Traumatology and Orthopedy
The experience of using the hematopoietic progenitors for the treatment of damaged joints in arthrosis, arthritis and osteoarthrosis.
The possibility to repair the hyaline cartilage in degenerative-dystrophic large joints through the method of intra-articular introduction of cultivated mesenchymal stem cells was first proposed in the USSR by Professor Ruben Chailakhyan in 1989. He patented this technology and demonstrated the possibility to repair a damaged hyaline cartilage through its regeneration first on rabbits and then on humans. The first stage of clinical trials was successfully completed. However, Professor Chailakhyan was unable to arrange the limited trial in humans as the “perestroika” (political and economic reconstruction) had already begun and all subsequent investigations had been terminated due to the lack of funding.
In 2008 our team in cooperation with Professor Viktor Sevastyanov patented the biodegradable heterogenic matrix SpheroGel© which was later used for implantations into large joints. The clinical experience of using the matrix for deforming arthrosis in more than 100 cases significantly reduced the intraarticular pain and improved the joint function. To enhance the effectiveness of reparative and regenerative properties of the SpheroGel based intraarticular implant, we have supplemented it with the hematopoietic stem cells (HSCs) and hematopoietic progenitor cells (HPCs) from the primary mobilized mononuclear cells of the human.
The simplicity and accessibility of this technology allow us the solution of two important issues. The HSCs and HPCs in the matrix help achieve the maximal survival of the implanted stem cells in the non-vascular medium as the cells are fed with the matrix and it enables their 3-D volumetric dissemination throughout the joint, thus promoting regeneration of the hyaline cartilage. By now, the approach has proved its safety and showed no complications. Moreover, the systemic transfusions of HSCs and HPCs increase effectiveness of bone regeneration in poorly healing fractures of large tubular bones.
The technology is for patients as well as professional athletes who sustained traumas or osteoarthritis of the knee or other joints and require optimal recovery in short period of time. The cells are isolated from the patients’ peripheral blood and mixed with the SpheroGel. Then the mixture is introduced into a damaged joint during the medical procedure. The condition may require repeated administration and the method provides for them. This treatment is a standardized service of hematopoietic transfusion when the medical intervention is implemented as individual application upon the consent of both parties.
Osteoarthrosis is the disease that leads to the progressive degeneration of the joint cartilage and that can damage any joint in the organism causing the inflammatory process, pain and deformation. The disease often develops gradually; it may remain untreated or be successfully controlled by medicines and/or physiotherapy. However, the osteoarthrosis causes pain and pronounced walking difficulties which may require a replacement of a joint by prosthesis. The treatment of a knee joint osteoarthrosis by hematopoietic stem cells allows significant reduction of pain and walking difficulties in more than 90% of patients with advanced osteoarthrosis. Pain relief as well as improved joint function preserved during 1-3 months following the treatment and continued to improve after 12 months and sometimes longer.
The procedure is able to stop the progressive loss of a cartilage and promotes its regeneration. To date the treatment has been used in over a hundred cases of osteoarthrosis of various joints, including knee, hip, ankle, foot, elbow, shoulder, writs and finger joints.
How is the damaged joint treated with the HSCs and HPCs? First, our experts examine the medical history of the patient and the MRI and decide whether there is an indication for a treatment. For safety reasons, before the treatment we conduct the examination that includes serological blood tests, electrocardiogram, and lung X-ray.
In case everything is normal, the procedure can be arranged.
First stage: Harvest of the hematopoietic cells.
Second stage: Administration of the hematopoietic cells along with the biodegradable heterogenic polymer matrix into the site of injury.
Unmanipulated stem cells are mixed with the heterogenic matrix and then injected into the site of injury under the local anesthesia. Afterwards, the aseptic bandage is placed and 30 minutes rest is recommended. Upon returning home it is necessary to stay in bed for 48 hours and to avoid loading the treated joint for a week. Rehabilitative program is prescribed individually according to the physician’s recommendations. After the procedure two control follow-up visits to the doctor are mandatory in 12 and 24 months.