Joint degeneration Stem cell and PRP therapy
What is it?
The biological treatments performed are indicated in those patients who suffer from both chronic and acute tendon disorders.
When is this procedure indicated?
The rationale behind their use is related to the immunomodulatory and inflammatory power which characterize the cells and molecules contained in the biological products. Cells and molecules act as mediators, restoring the tissue homeostasis with direct functional and clinical benefits for the patients. The treatments are non–invasive and in case of failure do not impede any further treatment/therapy. All the biological products are prepared from portion of tissue belonging to the patient (autologous treatment, donor = recipient) and prepared according to the highest standard of quality required for these procedures. The devices used to obtain these products have been selected accurately by a panel of expert basing on their clinic efficacy as reported in literature. The biological products are used both alone as injective treatments or in association with surgical procedures for tendon repair. These treatments are indicated in patients of all ages, although literature report better outcomes in the youngest ones.
How is it performed?
Regenerative medicine offers three different types of treatment, each based on specific therapeutic mechanisms. The effects have different duration and intensity depending on specific characteristics of the patient.
Infiltration of platelet concentrates (PRP, Growth Factors). PRP is a concentrated fraction of blood that contains a high concentration of platelets and therefore of growth factors contained in them, which can participate in the restoration of homeostasis (physiological condition) of the tissue by promoting its regeneration. Depending on the judgment of the specialist and the type of treatment chosen, it can be performed once or repeated at intervals of one or two weeks. The treatment has the following steps:
- The patient undergoes a venous blood draw (the volume of blood drawn varies depending on the processing system).
- The collected blood undergoes a high-speed centrifugation process to obtain platelet concentrate.
- Infiltration of platelet concentrate into the affected site (with or without ultrasound).
Total procedure time is approximately 30 minutes.
Infiltration of adipose tissue derivatives (MSC - Mesenchymal Stem Cells). Mesenchymal stem cells are adult stem cells that have the ability to contribute to tissue healing through the production of a wide range of growth factors and molecules that interact with the resident cells of the treated tissues (cartilage and synovial membrane cells). The treatment has the following steps:
- The patient undergoes a mini-liposuction procedure to harvest adipose tissue (under appropriate anesthesiological protocol, mild sedation and local anesthesia).
- Collection of approximately 60-80 cc of adipose tissue. In 90% of cases, adipose tissue is harvested from the abdomen, but in some patients it may be necessary to harvest tissue from other areas such as buttocks, hips, inner thighs.
- Isolated fat is washed, fragmented or separated.
- Infiltration of the final product into the pathological site, with ultrasound guidance, where required.
- Abdomen dressing.
The total time of the procedure is 1 hour, followed by the normal recovery time of the anesthetic treatment undergone.
Infiltration of bone marrow derivatives (MSC - Mesenchymal Stem Cells). Bone marrow contains, although in reduced quantities, a population of mesenchymal stem cells that are now believed to be able to promote the restoration of tissue homeostasis (a physiological condition) by controlling inflammation, and promote tissue regeneration.
- The patient undergoes a marrow harvest directly from the iliac crest (under appropriate anesthesiological protocol).
- Extracted bone marrow is washed and processed directly in the operating room.
- Infiltration of the final product into the pathological site, with ultrasound guidance, where required.
The total time of the procedure is 1 hour, followed by the normal recovery time of the anesthetic treatment undergone.
All treatments are carried out in the operating room to ensure absolute sterility and safety of the clinical course.
Recovery
PRP treatment. After treatment, discomfort, stiffness or swelling at the site of infiltration may occur. No heavy lifting and sports activities are allowed for 15 days. Daily activities including normal walking are allowed from the day after treatment. From day 15, the patiemt may return to normal and the practice of sports activities.
Treatment with MSC. After surgery, hematomas and pain may appear in the abdomen or in the iliac crest in the case of bone marrow harvesting. Sensation of discomfort, stiffness or swelling may occur at the site of infiltration. Assisted ambulation with crutches for 24 hours or more based on subjective symptomatology is required. Daily activities including normal walking are allowed from the day after treatment. No heavy lifting and sports activities are allowed for 30 days.
Short-term complications
Mini-invasive regenerative medicine treatments do not involve any particular side effects or complications. The infiltrated product is entirely derived from the patient himself and therefore guarantees the absence of rejection, allergy or intolerance. Once the infiltration has been performed, the patient can immediately resume light daily activities, and after a few weeks even more demanding activities such as sports. Immediately after infiltration, a feeling of discomfort, stiffness or swelling at the infiltration site may occur. In mesenchymal cell treatments, soreness may occur at the site of adipose tissue or bone marrow harvesting in the days following surgery.
Long-term complications
This type of approach is repeatable (if necessary) and does not preclude the possibility of performing other types of treatment at a later date.
Where do we treat it?
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