What are stem cells?
Stem cells are cells that can produce different types of tissue. They therefore have no function yet and, when in contact with a specific tissue, for example, they transform into the same cell type as the contact cell.
What is stem cell therapy?
Stem cell therapy is a type of therapy that makes use of the body's own resources and properties described above for healing. No foreign substances are required for this.
Stem cell therapy, for example, is a cutting-edge form of therapy that offers many seriously ill patients the prospect of working completely without surgery or medication.
In stem cell therapy, cells are removed from either the bone marrow or subcutaneous fat tissue and injected into the target organ structure. This usually involves working with stem cells from the bone marrow, which have hematopoietic functions. Extraction from other tissues is also possible, as stem cells are found in most tissues of the human body.
The ability of stem cells to renew and differentiate can be used medically to treat various diseases.
The transfer of stem cells is not only possible from a foreign donor. In autologous stem cell therapy, the cells are obtained from the patient and the patient then receives these cells back after they have undergone a treatment process.
We obtain stem cells from abdominal fat, as many studies show that the concentration of stem cells in adipose tissue is up to 500 times higher than in bone marrow.
We obtain the stem cells from your subcutaneous fat tissue under local anesthesia through a small liposuction of approx. 30 ml. Centrifuging the suspension results in approximately 1.5 ml of stem cells. It contains around 1,200,000—1,500,000 stem cells. These stem cells are then injected into the recipient tissue after prior local anesthesia.
How do stem cells work against osteoarthritis?
Osteoarthritis develops when the cartilage of a joint is destroyed and the bones are affected by rubbing against each other.
The affected persons suffer pain and lose their freedom of movement. This is because the joints become inflamed and swell. The knee is often affected, but the finger and ankle joints are also common weak points.
In principle, all joints can develop osteoarthritis. Stem cell therapy is a new and promising form of therapy for osteoarthritis.
In our orthopedic area, joint treatment is paramount. In addition to tissue renewal, this also inhibits inflammation. As a result of this combination, this therapy reduces pain and thus increases exercise capacity again.
Treatment with stem cells improves the natural cartilage layer and thus the function of the joint. In this way, you are pain-free in the long term, reduce inflammatory factors and avoid prosthetic replacement in the long term.
How effective is therapy for osteoarthritis?
A review from 2019* commissioned by the Korean Ministry of Health summarizes the most important studies on osteoarthritis therapy with stem cells.
All 203 patients who took part in the six studies had knee osteoarthritis of varying degrees of severity. They received knee stem cell therapy.
The knee joints are among the most commonly affected joints when it comes to osteoarthritis. Stem cell therapy on the knee ensures that patients can walk pain-free again, as stem cell transplantation supports and regenerates the inflamed tissue. The released growth factors trigger tissue reconstruction and inhibit painful inflammation. Side effects should not be expected.
*Kim et al.: Intra-articular Injection of Culture-Expanded Mesenchymal Stem Cells Without Adjuvant Surgery in Knee Osteoarthritis: A Systematic Review and Meta-Analysis, 2019.
What does treatment for osteoarthritis look like in practice?
For osteoarthritis treatment, stem cells are obtained and processed from adipose tissue or bone marrow. It is then infiltrated into the successful tissue. They take effect there just a short time after treatment. Patients should be able to feel a significant improvement just a few days later.
Where can stem cell therapy be used?
Until now, stem cell therapy has had little use in everyday medical practice. But it is not only successful when used against osteoarthritis.
The healthy cells can also help against many other diseases. To date, blood cell donation in leukemia therapy has been a common area of application. Stem cells can also be of good use in the case of skin burns, as they stimulate cell production in the injured area again. Stem cells have recently also been used to treat eye damage.
Medical research is currently making intensive efforts to open up further areas of application and to make use of stem cells against other diseases. Research is in full swing in the area of cardiovascular diseases, neurological diseases such as multiple sclerosis, Parkinson's disease and paraplegia. Stem cells are even said to be able to repair diseased hearts. For this purpose, stem cells are extracted from the patient's bone marrow. How successful the method is will be seen in the future.
Dr. Olaf Beck treats the following diseases through stem cell therapy:
- knee osteoarthritis
- hip arthrosis
- shoulder arthrosis
- ankle arthrosis
FAQ
How is a meniscus tear treated?
First of all, it depends on the degree of cross-linking of the meniscus tear. The damaged areas of the torn meniscus can be removed or sutured after diagnosis. During removal, the parts of the meniscus frayed by the crack are sheared off. This allows the rough surface of the torn meniscus to be smoothed out. In a few rare cases, the meniscus tear is restored by a transplant, which is sutured and replaced with donor meniscus or biological tissue replacement.
Can a meniscus tear heal by itself?
Whether the meniscus tear can heal by itself is also decided here on the basis of the degree of injury. You should also know that the meniscus contains various zones. Some areas have good blood flow and other regions that are more centered in the knee joint do not.
If the tear is in the well-circulated region of the meniscus and it does not go too deep into the poorly circulated areas, it can heal conservatively.
How long does it take for a meniscus tear to heal?
How long it takes for the meniscus to heal depends on the type and method of treatment and depends on the individual case of one of the patients. The exact type of injury and the location of the crack are decisive. It takes 6 to 14 weeks for the meniscus to heal in most cases.
How quickly does a meniscus tear have to be operated on?
The pain and inability to move can be painful after a meniscus tear. As a rule, the knee can no longer be fully extended or bent. You should therefore see a doctor as soon as possible to discuss the next steps.
What happens if a torn meniscus is not treated?
If you opt out of the recommended meniscus tear treatment, this will necessarily result in cartilage damage and osteoarthritis. The crack is further damaged with every movement until walking is only possible with great difficulty.
FAQ
1. Risks?
Post-operative effect. If this occurs, the inner lining of the prosthesis and joint must be removed. Knee is then rinsed several times and then a “spacer” is inserted (bone cement prosthesis containing an antibiotic). This spacer stays in the body for an average of 6 months; the patient is not allowed to buy for 6 months. After 6 months, it is replaced by a full prosthesis.
2. Complications?
- Improper placement of the prosthesis:
- implants that are too big or too small
Movement restrictions, in the worst case worse after surgery than before.
3. Rehabilitation?
6-7 days KH. There are also rehab facilities or outpatient rehab (4 hours a day in a hospital and treatment there) → but is out of the question for people living alone.
4. Lifespan and durability?
Depends on various factors:
- quality
- medicines
- Gender and burden
- Positioning the load, loose prostheses must be replaced. It is advisable to check every 2 years so that any easing can be seen and prevented.
5th sport?
Biking, swimming, no problem. Stop-and-go sports, both shear forces acting on the knee joint, should be prevented as far as possible.
6. Is the right time for the prosthesis?
This is achieved when the patient says it can't get any worse. After the knee prosthesis has been inserted, the symptoms may be worse than before. If a patient can walk 5 km before surgery, he may only be able to run 500 m after surgery. Therefore, the right time is only when there is no other way out.
7. Duration of sick leave?
They work sedentary work earlier than stressful work. On average, it is 8-12 weeks.
8. How long do you walk with crutches?
After arthroscopy using degenerative procedures, supports must be run for an average of 4 weeks, then, depending on the findings, a splint takes over this function. However, if the meniscus is still implanted or if the upper and lower legs have cartilage damage opposite each other and has been repaired, this period is extended by 6-6 weeks, but depending on the patient's body weight.
9. What should you discuss with a doctor before knee surgery?
As a patient, you should leave the consultation with the feeling that you know that and why surgery may be necessary. This is the only way you can start the operation with a good feeling. Therefore, you should definitely ask what the alternatives to surgery are (and why they might not be an option for you). You should also ask what the possible risks of surgery are — more about this below — and when is the best time for surgery. If you are still unsure after the surgery consultation, get a second opinion.
10. Should I get a second opinion before knee surgery?
Knee surgery should be avoided if it can be avoided. On the one hand, every patient probably prefers to avoid going to the clinic; on the other hand, every operation represents a limited but existing risk that should only be taken when other forms of therapy have been exhausted. This is especially true when it comes to the question of whether an artificial knee joint needs to be inserted.
The knee joint is the joint in the body that is exposed to the greatest load. As a result, problems with the knee joint occur frequently. There are many things you can do to relieve the joint. Avoid knee-straining sports, but knee-saving physical activities and targeted exercises for the knee (physiotherapy); medications, bandages, orthotics — all of this can help reduce pain and relieve and stabilize the knees.
Even when surgery is unavoidable, the use of an artificial knee joint is often not necessary. There are already procedures that can even eliminate extensive cartilage damage with a transplant (cartilage cell transplant).
If an operation is recommended by your attending physician, then it makes sense to obtain a second opinion. Obtaining a second opinion is often also covered by health insurance companies. Of course, there are clear criteria as to when which procedure is to be used. But there are also borderline cases in which different specialists may well have different opinions. So if you want to be sure whether surgery is really necessary in your case, you should definitely get a second opinion from an expert in the field.
But always remember: The risk also represents an opportunity; avoiding one risk can lead to the next. If you refrain from knee joint surgery, this can not only lead to permanent pain and a restriction of mobility in the knee joint and thus quality of life. It can also have repercussions on the leg and hip should the pain cause incorrect strain in the knee.
11. How is the recovery process going?
This question is very individual and cannot be answered in general terms. It depends on the individual case and in particular on the type of surgical procedure. In any case, it will take several weeks before you can walk again without crutches after knee surgery, until you can fully exercise your knee again, usually up to six months, in some cases even 12 months.
In the case of a cartilage cell transplant, for example, the knee is usually able to regain normal strength only one year after the operation. The recovery process for cruciate ligament ruptures also takes a very long time; a full load may take place after six months at the earliest. This is more difficult to assess during meniscus surgery. The healing process can take from one week to six weeks. Whatever knee surgery you have, it is very important that physiotherapy starts immediately after the operation and that the recovery process is well supervised by professionals. Therefore, do not miss the follow-up tests. They contribute to the fact that
Whatever knee surgery you have, it is very important that physiotherapy starts immediately after the operation and that the recovery process is well supervised by professionals. Therefore, do not miss the follow-up tests. They help make the operation worthwhile for you and hopefully you can move (almost) pain-free again.
