Stem cells may be the future of orthopaedics, general medicine

June 27, 2012

Topic: Orthopaedics

Orthopaedic-related emergency room visits.

When one walks through the various wards of a hospital, it is easy to encounter a wide range of patients who are dealing with a number of health issues. A child may be battling with leukemia. An elderly man could be struggling with Parkinson's disease, hoping that one day, scientists will find a cure. A college football player with a knee injury may wonder whether surgeons will be able to repair his tendons and get his career back on track.

On the surface, it may not seem like these individuals share much in common. However, in the eyes of science, these patients may all benefit from stem cell research. This field of medicine is rife with opportunities for therapy, drug development and other scientific advances that may ultimately lead to treatments for diseases that were once thought to be incurable.

At the Andrews Institute, doctors and surgeons are studying stem cells in order to bring the best treatments to patients in a manner that is safe, effective and ethically responsible.

Different stem cells and different uses

Stem cells are immature, undeveloped cells that have the potential to generate other cells that may form different types of tissue. There are several classes of stem cells, according to the National Institutes of Health.

Embryonic stem cells (ESCs) form during the earliest stages of cell division after a sperm fertilizes an egg. ESCs are pluripotent, meaning they have the potential to differentiate into any type of cell found in the human body.

Induced pluripotent stem cells (iPS) are taken from the body of a living person, then manipulated in the laboratory in order to become pluripotent, just like ESCs. Because iPS cells are harvested from people, they sidestep many of the ethical and moral questions posed by ESCs. However, ESC’s and iPS cells have the potential to develop into tumor cells.

Adult stem cells are found within different organs of the body. They can differentiate into only one or a few different types of cells that are usually related to the organ system from which they came. They can differentiate into nerve, fat, cartilage, bone, cardiac, skeletal muscle, liver, or pancreatic cells. Unlike ESC’s and iPS cells, these adult stem cells are safe to use in treating orthopaedic injuries.

Scientists are excited about the various possibilities that stem cells provide. For example, iPS cells that are harvested from a person with a genetic condition can be used to create a laboratory model of that disease. This can help doctors find a cure for an illness that was once difficult to study.

Bone marrow cells are an example of adult stem cells that are used for regenerative medicine, in which dead or diseased cells are replaced with healthy ones. Bone marrow cells may generate healthy blood cells, used to treat blood disorders, as well as  damaged cartilage, bone and/or skeletal muscle cells, which may one day help the healing process of orthopaedic injuries sustained by athletes and/or weekend warriors.

Orthopaedics, sports medicine and stem cells

The potential for stem cells in regenerative medicine has piqued the interest of many athletes who have sustained injuries, such as torn ligaments and tendons. Adult stem cells may be especially promising if they are harvested from an athlete's own bone marrow and fat cells. According to Joshua G. Hackel, M.D., Andrews Institute for Orthopaedics & Sports Medicine, regenerative treatments that use an individual's own stem cells are the safest and offer new minimally invasive treatment options for our patients with arthritic joints and tendon or ligament injuries that once required surgery to correct.

"We are using the patients' own mesenchymal cells from bone marrow and fat to treat potentially career-ending injuries," said Dr. Hackel. "We currently offer these treatments to athletes as well as non-athletes at the Andrews Institute."

However, such an approach remains controversial in the U.S., as it blurs the lines of drug regulation, resulting in a limitation of procedures that can be offered in the U.S. Therefore, many athletes are tempted to fly overseas for treatments that are not yet allowed in the U.S. and are neither scientifically proven nor monitored by a medical authority. In addition to potentially wasting their time and money, this may put athletes' health at risk.

"We'll be working with the FDA to identify the best source of mesenchymal stem cells, whether that is from the patients' own bone marrow, fat or blood, and to complete  research studies necessary for FDA approval of advanced procedures in the U.S.," said Dr. Hackel.

The staff of the Andrews Institute strives to advance regenerative medicine in cooperation with the U.S. Food and Drug Administration.

"There's no reason in the world for our elite athletes to have to go offshore somewhere else to get the best treatment to enhance biologic healing," James Andrews, M.D., told ESPN.

In the meantime, scientists are pushing forward in their pursuit of finding what may be the next great medical advance.

To learn more about regenerative treatment options currently offered at the Andrews Institute, or to make an appointment, call 850.916.8700 or click the "appointment request" link on

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