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We have put together some commonly asked questions to provide you with more information.
This is a blanket general term encompassing all treatments which enhance the body’s own power to regenerate natural tissue to heal and strengthen, at specific sites of “wear and tear” tissue damage, or injury. This includes: HESWT (high energy shock wave therapy); PRP ( Platelet Rich Plasma); Stem Cell, Mesenchymal Cell; and Bone Marrow injection Therapy
Stem cells are precursor cells of all human and animal tissues which have the potential to differentiate into various cell types and form diverse tissues such as tendons, ligaments, muscles, bone and cartilage. Embryonic stem cells are derived from an embryo. The use of embryonic cells for medical treatment is currently unethical and illegal in the UK. Adult stem cells are therefore used in clinical practise.
Mesenchyme tissue is part of the “embryonic middle Layer” (or embryonic Mesoderm), of adult human and animal tissue which forms connective tissue such as muscle tendon and ligament as well as lymphatics and blood vessels. Mesenchymal cells (or Mesenchymal Stromal Cells) are derivatives of Stem Cells which exist in adults in humans and retain the potential to differentiate into a range of tissue forming cells to “manufacture” muscle, tendon, ligament and bone tissue (amongst other tissues, even nerve cells).
These are mature subsets of Stem Cells (including Mesenchymal Stem Cells) which have more restricted potential for regenerating more specific tissues, such as bone, cartilage or connective tissue.
Stem cells can become different kinds of tissue cells such as bone or cartilage. Stem cells can also work by secreting a variety of chemicals such as growth factors, cytokines and microRNAs.The concentration of stem cells then works directly at the site of injury or degenerative tissue where they are re-injected. Here they increase the regeneration and healing potential by a series or cascade of cell recruitment, multiplication and differentiation into specialised cells, which then manufacture the new tissue required.
In addition to these properties of tissue regeneration and repair, MSCs have been shown to have immunomodulatory functions (suppressing inflammatory response), clinically effective in a range of disease processes including Cardiac disease modulation (eg: in acute Myocardial Infarction, enhancing heart muscle regeneration, and coronary artery angiogenesis [regeneration] ); as well as the anti-inflammatory effect in joint and tendon pain control.
Haemopoietic Stem Cells were first described in 1909 (Maximov), and clinically put to good use successfully in the 1960s for bone marrow transplantation following radical radio and chemotherapy for cancer treatment.
MSCs are found in higher concentrations Bone Marrow, Adipose (fat) tissue and surrounding and adherent to blood vessels, as well as in amniotic fluid and the umbilical cord (Wharton’s Jelly). Adipose tissue contains many times (1000s) more regenerative cells than bone marrow (whose effectiveness has been established for a long time), they also release numerous signal substances that are thought to play an important role in controlling and accelerating tissue repair and regeneration.
In the UK, and at our clinic, we use Stromal Vascular Fraction (SVF) derived Mesenchymal cells harvested from Adipose (fat layer) tissue. The sites include the abdomen (most commonly) and occasionally flanks, thighs or buttocks.
It can be effective in a range of musculoskeletal conditions to help the body heal itself, by repair and regeneration of localised tissue. It can include treatment of “wear and tear” or post trauma osteo-arthritis in any joint, including the hip, knee, shoulder, wrist and hand, ankle and foot. It can also be effective in damaged or degenerate soft tissues such as tendons and ligaments.
Most commonly used to regenerate bone defects and in degenerative joint conditions (including loss of articular cartilage, Osteo Arthrosis, etc)
At our clinic we use SVF cells harvested from fat layer tissue, typically from the abdomen or flanks, and occasionally from thigh or buttock fat; or Bone Marrow Cells (BMAC) typically harvested from the pelvis (Iliac Crest) bone.
Yes, SVF, Adipose Mesenchymal stem cell therapy, “fat cell” derived systems of various kinds, including the ACP SVF system, have been in clinical use and been used extensively for many years in many European countries including Germany and Italy, and have an excellent safety record.
These cells are natural, and autologous: taken from, and used in, single individuals (ie use only the patient’s own cells) so there are no risks of an allergic reaction as no foreign substances are injected.
They are harvested at the time of the procedure and used immediately, and under sterile conditions, so have virtually no risk of infection.
Bone Marrow (BMAC) harvesting and clinical use procedures have also been used in orthopaedic surgery for many years with an excellent safety record. As the bone marrow is natural and harvested at the time of the procedure there are no risks of an allergic reaction as no foreign substances are injected, and again used immediately, under sterile conditions, virtually eliminating the risks of infection.
The recommended process, following an enquiry, involves making an appointment with one of our experienced specialist Consultant Orthopaedic Surgeons who will fully discuss the symptoms and problem, carry out a thorough examination, and if necessary recommend further investigations such as specific imaging (Xrays, MRI or Ultrasound scans), blood tests etc. as indicated.
If deemed suitable for a regenerative treatment, the options and alternatives will be fully discussed and recommendations made; including the correct injection treatment; but also for other therapies which may be indicated, including for instance Physiotherapy, specific exercise, etc.
You will be given the opportunity to discuss the whole procedure and ask questions both at the time of the consultation and subsequently, prior to proceeding with the treatment plan.