Who’s a Good Candidate For Stem Treatment For Knee Osteoarthritis?
In the early part of December, the Vatican issued a pronouncement, again condemning the use of embryonic stem cells for medical research and medical treatment.
While this proclamation will hinder the development of some therapies in medicine, it should not be a major stumbling block in the management of osteoarthritis.
The reason?
Current approaches using stem cells for osteoarthritis are able to make use of autologous stem cells. These are stem cells obtained from the iliac crest (hip) of the patient using a special biopsy needle.
Stem cells are located within the bone marrow. The iliac crest is an ideal site for harvesting bone marrow. Since the procedure is done using local anesthetic, the risks of the procedure are minimal.
Autologous stem cells have the ability to differentiate into other tissue cells. Previously, it was felt this trait was not possible for adult stem cells; however, it has been confirmed that stem cells harvested from an adult are capable of differentiation.
Once the stem cells are harvested, they are concentrated using a special technique. In addition, platelet rich plasma which is derived from a patient’s whole blood is also obtained. Platelets are cells that contain numerous growth and healing properties. These growth factors have the ability to fire off tyrosine kinase receptors on the surface of stem cells and accelerate differentiation and multiplication.
The knee (or hip) is then prepared by “irritating” the cartilage using a special biopsy needle. After this, stem cells and platelet rich plasma are introduced into the joint.
Calcium chloride and thrombin are also used to create a “scaffold” for the stem cells to locate themselves.
Diagnostic ultrasound is used throughout to ensure the proper location for harvesting the stem cells as well as the best location for introducing the stem cells into the target joint. The use of ultrasound is mandatory for proper anatomic placement!
So who might be a candidate for this procedure?
First, it’s important to realize that a patient must have some cartilage remaining in the knee for stem cells to do their job.
Osteoarthritis is currently graded in clinical trials using standing knee x-rays to quantify the amount of cartilage present within the knee.
The Kellgren-Lawrence classification is used. Grade 1 means the amount of cartilage is relatively normal. Stage 4 means that the patient is “bone on bone”. Patients who are Kellgren- Lawrence stage 4 are not considered candidates for stem cell treatment. Patients who are grades 1-3 are acceptable.
Patients who are grade 3 must be at or near ideal weight.
Age also plays a role. It appears that as people get older, their stem cells respond less to stem cell stimulation. At our center, we generally use 75 as the cutoff. Even then the patient must be vigorous and active.
The ideal patient is between the ages of 30-70 and is at or near ideal weight. Healthy Baby Boomers who are athletic and active are felt to be the best candidates.
What measures are assessed?
We are currently evaluating both subjective as well as objective parameters. These include a visual analogue scale of pain, a Health Assessment Questionnaire (WOMAC), 50 foot walking time, knee x-rays done using special angulation to allow precise measurements of cartilage thickness, and ultrasound measurements of cartilage thickness.
The length of recovery is highly variable depending on factors such as age, general physical condition, Kellgren-Lawrence stage, and amount of “irritation” required to prepare the cartilage.
For more information regarding stem cells for osteoarthritis, call the Arthritis and Osteoporosis Center of Maryland at (301) 694-5800.
Nathan Wei, MD FACP FACR is a nationally known board-certified rheumatologist. For more info: Arthritis Treatment and Tendonitis Treatment Tips
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Do You Have a Systemic Yeast Infection? You’ll Be Surprised at the Symptoms
Systemic yeast infection is a serious fungal infection because it causes many illnesses and serious threats to a person’s overall health conditions. Almost all people, especially women, will experience yeast infection at least once throughout the course of their lives. This is almost considered normal and is typically not a huge issue, but if this regular infection gets out of control or if the fungal development is carried to other internal organs, it will become a systemic yeast infection which can wreak havoc on your body, health and well being.
The yeast infection fungi are very persistent and the growth is very fast with a systemic yeast infection which is why it often cannot be completely eradicated by the immune system which has become worn out from trying to prevent the fungi from spreading deeper into the body.
Conditions such as high sugar, acid, or toxin contents in the intestines, low level of white blood cells, and a yeast infection which is not treated immediately are the ideal environment for these fungi to grow and multiply.
If the systemic yeast infection or sometimes referred to as the ‘opportunistic’ yeast infection continues to grow and spread inside the body, it can cause problems such as acid reflux, dandruff, fatigue, arthritis, asthma, allergies, acne, hives, fibromyalgia, arteriosclerosis, eczema, psoriasis, depression, high cholesterol, gout, and irregular bowel movement. In fact, this is one reason why it is so hard to nail down as these symptoms can be symptoms of so many other things. In addition, a lot of people with these particular symptoms just accept them as part of life when, in fact, they may be caused by a yeast infection and treatment could relieve your suffering.
Fortunately, you can prevent this by eating a healthy and balanced diet, taking in a few vitamins and supplements, embarking on a periodic detoxification program, and changing your overall lifestyle to include healthier habits. In this kind of infection, it is best to use a holistic approach in curing it rather than focusing on one kind of treatment or one area because the root cause of this infection goes much deeper than what meets the eyes. Since the infection is affecting your whole body, you need to treat your body as a whole in order to totally get rid of the yeast infection.
By definition, a systemic yeast infection is invading your entire system, therefore spot treatments will not work. As described above, changing your lifestyle and eating healthy foods is the only way to battle this type of infection that is often misdiagnosed due to it’s many and varied symptoms. If you have any of the symptoms mentioned above, you don’t have to just accept them as part of life – go to your doctor and find out if have a yeast infection – or better yet, embark on a healthier lifestyle that will clear up the infection – it will be better for your health whether you have a yeast infection or not!
You don’t have to suffer with these systemic yeast infection symptoms anymore - if your ready to learn about a clinically proven holistic method, then all you need to do is click here!
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