Tuesday, October 4, 2016

Stem cell therapy – what can be said about it?

Intra-ArticularCellular Therapy for Osteoarthritis and Focal Cartilage Defects of the Knee

Patients with shoulder arthritis and rotator cuff often ask, “I’ve heard about stem cell injections and cryopreserved, injectable amniotic fluid-derived allograft, would they help my shoulder?”

The authors of a recent systematic review of stem cell treatment of knee arthritis and articular cartilage defects concluded that “the efficacy of cellular therapy injections has not yet been established.
The value and effective use of cell therapy in orthopaedics remain unclear largely because of the absence of 
(1) rigorous blinded clinical trials, 
(2) standardized use of nomenclature to define cell populations, and 
(3) quantitative metrics to define cell populations and clinical and structural outcomes. 

Although many of the studies reported were randomized, patients had not been blinded. Because cellular therapy carries a high level of expectation for possible benefits, it can constitute a strong source of bias in enrollment and in perception of patient-reported outcome.” 

 While this article is about the knee, it is likely that even less quality information is available about the shoulder.

At present, we do not use these agents in our practice because the lack of evidence of their cost-effectiveness.