Regenerative Medicine in Sport, a tool, potentially important for the Doctor.
By Dr. Matias Fernandez Viña.
Medical Director At Stem Cell Therapy In Argentina.
Many doctors and athletes use stem cell therapy to treat sports injuries, such as tendinopathy of the Achilles or the injured ligaments of the knee. Injections of stem cells, platelet-rich plasma (PRP), prolotherapy, and techniques for cartilage regeneration are examples of treatments of regenerative medicine that doctors use to treat sports injuries. While their popularity increases, the stem cell therapy is not considered a standard practice by the doctors of sports medicine and is not covered by most insurance companies. To the extent that it arises more scientific evidence on the use of these biologic therapies, the greater is the amount of benefit that is reflected in the sport to retrieve the injured.
WHAT TYPES OF SPORTS INJURIES TREATED WITH STEM CELLS?
Doctors use stem cells to treat a wide variety of sports injuries, including damage to the:
- Tendons
- Ligaments
- Muscles
- Cartilage
These injuries can be due to trauma at one time or the use of excessive chronic. Stem cells can be applied to an injured area through: Injection. A doctor can inject stem cells directly into the affected area. Surgical application directly. A surgeon may apply stem cells directly to the torn ligament, the tendon or the bone that is being repaired. Sutures carriers of stem cells. A surgeon can sew a muscle, ligament, or tendon that is torn apart by using a material similar to a thread that is coated with stem cells. To administer injections, many doctors use ultrasound or other medical imaging such as fluoroscopy or computed axial tomography to ensure that the cells are sent with precision to the site of damaged tissue. The treatments of regenerative medicine can be used independently or together. For example, the PRP can be used only in an injection therapy or can be applied during the surgery of cartilage regeneration. All of these treatments are outpatient procedures, and it is possible that they are not covered by insurance. It is possible that it requires more than one session of treatment before you feel the results and, as with any treatment, results are not 100% guaranteed.
1. STEM CELL TREATMENTS
A stem cell does not have a function specific body, but can become a cell that does, as a cartilage cell or a cell of the tendon. That is the evidence that is observed in various models of laboratory study. But what is more important, is that a stem cell will work according to the local environment that is exposed. That way, you will achieve a number of benefits of biological indispensable.
Doctors who use stem cell therapy believe that when placed in a certain environment, stem cells can transform to meet a certain need. For example, stem cells located near a damaged Achilles tendon are supposed to develop into healthy Achilles tendon cells. That doesn't happen 100%, the mechanism is a bit more complex, but the goal is to recruit as many progenitor cells from that tissue as possible to boost its activity.
Doctors usually collect the stem cells used for the treatment of fat, blood or bone marrow of the patient. Some companies sell to the medical stem cells from amniotic fluid, placenta, or umbilical cord tissue, but without close supervision, these cells usually die during storage and transportation, which makes the product ineffective. The growth factors that have these latter cells are the actual effectors of therapeutic, as well as exosomes (micro-fragments or nanoparticles RNA)
2. PLATELET-RICH PLASMA (PRP)
Many experts believe that the natural healing properties found in the platelets and the plasma of the blood can be used to facilitate the healing and repair of sports injuries. The PRP can be injected or applied to the injured area during surgery for example.
To make PRP, blood is drawn from the patient and then processed often using a centrifuge to create a concentrated solution of platelets, and plasma (PRP). The aim is to recruit the largest number of platelets possible.
When performed by a single centrifugation of the blood, you get what is called PDGF, which is a plasma rich in factors of growth. To get a good count of PRP, it is necessary to at least make two spun or more. Not all PRP are the same. Therapy with PRP varies, depending on such factors as the differences in the blood of patients, the method of blood processing and the use of other substances, such as anesthetics (e.g., lidocaine).
3. PROLOTHERAPY
The inflammation increases blood flow and attracts cells (granulocytes, monocytes, macrophages, and fibroblasts) that it can repair and improve the damaged tissue. Sports injuries usually cause inflammation, but in some cases, the inflammation disappears before the injury has healed. During prolotherapy, a doctor injects an irritant in the injured area, which temporarily increases the inflammation. The hope is that the additional inflammation facilitates the healing further. The prolotherapy sometimes used PRP as irritating, but the prolotherapy is not, by definition, a cell therapy. In fact, the irritant is most used is dextrose, a simple sugar. You can also use substances such as glycerin or saline solution.
Note: in comparison with other treatments in regenerative medicine, such as injections of stem cells and PRP, there is not much clinical research on prolotherapy and its effectiveness.
The goal is to have a doctor to treat an athlete, it is not to shorten the recovery time, although many times it is the desire of an entire team.
The primary objective is to achieve a regeneration of the tissue, in order to avoid future injuries recividantes on the damaged tissue.
