What are stem cells?
Stem cells are immature cells that can divide and change into different types of mature cells with different jobs.
There are 3 main types of stem cells:
- Adult stem cells are found in bone marrow, fat, blood, joints, and many other tissues. These stem cells are also called mesenchymal stem cells (MSCs).
- Induced adult stem cells are made from skin cells to become adult stem cells.
- Embryonic stem cells are found in embryos. These are not used in the treatment of osteoarthritis.
Can stem cells treat osteoarthritis?
Stem cells are not an approved treatment for osteoarthritis in Canada. Treating osteoarthritis with stem cells is still experimental and is being studied.
In Alberta, using stem cells to treat osteoarthritis only happens in research studies.
More research is needed before stem cells can become a standard treatment for osteoarthritis. Researchers are studying stem cells to find out:
- How they can use them.
- How well they treat osteoarthritis.
- When to best use them for osteoarthritis.
- If they might be a better treatment for some people than others.
How does the treatment work?
Most stem cells used for experimental osteoarthritis treatment are adult MSCs. Researchers can easily collect them from a person's fat or bone marrow.
MSCs are being studied because they can turn into cartilage, bone, muscle, tendon, ligaments, or fat, depending on the type of tissue that surrounds them.
Research shows that MSCs release anti-inflammatory factors that help heal and lessen pain. When they are injected into a joint, some studies show they may help relieve pain, swelling, and loss of movement.
Stem cells can also be used to make an artificial tissue in a laboratory. This lab-made tissue can then be put into a joint to help repair damaged bone, ligaments, and cartilage.
Is it safe?
The safety of stem cell treatment depends a lot on how the stem cells are prepared and where the procedure is done. (It must happen in a very clean and sterile place.)
Most stem cell treatments use a person’s own MSCs from their bone marrow or fat. Research shows these treatments are very safe for osteoarthritis.
Some stem cell treatments use stem cells donated from other people’s tissues. The possible risks of using donor sterm cells include:
- developing an infectious disease
- having an immune reaction where your body attacks the donor cells
If you decide to have a stem cell treatment for osteoarthritis, you will need follow-up to watch for unwanted side effects.
Does it work?
Research so far doesn’t show that a stem cell treatment alone cures osteoarthritis.
It also doesn't show that the treatment can rebuild a damaged joint in people who have been living with osteoarthritis for a while or who have advanced osteoarthritis.
Some tissue-engineering studies are showing that cartilage can be repaired if the damage is treated early.
People respond differently to this treatment. Some people have had long-term pain relief that lasts more than a year. Other people have not had any less pain.
More research is needed to know if stem cell treatment works well for osteoarthritis and why it works better for some people than others.
Is it available in Alberta?
Stem cell treatment for osteoarthritis is not available in Alberta.
You may see clinics in the United States, Mexico, or other countries that advertise stem cell treatments to Canadians, but you will need to pay all the costs yourself.
At this time, the Alberta Health Services Bone and Joint Health Strategic Clinical Network does not endorse any of these clinics.
What should I know before having this treatment outside of Alberta?
If you’re thinking about having stem cell treatment for osteoarthritis outside of Alberta, here is what you need to know:
- Stem cells treatment for osteoarthritis is still being studied. It’s an experimental treatment.
- Health Canada doesn’t allow clinics and providers in Canada to offer a stem cell treatment for osteoarthritis, unless it’s part of an approved research study.
- Guidelines for clinics and providers outside of Canada may have different standards than those in Canada.
- There is no strong evidence that stem cell treatment for osteoarthritis can repair damaged tissues, but it may help with pain.
Are there similar treatments?
Treatments called “regenerative therapies” are sometimes called stem cell treatments. But these treatments, including platelet rich plasma (PRP). don't use stem cells. It’s more correct to call this type of treatment a “cell therapy,” because it uses a type of blood cell called a platelet.
Some treatments also use materials shed from adult stem cells, but these are also experimental.
What questions should I ask about stem cell treatment?
If you are thinking about stem cell treatments for osteoarthritis outside of Alberta, ask the provider or clinic these questions to learn about safety and quality:
- Am I a good candidate for stem cell treatment and why?
Do you belong to a regulatory body, such as a college of physicians and surgeons?
Do you have proper training and certification in stem cell treatments for osteoarthritis?
- What stem cells will you use for my treatment? Are they from fat or bone marrow or some other source?
- Do you plan to use my stem cells or someone else’s stem cells?
- Will you inject anything else along with the stem cells?
- How much does the treatment cost? What does the cost include?
- What are the payment options?
- Does private or public health insurance cover any of the costs?
- Do you also collect and prepare (process) the stem cells?
- Where are the stem cells prepared before they are used in the treatment? Do you have equipment at the clinic to do this?
- What are the possible risks or side effects of the treatment?
- Are you able to handle any problems or emergencies that may happen during the treatment?
- How many stem cell treatments have you done for osteoarthritis?
- How many people at the clinic have had problems after treatment?
- How many people didn’t respond to the treatment?
- What can I expect in the days and weeks after the treatment?
- What is the follow-up after the treatment?
- Do you collect my data to track results?
