Stem cells: Legit medicine or a waste of money?
Everyone in my age group is getting their knees replaced. I don’t
want to. I have heard stem cell treatment helps. Is it worth it? — Sharon, Durango, Colorado
In recent years, stem cells have gained popularity as an alternative to knee surgery, both in the case of injury and normal wear and tear (or osteoarthritis, in medical terms). The thinking goes: Stem cells from a person’s own body, when injected, can help reduce inflammation and even help the body regenerate cartilage that acts as a cushion between bones.
Stem cells, which have the ability to transform into other types of cells, are a fascinating area of medical research. The hope is that one day we will use them to regenerate and repair all kinds of tissues impacted by disease. But while it’s promising, some of the science is still unproven. So clinics that promise miraculous-sounding treatments probably don’t have significant evidence to back up their claims.
“The best-case scenario I’ve heard is that stem cell injections seem to help their knees for a few months,” says Paul Knoepfler, a stem-cell scientist at the University of California at Davis. “And then they are right back where they started — but out $5,000, $10,000, or even $20,000 and still needing joint replacement.”
Those initially good results could be a real, short-term response to the treatment, or they could just be a placebo effect, according to Knoepfler.
In the universe of stem cell therapy, it’s often buyer beware — especially as these treatments often aren’t covered by insurance. Often, as Knoepfler points out in an exhaustive blog post on this type of knee therapy, what’s being billed as stem cells aren’t even real stem cells. It can be something called amniotic extract, or dead cells.
Actual clinical trials of stem cells also provide widely varied results, according to Knoepfler.
“The same is true for other related approaches often offered by the same clinics, like platelet-rich plasma or PRP injections,” Knoepfler says. “Some trials reported possible benefit, while others report no benefit.”
For example, one recent study found stem cells were no better than steroids at reducing knee pain. Many studies, including a large one by the Mayo Clinic, are inconclusive about whether stem cell therapy helps ailing knees. Some research does find benefits from the therapy, but often requires further study or long-term follow-up to determine whether the effects last.
“There are also risks, including infection, from the injections,” Knoepfler says.
Osteoarthritis of the knee is one of the leading causes of pain and disability as we age. Understandably, there’s a lot of interest in treating it, especially without surgery. One day, stem cells may be a key part of that. They’re just not quite ready for prime time yet.
“The bottom line is that there is no good evidence that stem cells can help avoid knee replacement when there’s severe arthritis or other joint damage,” says Knoepfler. — Kristen V. Brown