StemInject Procedure/Stem Cell Therapy

Stem Cell Therapy for Joint Restoration

Dr. Robert Ellsworth utilizes his special StemInject Procedure to inject stem cells for the relief of chronic pain and the restoration of damaged joints.

Prolotherapy, a non surgical intervention for ligament and tendon repair as well as joint restoration has been in existence in its modern day form since the 1930’s. Chronic musculoskeletal pain is often associated with laxity or injury to ligaments and tendons which causes destabilization of joints. The lack of stability leads to excessive wear and tear within the joint itself known as osteoarthritis and degenerative joint disease. Correcting these degenerative conditions can halt chronic pain and further arthritic changes within the joint itself. Studies confirm the effectiveness of prolotherapy in the resolution of many musculoskeletal pains, including low back pain, neck pain, and whiplash injuries, chronic sprains and strains, tennis and golfer’s elbow, knee, ankle, shoulder pain, coccyxdynia, chronic tendonitis, Achilles tendon pain, and other joint pain or musculoskeletal pain related to osteoarthritis.

The standard injected solution contains dextrose as a proliferative but may include glucosamine sulfate, morruate, sarapin, zinc and Vit. B 12, as well as a local anesthetic of either procaine or lidocaine. Formulas will vary depending on the practitioner’s background, training and experience. Injections using standard Prolotherapy solutions are what could be considered as a Level 1treatment protocol for the healing of ligaments, tendons and joint regeneration.  Level 2 began with platelet-rich plasma (PRP) prolotherapy which was introduced in the early 2000s. This method uses a patient’s own blood, centrifuged to concentrate growth factor–rich platelets as the proliferation formula. Level 3is the most cutting edge of the injection therapies for relieving chronic pain and joint restoration. It utilizes the newest in Autologous Stem Cell Therapy. Recently physicians have begun using adult stem cells, harvested from the patient’s fat tissue or bone marrow during an in-office procedure. Research has shown that an enhanced healing effect can be obtained when Adult Mesenchymal Stem Cells (AM-SC) are combined with the individual’s Platelet Rich Plasma (PRP) as the proliferation formula for injection into injured musculoskeletal tissue.

Adult Mesenchymal Stem Cells

In the early 1990s, existence of adult mesenchymal stem cells (MSCs),described as “non-committed progenitor cells of musculoskeletal tissues,” were discovered to have an active role in connective tissue repair. These cells were first labeled by Caplan as mesenchymal stem cells because of their ability to differentiate to different cell lines. In the early 2000s, appreciation of the potentials of

adipose tissue and its related stromal elements, led to examination of the adipose-derived adult mesenchymal stem cell content (AD-MSC). Stem cells facilitate tissue maintenance, regeneration, growth, wound healing throughout life and a crucial role in connective tissue regeneration. Adult stem cells can be found in all tissues in the body in various quantities. Historically, MSCs have been harvested from bone marrow aspiration. However, bone marrow possesses very few true MSCs compared with adipose (fat)-derived stem/stromal cells (AD-SCs). Adipose tissue is replacing bone marrow as a primary source of stem cells. Like bone marrow, adipose (fat) tissue is derived from embryonic mesodermal tissue so they can both differentiate into the same tissue types. Fat is a complex tissue that is not only easier to harvest, but offers a far greater number of  nucleated, undifferentiated stem cell counts than bone marrow. Research has shown as much as 500 to 1,000 times as many mesenchymal and stromal vascular stem-like cells exist in adipose tissue as compared with bone marrow. This has been a tremendous breakthrough in the use of regenerative stem cell therapy because most people have a more than adequate supply of adipose tissue that is easily accessable.

Current beliefs are that success in long-term stem cell therapy is actually due to activation of adherent progenitor cells (attached to mature adipocytes), and proliferation of those progenitor cells.They will differentiate into whatever cell type that they are injected into and adhere to.

As an example, if you inject a stem cell mix into a joint, the progenitor cells that adhere to cartilage will differentiate into that type of cell and rebuild cartilage. Stem cells that attach to a ligament will become and generate new ligament cells and so forth. As understanding of the maintenance and replenishment of cell cycles in the body increases, extensive research has been devoted to the study of microenvironment  cell to-cell matrix , automatic and hormonal signaling systems and their functions in orchestrating the healing mechanism. Since Adipose Derived Stem Cells are capable of differentiation for all mesogenic lines including: (1) Chondrogenic; (2) Fibro-muscular (including tendon, ligament, skeletal and cardiac muscle); (3) Osteogenic; and, (4) Adipogenic cell lines, uses in clinical applications have skyrocketed. Addition of Platelet Rich Plasma (PRP) concentrate-derived of growth factors and signal proteins (cytokines) to the progenitor cells, have greatly improved our ability to promote healing to sights of injury and chronic pain. Studies have demonstrated such improvement with adult stem cell therapy by the successful regeneration of osteoarthritic damage and articular cartilage defects, significant improvement in medial meniscus and cartilage regeneration with autologous stem cell therapy. Multiple studies have shownthat AD-SCs improve wound healingand stimulate fibroblast proliferation and collagen secretion. These proliferative changes increase connective tissue tensile strength and the healing capability of tissues that normally would not regenerate themselves. Stem Cells (AD-SCs) have the potential to differentiate to become cartilage, tendon, ligament, bone, and skeletal or smooth muscle. They also are capable of expressing multiple growth factors that influence control over  damaged neighboring cells. Studies have shown  AD-SCs are capable of stimulating the healing process needed to repair intervertebral discs.  The pain caused by bulging and ruptured discs send thousands of people into back surgery every year  It is reasonable to hypothesize, that when Level 1 dextrose prolotherapy and/or Level 2,  Platelet Rich Plasma (PRP) prolotherapy have not resulted in complete resolution of musculoskeletal pain and injury, Level 3 Stem Cell  Prolotherapy would be the logical next step.

In veterinary medicine, AD-SCs have been used effectively for more than 10years in the treatment of osteoarthritic  joints and connective tissue injuries indogs. Unfortunately, we have had to wait for the slow turning of the wheels of government regulations to be able to offer these cutting edge solutions to mankind.

Prolotherapy has come a long way since those early days in the 1930s when doctors were searching for a way to get the body to heal and regenerate.

Stem cell Prolotherapy offers a safe and clinically effective option in cases of musculoskeletal and connective tissue injury or joint degeneration which may be utilized by physicians to assist in their treatment of the patient with unresolved musculoskeletal pain. Autologous Stem Cell Therapy (AD-SCs) combined with HD-PRP concentrates have proven very effective in thousands of cases.

Don’t resign yourself to constant pain and suffering. Visit our office to see how Stem Cell therapy can change your life. Dr. Ellsworth utilizes the very latest technology for his in-office StemInject Procedure for treating pain from osteoarthritis and degenerative joint disease.