Tag Archives: osteoarthritis

Using Autologous Mesenchymal Stem Cells To Treat Hip and Knee Joint Pain from Osteoarthritis

Using Autologous Mesenchymal Stem Cells To Treat Hip and Knee Joint Pain from Osteoarthritis

I stated about 2 months ago that I wanted to expand the scope of the research that is done on this website, to include other subjects like the biochemistry of cancer, orthopaedic conditions, and similar issues. These next few posts will be dealing with this subjects. Some of the information will be related to what I’ve been researching before.

There was a very recent article (came out on August 3, 2014) that came out in the Australian news website The Age entitled “Stem cell trial hope for osteoarthritis sufferers” which showed that MSCs are being used to treat people who are suffering from knee pain associated with Osteoarthritis. While it may not seem too revolutionary and profoundly new to us who are so used to reading up on Patents and University backed cutting edge research on stem cells, this method would still be very interesting to a large group of the population who are suffering from joint pain from cartilage degeneration.

As the article says, a middle aged female underwent liposuction so that her fat can be sucked and then filtered to get the little bit of stem cells in her fat tissue. Those stem cells will be then be packed together in pure stem cell and high density form, which are injected into her hip joint region to relieve pain.

When looking at the overall procedure from a higher level, I am reminded of a similar type of procedure that is being done by Dr. Peter Wehling at Dusseldorf which is now called the Regenokine/Orthokine method as well as the Platelet Rich Plasma therapy. In all of these methods, the entire thing is minimally invasive.

The hope for the researchers who took the women’s fat out is to get the filtered stem cells to slow down the rate of cartilage degeneration in the woman’s hip. If that is possible, then the need for the complicated and expensive hip prosthetic replacement surgery can be pushed back by more than a full decade. The primary researcher is a Dr Julien Freitag, who would reference a South Korean study. I took the time to track down that exact article and found it. It is suggested in that Korean study that instead of just a single injection of the person’s own adipose derived stem cells, multiple injections will have much better results. 

There will also be a 2nd study looking at how this autologous MSC method would work for cartilage lesions which are the result of trauma which often lead to the onset of osteoarthritis after maybe just 4-10 years after trauma.

The name of the article that is referenced is “Infrapatellar fat pad-derived mesenchymal stem cell therapy for knee osteoarthritis” which is associated with the Department of Orthopedic Surgery, Yonsei Sarang Hospital, Seoul, South Korea. The same group of authors had written also the paper “Mesenchymal stem cell injections improve symptoms of knee osteoarthritis.” which was published in April of 2013.

Infrapatellar Fat PadIn the referenced article, the researchers took the stem cells from the infrapatellar fat pad region (aka Hoffa’s Fat Pad). Refer to the picture to the right for reference to where the fat pad is.

The stem cells which are isolated are then injected percutaneously into knees that have been suffering from arthritis.

Note: I might have made a mistake on assumption before. It seems that the method of PRP is used in this technique. Quoted from the article…

“After the stem cells were isolated, a mean of 1.89×106 (range, 1.2–2.3 × 106) stem cells were prepared with approximately 3.0 mL of platelet-rich plasma (PRP) and injected in the selected knees of patients in the study group. ”

I made the mistake of assuming that the stem cells would be reinjected in the body percutaneously and intraarticularly by themselves. I forgot to realize that the platelet-rich plasma would be used as the semi-liquid transport medium since stem cells by themselves with no medium would just shrivel up and dry out. This method is a type of PRP therapy.

After the first injection with stem cells and PRP, 3 mL of PRP was administered every 7 days as the second and third rounds of treatment. The results from the control group and the actual tested group were statistically significant.

Implications

From my search throughout the hundreds of patents for application of stem cells, I’ve already seen at least 2 groups which have put a patent on the technique on using MSCs to treat osteoarthritis or arthritis in some way, whether by the PRP method or some other idea. I quote was is said in the paper “With regard to in vivo studies, the transplantation of MSCs into full thickness articular cartilage defects has been attempted under various conditions.” so there has been many attempts already, and the results have come in have been very fruitful and promising.

Quoted further…

“In 2 reports, experiments on humans [16,17] involving the intraarticular injection of autologous MSCs yielded good results after 6 months. In 2008, Centeno and colleagues reported the use of autologous culture-expanded bone marrow- derived stem cells for knee cartilage regeneration in humans [17]. In their study, the patients’ pain, as determined by the VAS, and range of motion improved, and MRI showed significant articular cartilage growth and meniscus regeneration. “

What I personally got out of it…

I learned that the source of where you get the MSCs is quite important. While it is well known that MSCs can be filtered from bone marrow, bone marrow extractions are often very painful and have a high chance for infections and complications. In addition, as a person ages, the density of MSCs decrease. That seems to be why the researchers here used the infrapatellar fat pad as the source of the stem cells. They were able to get 9.4 g of infrapatellar fat pad which gave out on average about 1.89×10^6 stem cells, which is a nice cell to overall fat density. For future references, instead of asking that we get stem cells from bone marrow biospys, it would be much easier and simpler to use the source of fat from under the patella.

The last important thing that the researchers stated in the study was this ….

“the paracrine effects of the cytokines and growth factors released by the grafted cells, which favorably influence the microenvironment by triggering host-associated signaling pathways and lead to increased angiogenesis, decreased apoptosis, and possibly, induction of endogenous generation”

I am still trying to understand what this part means and what the implications are.

Theories On The Causes And Treatments For Cold Knees and Cold Feet

Theories On The Causes And Treatments For Cold Knees and Cold Feet

Cold KneesNote: This post does not deal with the endeavor of height increase, but is related. I have stated multiple times before that I planned to expand the scope of the research of this website to include bone and cartilage related medical conditions. Height Increase research is for cosmetic reasons, but real medical problems like osteoporosis and osteo-arthritis should always be dealt with first. 

Recently my Asian girlfriend started to notice that her feet and knees was getting unusually cold even though the temperature is quite warm in this Summer weather. She has had a history of dealing with cold knees and cold feet, as well as cold hands.

However, this recent episode has made me start to suggest that there might be some deeper connections and physiological causes to her condition which even most medical professionals have never been able to decipher. Having lived in Asia and seen the bone physiology of the East Asian ethnic groups, and done meta-statistical analysis to compare various racial groups, I feel that I might be able to give a completely new and rather original spin on this rather common and annoying little symptom.

Here is what I do know.

  • East Asian females on average, in general seems to have a lower than average bone mineral density (BMD) than other races.
  • It has been contributed to the fact that while still an embryo, the developing child did not get the high enough level of calcium needed for the prenatal baby to grow. (refer to Bone Health in Chinese American Women). it seems that based on the diet of East Asian cultures, the females of those cultures just wasn’t getting enough calcium (maybe high level of Lactose Intolerance??) , which translated to their developing baby, which grew up with low levels of bone density as well.
  • Not only that, since pregnancy means that a high level of calcium will be transferred from the mother’s body to the babies, the mother will have an increase chance of osteoporosis.
  • Anecdotally, my mother who has multiple Asian female friends have recently told me that they were getting knee replacements as early as their 50s. Knee replacements is one brutal surgery, where a prosthetic is placed where there used to be cartilage and bone before.

So what does this all have to do with cold knees and cold feet?

Based on my research of the past 2 years, cold knees and cold feet, which seems to predominantly effect East Asian females and Caucasian females, is the result of the individual who has a low level of bone mineral density, which has a ripple effect on the other types of tissue connected to the osteo tissue (aka bones).

The cold knees is a sign that they have weaker than average bones and joints. However, what do we mean when we use the word “weaker”?

I know from personal experiences that my girlfriend has never been able to donate blood because the blood donating centers say that she has a very low level of Iron in her blood, which has led to her having anemia. The result is that she has had to go see her personal gynecologist to get ferrous fulmarate intravenously dripped inside her on a regular basis.

In addition, she has a horrible habit of drinking very low levels of water consumption. Her incentive in changing her water consumption level has resulted in the cold knee symptoms disappearing for a long duration, until recently when she moved and changed her eating habits.

It was also found that she has a slight thyroid issue when I took her for a full medical exam more than a year ago. In addition, her menstrual cycle is much larger than average, resulting in more blood loss, which might also contribute to the low level of iron in her blood.

So here is what I am willing to outline for the medical condition of Cold Knees and Cold Feet…

Symptoms…

  • Cold Knees
  • Cold Feet – Sometimes Cold Hands is another symptom

Causes…

Note: All the following causes are theories and guesses based on my personal experience and research.

  • Lack of Iron – the person might be anemic
  • Hypothyroidism – the symptoms of hypothyroidism include 1) increased sensitivity to cold temperature, heavier or irregular menstrual periods, joint pain, and depression. (source)
  • If not hypothyroidism, then some type of thyroid issue (don’t quote me on that one)
  • Habitual Low Consumption of Water 
  • Low Bone Mineral Density – This suggest that the person has a much higher chance of getting osteoporosis later in life.
  • Decreased Circulation 

Update 8/13/2014: It seems there there might be 2 other medical conditions which might be linked to cold knees. They are 1) celiac disease/gluten sensitivity and 2) unusual period types, specifically heavy thick bleeding periods, which I suspect is causing the onset of the cold feet and knees.

Treatments…

Note: Everything I will recommend will be based on personal, amateur level research.

  • First, go to one’s GP (Primary/Family Doctor) to get a full blood work done to see if they are low on any vitamins or minerals. – Check for hypothyroidism and anemia.
  • Start Taking a MultiVitamin – I Suggest a Centrum Silver For Women at the local GNC or Walgreens
  • Take Vitamin D3 –
  • Take Iron Supplement – this is based on my experiences with a gf with anemic symptoms.
  • Take Vitamin K2 – This is critical. I can not stress how important MK-2 and MK-7 are.
  • Get the recommended daily level of Magnesium – (source: Magnesium Is Crucial for Bones). Magnesium is critical for Vitamin D to work properly.
  • Drink at least 2 liters of water each day – stay hydrated. This will improve on the circulation problem and help with the thyroid issue a little
  • If the person recently went through pregnancy ie a woman, add Calcium to one’s diet to replace for the loss of calcium which got transferred to the baby.
  • Get deep tissue massages ie Swedish – for increased circulation
  • Yoga – for increased circulation

Low Term Considerations.

Here is what my research has told me after many older females I’ve known in my life who had to go through full knee surgery has suggested to me.

If you are in your 20s or 30s and experience cold knees or cold feet (and hands) it is a sign that the bones (and thus also the cartilage) in your body is getting weak.

The way that humans anatomically work, being bipedal, and walk upright, means that structurally speaking, the knees are the weakest area on the human body. Knees and the lower back are the two most common locations to result in pain and problems with people, whether they have an active life or not. (Have anyone else noticed just how many chiropractors practices and offices have been popping up in American towns, even though the theory behind chiropractor work is based on Subluxation, which has no scientific basis? Based on my guesses, chiropractors is nothing more than modern bone setting (which was called Manipulation Surgery at the turn of the 20th century) combined with deep tissue massage physical therapy. The theory of chiropractors is just pseudoscience. From one source (available here) it is said that  “Back pain is the leading cause of disability in Americans under 45 years old. More than 26 million Americans between the ages of 20-64 experience frequent back pain”.  )

Cold knees and cold feet is a sign that the person is at a much higher level of risk for osteoporosis (aka low bone mineral density) and osteo-arthritis (aka degradation of articular cartilage structure) later in life, as quickly as even 10-15 years into the future. 

They will be the ones getting the total knee replacements and they don’t even realize yet in the future. No regular/family doctor with their limited experience and knowledge on the physiology of the bones and cartilage would be able to explain what is going on.

Physiologically speaking, it is caused by three main things…

  1. Decreased circulation in that area
  2. A specific mineral is being transported out of the region (currently, I am not sure which one). (Note: From a physics point of view, it would not make any sense how it is possible that within the human body, a certain local area is cooler than the surrounding area on a Summer Day (I measured the temperature on the skin using a Thermocouple) unless there is a biological process acting similar to an air conditioner going on i.e. a heat transfer and/or a type of chemical endothermic reaction.)
  3. Some form of hormonal imbalance is triggered at some level in the pathway upstream.

This post is for my fiance/future wife, and all of the rest of the people in the world who experience this condition and don’t know what it means. I’ve consulted internal medicine and orthopedic specialists and they have never been able to provide for me a decent and solid sounding answer to the causes and potential treatments to this condition, which I believe is a symptom and sign that something much worst is going to happen later in life.