Alternative to Shoulder Replacement
Stem Cell Therapy as an Alternative to Joint Replacement
The shoulder is the most mobile joint in the human body and is put under constant motion and stress every day. Because of this, many patients experience shoulder osteoarthritis during their lives, causing them to suffer from chronic joint pain, swelling and inflammation. Osteoarthritis is caused by deterioration of articular cartilage, the smooth, white substance that covers the ends of each shoulder bone. Over time, a patient’s bones may rub against each other while the shoulder is in motion from total loss of cartilage. Alternatives to joint arthroplasty may include injections such as cortisone. More recently, there is early data suggesting that biologic injections may be beneficial for patients with early to moderate osteoarthritis.
What is Stem Cell Therapy for the Shoulder?
Conservative measures, such as rest, ice, modified activities, anti-inflammatory medications (NSAIDs), pain medications and physical therapy, are often the first treatment option prescribed by Dr. Waterman in patients affected by osteoarthritis. Unfortunately, osteoarthritis is a progressive condition with no cure and certain patients may experience further articular cartilage damage during normal shoulder movements.
Currently, multiple studies are ongoing to determine the efficacy of biologic injections such as stem cells in the symptomatic management of shoulder arthritis. These injections contain cells and biologic factors which may help to modulate the inflammatory arthritis associated with osteoarthritis.
Adult Stem Cells as an Alternative to Joint Replacement
Autologous stem cells, also referred to as adult stem cells, have a natural ability to differentiate into multiple tissue types. In addition, they may provide valuable biologic factors to modulate the inflammatory process. Stem cell therapy for the shoulder offers a possible alternative to cortisone injections or shoulder replacement in young, active patients suffering from osteoarthritis. With this stem cell therapy technique, patients do not experience the ethical concerns associated with embryonic or fetal stem cells since adult stem cells are harvested directly from the patient’s own body or from discarded placental tissue.
Stem cell therapy for the shoulder as a management option for shoulder arthritis is a fairly simple procedure. It requires a sample of bone marrow to be harvested from the patient’s own body, commonly from the hip area. After the bone marrow is harvested, the sample is spun in a special machine called a centrifuge to separate a combination of adult stem cells, platelets and white blood cells. The combination of healing agents is then injected into the damaged shoulder joint to regenerate articular cartilage and accelerate healing. Alternatively, allograft (donor) type products with stem cells harvested from placental tissue are available for office based injections.
It should be noted that these injections are considered experimental at this time. While studies are ongoing to determine the efficacy of these types of injections, further study is needed to determine appropriate patient indications and expected outcomes.
At a Glance
Dr. Brian Waterman, MD
- Chief & Fellowship Director, Sports Medicine, Wake Forest
- Team Physician, Wake Forest University, Chicago White Sox
- Military affiliation/Decorated military officer and surgeon
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