A new study has validated adult stem cell therapy as alternative to total hip replacement in patients with severe hip osteoarthritis.

The study published in the April edition of the Journal of International Case Reports (ICARE) is titled Adult Stem Cell Therapy as an Alternative to Total Hip Arthroplasty in Severe Hip Osteoarthritis.

Medical Director of Glory Wellness and Regenerative Centre, Lekki, Lagos, Dr. David Ikudayisi, led the study.

Hip osteoarthritis is one of the leading causes of chronic hip joint pain and disability worldwide. According to research, the global incidence of hip osteoarthritis from 1990 to 2019 increased from 0.74 million to 1.58 million.

The aim of the study was to evaluate the importance of adult stem cell therapy as an alternative to total hip arthroplasty in severe hip osteoarthritis.

Arthroplasty is a surgical procedure to restore the function of a joint. Resurfacing the bones can restore a joint. An artificial joint (called a prosthesis) may also be used. Various types of arthritis may affect the joints.

A case study of a patient that had adult stem cell therapy on account of severe right hip osteoarthritis was used. Right hip severity was assessed using the Harris Hip Score (HHS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale. Radiologic studies (X-ray and MRI) were done. The patient had a session of adult stem cell therapy (autologous mesenchymal cells) and was observed for six months, then had allogenic exosomes and plasma rich platelet therapy. At 10 months, the patient had another session of ADSC Therapy and PRP Therapy and was observed with a follow up for 24 months.

The WOMAC and HHS assessed on the (zero, six, 12 and 24 months) showed quality improvement from an initial score of 96/96 to a score of 0/96 and from 31 per cent to 97 per cent at 24 months respectively. Post procedure radiologic studies of the hip done at the same months showed marked progressive changes.

The researchers concluded: Adult stem cell therapy is a promising alternative method of treatment in people with severe hip osteoarthritis. Results showed a positive outcome according to all the grading systems used in this study and this patient was followed up for 24 months and, he is still being followed up, which is proving its advantage in long-term outcome.

Commenting on the study, Ikudayisi said: Osteoarthritis is a chronic joint disease that has evidence-based conservative treatment options like exercise, weight management, patient education and some medications for pain. Definitive therapy known for stage 4 is usually total hip replacement, which is a surgical procedure, which is where adult stem cell therapy has it advantage as it is minimally invasive, safe, and with no reported treatment related adverse effect.

Recent literature has revealed the anti-inflammatory and healing properties of stem cells. The use of autologous SVF and BMAC in conjunction with PRP could be a novel therapy. Future studies could help to establish appropriate clinical protocols including repeat dosing, quantity/volume of MSCs (BMAC and SVF) or concentration of PRP for specific indications. Also, future studies need to compare cases with and without intravenous transplantation of SVF to determine the extent of the role of systemic transplantation of autologous SVF in localised regeneration of the hip joints.

Proposed mechanisms of action in this patient could be a paracrine effect or engraftment of the injected cells. The injection of the MSCs (ADSCs and BMSCs) most probably stimulated a reduction of inflammation followed by the formation of new, healthy tissue.

Direct injection of MSCs (SVF and BMAC) plus PRP in severe hip osteoarthritis can be effectively and safely completed in an outpatient setting according to this case study. The patient tolerated the procedure with no reported adverse events. Radiographic imaging depicted the stages of healing after a single injection of the cellular mixture. Anticipated outcomes for healing processes and detailed protocols could be determined with larger clinical studies.

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Adult stem cell therapy validated as alternative to total hip replacement - Guardian Nigeria