NMU 59 – Stem Cell and PLP Joint Injections for Arthritis, Tendon Damage, Joint and Sports Injuries: Do the help? A Research Update on Efficacy

Nutrition / Natural Medicine Update No. 59 (July 19, 2017)

with Dr. James Meschino

Research Topic: Stem Cell and PLP Joint Injections for Arthritis, Tendon Damage, Joint and Sports Injuries: Do the help? A Research Update on Efficacy

Source: Medscape Review Paper (July 12, 2017): Stem Cells in Sports Medicine: Ready for Prime Time?

Based on the prevailing research I encourage most patients over the age of 40 to take a supplement each day that contains 500 mg of glucosamine sulfate combined with several natural-anti-inflammatory agents such as quercetin, bromelain, and MSM. After age 40 the body makes less glucosamine, which is required for cartilage synthesis, and thus, without glucosamine supplementation, the rate of joint cartilage breakdown starts to exceed its rate of synthesis leading to osteo or degenerative arthritis. As well, white blood cells in the inner lining of our joints begin to secrete more inflammatory chemicals (cytokines) that increase the risk of pain and further destroy joint cartilage and bone. So I like the use of natural anti-inflammatory agents combined with glucosamine to preserve joint cartilage and help prevent age-related joint inflammation, stiffness, and pain.

Some studies have shown that glucosamine sulfate supplementation can actually halt further destruction in patients with mild to moderate stages of osteoarthritis and reduce associated joint inflammation when taken at a daily dosage of 1500 mg per day. So, for patients who already have osteoarthritis, I usually recommend a daily dosage of glucosamine sulfate at 1500 mg per day. It also helps if you follow an anti-inflammatory diet by reducing high-fat meat and dairy products, foods high in trans-fats, deep-fried foods and watching your refined sugar intake.

But what about people with more advanced stages of osteoarthritis, or severe cartilage damage, or severe tendon problems and acute sports injuries? Well, more and more doctors are experimenting with stem cell injections into the joints and/or Platelet-rich Plasma injections (or PLP injections) An update on the efficacy of these procedures was published in Medscape on July 12, 2017. Many patients now ask me about stem cell and PLP injections, often with respect to joint, tendon and cartilage injuries. So, I thought I would share what we have learned to date.

Stem cell injections into the affected joint have shown disappointing results thus far, largely because cartilage lacks a blood supply which is required for stem cells to get access to the areas required for repair and regeneration. However, for certain types of joint problems stem cell injections have shown some impressive results, especially with a condition known as osteonecrosis of the hip (femoral head and condyle), whereby bone degeneration and pain occurs due to loss of blood supply to the bone itself. However, new approaches using stem cell injections are being developed to help improve the ability of stem cells to repair cartilage damage in arthritis and other joint lesions and injuries. But they are not yet refined. What seems to be more effective, at this time, is the use of PLP injections. Platelet-rich plasma implies that a doctor extracts your whole blood then centrifuges it to remove red blood cells. The centrifuged blood has a higher concentration of growth factors than whole blood that appears to encourage the healing response in cartilage damage, tendon damage, and sports injuries.  In orthopedic applications, human studies have shown some impressive results in osteoarthritis of the knee and in speeding up the healing bone fractures. All this research is still early stage, but I think it has potential to be helpful in select cases, especially if combined with other evidence-based rehabilitation therapies performed by chiropractors, physiotherapists, athletic therapists and exercise rehab specialists.

PLP injections are also being used in dentistry and in dermatology and anti-aging medicine to promote the regrowth of hair in androgen or male-pattern hair loss. In fact, a placebo-controlled study published in 2015 showed impressive results in reversing male pattern hair loss in a well-designed trial, in case that may also be of interest to you.

As always, I have provided the scientific references in the text below

References:

1.Mandelbaum B. R. Stem Cells in Sports Medicine: Ready for Prime Time? Medscape July 12, 2017, http://www.medscape.com/viewarticle/882226?nlid=116577_1842&src=WNL_mdplsfeat_170718_mscpedit_wir&uac=62515BJ&spon=17&impID=1391837&faf=1#vp_1

2. Gentile P et al. The effect of platelet-rich plasma in hair growth: A randomized placebo-controlled trial. Stem Cells Translational Medicine 2015; 4:1-7.  http://pietrogentile.it/rel_04_2016/wp-content/uploads/2016/04/05-PRP-hair-sctm20150107_rp3.pdf

3. Rovati L. C. et al. Crystalline glucosamine sulfate in the management of knee osteoarthritis: efficacy, safety, and pharmacokinetic properties. Therapeutic Advances in Musculoskeletal Disease 2012.

4. Reginster J. Y. et al. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomized, placebo-controlled clinical trial. Lancet 2001. 357(9252):251-6.