Stem-cell treatments aim to regenerate injured joints

Friday, Feb. 2, 2018 9:31 PM
Dr. Patrick McLaughlin of Animas Spine uses ultrasound to guide him as injects bodily fluid rich in stem cells into Tom Holcomb’s thumbs. The fluid will stimulate healing in his arthritic hands.
Dr. Patrick McLaughlin of Animas Spine pulls fluid rich in stem cells from Tom Holcomb’s pelvic bone.
A centrifuge concentrates the stem cells and growth factors in fluid, known as bone marrow aspirate that was extracted from Holcomb’s pelvic bone a few minutes earlier.
Jessica Palmer, a medical assistant at Animas Spine, injects fluid from Tom Holcomb’s bone into a centrifuge that will concentrate stem cells and growth factors. Kaela Brevik, a medical assistant at Animas Spine, and Andy Corra, a representative of Arthrex Inc., observe. Corra is an independent contractor for Arthrex and also received injections of bone marrow aspirate.

Intensifying arthritic pain in his hands diminished Tom Holcomb’s interest in Nordic skiing and mountain biking and cut into his ability to do basic chores.

“Just getting dishes out of the dishwasher was uncomfortable,” he said.

So in January, he went to Dr. Patrick McLaughlin at Animas Spine to have fluid rich in stem cells extracted from his bone marrow and injected into his thumbs to help stimulate healing.

“The opportunity to go in there, have some tissue repair, it sounds super appealing to me,” he said, as he waited for his procedure to start.

McLaughlin started providing stem-cell treatments in the last few months. He describes them as the next step in regenerative medicine, with the potential to slow down degeneration of joints and possibly prevent the need for joint replacement. The injections provide growth factors and anti-inflammatory proteins that have been shown to promote bone and soft tissue healing and reduce pain.

“It’s creating an environment to help heal the tissue and improve the quality of tissue. And that’s translating into improved function and decreased pain,” he said.

McLaughlin has treated patients with arthritis in their knees, ankles and thumbs, and some patients reported experiencing significantly less pain and improved function in a few weeks, he said. The treatment can take six to 12 weeks to take full effect.

The stem-cell injections can be used to treat muscle injuries, tendon injuries, joint injuries, arthritis, spinal disc disease and many other ailments.

Dr. Patrick McLaughlin of Animas Spine extracts fluid from Tom Holcomb’s pelvic bone in January. The bone marrow aspirate is rich in stem cells that will be used to stimulate healing in Holcomb’s hands.
Jerry McBride/Durango Herald

The treatment relies on drawing fluid from a patient’s bones, known as bone marrow aspirate, and processing it in a centrifuge, which concentrates the stem cells and growth factors in the fluid.

To treat Holcomb, McLaughlin extracted aspirate from Holcomb’s pelvic bone, after giving him localized anesthetic. After processing the aspirate in the centrifuge, McLaughlin used ultrasound imaging to inject the processed fluid into Holcomb’s thumbs.

Immediately after receiving the injections, Holcomb said his thumbs felt bruised and tender.

McLaughlin advises his patients to expect pain for 24 to 72 hours after the injections because the body is starting the regenerative process.

Rather than flowing back into the body’s blood stream, the fluid restarts the healing process in a chronically injured area and brings with it 10 times the growth factors that were there previously.

The stem-cell treatment may not be a permanent solution, but joint replacement may not offer a permanent fix either and that kind of surgery can be traumatic for the body, McLaughlin said.

If needed, the injections could be done multiple times safely because the treatments rely on the body’s natural processes, which is not the case with some other long-standing options.

“Some of our other treatments, like steroids, can degrade the tissue over time,” he said.

Holcomb received a steroid shot before coming in for his treatment and hoped the stem-cell treatment would alleviate his need for them.

He is allergic to ibuprofen and similar medications so his pain management options are limited.

“I feel fortunate to have this opportunity,” he said.

Dr. Patrick McLaughlin of Animas Spine uses ultrasound imaging to guide him as he injects fluid rich in rejuvenating cells into Tom Holcomb’s thumbs.
Jerry McBride/Durango Herald

About three weeks after the treatment, he was happy with the function of his right hand.

“I couldn’t be more pleased with the progress there,” he said. His left thumb, which suffered from an old injury, felt largely the same.

“There is still lots of room for improvement there that I’m hopeful for,” he said.

He was optimistic about seeing more improvement in the coming weeks.

After the treatments, McLaughlin recommends patients rest for at least two weeks and maybe more depending on their condition. After the procedure, patients can have more success with physical therapy than they had in the past.

Some patients turn to the treatment after they have failed physical therapy and other treatments. But it’s better, especially for those with arthritis, if they can have the treatments earlier to help maintain the function of the joint.

“So if there’s less deterioration, less damage to the tissue, less functional decline, then a finite dose of stem cells can possibly fix the problem earlier or slow it,” McLaughlin said.

They are not a panacea, he cautions.

“Every situation needs to be evaluated independently and realistic expectations should be adjusted to the situation,” he said.

The treatments are limited in several ways because they are experimental, and the medical community doesn’t fully understand the mechanisms at work or why it is more effective in some people than others with the same condition, he said.

Although, it’s possible that as humans age, the quality of their bone marrow declines and that may influence the potency of the treatment, he said.

In part because the treatments are experimental, they are not covered by insurance companies, and patients could pay between $3,000 and $5,000 for a treatment.