Cecilia Pascual-Garrido, MD, is a sports medicine and hip preservation surgeon
. An avid marathoner herself, she's also treated world-class athletes at the U.S. Open Tennis Tournament and has been an assistant team physician for the New York Knicks and Mets.
She's seen a lot of sports injuries over the years, and she's also spent the past decade investigating the role of stem cells and growth factors in cartilage.
Patients often ask her about the potential of stem cell treatment, so we wanted to share the answers to a few of the most common questions.
What exactly is a stem cell?
Stem cells are cells that can self-renew and transform into other specialized cells in the body, including bone and cartilage.
There's been a lot of controversy surrounding embryonic stem cells, but adult stem cells are a bit different. Taken from living tissue such as bone marrow or fat, they are more tissue-specific and can be used by orthopedic surgeons to repair bone, muscle, and cartilage.
Lastly, researchers have shown interest in IPSCs (induced pluripotent stem cells), which are obtained from a skin biopsy. These are reprogrammed to become pluripotent, which means they can differentiate into many different cell types including neurons, heart cells, and more.
How are stem cells obtained?
Adult stem cells are most often taken via a needle from the bone marrow in the outside part of the pelvis, the iliac crest. The procedure itself only takes 15-20 minutes.
Some surgeons use this bone marrow concentration directly to help bone-tendon healing or bone and cartilage repair. Others work to first differentiate the cells before injecting them into the area of concern. This takes an extra week to three weeks in the lab.
What has recent stem cell research shown, and what's next?
There's still some variability, but researchers have seen positive results for the treatment of chronic tendinopathy (cellular damage to a tendon). Stem cells have also been used to successfully treat avascular necrosis (death of bone tissue) of the femoral head, cartilage lesions, and early osteoarthritis.
Dr. Pascual is currently researching the capability of stem cells to repair articular cartilage, or the tissue that covers bones where they form joints. She is developing cutting-edge therapies for cartilage lesions and early osteoarthritis of the hip. This understanding will help guide future treatment for injuries to that cartilage.
What are some treatments on the horizon?
While articular cartilage is hard to regenerate, stem cell therapies show promise for preventing and treating cartilage lesions and arthritis.
Genetics will also play a role in prevention and treatment, as patients will be able to be screened to determine if they're susceptible to arthritis. Identifying susceptible patients will allow us to use disease-modifying therapies including stem cells and growth factors to reverse cartilage damage at an early stage.