Stem Cells: The Future of Orthopaedics

Stem cells have been regarded for their remarkable ability to grow into different cell types, but their potential applications in orthopaedics remains a matter of confusion among doctors. Mesenchymal stem cells are adult stem cells that are found in the bone marrow, butstudies have revealed that they are located in other parts of the body as well, including adipose and umbilical cord blood tissues. This property has allowed its use and examination to become widespread. Stem cells have been noted for their prevalence of growth factors, proteins that stimulate the growth of tissues, and cytokines, proteins that are involved in cell signaling and affect the behaviour of cells. With these properties, stem cells have been used in common orthopaedic surgery procedures such as hip and knee replacements, and they have also been tested in treatments for arthritis and osteoporosis.

There are over 100 types of arthritis, which is characterized by inflammation of the joint, and osteoporosis is a disease that causes bone loss. Stem cells can be modified to treat both, and their effects are constantly being improved upon using polymers, chemical treatments, and hormone enrichment. Since stem cells contain growth factors, cytokines, and foster growth at injury sites, they should be used to treat orthopaedic injuries and diseases such as arthritis and osteoporosis. Stem cells can be used to reduce healing times and alleviate pain in patients. The most common injuries in orthopaedics involve fractures and tears, which in some cases will never heal for injured patients.

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To resolve this, stem cells have been shown to stimulate healing for bone breakages. The infusion of stem cells adds growth factors and coenzymes to the injury sites, spurring healing and growth. Examples of its effectiveness can be seen in patients who have had arthroscopic knee surgery using stem cells, where they reported increased levels of pain relief and meniscus growth, as well as no abnormal tissue formation. These cases are a clear indication of the effectiveness and capability of stem cells. Studies have also found that the migration of MSCs is time and dose dependant. This discovery was found after examining stem cells in the fracture site of a tibia using bioluminescence imaging.

This can mean that patients will require specific treatments that include the dose concentration and time required that would be most effective for their recovery. The potential of stem cells to treat the most basic orthopaedic injuries make it an optimal choice for doctors wishing to treat these injuries. Stem cells are also being used with polymers to enhance its properties. Scientists were able to use polymers to scale up stem cells to skeletal cells to aid in bone repair therapy techniques. The polymers can improve MSC attachment, allowing the cells to bind to the affected area. They can also improve differentiation among the cells and allow them to develop into various types of bone cells.

. This method is performed by blending stem cells with a specialized gel and injected it into a damaged bone, spurring growth in a shattered leg. The gel allows the cells to adhere to the injury site, so polymers are highly effective in cases such as this. Scientists have also used polymers to create scaffolds to localize stem cells to an injury site. By containing the cells to the area needed for growth, the scaffold allows the MSCs to proliferate in the most damaged and urgent areas. Due to the various properties of adherence that polymers provide stem cells, they should be used more frequently in order to allow stem cells to integrate more easily into the damaged site.

Stem cells are periodically used to enhance certain orthopaedic procedures and as new methods develop their use is increasing in popularity. In surgery, stem cells grafts can be used to act as a filler for bone loss in patients with orthopaedic injuries. The cells possess excellent biocompatibility that allows the bone to fuse together more easily. The cells are also incredibly durable and can withstand various biological forces that may cause them to denature. Cartilage stem cells can be taken out of patients and put into the injury site during surgery to generate cartilage. This is done by taking blood out of the patient and extracting the stem cells using a centrifuge.

Certain scaffolds are also being used in procedures to localize stem cells in needed areas. Collagen scaffolds are biodegradable frames that are often used since the matrix of the collagen sponges dissolves slowly. This gives the stem cells and their matrix a sufficient amount of time to be integrated into the damaged site, causing the cells to behave more effectively in improving the patient’s condition. The potential of stem cells to augment orthopaedic surgeries make it an ideal candidate for surgeons wishing to enhance the effects of their procedures for patients in the long term. Hormones and other chemicals can be used to enrich stem cells and enhance their effects in surgical procedures.

Stem cells can be enriched with the IGF-1 hormone to treat abnormal fractures that do not heal normally. Cases such as this are frequent, but since the hormone is an insulin growth factor, it has been shown to spur growth in patients with these ailment. Different hormones can result in distinct effects when chemically combined with stem cells. Combining the parathyroid hormone (PTH) with stem cells has the potential for cartilage regeneration and can stimulate bone formation. PTH also promotes chondrogenic differentiation of MSCs, so they can develop into a variety of bone generative cells that can stimulate healing.

Stem cells derived from adipose tissue can also be grown in mediums containing hormones to allow for rapid proliferation. The hormones can allow the cells to reproduce at a faster rate, which can be useful as demand for the cells increases. Hormone use with stem cells is only now used in selective cases, but its effectiveness makes it an obvious candidate to improve the properties of stem cells. Arthritis is an affliction characterized by inflammation of the joints, and stem cells have been shown be effective in easing pain for arthritic patients. A characteristic of mesenchymal stem cells that makes them so effective is that they can suppress effector T cell responses. These responses trigger immune function, so by suppressing them, they can be beneficial in treating immune disorders such as rheumatoid arthritis.

After given stem cell treatments, patients with rheumatoid arthritis responded favorably and reported increased comfort and decreased pain levels. The patients were compared to those given a placebo who did not respond as favorably compared to the experimental group. In osteoarthritic patients, there are joints that are worn down with deteriorated cartilage. Bone marrow stem cells can be used used in these patients to regenerate cartilage. Since cartilage tissue is composed primarily of chondrocytes, bone marrow stem cells can differentiate into chondrocytes and cause cartilage tissue to grow.

The stem cells can be easily isolated and expanded in culture, and by secreting various bioactive soluble factors, bone marrow stem cells can protect cartilage from further damage and facilitate the regeneration of cells in the surrounding area. Stem cells derived from umbilical cord blood have also been used to repair damage associated with osteoarthritis. The cells are mixed with polymers that can target localized cartilage damage spur growth. Osteoporosis is a bone diseases in which the bones become brittle and more susceptible to fractures. Scientists have been able to tweak a group of stem cells with an interferon gamma hormone that can result in bone growth for osteoporotic patients.

The hormone reinforces the immune system, and can be used to differentiate stem cells into bone cells to prevent the disease from worsening. Osteoporotic bone has been shown to delay callus formation and bone development. In order to inhibit these effects, human mesenchymal stem cells injected into patients with this disease in order to enhance their condition. The transfer of stem cells was able to transfer cytokines into the patients, resulting in an improvement to the health of the patients. Furthermore, stem cells in bone marrow need to produce hydrogen sulfide in order to differentiate into bone cells.

Since hydrogen sulfide governs the flow of calcium ions, it is necessary for stem cells to produce the chemical in order to treat osteoporosis. Using these methods, stem cells can an enormous impact in the conditions of osteoporotic patients who currently face limited treatment options and they can also benefit doctors who see these patients frequently. Stem cells have applications that even extend to cancer treatments. Stem cells can be combined with high dose radiation chemotherapy to grow healthy cells in the place of cancerous ones. The chemotherapy would eliminate both cancerous and healthy cells, allowing stem cells to fill the gap and proliferate.

Stem cells can enter the body through other means as well, and after an intense course of chemotherapy, stem cells can be inserted via a drip to travel through the bloodstream into the bone marrow. Healthy bone marrow is needed to make blood cells, so the stem cells can spur healthy blood cell generation in the patients. Mesenchymal stem cells can also produce biological agents locally at tumor sites. The tumor environment promotes the proliferation of mesenchymal stem cells, so the introduction of the Interferon-B cytokine can deliver biological agents that can destroy the tissue. As means of transferring drugs and administering chemotherapy, stem cells can have a tremendous impact in the treatment of cancer patients. Considering stem cells possess growth factors, cytokines, and stimulate growth at fracture sites, they should be used in treatments for orthopaedic injuries and diseases such as arthritis and osteoporosis.

The discovery of stem cells in multiple locations throughout the body has opened up a myriad of applications and possible uses for the cells. Stem cells can alleviate pain and reduce healing times for patients, and they can even be mixed with polymers to enhance its properties. Orthopaedic surgeons can use stem cells in their procedures as a filler for bone loss in bone replacements surgeries and to generate cartilage. In addition, the cells can be enriched with hormones to further promote healing. The many types of arthritis cause millions of people pain, but stem cells have shown to alleviate discomfort in patients. Furthermore, modified stem cells can also be used to treat osteoporosis by increasing the flow of calcium ions in the body.

Along with these applications, stem cell treatment can be used to extend cancer treatments. Mesenchymal stem cells can suppress effector T responses to treat autoimmune diseases, and the cells can be combined with chemotherapy to grow healthy cells in the place of cancerous ones. The adoption of stem cells in orthopaedics will allow for faster healing times, improved procedures, and alleviated pain in patients; therefore, scientists should continue pushing the boundaries in enhancing the properties of the cells and orthopaedic surgeons should consider including stem cells in many of their procedures.