Arthritis in knees, in other words corrosion of cartilage is a disease that majorly decreases the quality of life due to severe pain in knees as well as limitation of movement. Nowadays , it is not only a problem for elderly, but also for individuals below the age of 35 due to uncontrolled sport and as the obesity, the important problem of our age became more common. There is unfortunately no definite remedy for arthritis in knees. The treatment methods are more focused on the complaints in order to relieve them with exercise, medicines, physical therapy, intra-articular injections and even surgery at the last stage. Good news is, recent studies on stem cell therapy are promising for the treatment of arthritis in knees. Orthopedy and Traumatology Specialist Prof Dr. Alper Kaya from Acıbadem Altunizade Hospital indicated that stem cell therapy brings some improvements in the functions by decreasing the complaints and increasing the mobility of joints although it has not provided a definite remedy for arthritis in knees yet. He also added, “We believe that biological treatments like stem cell therapy will be used more often in near future.”
The major symptom of arthritis in knees is pain. This pain is first felt when moving, going up and down the steps and overusing the knees and then starts arising even while resting. Orthopedy and Traumatology Specialist Prof. Dr. Alper Kaya warns that this gradually exacerbating pain is accompanied with limitation of mobility in later stages and lists other symptoms as follows: “There might be some other complaints around the knees like swelling, noise, tripping and blockage. In later stages, curvature also arises in knees. As a result of all these complaints, the patients feel like they have to take painkillers every day and sooner it becomes impossible for them to leave the house.
There is no single therapy for the arthritis in knees. The treatment is chosen according to the age, the severity of the pain, other diseases, the social condition of the patient and the effects on daily activities. At the beginning of the disease, exercises aiming to strengthen the muscles around the knees, losing weight and pain killers could be beneficial and sufficient. Medicines supporting the cartilage might decrease the pain in some patients. Furthermore, physical therapy procedures and intra-articular injections can also be applied. Closed arthroscopy surgery can be performed for patients in later stages or for those who could not benefit from other treatment options whereas bone surgeries can be done in cases where the carrying axis of the bone is disturbed. When the level of arthritis is higher and there is no more cartilage on the bone surface, prosthesis is required.
Stem cells are not only abound in bone marrow and fat tissue, but also relatively easy to obtain in these areas. Orthopedy and Traumatology Specialist Prof. Dr. Alper Kaya indicates that the stem cell therapy can be performed as a day therapy without requiring the patients going into the operation room and being hospitalized. He also adds: “In this method, the stem cells are taken from the bone marrow or the fats in abdomen via a minor procedure under local anaesthesia or sedatives and then the stem cells are proliferated in laboratory. The proliferation continues a few hours. During this step, the patient takes a rest in the resting room of the stem cell unit. The proliferated stem cells are injected into the joints in liquid form on the same day. After this procedure is completed, the patient can be discharged immediately.”
Stem cells are special cells that can proliferate and differentiate to other cells. It is estimated that these stem cells from various tissues of the body such as bone marrow and fat settle on the cartilage tissue and differentiate into new cartilage cells. It is also believed that stem cells decrease the breakdown of the cartilage by secreting some substances. Orthopedy and Traumatology Specialist Prof. Dr. Alper Kaya emphasizes that some recovery and in turn a decrease in the complaints are expected as this transformation occurs. He also says: “Although the problem has not been completely eliminated, studies show that there might be a recovery that leads to some improvements in daily activities like decrease in pain and increase in the mobility of the joint. Even though the stem cell therapy is a promising treatment method, more studies and evidences are still required and it is expected to obtain more definite results in the future.
Orthopedy Specialist Prof. Dr. Alper Kaya explains the cases as follows: “Stem cell therapy can be considered as an alternative treatment method when other non-surgical methods have not been successful or there is arthritis with mild to moderate corrosion in cartilage. Furthermore, for patients at younger ages having cartilage deformation only in a certain area, stem cells can be placed into the deformed cartilage area within a special synthetic tissue via surgery. Stem cell therapy does not provide improvement in very late stages of arthritis that requires prosthesis surgery. Therefore it is not recommended in such cases. The decision on which patient may take the therapy can vary according to the physician.”