What ever happened to stem cell research? I thought this was going to be the miracle cure for all diseases including arthritic joints. I’m definitely interested!

Stem cell research originally got stymied by lack of approval and funding from the White House (under former President Bush’s administration). But now under the Obama plan, approval of stem cell research has moved ahead. Funding is still always what holds back any scientific or medical research.

Some of the newer ideas involving tissue engineering (like using stem cells and growth factors in healing) appear to have lots of potential for clinical application. But they have not produced the kind of positive results expected. The reason for this disconnect isn’t clear yet but it is something scientists are paying attention to and exploring further.

Here’s what we know so far. First, when it comes to using stem cell therapy during surgery to reattach a torn tendon to the bone, it looks like more research is needed. Before this treatment can be successful, scientists must find ways to signal stem cells to form the different cells needed at the insertion site. The goal is to find ways to use the patient’s own stem cells (rather than injecting donor stem cells from someone else) to form what is needed at the specific site of injury.

The results of studies so far suggest that this transition site from tendon to bone is very complex. In normal anatomy, joint stability, and movement, there is a load transfer from tendon to bone. Tendon and bone are two uniquely different types of tissue. One type of stem cell may not be enough to accomplish the task of restoring normal anatomy and function. Some cells must be formed of stiffer collagen fibers for bone while other cells remain soft and flexible to form tendons.

In the area of osteoarthritis research, researchers continue to focus on understanding what happens to the joint cartilage in the formation of osteoarthritis. Scientists have been able to identify key molecules involved in the process. Applying this information to mice has resulted in decreased osteoarthritis.

Right now, various types of growth factors are being tested in the treatment of joint pain from early osteoarthritic changes. It has been discovered that when osteogenic (bone) protein is combined with insulin-like growth factor joint regeneration is possible.

Other biologic therapies for the regeneration of tissue such as joint cartilage currently under investigation include autologous conditioned (blood) serum and bone marrow concentrate. Autologous refers to the body’s own cells. Any time autologous sources of cells can be used, it is considered an advantage both in terms of (lower) cost and (easy) administration.

Most of these ideas are still being investigated in the laboratory and are not yet fully available to the public at large. Your orthopedic surgeon will be the first one to let you know when new, innovative treatment is available.

In the meantime, studies do show that strengthening and flexibility exercises are still the best way to control joint flare ups from osteoarthritis. If you are interested in a specific program of supervised exercises for this problem, see a physical therapist. The therapist can get you headed in the right direction and help keep you on track for the best possible outcome with conservative (nonoperative) care.