Are stem cell injections an effective treatment for knee osteoarthritis?
Frank McCormick M.D.
Emmanouil Kiriakopoulos B.S.
LESS Surgical Institute
Shoulder and Sports Division
Fort Lauderdale/Boca Raton Florida
Osteoarthritis (OA) of the knee is a degenerative disease of cartilage resulting in activity limiting pain and disability. Knee osteoarthritis alone is one of the nation’s leading causes of disability. Many athletes with a knee injury are at risk of developing early-onset arthritis. The cartilage may erode completely over time, creating bone on bone friction and breakdown of the joint. Cartilage cannot heal itself, as it does not have a blood supply to stimulate the healing cascade. Thus, surgeons have turn to the injection of stem cells and other growth factors (i.e Platelet Rich Plasma (PRP))to initiate a cartilage healing process.
Current treatments for osteoarthritis include physical therapy, weight loss, lowimpact cardiovascular exercise, and medications to reduce inflammation and discomfort.
Current medication options include the use of non-steroidal anti-inflammatory drugs
(NSAIDs), viscosupplementation with hyaluronic acid, corticosteroid injections, and now stem cells and PRP. As the disease progresses the efficacy of these treatments decrease, usually requiring a surgical intervention.

Mesenchymal stem cells (MSCs) are a new intervention focus aiming to regenerate damaged knee cartilage from OA, or at least reduce the pain associated with this condition. MSCs have the ability to differentiate into many types of connective tissues, including chondrocytes (the cartilage-building cells). These cells also have the ability to self-renew, migrate toward injured tissues to repair them, and can inhibit immune responses like anti-inflammation (pain reduction). There are many different sources of MSCs including the bone marrow, fat tissue, umbilical-cord blood, and amniotic fluid. Current debate exists in which source is the best to use in the regenerative scope of orthopedics and sports medicine. Many animal and early clinical studies show the effectiveness of MSCs in suppressing the pain and a possibility of regenerating cartilage, though further investigation is needed. There is increasing clinical evidence supporting its use by studies performed in Europe and Asia. A recent randomized controlled trial in the United States demonstrated decreased pain and a regrowth of meniscus after knee arthroscopy. We are currently enrolling patients in a study to assess the use of stem cells from one’s bone marrow to regrow cartilage and reduce the pain and disability associated with this condition.
In order for insurance companies to cover a medical intervention, the U.S. Food and Drug Administration (FDA) must first approve the treatment. Currently, there is no
FDA approval for “Stem Cell” injections or treatments. However, if the tissue is
“minimally manipulated,” the application of stem cells is allowed. This has been an ongoing problem due to stem cells being considered a pharmacological treatment and currently lacks a consistent means of acquiring, culturing, and administering to patients.
However, Because of this, MSC therapy is very expensive with costs ranging from $450-

3000. Our goal is to keep our active South Floridian out of the operating room, and out in the sun.
We have several biologic clinical trials currently at the LESS Surgical Institute, offering a variety of interventions suitable for any budget. Our clinical position is to use these new approaches as an alternative to surgery, only when all other efforts have proven ineffective. We are finding we can make a clinical improvement in most, but not all patients.