Stem Cell Therapy for meniscus related osteoarthritis

If you are a patient suffering with long-term knee problems caused by a damaged or surgically removed meniscus, you have likely been made aware that your meniscus, or what remains of it, has a limited capacity to repair itself. You may have also been made aware that meniscus related surgery also has a limited capacity to improve your situation.

This is why researchers are looking at stem cells injections

Stem Cell Therapy is part of a family of treatments that fall under the broad umbrella of “Tissue Engineering” or “Regeneration or Regenerative Therapy.” In a recent medical papers, doctors say that the future of meniscus repair is not in surgery, but meniscus tissue engineering and that more research should be given towards maximizing the healing/regenerative properties of stem cells.1

More research is arriving 

  • In new studies doctors in China declare that “The repair of meniscus tissue in the avascular zone (without blood vessels to bring healing components) remains a great challenge, largely owing to their limited healing capacity. Stem cells based tissue engineering provides a promising treatment option for damaged meniscus because of their multiple differentiation potential (their ability to change into meniscal and cartilage cells).”2
  • In new research, scientists looked at rabbits with massive meniscal defects. Their goal was to see if a single stem cell injection would improve the defect. This is what they said: “(stem cells) injected into the knee adhered around the meniscal defect, and promoted meniscal regeneration in rabbits.” This also lead to a preservation of the articular cartilage and subchondral bone.3
  • Doctors at Harvard University found unique characteristics in the stem cells of mice meniscus that could be reawakened by stem cell augmentation. The findings were so optimistic that the Harvard team declared that studying the mouse meniscal stem cells would provide essential information for enhancing therapeutic strategies for treating knee joint injury and disease.8

This agrees with other research which strongly supports Stem Cell Therapy as a means to regrow meniscal tissue. From the American Journal of Bone and Joint Surgery:

  • There are limited treatment options for tissue restoration and the prevention of degenerative changes in the knee.
  • Stem cells have been a focus of intense preclinical research into tissue regeneration but limited clinical investigation.
  • In a randomized, double-blind, controlled study, the safety of the intra-articular injection of human mesenchymal stem cells into the knee, the ability of mesenchymal stem cells to promote meniscus regeneration following partial meniscectomy, and the effects of mesenchymal stem cells on osteoarthritic changes in the knee were investigated . . .
  • There was evidence of meniscus regeneration and improvement in knee pain following treatment with mesenchymal stem cells.
  • These results support the study of human mesenchymal stem cells for the apparent knee-tissue regeneration and protective effects.4

Research says meniscus surgery for knee osteoarthritis no help to patients

Repair and regeneration is a far cry from surgical removal: In a recent  study in the New England Journal of Medicine  doctors questioned that while arthroscopic partial meniscectomy is one of the most common orthopedic procedures, there is no evidence it works.

In the study, doctors asked patients to have a real surgery or a fake (sham) surgery without knowing which one they would get. The results? “In this trial involving patients without knee osteoarthritis but with symptoms of a degenerative medial meniscus tear, the outcomes after arthroscopic partial meniscectomy were no better than those after a sham surgical procedure.”5

Stem Cell Therapy and meniscus surgery alternatives

We see many patients with a date for meniscal surgery already planned who would like to avoid the surgery. One reason is the connection between Meniscal surgery and osteoarthritis as documented by these research observations:

  • The extent of the meniscectomy should be kept to a minimum to prevent the risk of secondary osteoarthritis. 6
  • “Preserving the meniscus is ideal because the loss of any portion of the meniscus can lead to significantly increased articular cartilage contact stresses compared with the intact state.”7

1 W, Guo W, Han S, Zhu Y, Liu S, Guo Q. Cell-Based Strategies for Meniscus Tissue Engineering. Stem Cells International. 2016;2016:4717184. doi:10.1155/2016/4717184.

2. Hana Yu, Adetola B Adesida and Nadr M Jomha1. Meniscus repair using mesenchymal stem cells – a comprehensive review.Stem Cell Research & Therapy 2015, 6:86 doi:10.1186/s13287-015-0077-2

3. Hatsushika D, Muneta T, Horie M, Koga H, Tsuji K, Sekiya I. I Intraarticular injection of synovial stem cells promotes meniscal regeneration in a rabbit massive meniscal defect model. J Orthop Res. 2013 Sep;31(9):1354-9. doi: 10.1002/jor.22370. Epub 2013 Apr 17.

4.Vangsness CT Jr, Farr J , Boyd J et al. Adult human mesenchymal stem cells delivered via intra-articular injection to the knee following partial medial meniscectomy: a randomized, double-blind, controlled study. J Bone Joint Surg Am. 2014 Jan 15;96(2):90-8. doi: 10.2106/JBJS.M.00058.

5. Sihvonen R, Paavola M, Malmivaara A, Itälä A, Joukainen A, Nurmi H, Kalske J, Järvinen TL; Finnish Degenerative Meniscal Lesion Study (FIDELITY) Group. Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear. N Engl J Med. 2013 Dec 26;369(26):2515-24. doi: 10.1056/NEJMoa1305189.

6. Flouzat-Lachaniette CH. At-risk situations for knee osteoarthritis. Rev Prat. 2012 May;62(5):630-4.

7. Delos D, Rodeo SA. Enhancing meniscal repair through biology: platelet-rich plasma as an alternative strategy. Instr Course Lect. 2011;60:453-60.

8. Gamer LW, Shi RR, Gendelman A, et al. Identification and characterization of adult mouse meniscus stem/progenitor cells.Connect Tissue Res. 2016 Dec 22:1-8. doi: 10.1080/03008207.2016.1271797.