09 Nov Chondromalacia Patella Treatment with SVF Therapy
The patella is covered with a layer of articular cartilage. that allows for smooth gliding of joint surfaces during knee movement. Chondromalacia patellae are degenerative softening of the articular cartilage in the joints associated with patella.
The causes of chondromalacia include trauma, muscle imbalance around the knee, overuse, poorly aligned bones near the knee, meniscus injury, rheumatoid or osteoarthritis, knee joint infection or bleeding inside the knee joint.
The main symptom of chondromalacia is a dull pain behind the kneecap, which gets worse climbing stairs or getting up after sitting in one position for a while. The knee to catch or buckle, or swell and appear puffy. There may be creaking or grinding sound upon knee movement.
ADSCs may play an important role in the cartilage repair. ADSCs treatment may prove to be a new non-surgical method of treatment for chondromalacia patellae.
There are multiple sources of mesenchymal stem cells, most common of which are bone marrow and adipose tissue. These cells differentiate into a wide variety of cells and therefore, has therapeutic potential.
ADSCs are obtained through lipoaspirates. The stromal vascular fraction (SVF) is separated from the lipoaspirates by centrifugation and mixed with calcium chloride-activated platelet-rich plasma (PRP). This mixture can then injected in the retropatellar space under ultrasonographic guidance.
Pain scores and physical therapy assessments can be used to look for immediate, early and long-term clinical changes. Magnetic resonance imaging (MRI) can be used pre- and post-treatment to assess regenerative changes. It has been reported that 1 month after the injection of autologous ADSCs, patients reported pain improvement of 50-70% and 80-90% after 3 months. Furthermore, the pain improvement persisted over 1 year according to the reported follow-ups. No serious side effects were reported in the study. According to that study, MRI at three months showed improvement of the damaged tissues in patellofemoral joints.
PRP alone has also been shown to be helpful in the treatment of patellar tendinopathy. After PRP treatment, the patients showed significant improvement.
Another study showed that stem cell treatment in athletes with chronic patellar tendon degeneration is beneficial. In this study, they used stem cells from the bone marrow. The patients were followed up for 5 years and showed significant improvement in most clinical scores. As we know that SVF from lipoaspirates yields more stem cells and growth factors, it may be inferred that ADSC-based treatment may well be even more beneficial if not as much.
Chondromalacia has shown very favorable results with SVF stem cell therapy with and without PRP. These treatments are especially appealing to patients who want to avoid surgery. While the initial results are encouraging, these therapeutic approaches are still experimental. Further studies proving its efficacy and safety will help establish its clinical application. Your doctor will inform you about the current status of the approval and availability of stem cell therapy for your joint issues.