What does Wake Nonsurgical offer in terms of Cell therapy?
Wake Nonsurgical Ortho currently offers Microfragmented Adipose MFAT cell injections FOR LARGE JOINTS (KNEE , HIP , SHOULDER) and large muscle injuries and tendon tears.
The procedure involves an easy mini liposuction where we will concentrate the fat tissue and break it down manually. We do not and are not allowed to add any enzymes or additives to manipulate the fat tissue beyond what the FDA permits currently.
We do not advise Adipose injections for minor sprains and strains or for mild arthritis.
Benefits of Adipose Cell injections:
- Well tolerated, less invasive procedure than Bone Marrow
- Safety profile is very good
- Seems to create a cellular cushion for joints
- Number of stem cells in adipose tissue is very high
- MFAT contains more mesenchymal stem cells (MSCs) than BMAC, and MSCs are a key component of regenerative medicine. MSCs in BMAC decrease significantly after age 50, while stem cells in adipose tissue remain numerous with age
Here is a study on MFAT vs BMAC : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6811695/
Here is a study on MFAT alone: https://link.springer.com/article/10.1007/s00402-023-05143-y#:~:text=Conclusions,benefits%20at%20mid%2Dterm%20evaluation.
What does the FDA say about stem cells?
The U.S. Food and Drug Administration (FDA) is responsible for the evaluation of
drug and biologic product safety. The FDA regulates the use of stem cells as
Human Cells, Tissues, and Cellular and Tissue Based Products (HCT/Ps) under
CFR Title 21 Part 1271. Most stem cells that are approved are use in the treatment of blood cancers.
Unsafe and NOT approved Stem cells include:
- Amniotic tissue Stem cells
- Exosomes
- Any bone marrow or fat cells that are more than minimally manipulated in any way
You can read more here from the FDA : https://www.fda.gov/vaccines-blood-biologics/consumers-biologics/consumer-alert-regenerative-medicine-products-including-stem-cells-and-exosomes
There are some cell injections for Orthopedics that the FDA “permits” currently (but does not “approve”), so long as the clinic does not make any false claims.
These include:
- Adipose (fat) cell transfers
- BMAC (bone marrow) transfers
However these cells must not be manipulated in any way. And the clinic must not claim that they can “regrow” cartilage or cure arthritis.
Why try PRP first ?
Recent studies are showing that High Dose PRP is very effective in mild to moderate arthritis and injuries. Severe arthritis and major tears are probably better suited for cell therapy with MFAT
Here are some studies : https://www.nature.com/articles/s41591-023-02632-w
https://josr-online.biomedcentral.com/articles/10.1186/s13018-020-01753-z
https://www.arthroscopyjournal.org/article/S0749-8063(24)00269-X/fulltext
https://press.rsna.org/timssnet/media/pressreleases/14_pr_target.cfm?id=2386
https://pubmed.ncbi.nlm.nih.gov/35984721/
What can we summarize from studies?
- Stem Cells (fat, bone marrow) treatments seem to give equal relief to steroid in some studies
- PRP seems give superior and longer lasting pain relief compared to steroid
- High dose PRP seems to be better than low dose PRP for many patients
- Steroid is not great for joints and tissues longer term, and can degrade tissue
- PRP is also less invasive and less costly than stem cell procedures.
CONCLUSION : For the majority of our patients, High Dose PRP will work just as well stem cell injections at a lower cost to the patient, but adipose cells may be useful in severe arthritis due to the cushioning effect and cell volumes.
Don’t wait! Contact us today to experience pain relief without the risk of surgery. call (919)719-2270 , or click the appointment button in the upper right corner of the screen.