BIOLOGIC THERAPIES FOR CHONDRAL LESION RECONSTRUCTION. FROM MYTH TO REALITY !

By 12 February 2017July 14th, 2020NEWS
 

Article of Dr. Stavros Alevrogiannis that was (published in the website of iatrikanews.gr) Biological therapies are undoubtedly an important weapon in the quiver of the orthopedic for the repair of cartilage damages, osteoarthritis and sport injuries. Innovative treatments, such as Biokine, EGFM and Combo Therapies (a combination of stem cells with active biomolecules) are offered exclusively from the clinic of Regenerative & Reconstructive Orthopedic Surgery of IASO GENERAL. But are everything that is heard a reality or is it just a myth? Myth: The stem cells of fat are better compared to the ones of the bone marrow for the repair of cartilage damages Reality: The stem cells that are used for the treatment of cartilage damages can come from either the bone marrow or the adipose tissue. However stem cells of the bone marrow are preferred for the below reasons: Stem cells of the bone marrow have already begun to differentiate to precursor chondrocytes and therefore have a higher ability of repairing cartilage damages. Bone marrow contains a much higher amount of nucleated cells compared to the fat. These nucleated cells also contain other types of cells (such as osteochondroreticular cells), which have a very significant action for the repair of orthopedic damages. Bone marrow stem cells are quickly isolated through a procedure of minimal handling of the biological material. Contrarily, fat stem cells need a more complicated handling, while their isolation procedure is more complex and requires the usage of specific enzymes (meaning other, exogenous factors). In general, bone marrow stem cells are isolated in about 20 minutes, while for the isolation of fat stem cells around 3,5 hours are required. Therefore, bone marrow stem cells have a direct application to the patient (Same-Day application), without requiring a waiting or extended hospitalization. Myth: The stem cells collection procedure from the bone marrow and their application is painful Reality: The collection of a small amount of bone marrow that is required for the treatment, lasts for just a bit and is painless for the patient, with the usage of local anesthesia or narcosis. As far as their application is concerned, in no case would we call it painful. The patient feels like he/she had a simple injection or vaccine and can return promptly to his/her daily routine. Myth: The PRP that is created from the blood is the same therapy with the stem cells Reality: The PRP contains only platelets from the peripheral blood and in no case is a treatment similar to the stem cells. The stem cells used for the repair of orthopedic conditions can come from the bone marrow or adipose tissue. Their concentration in the peripheral blood, from where platelets come from, is very little and thus has no usage. Myth: The PRP is the same therapy with the Enhanced Growth Factor Mix (EFGM) Reality: The EGFM is an innovative, one of its kind product, which is used for the treatment of orthopedic pathological conditions. It is an autologous, Enhanced Growth Factor Mix which is isolated from the platelets of the patient’s blood. In fact it is a non-cellular extract of blood’s platelets that consists of only useful proteins that exist in the platelets – all cellular products have been removed. The Enhanced Growth Factor Mix (EGFM) is nor PRP. In fact this product is much more efficient than the simple PRP – at least 20 times more powerful. It’s unique components reinforce significantly the natural ability of the organism for repairing damages through a unique mechanism of action. Myth: Biological therapies for the repair of orthopedic conditions are applied by various centers and doctors Reality: Absolutely not. Our team (medical and scientific) has a lonterm experience in the usage of biological therapies and is the only one in Greece that offers that kind of treatments, in the hospital area, with an organized medical and scientific team and with the approval of the Committee of Ethics & Conduct of the hospital. Our biological products are made based on the international speculations and approved protocols, under the supervision of a molecular biologist, while the final sample is checked for the final number of nucleated cells and their phenotype with flow cytometry and is certified for the absence of microbial infection. We are already training in our centre other doctors in Greece. However, as in other techniques, time is required in order for this new technique to be adopted from the scientific community. The patient must be very careful when he/she discusses such treatments, in order to understand what it is in fact offered to him/her.

Biological therapies are undoubtedly an important weapon in the quiver of the orthopedic for the repair of cartilage damages, osteoarthritis and sport injuries. Innovative treatments, such as Biokine, EGFM and Combo Therapies (a combination of stem cells with active biomolecules) are offered exclusively from the clinic of Regenerative & Reconstructive Orthopedic Surgery of IASO GENERAL. But are everything that is heard a reality or is it just a myth?  

Myth: The stem cells of fat are better compared to the ones of the bone marrow for the repair of cartilage damages  

Reality: The stem cells that are used for the treatment of cartilage damages can come from either the bone marrow or the adipose tissue. However stem cells of the bone marrow are preferred for the below reasons:

  • Stem cells of the bone marrow have already begun to differentiate to precursor chondrocytes and therefore have a higher ability of repairing cartilage damages.
  • Bone marrow contains a much higher amount of nucleated cells compared to the fat. These nucleated cells also contain other types of cells (such as osteochondroreticular cells), which have a very significant action for the repair of orthopedic damages.
  • Bone marrow stem cells are quickly isolated through a procedure of minimal handling of the biological material. Contrarily, fat stem cells need a more complicated handling, while their isolation procedure is more complex and requires the usage of specific enzymes (meaning other, exogenous factors).
  • In general, bone marrow stem cells are isolated in about 20 minutes, while for the isolation of fat stem cells around 3,5 hours are required. Therefore, bone marrow stem cells have a direct application to the patient (Same-Day application), without requiring a waiting or extended hospitalization.

Myth: The stem cells collection procedure from the bone marrow and their application is painful  

Reality: The collection of a small amount of bone marrow that is required for the treatment, lasts for just a bit and is painless for the patient, with the usage of local anesthesia or narcosis. As far as their application is concerned, in no case would we call it painful. The patient feels like he/she had a simple injection or vaccine and can return promptly to his/her daily routine.  

Myth: The PRP that is created from the blood is the same therapy with the stem cells  

Reality: The PRP contains only platelets from the peripheral blood and in no case is a treatment similar to the stem cells. The stem cells used for the repair of orthopedic conditions can come from the bone marrow or adipose tissue. Their concentration in the peripheral blood, from where platelets come from, is very little and thus has no usage.  

Myth: The PRP is the same therapy with the Enhanced Growth Factor Mix (EFGM)  

Reality: The EGFM is an innovative, one of its kind product, which is used for the treatment of orthopedic pathological conditions. It is an autologous, Enhanced Growth Factor Mix which is isolated from the platelets of the patient’s blood. In fact it is a non-cellular extract of blood’s platelets that consists of only useful proteins that exist in the platelets – all cellular products have been removed.

The Enhanced Growth Factor Mix (EGFM) is nor PRP. In fact this product is much more efficient than the simple PRP – at least 20 times more powerful. It’s unique components reinforce significantly the natural ability of the organism for repairing damages through a unique mechanism of action.

Myth: Biological therapies for the repair of orthopedic conditions are applied by various centers and doctors

Reality: Absolutely not. Our team (medical and scientific) has a lonterm experience in the usage of biological therapies and is the only one in Greece that offers that kind of treatments, in the hospital area, with an organized medical and scientific team and with the approval of the Committee of Ethics & Conduct of the hospital. Our biological products are made based on the international speculations and approved protocols, under the supervision of a molecular biologist, while the final sample is checked for the final number of nucleated cells and their phenotype with flow cytometry and is certified for the absence of microbial infection. We are already training in our centre other doctors in Greece. However, as in other techniques, time is required in order for this new technique to be adopted from the scientific community. The patient must be very careful when he/she discusses such treatments, in order to understand what it is in fact offered to him/her.