Degeneration of tendons, muscles and joints remains one of the workhorses of modern orthopedic surgery. But since the advent of biological therapies many experts believe that it has begun a new era in the treatment of these injuries.
The initial use of growth factors derived from platelets or platelet-rich plasma (PRP) and more recently the pluripotent stem cells (CMP) has been spreading among specialists in Trauma and Orthopedic Surgery with the aim of stimulating healing of bone and soft tissue lesions suffered by many patients.
The autologous platelet rich plasma is an inexhaustible source of such
growth factors: PDGF (platelet-derived growth factor), TGF-β (transforming growrh fctor-beta), IGF (insulin-like growth factor), EGF (epidermal growth factor) and FGF-2 (fibroblast growth factor-2) among others. Its use was limited initially peridodontal surgery as a supplement to conventional graft in the treatment of bone defects, but good results published in this specialty extended their use to other branches of medicine, including orthopedic surgery.
Called pluripotent stem cells (CMP) or Troncal?? cells, a special type of undifferentiated cells that have the ability to indefinitely divide and potentially produce specialized cells of any tissue. They come from two sources: from newly formed embryos (embryonic stem cell) whose use raises important ethical issues or adult tissue, usually from the iliac crest of the patient (adult stem cells), where they accumulate to replace, when necessary, a dead adult cells.
Both therapies can be combined to treat degenerative lesions in tendons, muscles or joints. However even today there are no conclusive studies that unequivocally demonstrate its effectiveness, although the initial results are very promising.
With a simple blood sampling (similar to that needed for completion of a conventional analytical) and a needle aspiration at the level of iliac crest and under local anesthesia, both the PRP and the CMP are obtained and processed in the operating room during 15 0 20 minutes. After that time they are available for injection into any joint, tendon or muscle of the patient. This type of therapy can be used either alone or as a supplement after the completion of any open or arthroscopic surgical technique for promoting regeneration-repair of any injured organ or tissue.
Probably in a few years we will see a further step in the development of these new technologies that combine cell biology and tissue engineering: the implementation of even whole organs to replace those damaged, reproduced in the laboratory from a patient’s own stem cells.
At the time that this becomes a reality, the problems of rejection of organ shortage and logistics related to the removal and installation of conventional transplants may be considered outdated.