Knee Stem Cells and Tennis
Some sports are more grueling on the knee than others. Tennis is hard on many joints the knee is one of them. Stem cell therapy has made its way into the treatment of many knee problems. Tennis and Stem Cell Therapy will most likely remain on friendly terms. Many professional athletes from a variety of sports have discussed their treatment with Platelet Rich Plasma (PRP). These include elite athletes from all major sports including tennis star Rafael Nadal. Most recently Nadal’s camp has stated he will undergo back stem cell treatments and has previously undergone knee stem cell treatments. Tennis fans know of Rafael Nadal’s struggles with knee problems and his frequent return to championship form following his chronic knee problems.
Trauma perpetuates knee arthritis. Repetitive trauma only aggravates this phenomenon. Early arthritis has ended many sports careers. Surgery also accelerates knee joint arthritis. Arthritis medications and cortisone injections do not halt this progression.
Though long term studies are not yet available for 20-30 year outcomes with stem cell therapy in knee arthritis, the pathophysiology of how degeneration of the knee joint is better understood now from a cellular level. The role that stem cells exert on influencing the inflammatory process is also now better understood.
Tennis will exert repetitive stress to the knee joint. This may never completely halt the degenerative cascade with repetitive micro trauma in some athletes. However, methods to aid in repair are desirable in those who wish to continue in their chosen sport. Stem Cells may exert anti-inflammatory as well as regenerative effects. The regenerative effects can occur by the formation of knee cartilage cells. This is one mechanism by which stem cells may exert positive effects in sports medicine applications.
Some athletes are blessed with good fortune and genes, and will play tennis as seniors. Others may need help.
Stem Cell Therapy may be a viable option for chronic knee problems associated with tennis.
Stem cells are part of the emerging field of Regenerative Medicine. Biologics and Platelet Rich Plasma (PRP) are also regenerative medicine procedures. Platelet Rich Plasma (PRP) gained popularity after numerous elite professional athletes in a variety of sports began surfacing in the news media. That is old news, and stem cells much as they did in race horses are taking the notoriety in professional athletes away from PRP.
Regenerative Medicine deals with the field of regeneration and tissue engineering. Helping the body heal itself is a cornerstone. Growth factors in Platelet Rich Plasma (PRP) assist tissues to heal by direct actions and by influences cell signaling responsible for tissue breakdown.
Stem cells are much more effective at this healing response than PRP alone.
That is because stem cells are master control cells. They have been referred to as medicinal cells by one prominent stem cell researcher for their ability to heal and control the immune system and anti-inflammatory properties.
Stem cells also are capable of differentiating into new cells in the knee most importantly is cartilage cells or chondrocytes. This process can be referred to as regeneration. The degree of regeneration may be dependent upon many factors. Regeneration may not always occur. Another property of stem cells is their ability to affect inflammation.
At times stem cells may exert their healing effect by controlling cell signaling which promote tissue breakdown or catabolism. By inhibiting catabolism or cartilage breakdown arthritis does not progress.
If repair is allowed to occur by regeneration than new cartilage growth can actually demonstrate reversal to some degree of the degenerative arthritis cascade. No other form of treatment is capable of doing this.
If knee breakdown is halted than no net cartilage loss occurs over a period of time which in itself is positive as well. Studies have shown that knee arthritis can progress significantly over a 3-5 year period on serial x-rays. Therefore measures showing no net loss are actually positive in a known progressive degenerative or arthritic situation.
Stem cells exert many more complicated effects by direct and indirect signaling with other cells and tissues. These multiple effects can be so complex that all possible interaction patterns for every situation, and each person own unique cell signaling responses may vary by multiple other factors further augmenting or confusing the issue.
Needles to say there are some patients who will always respond better than others. No different than younger healthier patients typically respond better to any procedure. Many of the reasons apply equally to stem cell effectiveness.
Stem cells still have some hidden mysteries, as do our own brains. Yet the therapeutic potential and applications of stem cells continue to expand in many areas of medicine.
Soccer places significant stress on the knee. Trauma to the knee is a frequent injury in soccer. Stem cells for knee problems has become more frequent in sports and including in the professional ranks. Stem cells for soccer players with knee problems is also more commonly occurring.
Dr. Dennis Lox has treated many soccer players for knee problems with Stem Cell Therapy. As with all sports that trauma occurs to the knees, arthritis is a well known consequence. Delaying the development or halting the progression of arthritis in athletes is extremely important. It is unclear if trauma associated arthritis will ever be fully curable with the continuation of sports, the ability to modify or decrease the progression of knee joint arthritis is vastly important to athletes wishing to continue in sports. The multi-factorial nature of degenerative arthritis including genetics further complicates the issue.
Soccer can result in meniscal tears, ACL tears, MCL tears, in addition to early degenerative arthritis. Knee surgery in the soccer player can accelerate the degenerative arthritis cascade. Fractures and avascular necrosis (AVN) may also occur in soccer players knees.
Stem Cell Therapy may be a viable option for soccer players who may be afflicted with a variety of knee problems.
Knee stem cells are becoming an increasingly know treatment strategy. The exact science is better understood, yet all is still not known of how stem cells exert all their effects or why not every patient improves the same.
This is as complex issue. Yet, when taken in light of not ever athlete improves with surgery, or not every patient responds to physical therapy and rest, the mysteries become less vague and the facts we do know become more clear. Many treatment modalities in sports medicine are not fully understood. Cold laser, electrical currents, acupuncture are some examples.
We do know that safety trials with human adult stem cells have been shown stem cells to be safe.
This can not be said as clearly as commonly prescribed medications, especially oral anti-inflammatories or arthritis medications. These can cause stomach ulcers, liver and kidney disease and death. Necessitating a removal from the market of Vioxx, a previous popular prescribed NSAID medication.
Stem cells from the patient have been used to treat many types of musculoskeletal problems as well as Platelet Rich Plasma (PRP). These uses have also included the treatment of a variety of knee problems with both Platelet Rich Plasma (PRP) and stem cells.
The use of these Regenerative Medicine procedures has included elite professional athletes in all major sports. Tiger Woods, Kobe Bryant, Rafael Nadal, Alex Rodriquez, Hines Ward all have used PRP for their knees. While some others have also reported their own use of stem cells for knee pain (Rafael Nadal), it was very famously described in the news when professional football player Peyton Manning had stem cells in his neck following surgery. Though not an athlete in the classic sense, even Pope John Paul had knee PRP.
A common misconception is the Vatican is opposed to stem cells. The Vatican actually supports the use of adult stem cells, and has held stem cell conferences at the Vatican.
The athlete has unique circumstances. Their sport is important to them and may be their livelihood. Extending their playing career by assisting the healing response or slowing the degenerative cascade has profound implications for the athlete.
Understanding the pathophysiology of knee trauma and degeneration is important to fully appreciate the ability of stem cells in sports medicine applications.
While complete mastery of the science is not necessary, the basics are helpful in understanding the process and evaluating potential therapeutic applications of the use of stem cells in athletes and sports medicine.