stem cells Chandler: what can help a sore joint?

What can I do for the soreness today?

First, scale back the motion that keeps stirring the ache. You can still move in ways that feel comfortable.

A short, flat walk may suit you better than a long one. Gentle exercise can keep the muscles around your joint working.

Change just one daily task at first. That makes your joint's response easier to notice.

Use any brace, cane or medicine only as directed. If your doctor suggested ice, have it ready at home.

Check the joint again later that day. If it doesn't settle, the activity was likely too much.

When is it time to have the joint checked?

Have a doctor check aches that keep coming back or limit normal tasks. You might need an X-ray and a check of joint movement.

Say when you first felt sore and which actions worsen it. Write down every medicine you take and any earlier care.

Call promptly about fever, spreading redness or unusual joint heat. Sudden weakness, numbness or trouble standing also needs fast care.

Seek help now for an obvious shape change after an injury. That problem can't wait for a regular visit.

Sources

1. A retrospective comparison of 523 bone marrow aspiration procedures against 435 open iliac crest bone graft harvests found aspiration significantly reduced complications - relevant because marrow aspiration for a joint injection is a real procedure with a real, if low, complication rate.

   Hernigou P, et al. — Morbidity of graft harvesting versus bone marrow aspiration in cell regenerative therapy. Int Orthop, 2014. DOI: 10.1007/s00264-014-2318-x.

2. In 96 patients, concentrated bone marrow aspirate contained a mean of 26.3 million nucleated cells per mL but only about 1,422 colony-forming units of connective tissue progenitors, and the nucleated cell count had negligible predictive value for how many progenitor cells were actually present (r-squared 0.28).

   Muench LN, et al. — Nucleated Cell Count Has Negligible Predictive Value for the Number of Colony-Forming Units for Connective Tissue Progenitor Cells (Stem Cells) in Bone Marrow Aspirate Harvested From the Proximal Humerus During Arthroscopic Rotator Cuff Repair. Arthroscopy, 2021. DOI: 10.1016/j.arthro.2021.01.064.

3. In a 480-patient, four-arm, multicenter randomized phase 2/3 trial, none of three orthobiologic cell injections - autologous bone marrow aspirate concentrate, autologous adipose stromal vascular fraction, or allogeneic umbilical cord tissue-derived mesenchymal stromal cells - was superior to any other, or to a corticosteroid injection control, on pain at 12 months.

   Mautner K, et al. — Cell-based versus corticosteroid injections for knee pain in osteoarthritis: a randomized phase 3 trial. Nat Med, 2023. DOI: 10.1038/s41591-023-02632-w.

4. FDA states in its consumer alert that the only FDA-approved stem cell products in the United States are blood-forming stem cells derived from umbilical cord blood, approved for disorders of the blood-forming system, and that NONE of these products - stem cells, stromal vascular fraction, umbilical cord blood, Wharton's jelly or amniotic fluid - has been approved for the treatment of any orthopedic condition, including osteoarthritis, tendonitis, disc disease, tennis elbow, back pain, hip pain, knee pain, neck pain or shoulder pain.

   US Food and Drug Administration, Center for Biologics Evaluation and Research — Consumer Alert on Regenerative Medicine Products Including Stem Cells and Exosomes. , 2020.