Placenta stem cells in the treatment of joints injuries and diseases

Most people are amenable to osteoarthritis: 80% of individuals over 60 years old
have this degenerative joint disease. The older the person, the more pronounced the
manifestations of osteoarthritis, the more painful the joints are, the mobility is
limited, and sometimes disability occurs as well as the loss of the ability to move
independently. At a young age, osteoarthrosis develops less often, however, if the
body is subjected to high physical exertion and trauma, the likelihood of damage to
a joint and its subsequent destruction increases. This often happens with
professional athletes, for whom joint damage can mean the end of a career. The use
of placental stem cells in the treatment of osteoarthritis and joint injuries opens up
new possibilities for full recovery after severe injuries, and also makes it possible
to delay endoprosthetics for severe joint damage with osteoarthrosis or to reject
this option completely.

Why does osteoarthritis occur and how does it manifest

Even in a relatively healthy person over 60 years of age, processes occur in the
body that gradually worsen the condition of all organs and systems, slow down the
restoration of cells and tissues, and reduce the elasticity of blood vessels, muscles,
and joint cartilages. At the same time, coordination of movements and general
mobility worsen with age, the reaction rate decreases, and as a result, a person is
more susceptible to falls, which, combined with the vulnerability of cartilage, can
lead to serious injuries. Even if the joints are not injured, they still undergo age-
related degeneration, which causes pain, decreased mobility and range of motions,
worsening of the general physical condition, and gradual refusal of physical
activity. There are also factors that provoke or accelerate the development of
osteoarthrosis: heredity inflammatory joint diseases resulting from hypothermia or occupational loading
increased physical activity (usually in athletes) excess weightjoint injuries (most commonly found in athletes or associated with sports loading)
In osteoarthritis, any joints can be damaged, but most often – knee, femoral, ankle, as well as joints of the shoulder and arms. Osteoarthrosis has characteristic signs: pain under conditions of loading on a damaged joint (for example, during walking)
and a decrease in pain at rest; also, pain can occur in the evening, after a load
during the day; joint pain when weather conditions change (a sharp change in air temperature,
atmospheric pressure), due to which the pressure in the joint cavity increases;
stiffness in the joints, which disappears within half an hour after the onset of
activity; crunch in the joints; the appearance of edema or swelling at the site of the affected joint;
in osteoarthritis of the interphalangeal joints of the hands and feet – the occurrence
of "nodules" that lead to persistent deformation;
in osteoarthritis of the knee, femoral joints – difficulty to walk up the stairs,
especially when descending. The doctor establishes the diagnosis after evaluating the clinical symptoms and
conducting diagnostic examinations: x-rays of the changed joints, MRI and
ultrasound of the affected areas.

Osteoarthritis Treatment: Stem Cells for Effective Therapy

For a long time, the treatment of osteoarthritis implicated the application of non-
steroidal anti-inflammatory drugs to reduce pain and inflammation in the joints, the
use of local painkillers and anti-inflammatory drugs, hormonal drugs, as well as
the use of chondroprotectors – drugs that can positively affect the condition of
cartilage. The effect of the latter, unfortunately, is not so obvious that these drugs
are considered mandatory in the treatment regimens of osteoarthrosis. In addition,
injections are performed directly into the joint, contributing to the restoration of
joint fluid – this is a temporary measure, thanks to which a person can get rid of
severe pain for several months, but such treatment does not restore directly the
cartilage. If the joint cartilage is a subject to significant degeneration and can not
perform its functions, the patient is offered surgery with replacement of the joint
for the artificial one. Prosthetics is a necessary measure for those who, due to
osteoarthritis, lose the possibility to engage in professional activities (for example,
athletes), as well as for people who, due to joint damage, cannot service
themselves or move around, suffering from severe pain.
A few years ago, the situation in the treatment of osteoarthritis has changed. Over
the past decade, cell therapists around the world have been actively exploring the possibilities of mesenchymal stem cells, which are derived from the placenta that
has been preserved after birth. We already wrote about the collection and storage of the placenta, as well as about the possibilities of
using its cells and extract in various fields of medicine and cosmetology.
Mesenchymal stem cells have a number of properties that make them an ideal
building material in the treatment of joint diseases – in particular, they are able to
differentiate into cartilage tissue cells, which slows down the process of joint
degeneration, improves its functional state, helps restore functions, and as a result
can even help to avoid prosthetics, which without such treatment would be
inevitable. Given these capabilities of stem cells, they began to be used in the
treatment of musculoskeletal system diseases. Today, there is enough evidence to
confirm the effectiveness of cell therapy for osteoarthritis. In particular, an analysis
of the results of treatment of more than 10,000 patients with these diseases in
different countries confirmed that pain and other manifestations of osteoarthritis
are significantly reduced during 12-24 months after therapy. According to 2018
data, there were no side effects from mesenchymal stem cell transplantation. Recall
that mesenchymal stem cells have many different properties that distinguish them
from hematopoietic stem cells, and one of them is that transplantation does not
require immune matching. However, the biological material required for
administration is very expensive – because these are donor stem cells. One of the
few ways to provide access to mesenchymal as well as hematopoietic stem cells is
to collect the placenta and umbilical cord blood at birth. Since osteoarthritis is a
disease that develops in most people, a person whose cells are stored by parents at
birth can use them at any time not only to treat serious rare diseases, but also to
restore joints during osteoarthritis or after an injury. At the same time, there will be
no need to buy donor stem cells that cost tens of thousands of euros (a cord blood
sample costs about 20,000 euros). The use of mesenchymal stem cells in the treatment of musculoskeletal system
requires further clinical trials, but today it is clear that in the restoration of joints,
the fight against pain, and the delay in prosthetics of the joint, stem cells have no
equal.

Placenta stem cells in the treatment of knee ostearthrosis: personal experience

At the end of 2019, a press conference was held in Kiev, where the prominent
athlete, a world-famous football player, trainer of the Ukrainian football team
Andrey Shevchenko shared his personal experience of treating the knee joint. As a
professional athlete, the quick effect of treatment was fundamentally important for him, and in this regard the legendary football player was pleasantly surprised. In
addition, subjective indices improved significantly – he managed to get rid of knee
pain, increase range of motions, return to normal loads, and the effect was also
confirmed by experts: mesenchymal stem cells really have the ability to repair joint
cartilage damaged in a result of trauma or age-related deformation. Speaking to
reporters, Andriy Shevchenko noted that he was impressed by the high level of
service in the national clinic and was proud that the world-class cell therapy
opportunities are available in Ukraine. Feeling the effectiveness of the treatment,
the athlete confidently recommends this type of trauma therapy to his colleagues
and relatives. In order to provide his children with the opportunity to receive the
most progressive treatment of many diseases and give them a chance to maintain a
long youth, Andriy Shevchenko and his wife made sure that their stem cells of
umbilical cord blood and placenta were stored in a cryobank.

From clinical research to routine practice

Both athletes and doctors say that sports injury is a common occurrence.
According to the orthopedist and traumatologist of the Department of
Traumatology and Orthopedics of the Kiev City Clinical Hospital No. 6, a doctor
of the highest category, Roman Birsa, football players are among the athletes
whose joints suffer increased stress and are often injured. Dislocations, sprains,
fractures, bruises lead to degenerative-dystrophic changes in the joints and the
development of arthrosis of the knee joint. As shown by the practical use of stem
cells in the treatment of affected joints, which was jointly carried out by specialists
of the Kiev hospital No. 6 and the Institute of Cell Therapy, providing a cell drug
of mesenchymal stem cells, this innovative treatment method is very promising, as
it allows not only to reduce the clinical manifestations of the disease and return the
ability to move normally to a patient, but also helps to delay the necessary
prosthetics of the joint, and sometimes even to refuse from it at all.
The clinical trial, in which Andriy Shevchenko got treatment of knee osteoarthritis,
is carried out in accordance with the order of the Ministry of Health of Ukraine
dated October 10, 2007 No. 630, which, among other things, involves the
mandatory signing of informed consent by the study participant. According to Petr
Nemtinov, senior researcher at the Coordination Center for Organ, Tissue and Cell
Transplantation of the Ministry of Health of Ukraine, the result of clinical trials
conducted jointly by the Institute of Cell Therapy, the Institute of Traumatology
and Orthopedics of the National Academy of Medical Sciences of Ukraine and
Kiev Clinical Hospital No. 6 should be the opportunity to use cell drugs in the
treatment of knee joints arthrosis, improve the life quality of patients with this  disease, as well as delay or cancel surgical operations to replace the knee joint for
the artificial one.