Recent scientific advances in the field of orthopaedic biologics have begun to uncover the potential of amniotic tissue allograft in the treatment of chronic joint pain. While safely used for years as a FDA-approved biologic “dressing” for healing wounds, evidence now suggests that in combination with your own (“autologous”) growth factors, such mesenchymal stem cell (allograft MSC) tissue may provide powerful and long-lasting relief from mild-to-moderate arthritis upon direct injection into a painful joint. This may offer a welcome alternative to knee, shoulder or hip replacement for a significant period of time, allowing a mature or “baby-boomer” athlete to participate longer in the sports and activities they enjoy.
This exciting advance uses the maternal, not fetal aspect of the placenta, yielding a morselized, injectable tissue rich in collagens (which make up healing structural tissue), growth factors, hyaluronic acid and other proteins to stimulate healing. It is also “immune-privileged” with little potential for rejection and naturally antimicrobial. The addition of PRP (platelet-rich plasma) from your own blood helps initiate the natural healing process via growth factors and presents a “biologic scaffold” for healing in the joint. This tissue infusion delivers a powerful anti-inflammatory signal to the lining of the diseased joint, often substantially relieving pain and improving function. It may also act as a magnet for the body’s own healing stem cells.
There are many different preparations of allograft tissue matrix as well as PRP to choose from. The combination we have chosen is based on extensive experimental study and several years of clinical use in recreational and even professional athletes, with a strong record of success in relieving joint pain. With just one injection, pain relief is often profound and long-lasting (a year or more).
While the process is FDA-approved, this specific combination is considered experimental and not covered by most insurance plans (see the ABN). As with all new and innovative techniques, further study is ongoing and there may be some risks: “allograft” (not your own) tissue can cause inflammation and swelling of the joint; infection can occur (true of any injection); there may be some risk of abnormal tissue stimulation/growth (tumor potential of pluripotent cell lines), although none has been seen to date. There does appear to be some genetic and perhaps even day-to-day variability in the response of individual patients, which is a factor that cannot be predicted at present. Also, a more severely diseased joint may fail to improve.
However, when it works, a consistent decrease in pain is very noticeable over a four-to-eight week period, often greatly improving joint function and mobility. This improvement tends to last for months if not years longer than that of a steroid or “lubricant” shot.
During the two days after injection, you should ice the joint and take Tylenol (no anti-inflammatories such as ibuprofen, Aleve, or aspirin, preferably for 4 weeks) and resume normal activity without exercise. Gentle range of motion of the joint is encouraged. Joint soreness may be more noticeable for the first week or so. After two weeks, you can resume your normal exercise schedule at half the normal pace and/or distance and gradually ramp up your level from there; you should let pain be your guide. Physical therapy may also be recommended. At six to eight weeks, if the pain relief is not 80% or more, a second PRP-only injection may be scheduled.
Feel free to review these issues with and ask any questions of Dr. Cunningham prior to deciding on a treatment for your joint condition. More information about these products can be found at AustinOrthoBio.com and the associated internet links.
Disclaimer: Austin Ortho+Biologics is not affiliated with the data, content, or conclusions of this article.
