The cutting edge of regenerative medicine often uses stem cells, with a focus on tissue regeneration, replacement and engineering. These techniques have long held interest in the orthopaedics space, in which joints are particularly difficult for natural processes and specialists to treat. This is due to the requirement for mobility, which brings a range of specialised tissues, intense stresses and chances of complications. Expectations for new treatment options in this space are high.

In orthopaedic joint therapies, the aim is to restore painless function with the least invasive procedure available. The standard of care is to repair a damaged joint using existing tissue from the patient. Replacing a knee with an artificial joint is riskier and less desirable when a similarly effective result can be achieved using autografts. One compelling idea in this space is that an injection of stem cells will eventually be able to revitalise damaged ligaments, cartilage and bone to a healthy state.    

Regenerative medicine has not yet demonstrated results using mesenchymal stem cells that rise to orthopaedic clinical acceptance. Initials trials showed that regenerative medicine holds some promise as an arthritis treatment and further study is being called for, but there has been no consensus about which cases will benefit from a regenerative approach. These treatments are not an affordable alternative to traditional orthopaedic techniques. Severely damaged tissue will also almost always require direct intervention in order to remove scar tissue or deal with tears.

Based on currently available research, stem cells seem to be effective in short-term pain reduction and help speed recovery. These properties alone should result in the inclusion of stem cell therapies in traditional orthopaedic techniques, resulting in improved outcomes and expanding the definition of good candidates. In particular, trauma cases that require extensive rehabilitation could start earlier and be less arduous for the patient. The cost of stem cell treatments is less prohibitive in the context of these more complex procedures, especially when the results are more tangible.

The cost and scale of mesenchymal stem cell treatments are expected to improve as techniques and research progress. While this is an exciting development for the field of orthopaedics, questions remain about whether mesenchymal stem cells will prove to be most effective as a standalone therapy or as a complement to the effectiveness of traditional orthopaedic practices.

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