What are Biological Therapies?
Biological therapies or Biologics include stem cell therapy (including bone marrow aspirate concentration) and platelet-rich plasma (PRP) therapy. These are all relatively new treatments that may be used in selected cases to treat early arthritis and localised cartilage damage / defects in the hip and knee. They are also used for chronic tendonitis / inflammation of tendons, including the hamstring and gluteal tendons around the hip.
Would I be suitable for Biological Therapies?
Mr Hoad-Reddick can discuss whether you are suitable for biological therapies in outpatient clinic based on investigations including x-rays and MR scanning. Unfortunately, biological therapies are not an established treatment when advanced arthritis of the hip is present. Once there is full thickness loss of cartilage in the joint, the results of biological therapies are not predictable and it may be better to considerate more established treatments such as hip replacement surgery.
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Mr Hoad-Reddick offers different types of biological therapy:
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Platelet Rich Plasma Therapy (PRP)
Mr Hoad-Reddick can discuss whether you are suitable for Platelet Rich Plasma therapy in outpatient clinic, based on your history, examination findings and investigations including x-rays and MR scanning.
Platelet Rich Plasma (PRP) therapy is when patient’s own blood platelets are injected into the affected joint area to provoke the body’s own healing process. Platelets have an important role in natural healing as they contain various natural growth factors.
Mr Hoad-Reddick regularly performs PRP injections for chronic tendonitis around the hip and knee.
PRP injections are just being approved by insurance companies for use in early hip arthritis. The outcomes of this procedure are uncertain at this relatively early stage but initial results are encouraging.
Procedure
The PRP therapy procedure involves a small amount of blood being taken in the standard way, usually from your arm. It is then placed in a centrifuge which spins and separates the platelets from the rest of the blood. The highly concentrated platelets are then injected into the injured area. In response to this, growth factors are released, triggering the body’s natural healing response.
The majority of biologics treatments can be carried out in the clinic setting, as an out-patient. The injection may require radiological guidance to allow precise localization of the therapy. Mr Hoad-Reddick works closely with an experienced musculoskeletal radiologist where this is required.
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Stem Cell Therapy
Stem cells have the ability to divide and form various tissue cells such as cartilage and bone. Stem cells can be found at various locations in the body including bone marrow, fat tissue and circulating blood.
The aim of this type of therapy is to preserve the natural joint and to potentially delay the need for joint replacement surgery. In trying to preserve joints, stem cells can be used to encourage regeneration of the surface layer of damaged cartilage in the treatment of early arthritis of the hip and knee.
Unfortunately, biological therapies are not an established treatment when advanced arthritis is present. Once there is full thickness loss of cartilage in the joint, the results of biological therapies are not predictable and it may be better to consider more established treatments such as hip or knee joint replacement surgery.
Procedure
Mr Hoad-Reddick can discuss whether you are suitable for Stem Cell therapy in outpatient clinic, based on your history, examination findings and investigations including x-rays and MR scanning.
To harvest stem cells, the procedure is carried out in the operating theatre. During the procedure, your surgeon will take a sample of blood and bone marrow. Bone marrow sampling involves the use of a specialist needle to aspirate cells from a prominent bone over the hip area or from the lower leg. At the same time, your surgeon will perform arthroscopy (keyhole surgery) of the hip to gain direct access to the hip joint surfaces. The harvested stem cells are then injected directly into the joint during the arthroscopy procedure.
The majority of biologics treatments can be carried out in the clinic setting, as an out-patient but if the treatment is carried out as part of an arthroscopy procedure, patients are treated in a day case setting or may occasionally have an overnight stay. Post procedural advice relating to arthroscopy procedures will apply in terms of recovery times. Please see hip and knee arthroscopy details for further information.
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Potential Complications of Biological Therapies
Biological therapies are generally considered to be safe but all procedures carry some risk. Specific complications of your procedure will be discussed in out-patient setting ahead of the procedure.
There are standard risks associated with any injection therapy such as infection, localised inflammation, transient numbness from local anaesthetic injection and pain. There is no risk of allergic reaction as the patient’s own cells are used.
Hip and knee arthroscopy risks and complications are fully outlined under hip and knee arthroscopy.