As of April 1, 2015, the CDC reportsthere were 719,000 total knee replacements in the United States, and 332,000
total hip replacements.
In 2014, the Mayo Clinic
reported that 4.7 million Americans have had knee replacement surgery; 2.5 million
have had hip replacement surgery – more women than men. Their point was that the replacement surgery helped these patients to
stay mobile. They did not present evidence of mobility, just that a lot
of people were living with artificial joints in the United States.
A Japanese study published in 2010 followed 41 patients for 11 years after
bone marrow-derived mesenchymal stem cell transplantation for cartilage
repair. The patients were initially treated in 1988. None of the patients
had developed tumors or infections in all that time. The abstract did
not discuss how mobile the patients were after 11 years, but it did emphasize
the safety of the procedure.
Healthline, a provider of health information and technology solutions headquartered
in San Francisco, the average charge for in-hospital total knee replacement
in the USA is $57,000. There are additional charges for pre- and post-hospitalization
visits and physical therapy. Typically Medicare pays for around 80% of
these charges, leaving the average patient with over $11,000 in out-of-pocket costs.
You will be pleasantly surprised to learn that the average out-of-pocket
cost for stem cell therapy in the United States is about $7500, including
pre- and post-procedure visits and follow-up.
Curiously, stem cell therapy is still considered experimental, since it
was first reported by the Japanese in 1988 – twenty-seven years
ago. One wonders how long it will take before this form of therapy is
considered standard of care, rather than experimental.
Arthroscopic knee surgery shows no particular long-term benefits, as reported
in the British Medical Journal in 2015. Initial benefits are limited to a small decrease in pain, and no benefit
in physical function. These benefits were limited to the first 6-12 months,
and appeared to vanish within one or two years of the surgery. Adverse
effects of the procedure included deep vein thrombosis (blood clots in
the legs), pulmonary embolism (blood clots traveling from legs to lungs)
and even death.
A Japanese group reported in 2014 both a phase I study for safety and a
phase II study for efficacy of stem cell injection treatment for injured
knee joints with cartilage defects. There were no treatment-related adverse
events. The pain and function scores improved at 6 months, and the size
of the cartilage defect decreased. The new cartilage appeared to be normal
when examined under the microscope.
Twenty-seven years ago the procedure was both safe and effective. In 2014
the procedure is again reported to be both safe and effective.
What are we waiting for? This form of therapy can be available in your
physician’s office. It is safe, and effective, and cost-effective.
But not covered by insurance since, after 27 years, it is still considered
to be “experimental”.
Call the Arizona Center for Advanced Medicine to schedule a free 15-minute
phone consultation with one of our practitioners, to discuss the possibility
of effective forms of cell therapy for chronic knee, hip or shoulder joint
pain and arthritis. You may be able to save yourself a trip to the operating room.
 Wakitani, S., Okabe, T., Horibe, S., Mitsuoka, T., Saito, M., Koyama,
T., Nawata, M., Tensho, K., Kato, H., Uematsu, K., Kuroda, R., Kurosaka,
M., Yoshiya, S., Hattori, K. and Ohgushi, H. (2011),
Safety of autologous bone marrow-derived mesenchymal stem cell transplantation
for cartilage repair in 41 patients with 45 joints followed for up to
11 years and 5 months.
J Tissue Eng Regen Med, 5: 146–150. doi: 10.1002/term.299