so you have really bad pain in your knees and you've tried everything to treat them but nothing
is getting you relief you've heard of a lot of success stories with regenerative medicine
treatments such as prp injections and stem cell therapy but you're wondering are these stories
too good to be true do people really feel better and who can you trust to learn more about these
treatments well you're in the right place because we're going to go through the most up-to-date
clinical trial data and these studies will tell us whether prp injections and stem cell therapy
actually work they will hopefully help you decide which treatments may or may not be worth pursuing
let's get started hey everyone dr jeff peng here now if this is the first time you are watching
one of my videos my goal is to help each and every one of you live an active and healthy
lifestyle so if that's something you're interested in please consider subscribing to my channel
okay so let's talk about prp versus stem cell therapy for knee arthritis both prp and stem
cells fall under the big umbrella category of treatments called regenerative medicine or ortho
biologics these are very new techniques with the goal of using your own body cells to help relieve
pain and inflammation both prp and stem cells contain an enormous amount of growth factors they
initiate cascades which are responsible for tissue healing tissue remodeling tissue proliferation and
in controlling pain and inflammation but more specific to osteoarthritis they are incredibly
important in altering the biochemistry of a knee suffering from arthritis and that's
because arthritis causes a very toxic environment in the knee it's incredibly inflammatory and all
of this leads to pain and disability so the goal of biologic treatments such as prp and stem cells
is to use your own cells to reset the environment in the knee to create and maintain a healthy and
neutral environment our hypothesis is that these cells will not only reduce symptoms but they can
also decrease the progression of arthritis so let's talk about stem cells first what are they
when most people talk about stem cells they are thinking of pluripotent stem cells these are cells
that can divide and grow into pretty much anything think of embryos that are just starting to grow
and create new organs they are incredibly versatile and can potentially regenerate or repair
diseased tissues and organs but when we talk about stem cell procedures or stem cell injections
we are actually using and referring to another type of stem cell not the pluripotent stem cells
instead we are using a special type of adult stem cell called the mesenchymal stem cell these cells
have limited capacity when compared to pluripotent stem cells but they still have tremendous ability
to reduce pain and symptoms so the two most common places to get mesenchymal stem cells
are either from adipose or fat tissue or from the bone marrow and it's important to point out that
once we isolate the mesenchymal stem cells and then inject them there's no current evidence that
suggests that we are regrowing or regenerating anything remember these cells are not pluripotent
you don't get a new knee after stem cell injections so you may ask what's the point then
well mesenchymal stem cells are incredibly strong signaling cells they initiate cascades in the body
that provide all sorts of health benefits but most important among them are reducing
pain and reducing inflammation and how does that compare to what prp does prp stands for
platelet-rich plasma in prp we draw your blood into a specialized tube put it in a centrifuge
and then separate out your platelets and all the growth factors that circulate in your blood
we then take that out and then inject it into your knees again we are not growing or regenerating
anything but we are using the cells that initiate incredibly strong cascades in the body to provide
pain relief and reduce inflammation our current understanding of mesenchymal stem cell injections
and prp injections is that they initiate similar pathways to help improve symptoms the question
then becomes do they work and which one is better let's tackle the first question do they work in
treating knee arthritis so this study looked at people with knee arthritis who were treated with
adipose derived mesenchymal stem cells so adult stem cells from fat tissue and published their
results at two years follow-up in terms of pain the researchers found that there were significant
improvements at 6 months at 12 months pain was slightly worse than 6 months but still better than
before treatment was started at 24 months pain was essentially back to the pre-treatment baseline
in terms of function the researchers found gradual improvements at 6 months 12 months
and then a plateau effect at 24 months these results included people with mild moderate and
severe arthritis now i think it's important to point this out because our current medical
thinking is that once you reach grade 4 or bone on bone arthritis there's almost nothing we can
do except for a knee replacement surgery in this study people with severe arthritis definitely
had improvements from their baseline just not as much as those with mild arthritis so what
about mesenchymal stem cells obtained from bone marrow and how do they compare to the ones from
adipose tissue so this study was a systematic review and meta-analysis looking at 19 studies
and compared those who got mesenchymal stem cell injections from bone marrow
and from adipose tissue they found that both groups had significant improvements in pain and
function for the treatment of knee arthritis more interestingly they found that the patients who got
bone marrow mesenchymal stem cell injections had significantly better outcomes compared to
people who got adipose derived mesenchymal stem cells so from these studies we know both types of
mesenchymal stem cell injections are effective at treating symptoms related to knee arthritis and it
seems that bone marrow may be better than adipose tissue now what about prp platelet-rich plasma
injections have also been shown to be incredibly effective at treating symptoms related to
knee arthritis i made an entire video discussing prp injections which i will link here so please
check that out if you are interested but here is one of the most recent studies looking at the use
of prp injections to treat knee arthritis it's a systematic review and meta-analysis looking at 40
different studies comparing prp to hyaluronic acid corticosteroids and placebo injections
they found that at six months prp was as effective and in some studies more effective than other
therapies regarding pain function and stiffness so all of these studies add to the growing body
of literature which supports the use of ortho biologics to help treat and relieve symptoms
related to arthritis but which ones are better so the next question we want to ask is are there any
studies that directly compare mesenchymal stem cell injections to prp injections and the answer
is yes this study was published very recently and is a two-year outcome study comparing bone marrow
mesenchymal stem cells to prp treatment patients with knee arthritis were randomized to get either
one bone marrow injection or one prp injection and they found that both groups had significant
improvements in both pain and function at 3 months 6 months 9 months 12 months 18 months and
24 months but what they found was there was no difference there was no difference between prp
and bone marrow mesenchymal stem cell at any time point the researchers go on to conclude
that for the treatment of osteoarthritis prp and bone marrow concentrate performed similarly out to
24 months bone marrow was not superior to prp so from these studies we can conclude the following
both stem cell injections and prp injections work similarly well for the treatment of knee arthritis
again we think they work by treating and changing the biochemistry inside a knee with arthritis the
hypothesis was that stem cells would provide a greater effect than prp but at this point in time
that hypothesis has not been proven to be correct both prp and stem cells are equally effective
but here's the thing let's talk about cost both of these treatments are not covered by insurance
and they are cash pay however stem cell injections can cost thousands and even tens of thousands of
dollars prp is significantly cheaper in the hundreds of dollars and until clinical trials
start to show otherwise when we do a cost benefit analysis prp is the clear and easy
winner hopefully that provided a good summary of prp versus stem cell therapy for the treatment of
knee arthritis my channel has an entire playlist going over prp and orthobiologics so check that
out if you are interested in more content and lastly everyone who has knee arthritis really
should take a multimodal approach to treating their knees so check out this video next
where i go through all the treatment modalities that i recommend most thanks for watching