What are stem cells?

Stem cells are immature cells that can divide and change into different types of mature cells with different jobs. There are 2 main types of stem cells:

Can stem cells be used to treat osteoarthritis?

Stem cells are not an approved treatment for osteoarthritis (OA) in Canada. Treating OA with stem cells is still experimental (under study). In Alberta, using stem cells to treat OA only happens in research studies.

More research is needed before stem cells can become a standard treatment for OA. Researchers are studying stem cells to find out:

• how they can use them
• how useful they are to treat OA

How do stem cells treat osteoarthritis?

Most stem cells used for the experimental treatment of OA are adult MSCs. Researchers can easily collect them from fat or bone marrow.

MSCs are able to turn into cartilage, bone, muscle, tendon, ligaments, or fat, depending on the type of tissue that surrounds them. This is why researchers are studying MSCs in stem cell treatments for OA.

Research shows that MSCs release anti-inflammatory factors that help heal and lessen pain. When they are injected into a joint, some studies show they may help relieve pain, swelling, and loss of movement.

Stem cells can also be used to make an artificial tissue in a lab through a process called tissue engineering. This lab-made tissue can then be put into a joint to help rebuild (repair) damaged bone, ligaments, and cartilage.

Are stem cell treatments safe for the treatment of osteoarthritis?

The safety of a stem cell treatment highly depends on:

• how the stem cells are prepared before they are put into the body
• where the procedure is done (this needs to happen in a very clean and sterile place)

Research to date shows that stem cell treatments using a patient’s own cells tend to be safe for OA. Most injection-based treatments use a patient’s own MSCs (called autologous MSCs) taken from their bone marrow or fat.

Some stem cell treatments use stem cells donated from other people’s tissues (called allogeneic MSCs). There are possible risks when donor stem cells are used. These risks include:

• developing an infectious disease
• your body attacks the donor cells (called an immune reaction)

If you decide to have a stem cell treatment for OA, you will need to have follow-up to watch for unwanted side effects.

Do stem cell treatments work to treat osteoarthritis?

Research so far doesn’t show that a stem cell treatment alone cures OA. It also hasn’t shown that the treatment can rebuild a damaged joint in patients who have been living a while with OA or who have advanced OA.

Patients have had different responses to this treatment. Some have had long-term pain relief that lasts more than a year while others have not had any less pain. More research is still needed to know if stem cell treatments work well for OA and why some people find the treatment works better than others.

Can I get a stem cell treatment for osteoarthritis in Alberta?

A stem cell treatment for OA isn’t available in Alberta. You may see clinics in other countries, like the USA or Mexico, advertise stem cell treatments to Canadians. At this time, the Bone and Joint Health Strategic Clinical Network (BJH SCN) doesn’t endorse any of these clinics.

What do I need to know before getting stem cell treatment for osteoarthritis?

If you’re thinking about having a stem cell treatment for OA outside of Alberta, it’s important to know that:

• Health Canada doesn’t allow clinics and providers in Canada to offer a stem cell treatment for OA, unless it’s part of an approved research study.
• Guidelines for clinics and providers outside of Canada may have different standards than those in Canada.
• Look for treatments offered by a regulated healthcare professional who belongs to a regulatory body (such as a College of Physicians and Surgeons) that protects public safety.
• Research the provider and clinic to make sure they have proper training to give stem cell treatments for OA. They also need to be certified to do the treatment by the appropriate regulatory body.

It’s important to remember that using stem cells to treat OA is still under study. It’s an experimental treatment and there isn’t strong evidence that it works.

Please be aware there are treatments called “regenerative therapies” that are sometimes called stem cell treatments. But these treatments don’t use stem cells. These include platelet rich plasma (PRP) treatments. It’s more correct to call this type of treatment a “cell therapy” since it uses a type of blood cell called a platelet.

Questions to ask about stem cell treatment

Stem cell treatments are not available in Alberta. If you are thinking about a stem cell treatment for OA outside of Alberta, you may want to ask the following questions. This will help you to learn more about the safety and quality of care of the clinic or provider.

• Am I a good candidate for stem cell treatment?
• What stem cells will you use for my treatment? Are they from fat or bone marrow?
• Do you plan to use my stem cells or someone else’s stem cells?
• Will you inject anything else along with the stem cells?
• How much does the treatment cost? What does the cost include?
• What are the payment options?
• Does private or public health insurance cover any of the costs?
• Does the clinic (or provider) also collect and prepare (process) the stem cells?
• Where are the stem cells prepared before they are used in the treatment? Do you have equipment at the clinic to do this?
• What are the possible risks or side effects of the treatment?
• Is the clinic able to handle any complications or emergencies that may happen during the procedure?
• How many stem cell treatments has the clinic (or provider) already done for OA?
• How many people at the clinic have had complications after the treatment?
• How many people didn’t respond to the treatment?
• What can I expect in the days and weeks after the treatment?
• What is the follow-up after the treatment?
• Do you collect my data to track good or bad outcomes?

More information

If you would like to learn more about research on stem cells for OA in Alberta, contact the Scientific Office of the Bone and Joint Health Strategic Clinical Network (BJH SCN) at BJHSCN_SO@ahs.ca.