How to Treat the Hip with Stem Cells
Adult adipose derived stem cells that are harvested are carefully injected into the hip joint under fluoroscopic guidance with local anesthesia. Once inside the hip joint, the stem cells have the ability to repair the cartilage in many ways as they can multiply and generate into cartilage cell lines.
Stem cells secrete soluble factors which manipulate the tissue microenvironment such as:
- Control of joint inflammation with cytokines.
- Important growth factors stimulating cartilage repair.
Osteoarthritis is also known as degenerative joint disease. This occurs when the cartilage that covers the top of the bones, known as articular cartilage, degenerates or wears down. This causes swelling, joint pain, stiffness, and decreased range of motion. Damage from mechanical stress with insufficient self-repair by joints is believed to be the primary cause of osteoarthritis.
Osteoarthritis most often occurs in people who are over 50. In younger people, osteoarthritis can result from an injury or trauma such as a fractured or dislocated joint. Rarely, osteoarthritis may also be hereditary.
Osteoarthritis is the most common form of arthritis with disease of the knee and hip, affecting about 3.8% of people.
The development of hip osteoarthritis is correlated with the history of previous joint injury and with obesity. Changes in sex hormone levels may also play a role in the development of osteoarthritis, as it is more prevalent among postmenopausal women than among men of the same age. Diagnosis is made with reasonable certainty based on history and clinical examination, as well as the x-rays to confirm the diagnosis. X-ray findings include joint space narrowing, subchondral sclerosis (increased bone information on the joint), subchondral cyst formation, with development of osteophytes (bone spurs).
Joint injections of a steroid leads to short term pain relief that may last between a few weeks and a few months. Injections of hyaluronic acid may also be indicated and undertaken. Many dietary supplements such as glucosamine and chondroitin sulfate are sold as treatment for osteoarthritis. The effectiveness of these supplements is controversial, and its effect on osteoarthritis progression is unclear. Its use as therapy for osteoarthritis, however, is usually safe.
If the impact of symptomatic hip osteoarthritis on the quality of one’s life is significant, and more conservative management has been ineffective, total hip arthroplasty or resurfacing may be recommended and considered.
Greater trochanteric bursitis, also known as greater trochanteric pain syndrome, is inflammation of the trochanteric bursa, a part of the hip. This bursa is at the top outer portion of the femur, between the gluteus muscles attachment into the greater trochanter of the femur.
It’s function, in common with other bursa, acts as a shock absorber and a lubricant for the movement of the of the hip muscles adjacent to it. Occasionally, this bursa can become inflamed and clinically painful and tender to touch. Although this condition can be due to an injury, such as twisting motions or from overuse, it can sometimes arise for no obvious cause.
The symptoms include hip pain on walking, and the tenderness over the upper part of the femur, with inability to lie in comfort on the affected side. Other causes of trochanteric bursitis include uneven leg length, iliotibial band syndrome and weakness of the hip abductor muscles.
The primary symptom is hip pain, especially on the outer side of the hip joint. This pain may appear when the person is walking or lying down on that site. X-rays, ultrasound and Magnetic Resonance Imaging may reveal tears or swelling.
Tendonitis / Tendinosis
Tendinitis refers to inflammation of a tendon, a flexible band of tissue that connects the muscles to the bones. The pull of the muscles is transmitted to the bone by the tendons which allow movement. When the tendons are inflamed and irritated, the pulling action of the muscle is impaired with loss of function of the joint.
Symptoms can vary from aches or pains and local joint stiffness, to a burning that surrounds the whole joint around the inflamed tendon.
In some cases, swelling occurs along with heat and redness, and there may be visible knots surrounding the joint.
With this condition, the pain is usually worse during and after activity, and a tendon and joint area can become stiff the following day, as muscles tighten from the movement of the tendon. Tendinosis, however, is a chronic injury caused by an accumulation of small tears in the tendon that have failed to heal properly over time. Patients commonly find it almost impossible to keep from restraining the tendon, because even when the pain is gone, the tendon still hasn’t fully healed.
Tendinitis about the hip, is usually caused by disease of the gluteal tendons that attach to the lateral hip, as well as inflammation of the iliopsoas tendon which can cause snapping hip syndrome. Diagnosis is usually ascertained by physical examination, including palpating the hip and leg region, as well as ultrasound and occasionally Magnetic Resonance Imaging.
The acetabular labrum is a ring of cartilage that surrounds the acetabulum (the socket) of the hip. The anterior portion is most vulnerable to labral tears. It is estimated that 75% of acetabulum-labral tears have no known cause. Labral tears can occur from a single event or from recurring trauma. Activities requiring frequent lateral rotation or pivoting on a loaded femur is a known cause of labral tear. Falling on one’s side causes a blunt trauma to the greater trochanter of the femur. Since there is very little soft tissue to diminish the force between the impact of the greater trochanter, the entire blow is transferred to the surface of the hip joint. This may instigate a labral tear. Anatomical modifications of the femur or hip socket cause a slow buildup of damage to the cartilage, resulting in a condition known as femoral-acetabular impingement (FAI).