Regenerative Medicine Applications in Knee Osteoarthritis

What is osteoarthritis?

Knee osteoarthritis, known as "calcification" among the public, refers to the reduction of joint fluid, cartilage erosion, and bone friction. In reality, it is a non-inflammatory rheumatic condition associated with aging and represents a degenerative process affecting the joint and surrounding structures.

Who can develop osteoarthritis?

Osteoarthritis can occur, particularly in individuals over the age of 50, who experience symptoms such as knee pain, cracking sounds, and difficulty squatting or climbing stairs.

What treatments are available for knee osteoarthritis?

In addition to traditional treatments we have been using for years, the inclusion of new-generation regenerative therapies has provided highly promising results. Traditional treatments for osteoarthritis include:

• Pain and swelling-relieving medications
• Supplements that support knee joint fluid
• Knee braces
• Physical therapy applications and exercises

Encouraging patients to lose weight is critically important. It is well-known that losing just 1 kilogram of body weight reduces the load on the knee by 5–6 kilograms. Additionally, traditional treatments include hyaluronic acid injections, popularly referred to as "rooster comb," and ozone injections, which have been used for years.

What are regenerative treatments for knee osteoarthritis?

Regenerative treatments, introduced in recent years, go beyond merely reducing pain by stimulating tissue regeneration, encouraging the repair of damaged tissues, and promoting healing. Among these are platelet-rich plasma (PRP) injections, which have been widely used for years. However, the introduction of more effective plasma injections in recent years has increased success rates. Regenerative treatments like smart plasma and cell-retentive serum injections, derived from the patient’s own blood, have demonstrated fewer side effects and better outcomes compared to PRP.

What is the role of stem cells in knee osteoarthritis treatment?

Stem cell therapy, involving stem cells derived from abdominal fat or bone marrow, is frequently used among regenerative treatments and provides promising results. Stem cells have the potential to transform into various cell types. When injected into the knee joint, they aim to differentiate into cartilage cells and reverse osteoarthritis. For example, stem cells extracted from abdominal fat involve a procedure where fat is collected under local anesthesia in an operating room, separated into stem cells, and injected into the knee joint. Patients can resume their daily activities immediately after the procedure. A significant advantage of using products derived from the patient’s own tissues is the minimal risk of allergic reactions.

What is exosome therapy obtained from newborn umbilical cords?

Exosomes are small protein vesicles that play a role in intercellular communication. They can be derived from the patient’s own blood or from tissues like newborn umbilical cords in a laboratory setting. Exosome applications in osteoarthritis aim to promote the proliferation of healthy, high-quality cells while eliminating damaged cells. This procedure is performed in outpatient settings, and patients can return to their daily activities immediately after treatment.

What are other treatment options for osteoarthritis?

Prolotherapy injections, using dextrose solution, strengthen the surrounding tendons and muscles. Additionally, for patients with advanced osteoarthritis who are not candidates for surgery or cannot benefit from other treatments, injections targeting pain nerve blockages around the knee can provide a pain-free life.

What are our recommendations for patients?

We have made significant progress in osteoarthritis treatment compared to the past. With a variety of treatment options, we can create personalized plans for each patient and achieve successful results. To maximize the benefits of these treatments, it is crucial for patients to consult a Physical Medicine and Rehabilitation specialist at early stages and take advantage of these therapies. In early-stage treatments, osteoarthritis can be completely reversed or its progression can be halted. Additionally, all patients with osteoarthritis are advised to maintain weight control and support their treatment with exercise.

Let us not forget: early treatment can prevent the need for joint replacement surgery.

Assoc. Prof. Dr. Dilek Eker Büyükşireci
Physical Medicine and Rehabilitation Specialist