Stem cell therapy for arthritis.

Osteoarthritis

Wear-and-tear arthritis in the hip, shoulder, hand or ankle. Cells from your own bone marrow or fat, or from donor cord, are injected into the joint. For the knee, see stem cell injections for knees.

Rheumatoid and other inflammatory arthritis

Donor cells are given through a drip, on top of the usual medicines. Every trial added cells to ongoing drug treatment rather than replacing it.^[2][3]

The procedure

Joint injections are a single outpatient visit, with a bone marrow or fat harvest first if your own cells are used. Patients describe shoulder injections as the mildest, and multi-joint or spine sessions as the most painful.^[4] Nobody in our review of patient accounts was kept in overnight.^[4]

When it works, and how long it lasts

Patients rarely report a change inside a month, and three to six months is the window clinics quote.^[4] It is not permanent: in the hip, scores were better than baseline only at one and three months in the one study that measured them, and ankle scores worsened between one and two years.^[5][6] In rheumatoid arthritis, each infusion helped for three to six months.^[2]

Who it suits, and who it doesn't

The hip and shoulder studies are mostly of mild arthritis, and results were better in mild disease.^[5][7] Inflammatory arthritis has only been treated alongside drug therapy, never instead of it.^[2][8]

Risks

A few days of joint pain and swelling, and bruising at the harvest site.^[9] After a drip, fever is about twice as likely as with placebo, and donor cells make some people produce antibodies against them.^[10][11] In patient accounts, about one in five had a flare in the first weeks.^[4]

Does it regrow cartilage?

Not shown. No controlled imaging study at the hip, shoulder, hand or ankle has found structural change.^[1][22]

Can it replace my rheumatoid arthritis drugs?

No trial has tested that. One trial saw methotrexate and steroid doses fall, but not beyond a year.^[3][2][23]

Will it let me avoid a hip replacement?

The study usually quoted for this was written by people employed by the company selling the treatment, and injected cells into bone rather than the joint.^[24] Stem cells for hips

Questions to ask a clinic

1. Which joint, and has this cell product been tested in that joint?
2. How many cells will I get, and is that a stem cell count or a total cell count?
3. Can I see the certificate for my batch?
4. How bad is my arthritis on X-ray, and does that change your advice?
5. For rheumatoid arthritis: do I keep taking my usual medicines?
6. Who reviewed my scans: a doctor, or a patient adviser?