1. Working with true stem cells. Unlike platelet-rich plasma or other stem cell therapies used to promote cartilage healing and growth, AlloStem uses true stem cells that will stimulate bone formation. “In this particular case, these are true stem cells harvested from fat that is taken from a cadaver,” says Dr. Myerson. “For this unique process, the fat cells are removed from the tissue and we are able to isolate a stem cell from the fat cell line. The stem cells are coated onto the bone product to stimulate bone formation.”
AlloStem was developed in such a way to take the stem cell from the fat and apply it to the de-mineralized bone through sponge-like material. The cells can be applied to any bone in the body where a patient needs stimulation for the production of new bone.
2. Best indications. The patients who would benefit most from this type of stem cell treatment are those who are missing a huge portion of bone, either from trauma, tumor, infection or a failed surgery. “These patients have a hole where there is dead bone present and you want to have some way to help that dead bone to heal,” says Dr. Myerson. “You have to stimulate the body’s natural bone healing potential and there are times when that process doesn’t get switched on naturally. That’s where this treatment comes in.”
The applications for these stem cells are fairly extensive, including bone that is affected by arthritis, stress fractures, non-unions and situations where there is avascular necrosis.
3. How it works. Surgeons first need to clear the problem site, which may mean clearing out the dead bone that has accumulated in that area. Once the area is clear, the gap needs to be filled and the bone growth stimulated. “This is where AlloStem comes in because it makes it possible to use a small sponge instead of a huge bone graft to promote healing,” says Dr. Myerson. “You insert little sponges in critical points around the leg, foot or ankle where we have dead bone.”
To prepare the sponges, surgeons cut it into small pieces and place the pieces onto the problem area. “There isn’t any learning curve involved,” he says. “It can be used in a non-invasive manner. Instead of doing an extensive surgical procedure, you can make tiny incisions, insert the sponge and it’s able to stimulate the production of the bone.”
4. Weighing the different bone growth options. There are three options for surgeons who need to stimulate bone growth: artificial bone products like AlloStem, cadaver bone or the patient’s own bone. The cadaver bone is already dead, so it can only act as a void-filler and does not have any healing potential. The patient’s own bone also fills the void and has the potential for healing, but surgeons must perform an invasive procedure to extract the grafts from various locations, including the pelvis.
While the artificial bone products may provide good results, they aren’t always practical from an economic standpoint. The products are expensive, especially when the alternative of the patient’s own bone is free. The costs associated with artificial bone products are one of the roadblocks preventing them for being more widely used by orthopedic surgeons.
Learn more about Dr. Mark Myerson.
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