Meniscus tears are very common. Surgery to remove the torn part of the meniscus is also very common. Unfortunately, many people who have torn their meniscus, or who have the torn piece removed will go on to develop osteoarthritis. Until recently, a person with persistent pain following meniscus surgery had very few options. They could undergo a meniscus transplant, or simply try medications or injections to treat the pain.
In January 2014 a preliminary, but exciting study revealed that a single injection of stem cells may help certain patients regrow a portion of the meniscus which was removed at the time of surgery. This study also showed that pain relief was higher in the stem cell-treated meniscus tear group.
Each knee contains two menisci. The meniscus functions as a shock absorber. It also helps distribute your weight across the knee joint to minimize the stress on the bones and articular cartilage. A torn meniscus is not capable of functioning normally. This results in abnormal stresses around the knee which can lead to arthritis, further loss of cartilage and pain.
There was evidence of meniscus regeneration and improvement in knee pain following treatment with allogeneic human mesenchymal stem cells. These results support the study of human mesenchymal stem cells for the apparent knee-tissue regeneration and protective effects.
What are stem cells?
Stem cells are unique cells within our body. They are “immature” which means that they haven’t grown into a skin cell, a cartilage cell, or a heart cell yet. Stem cells have the ability to grow into almost any type of cell within our body. Each tissue in our body has unique chemical compounds. Those chemicals can cause stem cells to start the process of maturing and becoming a fully developed cell. Theoretically.. if a stem cell is placed in the knee, the chemicals present in the knee will lead the stem cells to mature into cartilage cells.
Can Stem Cells Treat A Meniscus Tear?
The study quoted above was the first (to my knowledge) to show that stem cells, injected into the knee can regrow a portion of the meniscus which was removed at the time of surgery. The study showed that some patients regrew up to 20% of the torn part of the meniscus. More importantly, this study showed that patients who received the stem cells after their surgery felt better and had better pain scores.
This is the first in what will likely be a number of studies to determine whether or not stem cells possess the ability to completely regrow a meniscus after a portion of it is removed. Further studies will be needed to see if two or more treatments can improve the amount of the meniscus that grew back. Further study is also needed to see if these results stand the test of time. Will the new meniscus tissue last?
This is a very exciting time. Can stem cells treat meniscus tears? Should you receive stem cells after your meniscus surgery? These are very important questions and it is something you need to discuss with your doctor.
Please keep in mind that this is still considered experimental.
Oliver Berlin
Dear Howard J. Luks,
I am 23 years old and facing the full removal of my inner meniscus. Main reason for that is a wrong diagnosis and consultation which made me wait for 6 months with my surgery. It has not happened yet, but will in around 1 and 1/2 weaks. Chances are high to have removed my full meniscus as it is completly torn of the side wall of my knee (not a native speaker sorry). Normal procedure would have been to sew my meniscus back there and leave it there, due to having my body disintegrate / retrench my meniscus though it probably won’t be possible to fix and sew it anymore then. Therefore I would soon or late face an athrose and a knee prothose in early years. Desperatedly I am searching for options.
My question now is, is there any news? This article has been 2 years ago. And is it eventually possible to inject stem cells into the meniscus which is still in my knee and then with a better quality of it and a bit of regeneration to sew it back to my knee?
In case you know about any other options please let me now, the operation would be in around 1 1/2 weeks as said. Time is running.
best regards,
Oliver Berlin
Howard J. Luks, MD
Best option is to try a repair. we can always go back again if it fails. There are trials going on with regards to meniscus transplantation which remains an option if the repair fails.
Good luck
Georgia
My husbands knees are basically bone on bone .. I have heard that stem cell is not capable of renters tin tissue . I see now in your article that it has in small quantity. Would you know if meniscus replacement or if there is a jelly that could be implanted that would possibly be covered in our insurance .. $5000 is a lot of money out of pocket.. He’s in pain and wants a quick fix I’m tryin to find different insurance coverd options !!!!! Help !!!!!!!!
Howard J. Luks, MD
The research shows that he will likely be very disappointed with the results of those injections. If he is bone on bone, then he has non-functional meniscus cartilage, AND complete loss of articular cartilage.
Craig
Living in Colorado, I asked a buddy of mine who is an Occupational Med Doc about the stem cell treatments being touted by Dr. Centeno and Dr. Schultz. He said that there had been no double blind study and that their results were, therefore, anecdotal and only confirmed by themselves. I also read that in their original stem cell treatments, they cultured patients’ stem cells for a number of days to grow more before injecting them back into their knees. That was when most of the great results were found. However, the FDA stopped them from continuing that process because it crossed over from a quick treatment into the “manufacturing” of a stem cell drug.
I am 61 and have had repairs of both menisci also cleaning out arthritis. I still ski and play tennis pretty hard and notice that my knees are getting stiffer and swelling behind the knee is more common. Is there any chance that the FDA is looking into approving a cultured stem cell treatment and would it possibly help me?
Thanks.
Howard J. Luks, MD
HI craig… you are correct. The literature to support the claim that stem cells regrow cartilage, etc doesn’t exist. I agree with your assumptions about the data from Regennex too. in time we will figure out how to get these cells to work. hold onto your money for now.
Good luck
LVPWilson
I have a torn meniscus (Medial meniscus, horizontal tear, posterior horn) and two surgeons have recommended partial menisctectomy. With a loss of 25 – 40% of the meniscus. I’m 53, overweight but very active. I have a job that requires me to work 12 – 18 hours in a day, on my feet and walking. The MRI also showed the start of osteoarthritis. I really want to work another 8 years so a partial menisctectomy seems like it would be detrimental to my plan, putting me on a path to knee replacement.
The tear I have, being horizontal, why wouldn’t they seek to repair instead of remove?
I’ve been looking into other options such as stem cell and collagen implant and found mostly positive results. Wouldn’t it be better to repair and use stem cell therapy to help with healing?
Howard J. Luks, MD
Many of us can try and repair horizontal tears… stem cells alone will not do it. The problem is that you do not know until you put the camera into the knee whether or not the meniscus is repairable.
Good luck
adam
Hi Dr Howard
2 years ago I snapped my left acl and had a reconstruction from patella tendon. No problems there.. Along with this I tore my medial meniscus, had it repaired then tore out the soutches and he did a partial removal. Lot’s of pain in the medial area since. Also lots of pain in the same place on my right knee. He says it is because I have slightly valgus legs and suggests a high tibial osteotomy with wedge.. I am not fond of this idea. I also have arthritis in both ankles when I broke them 8 years ago and created large osteochondral defects in each talus.
I am still extremely active at 36 years of age I enjoy hill running, biking and boxing but on a daily basis use naproxen, tramadol and paracetamol.. I couldn’t do what I love without it as the pain is too much.
What are your thoughts and any recommendations for the future. I have my fingers firmly crossed for some stem cell developments..
Thanks for your time
Adam
Howard J. Luks, MD
I assume you meant varus….
Valgus producing HTOs are an option in some people.
As are meniscal transplants.
But without seeing you, your studies and examining you I can’t even begin to discuss why you have pain and what the potential remedies might be.