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Stem Cell Therapy for the Hand and Wrist

 

Thumb and hand joint arthritis and carpal tunnel syndrome affect millions of Americans. The constant pivoting and swiveling of the basal (base of the thumb) wears the joint out easily. In addition, repetitive use of the wrists leads to damaged tendons. To relieve the pain and inflammation of these conditions, orthopedic surgeons and pain management specialists are using stem cell therapy.

 

Stem cell injections use your body’s own cells, growth factors, and platelets to repair damaged wrist and hand structures that cause loss of mobility and pain. As we age, the body is not able to recruit enough stem cells to the site to fully repair the injured structure. Stem cell injection procedures help overcome this problem by administering the cells into the damaged area directly.

Conditions Treated with Stem Cell Therapy

Many hand and wrist problems respond to stem cell injection therapy. These include:

  • Basal joint arthritis – Affects the hand and thumb joints, in young and old persons.
  • Injuries – To the hand, fingers, thumb, or wrist are common in athletes (skier’s thumb and gamekeeper’s thumb).
  • Overuse conditions – Gamer’s thumb, which is a repetitive stress injury to the tube caused by spending long periods of time interacting with game controllers and mobile devices.
  • Carpal tunnel syndrome – Tendon damage that occurs from repetitive use of the wrists over time.
  • Stenosing tenosynovitis – Also called trigger finger, this condition results in one of your fingers getting stuck in a bent position. The stenosing occurs from inflammation that narrows the space within the tendon sheath, which surrounds the tendon.
  • Triangular fibrocartilage complex (TFCC) tear – Injury to the TFCC found in the wrist between the carpal bones and the end of the ulna.
The Stem Cell Protocol

Stem cell injections involve two procedures, done in the same day. Depending on the condition, site, and level of injury, 1-3 injections are needed. The procedure involves:

  • Prolotherapy pre-injection – To prepare the finger/wrist/hand joint and tissue for the stem cell injection, the doctor may stabilize the affected structure by administering a prolotherapy solution. The injection uses a dextrose solution that causes mild inflammation to stimulate increased blood flow. In addition, this leads to your own resident stem cells differentiating and proliferating.

 

  • Stem cell injection – The stem cells are obtained from the body’s bone marrow at the iliac crest (hip region). After cleaning with an antiseptic, the skin and deeper tissues is numbed using an anesthetic agent. The procedure needle is inserted into the bone under real-time x-ray. After removing the bone marrow blood, the specimen is processed in the laboratory. Once the stem cells are concentrated, they are then injected into the joint or wrist region using a similar technique as the aspiration maneuver.

 

  • Platelet-rich plasma post-injection – After the stem cell injection, the doctor may choose to inject a platelet-rich plasma solution into the region. This solution contains pure growth factors from your own blood. Similar to the stem cell process, your blood is drawn from the arm and processed in the laboratory to concentrate the platelets. The platelet-rich solution is high in pure growth factors, which stimulate the stem cells in the regenerative process.
Efficacy and Outcomes

Stem cell research is being conducted with patients who have hand and wrist conditions. In a recent animal model study, stem cells were used for osteoarthritis in donkeys. Researchers found that the stem cells partially delayed cartilage deterioration. Another study involved implantation of bone marrow-derived stem cells with hyaluronan and gelatin, which maintained bone height observed at 12 weeks. Bone formation was abundant after the injection, and neovascularization also occurred.

Resources

Frisbie D D, Kisiday J D, Kawcak C E, Werpy N M, McIlwraith C W. Evaluation of adipose-derived stromal vascular fraction or bone marrow-derived mesenchymal stem cells for treatment of osteoarthritis. J Orthop Res. 2009;27(12):1675–1680.

Mokbel A N, El Tookhy O S, Shamaa A A, Rashed L A, Sabry D, El Sayed A M. Homing and reparative effect of intra-articular injection of autologus mesenchymal stem cells in osteoarthritic animal model. BMC Musculoskelet Disord. 2011;12:259.

Ogawa T, Ishii T, Mishima H. et al. Effectiveness of bone marrow transplantation for revitalizing a severely necrotic small bone: experimental rabbit model. J Orthop Sci. 2010;15(3):381–388.