Orthopedic Stem Cell and Extra Cellular Matrix Research Summary (1997 - 2021)
Chris Centeno, MD - Some physicians and scientists argue that we don’t have much research supporting the use of stem cells to treat orthopedic conditions. Here I list all significant publications from the late 90s through May, 2021. The list was complied by running various searches on body parts and various cell types on PubMed. Each circle represents a research study and is hyperlinked to the abstract in the U.S. National Library of Medicine or the full text article. The main author is listed, the area of treatment, the number of patients involved, and the type of stem cells used. The scalpel or injection icons represent the three types of delivery techniques: injection, surgical, or both. The shape of the icon denotes cell source (circle=bone marrow, square=adipose, triangle=birth tissues). I have also included amniotic ECM (Extra Cellular Matrix) papers, as these tissues contain no live and functional cells, but instead act as growth factors and extracellular matrix. Regenexx publications are highlighted.
I’ve been blogging a bit less lately due to the hours and hours that these two annual stem cell research infographics have consumed. This morning I’m finally done with the all cell types document which has some new surprises. Let’s dig in.
What Are These Infographics?
These are documents I produce every year (except last year due to COVID) that summarize all of the clinical research on stem cells for orthopedic use. They are PDFs with each circle, square, or triangle representing one study with a link out to the actual abstract or study online.
Why Do This?
This helps me get a sense of what’s been published and the trends. It also serves as a great resource for the field when other physician-scientists are writing papers or giving presentations. Finally, it helps patients understand just how much actual research on patients with orthopedic problems is out there and published already.
The “All Cell” Infographic
For this one, I pulled together everything published on bone marrow, fat, and birth tissue stem cells. For the latter, these studies are NOT on products sold and used here in the US, but instead on drug products that are culture-expanded and undergoing approval, usually in Asia. Meaning that when you see an umbilical cord study on this document, this is VERY different than the fake umbilical cord products used by US clinics scamming patients.
The circles represent bone marrow studies, the squares represent when fat stem cells were used, and the triangles represent birth tissues (almost always cultured umbilical cord cells).
What Is the Biggest Trends Over the Past Two Years?
The number of studies using stem cells derived from fat has exploded. You can see that by looking at the increased number of square symbols in 2018, 2019, 2020, and 2021. This year, to date, 7/28 studies in cellular orthopedics (25%) have involved fat.
Most of the more sophisticated research on adipose stromal vascular fraction (same-day digested fat stem cells which aren’t legal in the US) is out of Europe or Asia. Almost all of the research on adipose cultured cell products is out of Asia. This brings up another HUGE trend. The Asians are killing us in human clinical stem cell research. I predicted this years ago because of their more relaxed regulations on cultured stem cell products. So right now, Asia is the orthopedic clinical stem cell research leader. Will the US and Europe catch up? Only time will tell.
It should also be noted that the number of studies that use culture-expanded umbilical cord cells in orthopedic surgery (in Asia) has also jumped. In 2018 and just prior there were one or two of these studies per year, in 2021 to date, 10 of the 33 published studies (30%) used this cell type.
Use of this Document
The goal is to share this document. So if you want a copy, just email me at email@example.com and I’ll send you one. If you use it in a presentation, just give me credit. To see the PDF, just click on the image above. That document has active links to each study at each icon. The author’s name, body area, number of patients treated in the study, and type of stem cells used are listed. The syringe icon means an injection-based study while the scalpel icon means a surgical study.
There Isn’t Enough Research?
This statement is almost comical at this point. Yes, we always need more research. Yes, we still need more in certain areas. However, we have so much research now that’s it’s almost getting a bit overwhelming just indexing it all. We have randomized controlled trials in spades. So if someone tells you there is no research that stem cells work in orthopedics, then run the other way, because they have never taken the time to look!
For research summaries on stem cell therapy for other indications, check out STEM CELL THERAPY: UPDATE AND CLINICAL TRIALS 2021.