Intra-Articular (Joint) Protocols and Treatments

Indications for Use

Common conditions treated with intra-articular stem cell therapy:

• Osteoarthritis (knee, hip, shoulder, etc.)¹
• Rheumatoid arthritis (adjunctive)²
• Chondromalacia patellae³
• Meniscal injuries and cartilage defects⁴
• Joint pain and stiffness associated with degenerative conditions⁵

Procedure Overview

1. Patience Evaluation

• Conduct a comprehensive clinical assessment of the patient, including a detailed medical history and physical examination.
• Use diagnostic imaging (e.g., X-ray, MRI, or ultrasound) to evaluate the condition of the joint and surrounding tissues.
• Confirm the suitability of the patient for intra-articular stem cell therapy based on diagnosis and joint health status.

2. Administration Preparation

• When clinicians conduct intra-articular joint injections, it is recommended that a numbing agent is used. Many clinicians prefer using nitrous oxide on patients and a topical numbing agent.
• It is also recommended that clinicians have a very good understanding of any joint being worked on as it is important to not harm any existing tissues or connective fibers within the joint.
• It is highly recommended that clinicians utilize ultrasound or fluoroscopy guidance for any joint injection. Ideally, the injection site is on or very near the point of discomfort or joint trauma.
• Typical intra-articular Joint Injection amounts are 2 cc’s for intra-articular stem cell injections. Often saline dilution will be used as well which assists with ease of injection and efficacy.

3. Administration

• Utilizing ultrasound or fluoroscopy, Inject the prepared stem cell therapy product directly into the joint space, targeting the site of injury or degeneration.
• Confirm correct placement of the biologic material using imaging as needed.

4. Post-Procedure care

• Of course, immediately following the procedure, monitor the patient for immediate reactions, such as discomfort or swelling at the injection site.
• Provide instructions for follow-up care including avoiding strenuous activities for 24-48 hours and choosing physical therapy or rehabilitation as necessary to optimize treatment outcomes.
• Schedule a follow-up appointment per your internal procedures.

Sources

^{1.Kim, S.H., Ha, CW., Park, YB. et al. Intra-articular injection of mesenchymal stem cells for clinical outcomes and cartilage repair in osteoarthritis of the knee: a meta-analysis of randomized controlled trials. Arch Orthop Trauma Surg 139, 971–980 (2019). https://doi.org/10.1007/s00402-019-03140-8 ; Rodriquez-Merchan, intraarticular Injections of Mesenchymal Stem Cells in Kne Osteoarthritis: A Review of Their Current Molecular Mechanisms of Action and Their Efficacy. Int. J. Mol. Sci. 2022, 23(23), 149↩}

^{2. While primarily an autoimmune condition, RA patients have experienced symptom relief and reduced inflammation following intra-articular MSC therapy, suggesting potential as an adjunctive treatment.↩}

^{3. This condition, characterized by the softening of the cartilage under the kneecap, has been treated with MSC injections, resulting in pain reduction and improved patellar tracking.↩}

^{4.Yang, Y., Lan, Z., Yan, J. et al. Effect of intra-knee injection of autologous adipose stem cells or mesenchymal vascular components on short-term outcomes in patients with knee osteoarthritis: an updated meta-analysis of randomized controlled trials. Arthritis Res Ther 25, 147 (2023). https://doi.org/10.1186/s13075-023-03134-3↩}

^{5. Patients with degenerative joint diseases have reported significant improvements in pain and mobility following intra-articular MSC treatments.↩}