Oct 19, 2021 Sarah Spivack LaRosa
Novel orthopaedic therapies such as injections of stem cells and platelet-rich plasma (PRP) are growing in popularity. But surgeons do not always agree on the use or effectiveness of the treatments.
Now a center, comprising surgeons and investigators at Cedars-Sinai, is studying which therapies are beneficial and how they work. The new multidisciplinary center known as the Regenerative Orthobiologics Center (ROC), will evaluate data related to these treatments and patient outcomes to identify the best therapies.
"This research is a year or two out, but we want to see if we can do even better than we do with PRP."
"PRP is a popular treatment in which a concentration of your own platelets is injected back into the body. Some patients do really well with it, and some don’t do any better at all," says Clive Svendsen, PhD, executive director of the Cedars-Sinai Board of Governors Regenerative Medicine Institute (RMI) and co-director of the Regenerative Orthobiologics Center (ROC). The other co-directors are Bert Mandelbaum, MD, co-chair of Medical Affairs at Cedars-Sinai Kerlan-Jobe Institute and Mark Vrahas, MD, chair of Cedars-Sinai Orthopaedics.
What if, Clive asserts, there is something in the cell material of those patients who do well with PRP that makes them successful?
Clinicians and researchers at the ROC are currently giving PRP to 20 patients and, at the same time, partners at the RMI are analyzing exactly what is in the cells they are injecting. They can correlate that data with outcomes and try to identify the beneficial components of the PRP in cases where it works. If successful, this will lead to a larger multicenter trial.
Clive’s team also is looking to induced pluripotent stem cells (iPSCs) for orthopaedic solutions. These special cells are created by taking adult cells from patients at any age. The ordinary cells are then engineered to create stem cells that are able to generate any cell of the human body.
"Instead of using PRP from the patient's blood, we can generate their own young stem cells using iPSC technology and transplant them back into the patient," Clive says.
Down the road, the ROC plans to create three or four different innovative, injectable stem cell products based on iPSCs to see if they can improve outcomes for patients with osteoarthritis and other conditions.
"This research is a year or two out, but we want to see if we can do even better than we do with PRP," Clive says.
He ultimately envisions PRP therapies that work for all comers, and novel stem cell therapies that can improve function of knees and other joints.