Total Joint Replacement vs. Stem Cell Therapy
By: Edward G. Loniewski, DO, FACOS, FAOAO
At Cellular Healing we tout the benefits of cell based therapies. However, my background is as a fellowship trained joint replacement surgeon. I have replaced thousands of knees and hips over the past 25 years. So, I would have a unique perspective which allows me to look at this comparison from an unbiased viewpoint. Many centers who claim to be experts in cell therapy have never replaced a joint, nor even seen the insides of a major joint. If you are interested in a more detailed version of this discussion you can visit our knee therapy page.
Who is Not a Candidate for Stem Cell?
I still feel that joint replacement may be the best option for specific patients and not everyone is a candidate for stem cell therapy. These would include:
- Patients with a bow of the joint greater than 10 degrees from normal
- Loss of more than 20 degrees of range of motion
- Instability or giving away of the joint more than 2 times per week.
- Chronic and severe swelling of the joint requiring more than 4 aspirations in one year
So, if you have any of the above and you are healthy enough to have surgery and you have proper social support for the recovery, you should have the joint replaced. However, if you do not have any of the above, you can consider stem cell therapy.
Side by Side Comparisons:
Here is the comparison between the two so you can make an educated choice:
- Pain- Joint replacement surgery requires either a general or spinal anaesthetic along with a local anaesthetic, narcotic medication, ice, elevation and even a TENS unit. Stem cell therapy on the other hand requires some oral sedation and maybe a few pain pills for 24 to 48 hrs.
- Rehab- Joint replacement surgery, especially knee replacements, are highly dependent upon compliance with a therapy program including both physical and occupational therapy for about 6 to 8 weeks. Stem cell therapy requires only a simple 15 to 20 minute daily home therapy program such as riding a bike or walking.
- Scars- Joint replacement requires an incision regardless if it is a minimally invasive surgeon, You have bought yourself an incision of at least 6 to 10 inches long. Stem cell therapy has no visible scars other than small puncture wounds from the bone marrow needle. The dressing is only used for a maximum of 3 days.
- Complications - Total joint replacement has a historical complication rate of anywhere from 3% to 16%. The complication rates elevate with specific medical conditions such as being overweight, diabetes, heart failure, stroke and previous blood clots. Stem cell therapy on the other hand has a historical complication rates of under 1% with the most common being bruising, blood clots and temporary nerve damage. There does not appear to be an increase in these low rates with your weight or age.
- Convenience- Total joint replacement requires numerous pre and post office visits. This includes a few pre-operative visits with the hospital and your physician. You have to be driven to and picked up from the hospital and someone must stay with you around the clock 24 hrs a day, 7 days a week for a minimum of 2 weeks. In addition, you will require therapy visits both at your home and in a physical therapy department 2-3 times per week for 6 weeks as well as follow up visits to your doctor at 2 and 6 weeks. Stem cell therapy can have as little as one pre-procedure visit and another 1-2 weeks afterwards.
- Cost- The cost of a total joint is a about $35,000 and a stem cell treatment can be anywhere from less than $3,000 to $6,000 depending upon the exact treatment chosen. However, with total joint replacement, the cost is not just the hospitalization and payment to the surgeon. There are numerous co-pays for the therapy visits as well as some physician visits as well as medication co-pays. In addition, there are costs associated with the loss of work for the 6- 8 weeks and anyone with a strenuous job may require up to 3 months off work. These costs of lost wages and co-pays need to be factored in if you are making an economic decision. Although stem cell may not be covered by your insurance, you may be able to use your health spending account ( HSA) and certain health sharing plans such as Medishare reimburse patients for these procedures. Overall, in total dollars spent, stem cell therapy is 10 x less costly than joint replacement.
- Efficacy - Does this really work? Although many physicians may tell you that there are no long term studies showing the efficacy of this procedure, this is not the truth. We have numerous long and short term studies showing that bone marrow stem cell is an effective and safe procedure. We have results from treatment of specific hip arthritis conditions for over 30 years and a most recently published study comparing the results of traditional knee replacement on one knee to stem cell therapy on the other knee. After an average of 12.5 years of follow up. With this published and peer reviewed studies, there were very low rates of complications and very high percentages of success. Most importantly, 7 out of 10 patients preferred the stem cell side over the knee replacement side. Our own data collection on over 500 patients over a 5 year period show that over 80% of the patients improved and only 10% went on to joint replacement. A majority of the patients had over 50% improvement in their pain and function.
Summary
Looking at the above reasons, stem cell treatment has a positive, safe and effective treatment option for patients whom meet the criteria for treatment. Our goal is not to push you into one treatment over the other since we offer all the treatments you may require. Rather, our goal is to find the right treatment to fit your special condition. You can learn more about our unique comprehensive health evaluation or a customized treatment combination on our web site.
If you are interested in scheduling a personal face to face consultation with Dr. Loniewski, please call 810-299-8552 or send a simple request on-line.