Ross Hauser, MD, Danielle Matias, PA-C, Demi Foster, APRN
Stem cell therapy can be an effective treatment for some chondromalacia patella patients, it can also easily fail as a treatment in some patients. We have two extensive articles on our website that can explain who stem cell therapy can and cannot help and why the treatment may fail. Please see When stem cell therapy works and does not work for your knee pain and Does stem cell therapy for knee meniscus tears and post-meniscectomy work?
An example of why or why not the treatment did not work is typically seen in emails we get.
I was diagnosed with patella femoral pain syndrome and chondromalacia and was recommended by an orthopedic to get Stem Cell injections (from bone marrow). After the injections, my condition worsen. I now have lateral tilting and subluxation of both patellas. Before I only had pain during weight-bearing activities and now I have chronic discomfort when sitting, standing, and sleeping. Several orthopedists have now recommended hyaluronic acid injections but I am not hesitant to inject anything else into my knees.
In this situation did the stem cells make the pain worse or did the ineffectiveness of the treatment prevent the continued deterioration of the knee joints. In many cases stem cell therapy is tried, it is given as a single cortisone-like injection with the promise that the stem cells injected will rebuild the knee and the patient and doctor wait for the results. While they are waiting, the knee continues to worsen because the treatment was not sufficient to treat the problem.
We have seen good success in selecting patients with knee problems using bone marrow-derived stem cell therapy. We say select because we do not find it necessary to offer this treatment to every patient.
A July 2021 study in the journal Stem Cell Research & Therapy (1) offers support for the use of stem cell therapy for chondromalacia patella and pain in the patellofemoral joint.
“(Various treatments) are conventionally proposed to treat cartilage lesions in the patellofemoral joint, but none have emerged as a gold standard, neither to alleviate symptoms and function nor to prevent osteoarthritis degeneration. Recently, researchers have been focused on cartilage-targeted therapy. Various efforts including cell therapy and tissue emerge for cartilage regeneration exhibit as the promising regime, especially in the application of mesenchymal stem cells (MSCs). Intra-articular injections of variously sourced MSC are found safe and beneficial for treating chondromalacia patella with improved clinical parameters, less invasiveness, symptomatic relief, and reduced inflammation. The mechanism of MSC injection remains further clinical investigation and is tremendously promising for chondromalacia patella treatment.”
In April 2024 doctors presented a case history in the journal Cureus (2) involving a 36-year-old male patient diagnosed with Grade III Chondromalacia patellae who did not respond to traditional treatments but found success with bone marrow-derived stem cell therapy. After six and twelve weeks of therapy, the patient experienced notable improvements in pain and functional outcomes. The doctors suggested that this study could shed light on the regenerative potential of bone marrow-derived stem cell therapy and emphasizes its promising role in treating chondral issues.
References
1 Zheng W, Li H, Hu K, Li L, Bei M. Chondromalacia patellae: current options and emerging cell therapies. Stem Cell Research & Therapy. 2021 Dec;12(1):1-1. [Google Scholar]
2 Soundharya V, Arthi R, Suresh Kumar I, Hari Haran A. Enhanced Bone Marrow Aspirate Concentrate (BMAC) Preparation Strategy in the Management of Chondromalacia Patella: A Case Report. Cureus. 2024 Apr 29;16(4). [Google Scholar]