By James Fell, Special to Tribune Newspapers
8:18 PM EDT, May 1, 2013
Until recently, I didn't know that I could use stem cells to help heal my bum shoulder. Perhaps that's because I don't use said shoulder for hurling baseballs or footballs at speeds approaching the sound barrier for obscene amounts of money.
I can see why elite athletes are interested in cutting edge therapies to stay in the game. They have their yellow Ferrari, but an injury is threatening to end their career, and they want to keep earning massive paychecks so they can get the matching yellow Lamborghini. Also, the love of the game, or something.
When it comes to medical stuff I'm unfamiliar with, I always start off speaking with a beautiful and brilliant woman. My wife has been a practicing family physician since 1997 and says stem cell therapy to heal sports injuries is "highly controversial."
Good to know as I began to dig.
As someone who would rather exercise than watch sports, it's understandable how I missed the stories about Oakland A's pitcher Bartolo Colon and Denver Broncos quarterback Peyton Manning crediting their returns to their games to having stem cells sucked out of one part of their body and squirted back into another part. (It's a little more complicated than that.)
Anecdotes are nice, especially from rich and famous people with yellow Italian cars. But there is also the possibility that forking out big bucks for a new treatment works because the person paying for it thinks it's going to work. You know, the placebo effect.
For average folks, should we consider bank loans to heal for weekend basketball, friendly tennis matches or just reduced pain and increased mobility? The answer is … maybe.
Personally, I'm planning on keeping that money in my retirement fund, because, as it stands with regard to the efficacy of stem cell therapy for sports injuries, we're 100 percent certain that we're just not sure.
How does it (allegedly) work?
"Your body uses stem cells to repair itself," said Dr. Joseph Purita, an orthopedic surgeon in Boca Raton, Fla., who does such procedures. Purita, who is perhaps best known for doing Bartolo Colon's stem cell injections in his elbow and shoulder, says, "What we're doing is mimicking the body's natural healing process. This is not a new science." He states that the injections can attract other stem cells to the injured area, and even transform into new tissue, such as cartilage.
Purita explained that bone marrow and/or body fat extracted from a patient undergoes "minimal manipulation" as per FDA guidelines, such as being spun in a centrifuge to cull out the stem cells. Other FDA regulations, according to Purita, state that these adult stem cells (not to be confused with embryonic) must be used in the same patient, on the same day, at the same facility.
Purita charges up to $5,000 for a series of three or four injections. This is for patients seeking the full follow-up treatment. Without the follow-up, the price is $3,000.
These types of treatments are generally not covered by health insurance, so it's an out-of-pocket expense. Is it worth the price? Some are skeptical.
"We don't understand what stem cell therapy is doing, and we don't know how to pick the people who will have the best outcome," said David Hart, a professor of microbiology at the University of Calgary. "There is a lot of anecdotal evidence, but there are very few controlled studies."
"The jury is still out," Hart said of stem cell therapy for treating injured/deteriorating joints. He also cautioned about managing expectations, adding that there is a big difference between alleviating pain and enhancing regeneration.
But the anecdotes, especially the examples of Colon and Manning crediting stem cell therapy with allowing them to return to the game, can make it seem like a miracle. "There is a lot of hope attached to stem cell therapy," Hart said, "but when hope becomes hype, expectations can get unrealistic."
"The more healthy someone is, the better the therapy works," Purita told me. He says they've had much success treating rotator cuff tears (in the shoulder), tennis elbow, meniscus tears (in the knee), and osteoarthritis.
Derek Leger, a 34-year-old ex-infantryman in Coral Springs, Fla., is one of Purita's patients. "I have a torn meniscus and osteoarthritis in my left knee," Leger told me. "I was a ground-pounder," he said of his military experience. "It caused my knees to wear out."
Leger, who had three injections over three months, starting in December 2011, said he began to notice a difference within a month of the first treatment. "A lot of the pain was going away, and I was happy with that alone." After a few months he noticed that he no longer needed the regular ice packs and ibuprofen, and he also regained some stability in his knee.
"I had trouble walking prior to the treatment, and now I can walk just fine," Leger said. He recently completed a regimen of the popular P90X exercise program. "I couldn't have done P90X before the procedure."
Leger was so pleased with his outcome that he has become a repeat customer of Purita, returning recently for stem cell therapy on his hip in the hope it will alleviate another injury incurred during his time in the military.
The science is still lacking, however. A 2012 report by researchers from the Department of Surgery at the University of Louisville published in Sports Health stated that while knee injury treatment with stem cells "shows potential," these are mostly animal studies that have not been translated to human clinical applications.
But the good news is, it's only money. "The only risk is that it might not work and you may have wasted a bunch of money," said Hart, who is skeptical of the potential benefits of adult stem cell therapy for joint injuries. For embryonic stem cell treatments there are concerns about potential cancer risks because the cells may grow out of control, possibly creating tumors, "but for adult stem cells, I'd say the cancer risk is very low," Hart said. Purita states there is no cancer risk.
If you're a professional athlete, the cost of treatment translates to minutes on the field, diamond, court or rink. For the typical wage-earner, however, the price is nothing to sneeze at, especially if travel is required.
While Hart believes there is a future for such stem cell therapies, "I think it's premature to be doing this as a commercial venture," he said.
So for those hoping to get past joint pain, and possibly achieve improved physical performance, it's buyer beware.
If so, then it's worth reading this. And if you're interested in taking part in a clinical trial involving stem cells, visit this site to see if you're a candidate to take part in research: clinicaltrials.gov.
Fell is a certified strength and conditioning specialist.
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