Biologic therapies call treatments with the patient 's own cells with a regenerative objective. We currently use two types of cells:
- Mesenchymal cells; They are undifferentiated cells of embryonic origin, capable of regenerating tissues depending on the place to settle, that is, if we put on muscle, regenerate muscle, and if we put bone, bone regenerate. They are particularly suitable in anoxic environments, ie, where no oxygen, since even in these circumstances they can act. These types of cells are obtained by bone marrow aspiration, usually held in iliac crest.
- Platelet - rich plasma; It consists in obtaining platelets in the blood by venipuncture, just as if we were making blood analysis for any other reason. a variable amount of blood is drawn according to the need for platelets, typically between 20 and 60 cc. Once the blood, by centrifugation cuvette sealed, are separated and concentrated platelets. This process is performed at all times avoiding blood contact with ambient air, so that the syringe is passed extraction cuvette sealed, and thence to the syringe infiltration. The obtained concentrations are between 7 and 8.5 times the original number of blood platelets. Contrary to what happens with or mesenchymal stem cells, platelet need oxygen to act properly, so it should not be used in environments low in oxygen.
In the case of mesenchymal cells, the process should be performed in the operating room and under sedation. cell extraction is performed by trocar aspirate marrow from the iliac crest, immediately proceeding to its processing to obtain a suitable concentration of mesenchymal. Immediately after collection, the cells are applied to the processes outlined in the surgery, so external contamination are avoided.
In the case of platelet - rich plasma (PRP), the production is done by venipuncture, as an analytical anyone, and the whole process is done on an outpatient basis in consultation with a total processing time of about 40 minutes, due to time spent in processing the cells.
Applications of biological therapies
The main applications of both cells are regenerative.
For use in various articular cartilage tissue, the therapeutic intent is regenerative, both from the viewpoint of formation of new tissue as in the treatment of inflammatory phenomena that occur as a result of these cells to modify inflamed tissues in their normal histology. Thus, in pure or combined with partial tears as shoulder pathology, trochanteritis fasciitis, etc inflammatory problems, have an absolute indication.
As palliative treatment have a clear indication in osteoarthritis. Articular cartilage can not regenerate, but the use of PRP causes the cartilage that remains is still better and destroyed more slowly. It also improves the functional characteristics of all other tissues, achieving better lubrication and better nutrition of the treated joints. The cadence of infiltrations in this aspect is palliative annual minimum.
In the case of mesenchymal cells, its maximum indication are bone necrosis and nonunion or defects of fracture healing.
PRP biological therapy carries no risk because there can be no reaction or rejection when cells of the same organism.
In the case of mesenchymal cells, the only risk presented is the inherent sedation or bone puncture with possibility of infection - frankly uncommon.