Biological treatments are the latest advance in Orthopedic surgery. They can heal a range of tissues without surgery. Dr.Venkatachalam offers these procedures in Chennai. Dr.Venkatachalam offers stem cell treatment for knee OA, AVN hip, shoulder OA and other musculoskeletal conditions. Visit www.stemcelljointsindia.com

1. Dr.A.K.Venkatachalam
MS Orth, DNB Orth, FRCS, M.Ch Orth
Specialist in Arthroplasty, Joint preservation &
Regenerative medicine
Guest hospital
E mail- drvenkat@kneeindia.com
Orthopedic Biological treatments

2. Goal in Regenerative medicine
 To recreate original tissue
 Pain relief
 Preserve joint function

3. Cartilage
 It is the lining tissue at the end of bones
 It acts as a shock abosrber.
 Wears down due to number of factors.
 Gives rise to pain, grinding, catching when worn
out.

4. Final condition is Osteo-arthritis
 Osteo-arthritis is a joint failure.
 Has epidemic proportions in India and world wide.
 In India, Knee OA is commonest.
 Final treatment is Knee replacement when non
operative measures have failed.

5. Environment within OA joint
 Presence of signals which promote inflammation,
suppress cartilage synthesis.
 Progenitor stem cells present in joint fluid which is
not present in normal cartilage.

6. Biological therapy
 Growth factors derived from Platelets. Platelet
rich plasma.
 Adult mesenchymal stem cells. ( Medicinal
signalling cells) may be a better name.
 Others- Human Embryonic stem cells, Inducible
progenitor stem cells.

7. Stem cells
 Pluripotent stem cells –They're able to
make cells from all three basic body layers, so
they can potentially produce any cell or tissue the
body needs to repair itself.
 Multipotent stem cells are cells that have the
capacity to self-renew by dividing and to develop
into multiple specialised cell types present in a
specific tissue or organ. Most adult stem
cells are multipotent stem cells.
 Multi potent stem cells are more limited than
pluripotent cells.

8. Adult Mesenchymal cell therapy
 Mesenchymal cells can be obtained from bone
marrow, adipose tissue, synovial fluid, umbilical
cord
 Have potential to differentiate into cartilage.
 Act by recruiting growth factors, chondrogenesis.

9. Source of stem cells – bone marrow

10. Bone marrow technique
 Bone marrow
aspiration
 Centrifuging
 Bone marrow
concentrate

11. Conclusion
 Osteo-arthritis is very common in India and
abroad
 OA knee is commonest.
 Cell based treatments are most promising to
restore normalcy.
 Early results are encouraging. Pain relief is
certain. Grinding sensation takes time to
disappear. MRI evidence takes time to appear.