Traditional nonsurgical Osteoarthritis therapies have limited utility and the treatment effect on the disease is very low. Most of the therapies are aimed at controlling the symptoms but have minimal or no effect on disease progression or repair. On the other hand, surgeries such as Total knee replacement and partial knee replacement are unwarranted until the disease progresses to moderate or end-stage. Stem cell therapy by the Interventional Pain specialist has shown some promising results and has shown disease modification to prevent knee joint destruction. Stem cell therapy for knee arthritis has shown a reduction of pain and stiffness, improvement in physical function, and maintains cartilage quality with minimal side effects. The cost of the procedure and affordability are a matter of concern and may not be suitable for the masses. With the DGCI approval of stem cell treatment for Knee osteoarthritis, IPSC is introducing stem cells into clinical practice. The success of any new treatment depends on strict adherence to the clinical protocols and research recommendations. In view of the above, IPSC is introducing its treatment protocol for stem cell therapy.

1. Stem cell treatment: Osteoarthritis Knee
IPSC Pain and Spine Hospitals Protocol
Stem cell therapy for Osteoarthritis knee.
· Among the chronic Joint pains, hip and knee osteoarthritis (OA) is the most prevalent and is a
leading cause of pain and disability in most countries worldwide.
· The prevalence of arthritis increases with age and is associated with heavy occupational
activities.
· 242 million people worldwide have symptomatic and activity-limiting arthritis of the knee.
· Knee Osteoarthritis affects sleep, mood, and quality of life. Pain- both chronic pain and
episodic- can result in depression and other mood disturbances, functional disabilities, and work
limitations.
· OA significantly limits a person’s ability to self-manage other chronic diseases like diabetes
and hypertension.
· Osteoarthritis knee also, increases the risk of developing heart disease by 50%.
Traditional nonsurgical Osteoarthritis therapies have limited utility and the treatment effect on
the disease is very low. Most of the therapies are aimed at controlling the symptoms but have
minimal or no effect on disease progression or repair. On the other hand, surgeries such as Total
knee replacement and partial knee replacement are unwarranted until the disease progresses to
moderate or end-stage.
Stem cell therapy by the Interventional Pain specialist has shown some promising results and has
shown disease modification to prevent knee joint destruction. Stem cell therapy for knee arthritis
has shown a reduction of pain and stiffness, improvement in physical function, and
maintains cartilage quality with minimal side effects. The cost of the procedure and affordability
are a matter of concern and may not be suitable for the masses.
With the DGCI approval of stem cell treatment for Knee osteoarthritis, IPSC is introducing stem
cells into clinical practice. The success of any new treatment depends on the strict adherence to
the clinical protocols and research recommendations. In view of the above, IPSC is introducing
its treatment protocol for stem cell therapy.
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2. General Description:
StemOne, adult human bone marrow derived, allogenic mesenchymal stromal cells.
Order is to be placed to sales manager, alkem 48 hours in advance. Alkem will take care of the
transportation in cold chain. OT will receive the shipment through pharmacy.
Indication:
1. Adult male or female.
2. Primary Idiopathic Osteoarthritis of knee
3. Pain manageable with NSAIDS/Mild Opioids
4. Grade 2 and Grade 3 OA on MRI (MRI should not be older than 3 months)
Contra Indications:
1. Meniscal and ligamental Tears
2. Subchondral Sclerosis
3. Grade 4 OA and Gross deformities
4. Inflammatory arthropathies
5. Active Local or Systemic Infection
6. History of Trauma or knee surgery in the past 2 years
7. Bleeding disorders, Allergies to Local Anaesthetics, Pregnancy
Doses and Frequency:
Single intra articular dose of 25 Million cells suspended in 1 ml CryoStor + 1 ml PlasmaLyte A,
followed by 2 ml Sodium Hyaluronan Injection.
Application procedure:
Patient will be admitted preferably for 24 hours or at least 6 Hours.
Consent for the procedure as per the IPSC protocols.
Pre Medications:
Inj Supacef 1.5 Gm IV over 30 min, one hour before the procedure
Inj Hydrocortisone 100 mg, 30 min before the procedure.
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3. Procedure will be performed in OT under strict aseptic precautions using ultrasound guidance by
MSK Ultrasound Specialist or Pain specialist trained in MSK ultrasound.
Post procedure, patient will be observed in recovery room for 1 hour.
Patient is to be discharged, if the discharge criteria of IPSC is met.
Follow up
After one week to see any side effects and at 1, 3 and 6 months for the improvement in pain
VAS and WOMAC-OA index will be used to evaluate pain and function of the joint.
MRI is to be repeated, preferably from the same MRI centre for better comparison.
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