Always an interesting and detailed read Mozzarc, thanks for all your work.
One thing I wanted to mention with posters Re: Stem Cell (SC) treatments as being a potential major competition and/or superior to iPPS (I saw this touched on in another thread as well).
Being a moderate Knee OA sufferer, I made a lot of investigations into available SC treatments available in Aus. and wrestled with getting it done 12 months ago. The most reputable and detailed treatments and studies I found, were instituted through Melbourne and after much study and consultation, there were some aspects of the treatment that held me back from going down that path.
I would certainly love to have some nice new strong layers of cartilage under my patellar (kneecap) and on my trochlear (femoral) groove, but at this point in time and technology, that just isn't going to happen. Stem Cell therapy is just a newborn baby and despite the concept looking pretty awesome, so far the technology provides no guarantees for success and is still largely inconclusive (from when I looked at it in 2018/19).
I was advised the following by the professor involved in my consults:
- the type of cartilage that is reproduced, isn't necessarily the durable type (there is more than one type and function), results show growth of variable thickness and the durability of the cartilage is unpredictable. - the treatment does apparently appear to have anti-inflammatory and pain benefits - it would cost around $11- $12 K to undergo the treatment for both (in total) - one knee is done at a time only (6 months apart), the harvest of the cells (a simple tummy fat extraction) would be one month prior (hopefully only one harvest required) and this is then followed by two 'in-knee' injections to be given one month apart. - follow up rehab involved considerable initial immobilisation and then controlled stationary bike activity to be carried out everyday for months on end. - as I have an active and physical job and the procedure required me to be off work from 3-6 months each per knee (that was the real negative clincher for me). The risk of damage to the cells apparently was too much to allow me to work. Therefore a total of up to 12 months off work was possible.
As further explained to me by the professor who runs it, whilst hopeful, there were no guarantees of the actual level of success. Just like knee replacements, I was also advised the SC therapy would not allow me to carry out any moderate or heavy impact type activity ( of course that is to be expected, the damage is done and there are no real comebacks under any treatment at this point for us oldies). He also considered my age (58) to be borderline for any real success.
I am sure that there is a lot of SC research currently going on around the world and in many types and forms (like the study I read in the other post), but for me, the fate of my short and medium term knee health sits with iPPS (still waiting to receive it through SAS). I have no idea what activity levels I will be able to achieve, but if I can just keep doing my yoga (but without the current pain), a bit of bike riding and walking, then that would indeed be awesome.
I realise that eventually some sort of surgery awaits, but I want to hang out as long as I can with an acceptable pain relieving treatment, that also gives reasonable longevity and activity level. From what I can gather from those posters who have received iPPS already, the magic juice has these definite benefits.
So in weighing up what treatment I preferred to pursue, what factors did I (and I might assume others would as well) consider in using SC therapy vs iPPS ? (me just being a regular type of middle-aged, reasonably healthy working stiff)
- cost vs risk of failure - recorded anecdotal success - ease and length of process and likely rehab restrictions - expected longevity of relief - overall pain relief and activity level possible
At this point, the prospect of iPPS getting me to where I want to go is the clear winner (although I may be proven wrong when I finally get the treatment). However, in my situation, the alternatives to iPPS are - SC therapy, pain relieving and anti-inflammatory drugs (useless), injection treatments (Hyaluronic Acid - didn't work, Cortisone - gave pain relief, but I have already had my allowable limit), and then joint replacement surgery. I pray that Zilosul gets the nod soon and that it is truly successful and therefore readily available to help so many.
As for SC therapy being a competitor? I personally just can't see it being a major factor in the near future, particularly for those that don't have a good base of health/fitness, are older, can't have time off work for the mobility and rehab restrictions and/ or can't afford the total cost outlay. Maybe one day it will be superior, but given the unknowns in the therapy, the testing and the approval processes involved, I doubt it will be available or preferred by the masses anytime soon.
Just my random personal thoughts, I am no expert on anything.
(20min delay)