Stem cells are among the cells found in the human body. They are a type of basic cell and can transform into different types of cells depending on the body's needs and the environment in which the stem cells are located. These special cells can also help form new, healthy tissues. Stem cell therapy also aids in the repair of cells in damaged tissues. With their versatile ability to multiply, stem cells are widely used in clinical applications. Stem cell treatments are utilized in areas such as dermatological diseases, aesthetic surgery, cardiology, and orthopedics.

What is a Stem Cell?

Stem cells are cells in the body that can transform into different types of cells. This allows stem cells to replace damaged or lost cells in the body. Additionally, they can be produced through the genetic reprogramming of differentiated cells. Recent research has significantly advanced stem cell therapy. Stem cell therapy could be a promising treatment option for various diseases and conditions that do not respond to current medical treatments, where disease progression cannot be prevented, or where symptoms cannot be alleviated. 

How Are Stem Cells Obtained? 

Stem cells can be obtained from embryonic tissues, as well as from adult tissues such as fat tissue and bone marrow. Fat tissues have an advantage in the collection, isolation, and proliferation of stem cells, particularly when compared to bone marrow, due to the larger number of stem cells present. While obtaining stem cells from fat tissue causes less discomfort to patients, it is easier to obtain and often has a higher proliferation capacity than those derived from bone marrow cells. Therefore, fat tissue can be considered an ideal source of stem cells. 

Stem cells derived from fat tissue have a strong structure and the ability to differentiate into various cells and structures, including vascular cells. Therefore, they support blood vessel formation and, due to their easy accessibility and lack of substances that stimulate the immune system, cause minimal discomfort to the patient. For these reasons, they are considered ideal for use in regenerative medicine. 

The process of collecting fat tissue begins with the careful identification of the target area. In practice, the most common donor areas are the outer thigh, hip, and abdominal regions. The procedure is performed under local anesthesia, where approximately 30 ml of fat is aspirated using special syringes. The syringes containing the collected material are cleaned two or three times with sterile saline solution, sealed, and left to rest for 30 minutes. The upper liquid layer is then discarded, and the remaining sediment is processed. The syringes containing the remaining fat are sent to the laboratory for processing in a closed and sterile manner. The expanded stem cells are stored in appropriate environments and injected into the necessary and suitable areas. Stem cells derived from fat tissue that has been separated with collagenase enzyme can differentiate into various cellular types, including adipose tissue, cartilage, bone, skeletal muscle system, neuronal cells, endothelial cells, cardiomyocytes, and smooth muscle tissue cells. 

What is Stem Cell Therapy? 

Stem cell therapy is a treatment method in which allogeneic stem cells taken from a donor or stem cells taken from the patient's own body are injected into the bloodstream to replace and repair diseased or dysfunctional cells. 

Stem cell transplantation is the process of administering healthy blood-forming stem cells to replace the patient's stem cells, which may have been damaged due to radiation or high-dose chemotherapy. This procedure aims to promote the generation of new cells to produce healthy tissue or repair damaged tissue. 

In Which Diseases Can Stem Cell Therapy Be Used? 

Stem cell therapy has a wide range of applications. Stem cells play an important role in the repair of damaged tissues and organs and in accelerating the healing processes. Stem cell therapy is particularly beneficial in fields such as dermatology, orthopedics, cardiology, and neurology. For this reason, stem cell therapy can be used in a variety of different diseases. 

Stem Cell Therapy in Dermatology and Aesthetic Surgery 

• Psoriasis 

• Epidermolysis bullosa 

• Scleroderma 

• Widespread burns 

• Lipoatrophy 

• Lipodystrophies 

• Acne scars 

• Wound and scar repair 

• Wrinkles and skin aging 

• Sun damage and photoaging 

Repairing and Rejuvenating the Skin 

Stem cell fat injection is an established technique for the revision and regeneration of damaged tissue scars. Stem cell fat injection is increasingly used to repair aesthetic imperfections such as acne scars, wrinkles, and aging for rejuvenation purposes. By applying fat tissue stem cells into the skin, improvements can be achieved in skin tissue, wrinkles, and dermal thickness. It can be used in aesthetic procedures for skin aging, wrinkles, sun damage, photoaging, and loss of fat tissue in the skin. 

Stem Cell Therapy in Orthopedics and Traumatology 

• Joint cartilage damage 

• Knee osteoarthritis 

• Prolonged tendon issues 

• Non-union fractures 

• Ligament injuries, including sprains 

• Avascular necrosis 

• Accelerated treatment for sports injuries 

• Cartilage patching 

Stem Cell Therapy in Cardiology 

• Myocardial infarction - intracoronary reperfusion 

• Heart failure 

• Ischemic heart disease - intramyocardial injections 

Stem Cell Therapy in Neurological and Neurodegenerative Diseases 

• Traumatic brain injury 

• Spinal cord injury 

• Stroke 

• Alzheimer’s 

• Parkinson’s 

Stem Cell Therapy in Bone Marrow and Blood Diseases

• Leukemia (blood cancer) 

• Lymphoma (cancer of the lymph nodes) 

• Aplastic anemia 

• Sickle cell anemia 

• Thalassemia 

• Bone marrow regeneration after cancer 

How is Stem Cell Therapy Performed? 

Stem cell therapy is a treatment method planned to repair diseased or damaged tissues. Through this therapy, stem cells are applied to the patient’s tissues to promote healing. The process involves several stages, from obtaining the stem cells from their source to applying them to the patient. 

The steps of stem cell therapy are as follows: 

1. In the first stage, the required stem cells are obtained. These stem cells can be adult stem cells, embryonic stem cells, or other types. 

1. The cells obtained here vary depending on the patient’s condition and the type of treatment. 

1. The collected stem cells are generally cultured in a laboratory environment and stored under specific conditions. 

1. The stem cells are applied to the patient using various treatment methods. 

1. Stem cell therapy may involve direct injection, intravenous administration, or surgical intervention to place the cells. 

1. The stem cells applied to the patient proliferate in the damaged tissue, initiating the repair process. 

1. After the treatment, patients who received stem cell therapy are regularly monitored. 

Frequently Asked Questions about Stem Cell Therapy 

Which Orthopedic Patients Should Receive Stem Cell Therapy? 

Cartilage tissue is found in many parts of the body, including joints, the ends of ribs, between vertebrae, and in the nose and ear. Cartilage tissue, which is not nourished by blood and lacks a nerve structure, has very limited self-renewal ability. 

In stem cell therapy, patient selection is crucial. It is not appropriate to apply stem cell therapy to every patient. The patient's condition, the nature of the disorder, age, and gender should all be considered when deciding on stem cell therapy. Especially in patient groups where nearly all of the cartilage structure has been lost, it is not appropriate to recommend stem cell therapy. 

Stem Cell Therapy: 

1. In the early stages of cartilage damage 

1. In patients with cartilage damage who do not want to undergo surgery 

1. In cases of muscle and tendon injuries, as well as early-stage bone nourishment issues in the hip and knee, diagnosed at an early stage 

Which Areas of the Skin Can Stem Cell Therapy with Fat Injection Be Applied to? 

Stem cell therapy with fat injection can be applied to various areas, primarily the face, as well as the neck, décolletage, hands, and other regions. In addition to these, it is also used in scar treatment. 

How Does Stem Cell Therapy with Fat Injection Affect the Skin? 

Stem cells are structures that quickly adapt to the areas where they are applied. When injected into the skin, they take on the task of replenishing the missing tissue and cells in the area where they were injected. They also support collagen production and enhance the skin's elasticity. As a result, the skin appears firmer, with a lively, radiant, and youthful look. 

How is stem cell therapy performed in orthopedic patients? 

The number and timing of stem cell treatments for orthopedic and traumatology patients are determined based on the individual patient. The outcome can vary depending on the patient and the severity of the disorder. 

• In orthopedic disorders, stem cells are obtained from fat tissue or bone marrow through a special process. The precision and method used in these procedures are very important in terms of stem cell viability and quality. 
• It is crucial for this process to be carried out under special laboratory conditions to ensure that no diseases are transmitted and unwanted cells are not transplanted. 
• If performed, cell culture procedures need to be conducted in special laboratory conditions to prevent the transmission of diseases and the transplantation of unwanted cells. 
• Stem cells are typically administered through injection. In addition, there are surgical methods available. 
• Depending on the stem cell application, the patient is given either local or general anesthesia. 
• In surgically applied stem cell treatments, the harvested stem cells are placed on carriers called matrices, which are in the form of a coating. These are then placed in the damaged area where healing is desired. With this method, it is expected that the stem cells will transform into cartilage structure after a certain period. 

Is stem cell therapy for orthopedic disorders painful? 

During the stem cell collection process, sedation is applied to ensure that patients do not feel any pain or discomfort. Patients may experience mild compression and pressure during the stem cell collection. Different painkillers are used depending on whether the treatment involves injection or surgical procedures. 

Can someone else's stem cells be used? 

Stem cell therapy is used in the treatment of many conditions. In the fields of orthopedics and traumatology, as well as dermatology, someone else's stem cells are not used. However, in cases like the well-known bone marrow transplant, stem cells from another person may be used. 

What are the risks of stem cell therapy used for orthopedic disorders? 

There are no common risks associated with the use of stem cell therapy for orthopedic and traumatology disorders. However, like any procedure, there can be risks involved in the application of stem cell therapy for orthopedic conditions. 

The risks of stem cell therapy are as follows: 

• The local or general anesthesia used may cause allergic reactions. 
• There may be bleeding or bruising at the site where stem cell therapy is applied. 
• Damage to nerves and blood vessels may occur. 
• Although rare, infection may develop at the application site. 
• Swelling, sensitivity to touch, or pain may develop in the area where the treatment was applied. 
• After the procedure, stem cells can transform into any type of cell. Particularly in stem cell applications for cartilage injuries, structures other than cartilage, such as bone, may form. While very rare, these formations can sometimes lead to the need for a second surgical procedure. 

Stem cell therapy can be applied for many different conditions. Particularly in areas like bone marrow, immunosuppressive drugs are used. However, in stem cell therapy for orthopedic disorders, there is no need for immunosuppressive drugs, so such risks are not present. 

After stem cell therapy: 

• Bleeding 

• Drainage from the injection site 

• Fever 

If pain occurs that cannot be controlled with painkillers, the patient should consult a doctor. 

Can stem cell therapy cause cancer? 

There is no scientific evidence to suggest that stem cell therapies used in orthopedics and traumatology cause cancer. On the contrary, scientific publications indicate that they do not cause cancer. 

How many sessions does stem cell therapy for orthopedic disorders last? 

The number of sessions for stem cell therapy in orthopedic disorders can vary depending on the issue being treated and the type of stem cell procedure used. In some cases, multiple sessions may be required, but typically, the goal can be achieved in a single session. 

How many sessions does stem cell therapy for the skin last? 

Stem cell therapy with fat injection for the skin varies depending on the condition and problem being treated, as well as the individual's skin type, age, and environmental factors they have been exposed to up until that point. These factors can influence the number of sessions required. 

How long does stem cell therapy for orthopedic disorders take? 

In stem cell therapies performed via injection, the process of obtaining the stem cells takes about 15-20 minutes. After that, depending on the procedure used, the stem cell separation process can take between 45 minutes and 2 hours. The injection itself takes about 1 minute. During these procedures, the stem cell collection and injection are related to the patient, while the separation process is done independently of the patient, who rests during this time. However, for surgical stem cell procedures using carriers called matrices, the duration can range from 1 to 2 hours, depending on the specific surgical procedure being performed. 

How is the follow-up after stem cell therapy for orthopedic disorders? 

The follow-up after stem cell therapy can vary depending on the procedure performed. Especially after stem cell treatments done through surgical procedures, follow-up may involve radiological methods such as MRI. The most suitable method for follow-up is the patient’s pain level. 

Can stem cell therapy replace standard treatments for orthopedic disorders? 

No. Stem cell therapy is an adjunctive treatment method. It is most effective when used in addition to primary treatments. In cases where primary treatments cannot be applied, it may be used to provide comfort for a certain period of time. To determine how much benefit you can gain and whether you are a suitable candidate for stem cell therapy, please consult your doctor. 

Is PRP the same as stem cell therapy? 

Contrary to popular belief, PRP (Platelet-Rich Plasma) and stem cell therapy are different treatment methods. Stem cells obtained from the person’s own fat tissue are used in the treatment of many diseases. 

Prepared by Memorial Medical Editorial Board.