Dr Tom Grogan Pediatric Orthopedic Surgeon West Los Angeles 11:00 - 11:55 WS #141: Future Applications of Stem Cell Therapy - An Orthopaedic Perspective 12:05 - 13:00 WS #153: Future Applications of Stem Cell Therapy - An Orthopaedic Perspective (Repeated)
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Dr Tom Grogan - GP CME north/Sat_Room7_1100... · ADSC + calcium alginate gel Calcium alginate gel only Controls Group 1 –sig improved healing Chinese J. of Trauma 14:6 (2011) 20
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Dr Tom GroganPediatric Orthopedic Surgeon
West Los Angeles
11:00 - 11:55 WS #141: Future Applications of Stem Cell Therapy - An Orthopaedic Perspective
12:05 - 13:00 WS #153: Future Applications of Stem Cell Therapy - An Orthopaedic Perspective
(Repeated)
APPLICATIONS FOR STEM CELL THERAPY
Thomas J. Grogan, MD
June 22, 2019
BACKGROUND
Orthopedic Surgery Residency at UCLA
Fellowships
Adult Reconstruction – NIH
Pediatric Orthopedics – Shriner’s Hospital
Trauma – Munich, Germany
Faculty – UCLA
Assistant Chief – Shriner’s Los Angeles
Currently Private Practice
West Los Angeles, California
Over 40,000 new patients over 22 years
BIOLOGICS IN ORTHOPEDIC SURGERY
Musculoskeletal diseases
Economic impact - $1 Trillion dollars annually
7.4% of GDP
Osteoarthritis leads to chronic pain, disability, difficulty with simple activities of daily living and selfcare
Public awareness may lead to adoption of treatments with little supporting evidence
ARTHRITIS = BIG BUSINESS
43 Million Americans have been told they have “arthritis”
12% of healthcare spending is musculoskeletal
$2.8 Trillion = $336 Billion
20,000 orthopedic surgeons - $16.8 Million each doc
800,000 joint replacements per year
$26,000 per on average
$20.8 Billion dollar industry
STEM CELL PHYSIOLOGY
Stem cells – two common characteristics
Offspring of cell able to reconstitute a functional tissue
Can renew themselves indefinitely
Every second – 15 million blood cells “drop dead”
Bone marrow stem ells keep you alive
MESENCHYMAL STEM CELLS
Adipose Derived Stem Cells (ADSC) versus Stromal Vascular Fraction (SVF)
ADSC – Cultured and expanded in vito
Surface markers – CD73, CD 90, CD 166, CD 105 – but not CD 45 (hematopoetic)
Expanded in 10% Fetal Bovine Serum (FBS)
Fat derived (ADSC) are 500 times more potent than bone marrow derived Stem Cells (BMDSC)
SVF – Fat collected – concentrated to form collection of cells including ADSC
Fat is disrupted / enzymatically broken down
Isolate is centrifuged and washed
Clean room
Can be mechanically isolated
Nano- fat
BIOLOGICS IN ORTHOPEDIC SURGERY
Current cell therapies
Harvest of native tissue – adipose, bone marrow, synovial
Stem cells and progenitor cells – pericytes lining the basement membrane of capillaries
Release by enzymatic digestion - Collagenase
Minimal manipulation
Only 1 in 1,000 to 1 in 1,000,000 cells collected are progenitor or stem cells
Ultimately, expansion in vitro may be key to get enough cells to be maximally effective