“The effectiveness of bone marrow stem cell injections has been proven safe and effective using a system called SmartMcell.”
Knee arthritis, often called “a side effect of the blessing of longevity,” is a disease of the elderly that is rapidly increasing with the aging population.According to the Health Insurance Review and Assessment Service, 3,201,368 patients received treatment for knee joint disease last year.This represents a roughly 30% increase from 2,411,308 patients ten years ago. Sixty percent of patients are over the age of 65. Treatment for knee arthritis typically involves steroid injections, known as “bone injections,” which have anti-inflammatory properties and are effective in alleviating pain, or procedures involving endoscopic insertion into the joint.Recently, however, autologous bone marrow stem cell injections have been recognized for their cartilage regeneration properties, leading to a surge in the number of such procedures.We met with Dr. Kim Jin-gu, Director of Myongji Hospital, to learn about the effects and precautions of autologous bone marrow stem cell injections, as well as how to manage knee arthritis. Autologous bone marrow stem cell injections are less effective for those over 50. The Ministry of Health and Welfare has approved “autologous bone marrow stem cell injection” as a new medical technology. The correct name is “intra-articular bone marrow aspirate concentrate injection for knee osteoarthritis.” This treatment involves extracting bone marrow from the patient’s pelvis, centrifuging it, extracting and concentrating the stem cells, and then injecting them back into the knee to reduce inflammation and improve joint function. Compared to existing hyaluronic acid injections, it has been reported to provide similar pain relief and improved joint function. The Ministry’s designation as a new medical technology signifies a certain degree of recognition of its safety and efficacy. However, the medical evidence is still insufficient to clearly demonstrate its effectiveness, and more research is needed. The Ministry of Health and Welfare has indicated that autologous bone marrow stem cell injection is indicated for intermediate-stage knee arthritis.Medically, these conditions are categorized as follows: △ A joint space is clearly narrowed compared to normal on an X-ray or falls within the osteoarthritis grade (KL Grade 2-3); △ More than 50% cartilage damage is confirmed via magnetic resonance imaging (MRI) or arthroscopy; or △ Grade 3 or 4 according to the International Cartilage Regeneration Society (ICRS) grading system. Director Kim stated, “Even if these criteria are met, autologous bone marrow concentrates in patients over 50 years of age are not a fundamental solution because their cellular potency is significantly reduced.” “Even in cases of severe bowlegs, injected stem cells are quickly damaged, making satisfactory results unlikely.” Director Kim continued, “According to the Ministry of Health and Welfare’s New Medical Technology Evaluation Report, the efficacy of autologous bone marrow stem cell injections is not limited to the concentrate extracted from bone marrow, but rather to the use of a specific system.” “Since the safety and efficacy of bone marrow aspirate concentrate separated and concentrated using a system called Smart M-Cell have been recognized, it is necessary to verify whether the procedure was performed using that system.” Carefully review whether actual cost insurance coverage is applicable. The term “autologous bone marrow stem cell injection” often leads to the misconception that extracting and injecting one’s own stem cells can generate new cartilage and treat arthritis. Bone marrow extracted from the pelvis contains only about 7% of stem cells, and even when concentrated, there is insufficient evidence to support cartilage formation. Recently, some hospitals have been emphasizing the cartilage regeneration effects of stem cells, sparking controversy. The Ministry of Health and Welfare removed the phrase “concentrated bone marrow stem cells” from new medical technology approval documents and revised the term to “concentrated bone marrow aspirate.” Furthermore, failing to accurately assess one’s joint condition and whether or not to receive autologous bone marrow stem cell injections can lead to disappointment.According to the Financial Supervisory Service, a patient requiring artificial joint replacement surgery received injections out of fear of the surgery and filed an actual cost insurance claim. However, an X-ray revealed that the patient had Grade KL 4, a terminal form of knee arthritis, and the claim was denied.There have been cases where patients receiving autologous bone marrow stem cell injections into their shoulders were denied insurance coverage because the new medical technology was deemed to be limited to “knee treatment.” The Financial Supervisory Service recommends that hospitals verify eligibility for actual cost insurance before treatment, including by issuing documentation. Director Kim advised, “Autologous bone marrow stem cell injections require an accurate diagnosis through imaging tests such as MRI or weight-bearing X-rays before undergoing the procedure.” Choose an exercise method that fits your physical condition. Aging is the primary cause of knee joint damage. Lack of lower body muscle strength combined with obesity in the upper body or prolonged habits like cross-legged posture can strain the knee joint and worsen symptoms. Therefore, efforts to reduce joint strain and strengthen the muscles around the joints are crucial. Dr. Kim stated, “While walking is often cited as an easy exercise for middle-aged and older adults to incorporate into their daily lives, walking may be limited in its effectiveness in strengthening the muscles around the joints.” He emphasized, “A balanced diet, including aerobic exercise, strength training, balance training, intrinsic movement, sensory recovery exercises, and stretching, is essential for joint health and pain prevention.” He added, “Consult with a fitness professional to determine the right exercise program for you. If knee pain persists and muscle strength is weakened, a combination of five or six moderate-intensity to low-intensity exercises is recommended.” For example, to avoid straining your knee joints, you should walk 8,000 steps, then do 100 squats, climb 20 flights of stairs, and ride an exercise bike for 20 minutes, with ample rest breaks in between. The most important thing is to consistently practice these exercises every day. Lee Jin-han, Medical Reporter and Doctor, likeday@donga.com Source: Donga Ilbo https://www.donga.com/news/Health/article/all/20240723/126061373/2