Biologic Treatments

What are stem cells?

Stem cells naturally occur in the human body and possess the unusual ability to transform into any of a number of more specialized cells. There are two distinct properties that a cell must exhibit to be classified as a stem cell: self-renewal and potency. A cell’s ability to of remain undifferentiated after undergoing cellular division and cellular growth is known as self-renewal. Potency describes the cell’s ability to develop into more specialized cell. The study of these cellular properties has been seminal in advancing regenerative medicine techniques and methodologies, Dr. Riley J. Williams, orthopedic bone and joint preservation doctor, treats patients in Manhattan, New York City, and the surrounding New York boroughs, who are experiencing a bone or joint condition that can be treated with stem cell therapy.

Where are stem cells found?

In adults, stem cells can be found in adipose tissue, marrow blood, and peripheral blood.

What is stromal vascular fraction?

Stromal vascular fraction (SVF) is derived from adipose (fatty) tissue, contains a form of stem cell and is used for regenerative therapy. This material is found in lipoaspirate, a liquid by-product of liposuction, and contains a substantial number of adipose-derived stem cells. The stromal fraction of adipose tissue is the non-fatty component of what we know as human fat. Similar to stem cells harvested from bone marrow, adipose-derived stem cells are capable of multilineage differentiation. There are multiple cell types within the stromal vascular fraction including mesenchymal stem cells, B-cells, T-cells, lymphatic cells, and pericytes. Some orthopedic conditions can utilize these stem cells as an alternative form of regenerative therapy, including but not limited to:

  • Arthritic conditions
  • Ligament, tendon, and soft tissue injuries
  • Cartilage injuries
  • Meniscal tears
  • Joint inflammation
  • Muscle tears (strains)

How are adipose based stem cells harvested

The procedure to harvest these stem cells take approximately 20-30 minutes. A twilight anesthetic is administered to the patient prior to the procedure. Dr. Williams uses a needle to removed fat from the belly and flank area of the patient.  Once the desired amount of whole fat has been removed, the stromal vascular fraction is separated from the lipoaspirate in a closed sterile system. The harvested adipose tissue undergoes multiple filtration protocols until the vascular fraction is isolated. The sterile, filtered stromal fraction is then injected into the injured area.

What are pericyte cells?

Pericyte cells can be found embedded in the membrane that surrounds capillaries and venules. The location of these cells allows them to play a significant role in the repair process by communicating with endothelial cells through paracrine signaling or direct contact. This cellular communication is the driving force behind vascular repair, the inflammatory response, constructing new blood vessels (angiogenesis), and the removal of toxins from the tissues.

These cells have long been known to play a significant role in the endothelial tissue repair process, but recent studies have shown pericyte cells to possess mesenchymal repair properties as well. Researchers have harnessed the potency and self-renewal characteristics of pericytes and developed a new method for stem cell therapy. This newer version of regenerative therapy has shown some promise in treating the following orthopedic conditions:

  • Muscle injuries
  • Cartilage injuries
  • Ligament and tendon injuries
  • Fractures

Similar to stromal vascular fraction, pericytes are harvested using lipoaspiration (liposuction). These cells are isolated using a closed filtration process.  The resulting tissue graft is typically injected into the injured area of interest.

For more information on stem cell therapy, stromal vascular fraction, or to discuss your joint preservation treatment options, please contact the office of Riley J. Williams, MD, orthopedic bone and joint preservation doctor at the Hospital for Special Surgery (HSS), serving Manhattan, New York City, and the surrounding New York boroughs.