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Stem Cells for Pseudogout

Can bone marrow aspirate stem cell injections be used in the treatment of pseudogout?  

To date no known published results of bone marrow aspirate stem cell injections for pseudogout have been published prior to the report presented below by Dr. Silberman.

Pseudogout was first described by Kohn and colleagues in 1962 depicting acute painful attacks of knee inflammation induced by calcium pyrophosphate dihydrate (CPPD) crystals, which clinically resemble gouty arthritis due to monosodium urate (MSU) crystal deposition. Pseudogout and CPPD deposition produces severe knee pain and swelling similar to septic arthritis, rheumatoid arthritis (RA),  or degenerative osteoarthritis (DJD or OA) (McCarthy, 2008).

"Unlike gout, the treatment of CPPD-related arthropathies can be difficult to the the lack of any effective agent to decrease crystal load" (Announ and Guerne, 2008).

"Unlike gout, there are no agents available that have been shown to decrease crystal load in CPPD-related joint disease" (MacMullan and McCarthy, 2012).

Below is a lab report of a knee joint synovial fluid analysis of a 52 year old active man with a severely painful, swollen, knee aspirated by another physician.  Identifying information has been removed.

Normal nucleated cell count is 0 to 200 and in this painful swollen knee the cell count was 12,639 with calcium pyrophosphate dihydrate crystals present in the knee fluid, which should not be present.  The diagnosis
was pseudogout based on no infection in the knee and rest of serum labs normal.

The patient came to Dr. Silberman for care looking for alternatives to cortisone and steroid injections taught to orthopedic surgeons and rheumatologists to be the primary treatment for pseudogout, gout, and inflammatory arthritis.

After discussing prolotherapy, platelet rich plasma therapy (PRP), and bone marrow aspirate stem cell injections, the patient chose stem cell injections for the treatment of his pseudogout and calcium pryophosphate deposition disease (CPPD).

Dr. Silberman's bone marrow aspirate stem cell procedure with Marrow Cellution required just one harvest site injection and aspiration of 10cc of bone marrow aspirate from the athlete's iliac crest. The entire bone marrow aspirate stem cell procedure from aspiration of bone marrow stem cells to injection into the knee took less than 30 minutes.

Six weeks after the bone marrow aspirate stem cell injection for the patient's pseudogout attack, knee fluid was aspirated and sent to the lab with the following report produced with patient identifiers removed:

The knee fluid post bone marrow aspirate stem cell injection now shows "No crystals seen under normal or polarized light".  Further the cell count, although still elevated at 5566, is far below the prior reading of 12,639.

This preliminary study, a case report with successful elimination of calcium crystals from a knee fluid analysis post bone marrow aspirate stem cell injection, points to a need for further research not just with bone marrow aspirate stem cells for pseudogout but with platelet rich plasma (PRP) and prolotherapy as well, as cortisone may be detrimental when repeated for this stubborn problematic condition and for other inflammatory conditions, such as rheumatoid arthritis (RA), lyme arthritis (lyme disease), psoriatic arthritis, and ankylosing arthritis (sacroiliac disease or AS), all of which have been treated by Dr. Silberman with platelet rich plasma (PRP) or bone marrow aspirate stem cell injections with encouraging clinical results.

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