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|Stem Cells for Pseudogout
|Can bone marrow aspirate stem cell injections be used in the treatment
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
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
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
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 markedly 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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