Category: Clinical Sciences/Health Conditions
Diagnosis: Case-1: Mr. A, 48 years, Dhaka came on 2nd February, 2019 with the complaints of pain in the right shoulder during playing Golf for last 3 months. On exam, mild tenderness (gr-II) over supraspinatus (SS) and empty can sign was positive. In US & MRI found that there was linear articular partial thickness tear in SS tendon. Case-2: Mr. B, a 72 years, businessman from Dhaka came on 5 March, 2019 with the complaints of chronic low back pain with the failure of response to repeated physiotherapy and medications for last 3 years. On exam, tenderness (gr-III) over lumber interspinous space (midline), both SLR 900,flexion of umber spine was painful. US of low back shows tear of interspinous ligament (IS lig) at L2-L3 , L4-L5 , L5-S1 level.
Both patients were advised to take Adipose Tissue-Derived Mesenchymal Stem Cells (AT-MSCs) into tear area for one time. With all aseptic precautions, after collection of 100ml lipoaspirate by lipoaspirate harvestor, 10ml AT-MSCs was achieved from each patient. US guided 2 ml AT-MSCs was given in tear of SS (case-1) & each tear of IS lig (case-2). After 2 weeks, they started rehab program and follow-up (FU) every 2 weeks interval for 3 months. After 3 months, FU US & MRI shows that there was filling of gap by fibriller regeneration of SS tendon (case-1) and IS lig (case-2)
Adipose stem cells are the richest source of stem cells in the body. It has the ability to differentiate into chondrocytes, fibroblasts, and other musculoskeletal tissue. The capacity of ASCs to differentiate into muscle was recently demonstrated in vitro and in vivo.
AT-MSCs reduces disability and prevents unnecessary surgery of these hidden pain generators. A large scale research is needed to establish the effectiveness of stem cell induced tendon & ligament regeneration.
mohammad moniruzzaman– Associate Professsor, Dhaka Medical College