CubaPLUS Magazine

Regenerative medicine is now a great option for orthopedic conditions because, in addition to improving the quality of life of sufferers, it removes the need to undergo surgery.

In Cuba, this type of treatment was started around 2004 by Dr Porfirio Hernandez Ramirez, a scientist, and it is mainly based on the application of autologous stem cells (the individual's own), a procedure carried out at the Dr Jose Manuel Ballester Santovenia Institute of Hematology and Immunology.

In an interview with CubaPLUS magazine, Dr.Amaury Socarras Arias, a first degree specialist and assistant professor in Orthopedics and Traumatology at the institute, explained at length the details of these procedures, which see positive results in an estimated 85% of the patients treated.

"We apply regenerative medicine treatments in orthopedic conditions, specifically in bone-degenerative diseases, such as joint osteoarthritis. Especially in load-bearing ones, which are the most affected: the hips, knees, and ankles. The shoulder, elbows and wrists, while not load-bearing, have great mobility," he explained.

At present, he explained, we apply three types of procedures to patients, which, while different, have the same purpose: to improve the patient's quality of life.

These therapies, he continued, include that which is applied through the use of peripheral blood mononuclear cells (PBMC); the application of platelet-rich plasma (PRP), after platelet lysate (PL), for the repair of damaged tissue; and the last one is through the application of very small embryonic-like stem cells (VSEL).

In general, all three therapies require rest in one form or another, followed by physical therapy. During this process, the patient is evaluated from time to time and it is estimated that from three months is when improvement is really seen, although there are people who already have some relief after 15 days, he said.

Today, we apply this treatment not only to degenerative bone conditions but also to tendinopathies and tendon ruptures, with very good results, he explained.

We are also performing regenerative therapies for patients with hemophilic arthropathy who may have bleeding in their joints due to coagulation disorders they suffer from, which greatly damages them, he said.

In these cases we apply regenerative treatments with platelet-rich plasma at the joint level, especially in the damaged areas, to regenerate the soft structures and space out the frequency of bleeding, which greatly benefits the patient, he said.

Depending on the diagnosis after an exhaustive physical examination, including imaging studies to allow us to make a good assessment, we present the patient with our treatment plan, in which we take into account the type of injury diagnosed. If he/she agrees, we proceed to apply it, he pointed out.

The specialist considers that the effectiveness of the treatment is related to the patient's degree of affection and age. The time of evolution is very important in the case of tendinopathies and tendon ruptures, and it is of great importance that the patient complies with the care that we suggest for him after the implant is completed, as that very much affects the final result.

This young doctor, specialized in orthopedic surgery, did not really believe in the effectiveness of regenerative therapies at the start because he considered them science fiction. However, when he began to apply them and saw the good results and their effectiveness, it motivated him to study this type of treatment in the search for new procedures.

"It is important to point out that regenerative therapy has a high impact on the quality of life of patients, achieving a decrease in pain, improving functional capacity, vitality, social function and people’s mindsets, reincorporating them into social and working life. It is a therapeutic alternative that increases the medical arsenal when treating osteoarthritis of the knee (OAR)," he concluded.

What patients say

Dominic Soave, Canadian resident in Cuba, considers that the treatment received has been extremely beneficial, because before undergoing the stem cell transplant he had many difficulties and pains in both shoulders that limited his arm movement and, above all, while sleeping and playing tennis, a sport he likes to practice almost daily.

A little more than a month after receiving the therapy, he felt much better, less sore, and says he is "very grateful to the Cuban health system for giving me the opportunity to receive this treatment, which has given me back the possibility of moving my arms almost as before I suffered from the disease in my joints".

Blanca Urquiza Bilches went to the Institute of Hematology for a rupture of the Achilles tendon in more than 50% of her left foot. She received stem cell treatment and by the fourth month after the first implant, she explained, the tendon was completely regenerated.

Oneidis Aguilar Tamayo, after some 8 years with numerous pains and countless treatments for her generalized osteoarthritis, was referred to the Institute of Hematology. Here, after several studies, it was decided to give her VSEL treatment, which gave her back her quality of life, thanks to the dedication of the multidisciplinary team, headed by Dr. Amaury, who attended her. I have no words to express my gratitude. I feel new¨