How Things Work: Shopping for bones a future possibility?
If medical technology continues to progress at a rapid rate, there exists the possibility that we will be able to “order” what bones we want and receive stem cell implants that can actually grow into our bones. According to Carnegie Mellon Emergency Medical Services, one of the most common injuries on our campus is hurting an ankle. So what happens when the injury to one’s ankle or foot is so bad that it needs surgery, particularly a bone graft?
Bone grafts are surgical procedures in which a missing bone is replaced with other bone material. Typically, the bone is taken from another part of the patient’s body, often the hip. Bone grafts are successful because bone, unlike most tissue, has the ability to regenerate completely, so as native bone grows, the new cells will almost completely replace the graft cells. The advantage to grafting bone from the patient, rather than a donor, is that the risk of rejection is low, although blood loss or infections may occur.
However, one issue with bone grafts is that some people who have had the procedure tend to suffer from pain up to five years later. Bone grafts are seen every day in the shape of dental implants. According to eMedicine.com, more than 500,000 U.S. and 2.2 million worldwide bone graft procedures are performed each year. Now surgeons are using methods that include using replacements for bone that can be taken right “off the shelf.” In a press release on March 11, Glenn Weinraub, president of the American College of Foot and Ankle Surgeons (ACFAS), said, “Harvesting a patient’s own bone has always been considered the gold standard, but nowadays I think the concept should be thought of as the historical standard.
The quality of the material that is available in a prepackaged format has been shown to be just as effective for bone healing and may yield fewer complications for the patient.”
The material mentioned in a “prepackaged format” is stem cells. Stem cells are special cells found in multicellular organisms that have the potential to morph into any type of cell. These stem cells can be cultured and then injected into a human at a particular location for the cells to grow a specific type of tissue. Advances in science have led to the ability for surgeons to use stem cells to assist the body in mending bone. When placed in the location of a missing bone, the stem cells proliferate and “become” the bone cells, effectively replacing the bone.
But do the stem cells have to come from the patient themselves, or can they be donated? Like bone graft material, stem cells can come from the patients or from a lab that harvests and makes billions of copies from the bone cells of donors. Unlike with bone grafts, the fear of rejection of the stem cells by the body is low.
But having lab-harvested stem cells is akin to having a packaged super-cell thatcan change into any type of cell when placed in the body, therefore giving the added advantage that the step of acquiring the material from the patient can be skipped entirely. Weinraub commented, “We are putting the cells right there on the defect, and because they are in a bone environment, these cells may direct and partake in the process of bone formation.”
So the next time you need ankle surgery, you might find yourself in a situation where surgeons are opening a box of stem cells and placing them in your foot. Now, the question is, how long before stem cells find themselves on the shelves of your favorite convenience store?