Extracellular Matrix (ECM) Allograft Injections for Joint Cartilage Regeneration
Extracellular matrix (ECM) allograft injections for joint cartilage regeneration is a type of regenerative therapy used in the regeneration and restoration of damaged joint cartilage. It is a novel, innovative, non-surgical treatment in which extracellular matrix derived from a donor (allogenic) is processed and injected into the treatment area, such as a hip or knee joint, to repair damaged cartilage.
Extracellular matrix allograft is a biologic injectable scaffold obtained from decellularized postpartum placental tissue to help the body’s natural ability to heal after an injury. It is available in solution and particulate forms to allow a variety of surgical and clinical applications. As opposed to steroid injections, extracellular matrix allograft injections aid in the replacement or supplementation of inadequate or damaged joint cartilage. It offers a structural foundation for damaged or weak cartilage tissue. When injected, the cell-friendly ECM allograft scaffold offers a conducive environment for cell attachment - the first stage in natural healing. Your cells migrate and attach to the ECM allograft scaffold. The attached cells then assist with the healing and repair of damaged cartilage tissue. Unlike standard therapies, ECM allograft injections offer a native extracellular matrix for cell attachment.
Indications
Extracellular matrix allograft injection is typically indicated for the treatment of osteoarthritis. Osteoarthritis is a degenerative joint disease that causes breakdown and eventual loss of cartilage in the joint, causing a painful rubbing of bone surfaces with movement. Osteoarthritis most commonly affects the hands, lower back, neck, and weight-bearing joints such as the knees, hips, and feet.
A joint is an articulation (junction) between 2 or more bones in the body. The articular surfaces of the body’s joints are lined by hyaline cartilage, a smooth tissue that serves as a shock absorber and allows easy movement of the bones within the joint. Normal wear and tear or injury can damage and cause defects in the cartilage, resulting in irregular articular surfaces that interfere with movement, causing pain, swelling and disability.
Extracellular matrix allograft injection has remarkable benefits compared to other osteoarthritis treatments such as medications and steroid injections. Other treatments may help relieve symptoms temporarily, whereas ECM allograft injections can help heal, rejuvenate, and repair damaged tissue and cartilage.
Preparation
Preparation for extracellular matrix allograft injections for joint cartilage regeneration may involve the following:
- A review of your medical history and routine diagnostic tests, such as blood work
- Informing your doctor about any medications or supplements you are taking
- Informing your doctor about allergies to any medications, anesthesia, or latex
- Disclosing any recent illnesses or other medical conditions
- Refraining from medications, such as blood thinners or other supplements, if contraindicated for the procedure
- Arranging for someone to drive you home after the procedure
- Signing an informed consent form
Procedure
During the extracellular matrix allograft injection procedure, you will be seated or lying in a comfortable position. The skin over the injection site is sterilized and numbed with a local anesthetic to mitigate any discomfort. The decellularized allograft tissue composed of extracellular matrix is then administered with a small needle to the affected joint cartilage. In some cases, an imaging technique such as fluoroscopy (live X-ray) or ultrasound is used to help guide the needle to the correct site. The extracellular matrix cells will begin to integrate with the surrounding tissue, repairing cartilage by impacting cartilage chondrocytes and their extracellular matrix, to produce new cartilage tissue in the damaged joint to restore or regenerate joint cartilage. A small bandage is applied over the injection site to complete the procedure.
Post-procedure care
After the procedure, you will be taken to the recovery room for observation. The anesthetic used to numb the skin usually wears off in 1 to 2 hours. Mild swelling and pain may occur at the site of the injection. Rest, elevation, and medications are recommended to relieve any pain and swelling. In addition, you may apply cold compresses on the injection site for comfort. Most patients will be able to resume their normal activities with no down time.
Risks and Complications
ECM allograft injection is a well-tolerated procedure with minimal side effects. The most common side effect is temporary pain, swelling, or discomfort at the injection site. Placental tissue obtained for preparation of ECM injection has also been reported to be non-immunogenic, meaning that the injection elicits little to no immune reaction, thereby reducing the risk of rejection.
Summary
Extracellular matrix (ECM) allograft injections for joint cartilage regeneration is a safe and effective non-surgical treatment option. It is obtained from placental tissue that comprises the same key components as connective tissue, including fibers, ground substance, and cells. The placental tissue utilized is from donations made after full-term pregnancy and birth. Administration of ECM injection to the joint area helps to promote healing and cell regeneration in regions where the connective tissue requires support. ECM injection is a non-invasive, simple, in-office procedure. There is no painful recovery, and patients are able to leave the office as they came in.
