By Phillip Steele, MD RMSK CAQ Sports Medicine
Performance Injury Care & Sports Medicine
Lubricin is a naturally occurring substance found in our joints as part of the synovial fluid. This viscous substance helps to cushion and lubricate our joints. Lubricin appears to be crucial in allowing the articular surfaces of the joint to glide over one and another with minimal friction. Think of it as the body’s Teflon coating allowing smooth gliding. Joint Lubricin declines with aging, increasing our risk of injury with activity and exercise. With the decline of Lubricin the joint can become painful and stiff as it begins the process of osteoarthritis and motion loss.
When a patient reaches this stage, Performance Injury Care & Sports Medicine (PICSM) tries to use the tools that are available to us with Regenerative Medicine to help decrease your pain. A healthy joint produces more Lubricin. By using regenerative medicine we help restore Lubricin production–not only to help decrease the painful symptoms of osteoarthritis but also to help control the progression of the disease. Ultimately, this is what we try to accomplish with regenerative procedures. By using a stem cell procedure that promotes a healthy joint, we help restore normal cytokine health (growth factors), Lubricin production and A2M (see March 15th, 20017 blog) helping to create a regenerative environment.
What does research say about Lubricin? In studies with mice, where an arthritic condition was created by transecting the ACL, two treatment groups were created. One group received Hyaluronic Acid (HA) and the other group was treated with growth factors and Lubricin. The conclusion was as follows: supplemental intra-articular Lubricin reduced cartilage damage in the ACL transected rat knee 6 weeks after injury, while treatment with Hyaluronic acid did not. It was found that when rats were treated with growth factors which reduce inflammation and increase Lubricin formation, the damage was much lower to the joint in the long run.
When most physicians and patients are thinking about joint lubrication they typically think of Hyaluronic Acid (visco-supplement). These two compounds are not the same. Hyaluronic Acid is typically given as a shot to people who have osteoarthritis. It is approved by most insurance companies. It works fairly well in improving symptoms on a temporary basis. However, stem cell therapy is superior by improving growth factor concentrations and Lubricin production. Lubricin seems to also help anchor HA into the articular surface of the cartilage making visco-supplement therapy even better. This combination therapy helps by improving joint function and has been shown in numerous studies that if given 6 weeks after a stem cell procedure, the addition of a visco-supplement helps further the effects of stem cell regeneration. The addition of stem cells, cytokines and increased Lubricin production all combine to help with cartilage restoration. Many studies have shown the additive effect of stem cells plus platelet rich plasma (PRP), visco-supplement (HA), alpha 2 macro globulin (A2M) or platelet lysate 6 weeks post stem cell procedure are helping us to understand the benefit of Lubricin production
Here at PICSM, we are proud to be the leaders of regenerative medicine in Montana. We understand the science of regenerative medicine and use the highest quality high resolution ultrasound diagnostic equipment for identification and treatment of musculoskeletal injuries.