Amniotic fluid has recently become available as a regenerative medicine treatment strategy in orthopedics. It is a human liquid tissue derived from the amniotic fluid within the amniotic sac used to protect, lubricate and cushion when applied in the clinical setting. The fluid does not contain a lyophilized or micronized membrane.
Amniotic fluid is appealing because it is an off-the-shelf option for patients who have already failed other multimodality conservative treatments like corticosteroid injections or ‘gel’ injections of hyaluronic acid.
Tissue regeneration is becoming the new standard for tissue healing and repair as the pathogenesis for osteoarthritis becomes better understood, and relevant signaling pathways are deciphered.
Cells are ‘smart’ and are turned on at various stages of their development by molecules attaching to their membrane receptors. These molecules are known as growth factors and cytokines and are the basis for many available regenerative treatment strategies. These molecules can change how the immune system responds in the setting of inflammation, resulting in the clinical relief of symptoms. Growth factor concentrates rich with cytokines that are by nature anti-inflammatory convert a catabolic, inflammatory joint into an anabolic joint, potentially slowing the progression of degenerative joint arthritis.
Amniotic fluid products are highly concentrated growth factors and cytokines that function through cell signaling, leading to cell differentiation, regeneration, repair, and remodeling in vivo. The consensus is that these products work through molecular signaling cascades affected by membrane binding and second messengers.
So what are the downsides?
The treatments are expensive and are not covered by third-party payers yet. Amniotic fluid treatments are new and do not have the track record of other treatments. While these treatments are FDA cleared for off-label use, the procedure is considered experimental.
If you have failed other treatments or are looking for a novel treatment strategy for joint arthritis, amniotic fluid may be a promising treatment option for you to consider. We can tell you more about it if you are interested.