Stem Cell Therapy Applied to Iraq War Injuries

AirForceTimes.com, March 10, 2008

At the annual meeting of orthopedic surgeons held in San Francisco during the week of March 3rd, doctors examined the possibility of growing new bone and possibly entire limbs from stem cells.

Currently more than 31,000 U.S. military men and women have been wounded in Iraq, 60 to 70% of whom have sustained musculoskeletal injuries. Traditionally, for blast injuries that destroy bone, military surgeons have usually applied nonorganic materials such as metal to rebuild the bone. Now, however, stem cell therapy offers a new and more effective treatment.

Such stem cell therapy would consist of the administration of stem cells either from external (allogeneic) sources, or fom naturally endogenous (autologous) stem cell sources which have been mobilized to harness the body's innate abilities for regeneration. Dr. John Huard, Director of the Growth and Development Laboratory at the Children's Hospital of Pittsburgh, cites animal studies in which scientists were able to regenerate bone that was identical in every way to the lost bone that it had replaced. Dr. Scott Boden of the Emory Spine Center in Atlanta, Georgia, has been studying the possibility of growing new spinal bone and tissue in humans. Stem cells are known to naturally target those regions of the body that are in need of repair, and Dr. Boden and his colleagues have developed further ways to mobilize and control the action of stem cells within the body by attracting the stem cells with specific protein signals to specific areas that are in need of regeneration.

Dr. Scott Rodeo, co-chief of sports medicine and shoulder service at the Hospital for Special Surgery in New York, and the team physician to the Super Bowl winning team, the New York Giants, sees stem cell therapy as a preferable alternative to current surgical techniques. A major clinical problem for orthopedic surgeons is the high failure rate of "tendon-to-bone" healing in many surgical procedures, which is especially problematic in torn rotator cuffs, the surgery for which often leaves the patients in constant pain and even weaker than they were before the surgery. Infection is also a common problem associated with surgery, especially on the battlefield but also among the civilian population. In 2005 alone, approximately 18,650 people in the U.S. died of staph infections that were acquired while in a hospital. Such infections can be life-threatening because they are often highly resistant to antibiotics. According to Dr. Richard Evans, Chief of Reconstructive Surgery at the University of Arkansas, "It's an ongoing problem that's actually getting worse. We have new organisms that are smarter than we are." By replacing surgery altogether with stem cell therapy, doctors would be able to eliminate such risks as infections that are secondary to surgical procedures, and other related iatrogenic illnesses.

Navy Captain Dana Covey, chairman of orthopedic surgery at the Naval Medical Center in San Diego, has been deployed to Iraq twice. He and many other doctors agree that the injuries which are occurring in Iraq present a major opportunity for medical science. According to Army Major Eric Bluman, Chief of Foot and Ankle Service at the Madigan Army Medical Center at Ft. Lewis, Washington, "There's a huge wealth of knowledge. Normally we see blunt trauma from car accidents or bike accidents. Iraq was almost like a second fellowship for me."

Some species, such as the salamander, are well known for their ability to regenerate entire limbs from their own, naturally occurring, endogenous stem cells. Even in many mammals, the natural, spontaneous regeneration of some tissue, on a smaller scale, is known to occur. Although further development of this science is needed before it becomes a routine therapy for humans, the regenerative power of stem cells nevertheless remains an area of intense focus and study by numerous researchers around the world.