I often get asked by patients considering knee replacement surgery if stem cells are any good for knee arthritis. My view is that they are snake oil, quackery and possibly fraud.
Clark Stanley was known in the wild west as the ‘The Rattlesnake King’ travelling the country with an elaborate show including rattlesnakes. He spruiked the benefits of his snake oil as a cure all for many conditions including ‘rheumatism’ an old term for painful joints. He eventually came unstuck when his snake oil was tested by the US government and found to not contain any snake oil. Since then the term ‘snake oil’ has come to mean any false cure.
Quackery is a slightly different term which arises from the old Dutch word ‘kwaksalver’ meaning a hawker of salve. In the Middle Ages the term ‘quack’ meant shouting, as these hawkers sold their salve shouting in a loud voice in the market. These days a quack is someone who promotes unproven or refuted treatments. Quackery is not the same as fraud because it is possible to do this through ignorance. Courts in the US have ruled that to engage in medical fraud the quack must know that they are misrepresenting the facts.
So how does this apply to stem cells?
Stem cell treatment is heavily promoted online, the modern equivalent of shouting in the market place. It involves liposuction to remove abdominal fat cells, laboratory treatment to isolate stem cells, and injection of these to treat knee arthritis and many other conditions. The procedure is unproven and very expensive, costing patients many thousands of dollars.
There are no high quality studies which have shown any benefit from these treatments. The small studies that are available are of poor quality and are often published by the same people that are promoting the benefits of the treatment. In Australia the National Health and Medical Research Council, the peak government medical research body, is so concerned that it has published a document describing the treatment as unproven and outlining the risks including infection, allergic reaction, rejection of the cells, and cancer.
The ABC has been following the issue closely and has produced an excellent documentary raising concerns about the potentially dangerous and unproven treatments being offered. There has been at least one death from fat derived stem cell treatment. In NSW an elderly woman died from bleeding from the liposuction component of the procedure and the NSW Coroner raised concerns about the ‘troubling hallmarks of quack medicine’.
So these stem cells treatments are clearly unproven and potentially dangerous. In my opinion they can be considered snake oil promoted by quacks, but does this constitute fraud? In September this year a Gold Coast stem cell marketer was referred to police for allegedly predatory practices relating to the use of an unproven stem cell treatment. It will be interesting to follow the case. Ultimately whether this is fraud may depend on whether those promoting this treatment genuinely believe it works or are knowingly misrepresenting the evidence to their patients.
Knee arthritis is a painful condition and patients considering surgery are often worried and looking for alternatives. There are excellent proven treatments available and my advice is to seek out a reputable practitioner and discuss the treatment options for your knee, the evidence and the outcomes before making a decision.
More information about treatment options for knee arthritis is available here.