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Stem cells for knee problems: WSJ doesn’t explore costs, harms, alternatives

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3 Star

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Stem Cells for Knee Problems? U.S. Doctors Investigate

Our Review Summary

The focus of this story seems to be this question: Where do we stand with regard to stem cells helping with wear-and-tear arthritis (osteoarthritis) of the knees?

The story does well in giving some background regarding stem cells, and how this is apparently a growing trend. The story would have been strengthened considerably by including the potential harms of treatments, the costs of stem cells vs. conventional therapy and discussing the alternatives more thoroughly.

 

Why This Matters

Osteoarthritis of the knee (like lower back pain) is one of the most common, but difficult-to-treat orthopedic ailments in the Western world. Given that we’re living longer, and experiencing historically high levels of obesity, this problem is expected to become even more common. With this will come a growing demand for non-surgical interventions (although injecting stem cells into the knee joint is still invasive).

Health claims about stem cells have exploded and include advertised benefits for everything from Alzheimer’s disease and multiple sclerosis to erectile dysfunction and blindness. This means journalists have a big opportunity to educate the public regarding what we do know — and what we don’t know — about this emerging technology. Also, it’s important to note that academic medical centers also have been making misleading claims about stem cells–it’s not just private clinics.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

While the story mentions that stem cell treatments are often not covered by insurance, they should have said how much these treatments typically cost.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The story features studies in progress, and gives brief mention to a handful of other published studies. But no results are quantified, and the implication is that that’s because past research isn’t worth discussing.

But if there is a “lack of research” showing that stem cell injections are effective, why allow sources to claim that “It’s helped us extend some players’ careers” and “There’s definitely a group of people that it helps”? Those claims, if they are repeated at all, should be immediately followed by cautions about the lack of evidence supporting them.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

This story does not clearly state the harms involved with either conventional therapy for osteoarthritis nor the injection of stem cells into the knee joint.

Does the story seem to grasp the quality of the evidence?

Satisfactory

This story is clear in stating that the evidence for effectively treating osteoarthritis of the knee with stem cells is currently lacking, and that more research is needed. One detail that might have been useful to add is that the current study underway doesn’t have anyone assigned to receive a “sham” procedure (in this case, likely an injection of saline), which is considered the gold standard way to test for the effectiveness of injection treatments. Also, the evidence is still unclear if either of the surgeries mentioned (arthroscopy and microfracture) are effective in and of themselves. So we’re essentially adding an unproven injection treatment on top of surgical treatments that are also unproven.

Does the story commit disease-mongering?

Satisfactory

There is no disease mongering in this story.

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

Four different physicians are quoted in the story. However, according to Dollars for Docs, three of these physicians have recent financial ties to companies actively involved in stem cell product development. This was not disclosed.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

Non-surgical and drug alternatives for treating pain from osteoarthritis of the knee were not discussed. Also, the story starts out by saying “Knee osteoarthritis, or arthritis of the knees, is a difficult-to-treat and painful condition affecting millions of people.” Many patients have mild symptoms that are well controlled with medicine, exercise, physical therapy and other simpler and less expensive treatments than discussed here. The article should have mentioned these and said that the treatments discussed are considered for those not responding to these other, first-line therapies.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The story implied that there are plenty of places to get these procedures, but lack of evidence and insurance coverage, as well as concerns by the FDA, are standing in the way of availability.

Does the story establish the true novelty of the approach?

Satisfactory

The story makes it clear this is an emerging technology that is currently being tested to see how it compares with existing approaches.

Does the story appear to rely solely or largely on a news release?

Satisfactory

This story does not appear to rely upon a news release.

Total Score: 5 of 10 Satisfactory

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