As the basketball frenzy that accompanies March Madness draws to the fever pitch of the Final Four, it brings to mind that basketball is a high contact sport. A quick peek at the NBA injured list reveals a catalog of breaks and tears that affect tendons, ligaments and bones.

The pressure to improve performance and search for quick recoveries has led some celebrity athletes to seek out stem cell treatments overseas and in the U.S. Among NBA players to get stem cell treatments are Jason Kidd, Tracy McGrady, Amar Stoudemire, Allan Houston and Kenyon Martin, according to a Sports Illustrated article.

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Dragoo said in a phone interview that the publicity has actually had a negative impact on the development of clinically proven stem cell therapies for orthopedic medicine and how it is perceived. Because of this market pressure, private clinics have been offering stem cells treatments both here in the USA as well as around the world. Often, these treatments have not been studied and are not regulated in any way. FDA [U.S. Food and Drug Administration] regulations have also severely limited new clinical trials in stem cell therapy in the USA.

The ethical debate of using embryonic stem cells taken from fetuses has been sidestepped to some extent by the viability of adult stem cells for stem cell therapy. Although the FDA permits cells being extracted from individuals and transformed into stem cells, and re-inserted back into the same person, it requires that the conversion involve no more than water, preservatives and storage products. Anything more than that, the FDA policy states, would be classified as a drug therapy and need to go through the proper application protocol.

But a much-awaited decision by the U.S. District Court in Washington, D.C. expected in May that may resolve a four-year-old battle between the FDA and Regenerative Science in Colorado could represent a sea change in how autologous adult stem cell treatments are regulated. The FDA is seeking to prevent the company from providing autologous adult stem cell treatment for musculoskeletal and spinal injuries. If the FDA were to lose, anyone with a medical license could develop autologous stem cells and inject them back into patients, without any regulatory oversight, according to a Cell Press article.

Although stem cells are the focus of numerous clinical trials, they are mainly for cancer and rare diseases, most are being conducted outside the United States. While there have been some developments for sports medicine applications produced by research from academic institutions, there have been no clinical trials for stem cell treatments in sports medicine in the United States because of the FDAs reservations about using adult stem cells. Despite the laxer regulations in Japan, China and Europe, its not in the financial interest of companies there to spend the money to do clinical trials if they dont have to.

Among the most interesting applications for orthopedic medicine are the restoration of articular cartilage and patching defects in joint cartilage, with the hope of resurfacing arthritic joints in the future, Dragoo said. Stanford is preparing to initiate its own clinical trial next year looking at inducible stem cells.

This technique takes adult cells and makes them young again by inserting four genes, which makes the cells immature and allows them to be directed into different types of tissues, Dragoo said.

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Basketball’s influence on stem cell treatments in sports medicine