What is the difference between bone marrow and adipose mesenchymal stem cells versus umbilical cord tissue commonly being used in stem cell therapies?

Bone marrow stem cells are derived from a source of cells that most closely match tissue origin for many orthopedic injuries such as cartilage tears, osteoarthritis, tendon damage and bone deterioration. With Bone marrow many different cells are extracted and isolated that play critical steps in tissue repair. This source of treatment is supported by the most clinical research and is seen as the gold standard for stem cell therapies. However, as a patient gets older it becomes harder to capture the amount of stem cells from bone marrow as it become depleted in the elderly years. Adipose (fat) mesenchymal tissue also originates from a very similar source to orthopedic injuries and is supported by numerous clinical trials and a large amount of anecdotal experience from clinics worldwide. It has been provided in clinic practice for a  number of years and does not have as much robust research supporting it as bone marrow therapies. Yet, the data showing these benefits is accumulating daily in new trials and out-patient treatments. This treatment type can sometimes be preferred over bone marrow in the elderly due to an ability to extract a higher volume of stem cells secondary to the above aforementioned limitations of bone marrow depletion. Umbilical cord blood is the newest tissue product used in tissue engineering for regenerative medicine treatments. As it is supported by the least amount of clinical research, there are some studies showing its benefits for orthopedic uses.  Basic science research has discovered that when fetal cord blood tissue is used at cell count numbers high enough to achieve a therapeutic response, it is longer living and more vibrant in its anti-inflammatory properties. This is important when considering acute injuries that develop into chronic problems. To date, much of the excitement surrounding the use of fetal cord blood mesenchymal tissue is anecdotal from clinical uses with patients throughout the country.