Amniotic Fluid Injections To Treat Painful Knees
Orthopedics This Week reports on the results of an HSS trial published in the Journal of Knee Surgery, which found amniotic suspension allograft injections may be a superior anti-inflammatory treatment for knee osteoarthritis.
The multicenter, three arm, randomized to a control trial compared the ability of ASA to modulate inflammation and swelling as compared to saline and hyaluronic acid injections. Primary endpoints included changes from baseline of patient-reported outcomes -EQ-5D-5L, Knee Osteoarthritis Outcome Score , visual analog scale , Tegner, and Single Assessment Numerical Evaluation . Patients who received ASA demonstrated greater improvements in overall pain , KOOS pain, and KOOS-activities of daily living scores compared to those in the HA group at six months and in both groups at six months.
Read the article at ryortho.com.
Amniotic Stem Cell Injections
Amniotic membrane stem cell injections may be used to reduce inflammation, regenerate joints, aid in the repair of a bone fracture, minimize scars, treat post-operative pain and reduce chronic pain caused by tendinitis and other disorders. An amniotic treatment is performed by injecting the area the disorder. A doctor will use ultrasound or fluoroscopic guidance to accurately place the injections
Amniotic membrane stem cell injections treat the root cause of a disorder and enhance healing. Amniotic injections contain substances that promote healthy tissue regeneration. Patients can experience significant improvement after a single treatment. In comparison, a cortisone injection may lessen pain but does not change the condition of the disorder causing the pain.
Amniotic stem cell injections are used to treat various degenerative conditions of the hip, knee, shoulder, and spine.
Examples of disorders and orthopedic conditions that may benefit from Amniotic Injection therapy include:
- Stimulate Tissue Growth
Potential Risks Of Knee Injections
All knee injections come with potential risks of bleeding, bruising, swelling, and increased pain following the procedure. There is also a risk of developing an infection at the injection site. Always make sure to discuss the risks of knee injections with your healthcare provider before any procedure.
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Who Should Get Hyaluronic Injections
Hyaluronic acid injections are sometimes recommended for patients with diabetes who have knee osteoarthritis because hyaluronic acid injections do not raise blood sugar the way corticosteroids do. There is no evidence, however, that suggests that hyaluronic acid injections provide significant relief for knee pain, and they are not recommended for managing knee osteoarthritis under the American College of Rheumatology and Arthritis Foundation guidelines.
What to expect:
- You may receive between one and five hyaluronic acid injections.
- If you have excess swelling and fluid buildup in your knee joint, your healthcare provider will use a needle to aspirate, or remove, the fluid before injecting the hyaluronic acid.
- You should avoid prolonged standing, walking, jogging, running, or heavy lifting for the first 48 hours after receiving a hyaluronic acid injection.
It may take up to four weeks to notice any significant improvement, and the effects can vary from two to six months. Hyaluronic acid injections may be repeated about once every six months.
Similar to corticosteroids, research examining the efficacy of hyaluronic injections has yielded mixed results, with some studies reporting significant pain relief and others reporting no effects or insignificant effects on pain.
- No major adverse events were associated with these injections
- Itcan cause a temporary increase in inflammation in the joint that was injected and has been linked to post-injection pseudgout flares.
Microct Analysis Of Cartilage
At sacrifice, hind limbs were removed, carefully disarticulated , and fixed with 10% neutral buffered formalin for 48h. Following fixation, limbs were transferred to 70% ethanol and sent to Covance Laboratories Inc. for micro computed tomography analysis of cartilage. Joints were removed from ethanol and stained using 2% phosphotungstic acid to enhance the contrast of the articular cartilage. Due to discontinuation of the previously used contrast that is negatively charged and binds to proteoglycans, we used PTA as the contrast agent, which is also negatively charged, has a low pH, and binds to collagen . As a result of using PTA for our study, lower cartilage attenuation correlates with more collagen degeneration, so an increase in cartilage attenuation shows reduced collagen degeneration and reduced cartilage damage. Specimens were placed individually into separate polypropylene tubes for imaging, and then placed back into 70% ethanol upon completion of scanning.
Scanning was done using a SkyScan 1176 , with reconstruction and analysis using the scanner-specific software. X-ray source was 90kV/25W, and the detector was 4000×2672 pixels. For imaging, the x-ray source was set on 65kV/25W with a resolution of 18m. Region of interests were divided into either lateral or medial compartments for each sample. Parameters measured included cartilage grayscale, cartilage attenuation, cartilage thickness, and cartilage volume.
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Amniotic Fluid Injection Treatments
Foot and ankle injuries are among the most common injuries across the globe and affects all ages. Injuries can be the result of a variety of different factors. It can leave many people with chronic and severe pain, taking a toll on the everyday lives and activities of all those who suffer from an injury. Finding a way to correct problems can be somewhat difficult, but with the right team of specialists behind you, you can achieve total relaxation and comfort. At Vittori Foot & Ankle, we are constantly looking for new and innovative ways to provide our patients with care for ankle and foot injuries.
Amniotic fluid injections are currently on the rise for many people looking for quick relief when it comes to any discomfort involving feet and or ankles. Amniotic fluid injections eliminate the need to use any kind of steroids or surgery to help with the condition. Amniotic fluid injections heal the affected area and help regenerate and heal damaged tissue, unlike surgeries in which injured tissue is completely eliminated to correct a certain problem.
- Foot & Ankle Wound Healing
Cell Therapy And Amniotic Fluid Injections
*Our health care practitioners perform one or more therapies that have not been approved by the United States Food and Drug Administration. You are encouraged to consult with your primary care physician prior to undergoing a cell therapy. It takes many years for such treatments and products to be approved. Those we use are processed in accordance with federal laws, have gone through rigorous testing and all are currently FDA-Registered.
Dr. Patricia Lutfy, MD, DC, Diplomate American Board of Physical Medicine and Rehabilitation offers regenerative medicine and ultrasound-guided treatments for pain and injuries at KOI Wellbeing, La Jolla.
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How Does Amniotic Fluid Help Joints
Amniotic fluid is the substance that surrounds a fetus during pregnancy, and it is dense in key elements that are vital for tissue growth. Hyaluronic acid, growth factors, antibodies and other factors in amniotic fluid can help stimulate healing in tissue when introduced through an injection.
Amniotic fluid is harvested from healthy births , and the substance is concentrated and purified for use in cutting-edge medicine treatments. For joint preservation, amniotic injections are used to stimulate healing in joints damaged from injuries, degenerative disease and other factors. The injections can help reduce inflammation and slow deterioration of the joint. While arthritis does not have a cure at this time, treatments like amniotic fluid injections for joint preservation can help extend the lifespan and health of joints to avoid or delay joint replacement.
Amniotic fluid injections can be performed during an office visit and require little to no downtime after the procedure. Our orthopedic specialists can determine if you are a good candidate for amniotic fluid injections and other joint preservation treatments that we offer. Many of our patients have experienced incredible results using one or more joint preservation treatments, reducing their pain and improving joint function.
Amniotic Fluid To Treat Painful Knees
A new study conducted at New Yorks Hospital for Special Surgery titled, A Randomized Controlled Single-Blind Study Demonstrating Superiority of Amniotic Suspension Allograft Injection Over Hyaluronic Acid and Saline Control for Modification of Knee Osteoarthritis Symptoms published in the Journal of Knee Surgery found clear evidence that amniotic suspension allograft injections may be a superior anti-inflammatory treatment for knee osteoarthritis.
This was a multicenter, three arm, randomized to a control trial where the ability of amniotic suspension allograft to modulate inflammation and swelling was compared with saline and hyaluronic acid injections in patients with knee osteoarthritis.
Two hundred subjects were randomized 1:1:1 to ASA, HA, or saline. Primary endpoints included changes from baseline of patient-reported outcomes -EQ-5D-5L, Knee Osteoarthritis Outcome Score , visual analog scale , Tegner, and Single Assessment Numerical Evaluation . Any patient who reported unacceptable pain at 3 months were considered treatment failures and removed from the study. They included 13.2% in the amniotic suspension allograft group, 68.8% in the HA group and 75% in the saline group.
Andreas Gomoll, M.D., a sports medicine and orthopedic surgeon at the Hospital for Special Surgery summarized the results of the study to OTW.
Schedule your Free joint pain consultation with Lifetime Health and Wellness today. No reason to continue to live with the pain.
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How Do Palingen Amniotic Injections Compare To Products Offered To Treat Similar Conditions
Platelet Rich Plasma is extracted from venous blood via centrifuging. It contains some growth factors, but the number of mesenchymal cells present is limited by the donors age, his or her medical history, and mechanical degradation in the centrifuge. These injections dont come with these limitations. Generally speaking, the younger the tissue being processed, the more MSCs its likely to contain, and of course amniotic tissue is quite young indeed.
Cortisone is used because of its supposed anti-inflammatory properties. But it has not yet been the subject of randomized controlled studies, and it has over 100 potential side effects including muscle and tissue atrophy, heightened glucose levels, and tendon rupture. In an effort to prevent these, doctors put a lifetime limit of 3 cortisone injections n any one anatomic area. In contrast, PalinGen amniotic injections have no side effects, so patients can take them as often as necessary, and theres no maximum dose.
Side Effects And Risks
Stem cell treatment for knees is noninvasive, and studies suggest that side effects are minimal.
After the procedure, some people may experience temporary increased pain and swelling. However, the overwhelming majority of people who get stem cell injections have no adverse side effects.
The procedure uses stem cells that come from your own body. In theory, this dramatically reduces the risk of any serious side effects. However, there are various ways of harvesting and processing the stem cells, which likely affects the various success rates of the published studies.
Before receiving any treatment, its best to:
- learn as much as you can about the procedure and how it works
- ask your doctor for advice
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Our Amniotic Stem Cell Injections Safe
Yes. More than 10,000 injections have been performed without a single reported adverse effect. All amniotic fluid donors go through a rigorous screening process as determined by the FDA and the American Association of tissue banks. There is no chance for rejection.
After the C-section the fluid is immediately frozen to -80 degrees Centigrade. The office receives the amniotic fluid frozen in dry ice by delivery. It is then thawed and prepared for injection.
The Beneficial Properties Of Amniotic Fluid Include:
- Creating an oxygen-rich environment for healing
- Lubricating properties that allow the treated area to move better
- Anti-microbial properties to prevent infection in the human body
- It contains an extracellular matrix . ECM, which is not present in platelet-rich plasma. ECM is especially useful for cell migration and attachment and signals the body’s own local cells to assist in the repair process.
- Over 200 growth factors, collagen, protein, inflammation modulators known as cytokines, nutrients, and hyaluronic acid . These factors create an ideal environment for cellular growth and remodeling.
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How Long Is The Recovery Time
While receiving amniotic fluid injections, there is almost no recovery time. The treatment is quick and targeted directly to the affected area. Depending on the problem that you are having, some time may be recommended to stay off your feet, but in most cases, you can continue with your day as normal.
What Is Amniotic Tissue
Amniotic tissue refers to the innermost layer of the placenta, the amniotic sac that encapsulates an unborn baby and the umbilical cord. The fluid from this tissue is laden with stem cells and hyaluronic acid, which is the same material that lubricates your knees so they move as they should. Plus, because amniotic fluid is regenerative as its largely responsible for the health of a fetus it can be used to treat inflammatory conditions such as osteoarthritis and reduce scarring.
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Top Clinics Test Amniotic Knee Injection For Oa
Eleven top orthopedic clinics, including OrthoIndy, Midwest Orthopaedics at Rush, Brigham and Womens Hospital, Missouri Orthopaedic Institute and The Hospital for Special Surgery, tested the use of amniotic fluid and tissue allograft in suspension for the treatment of osteoarthritis of the knee.
The product, brand named ReNu, is processed by Canton, Massachusetts-based Organogenesis Holdings, Inc.
The results of this company-sponsored study were presented by Jack Farr, M.D., medical director of the Cartilage Research Center of Indiana and an orthopedic surgeon at OrthoIndy at the recently concluded American Academy of Orthopaedic Surgeons 2019 Annual meeting.
The amniotic allograft injection used in the study was comprised of, according to Organogenesis marketing materials, cryopreserved, amniotic suspension allograft, derived from human amnion and amniotic fluid. The human amniotic tissues in ReNu contain cellular components, growth factors, and extracellular matrix, and anti-inflammatory cytokines.
Dr. Farr told OTW, Patients with knee osteoarthritis who received amniotic suspension allograft reported statistically significant improvements in pain and function when compared to those treated with saline or hyaluronic acid at six months after their knee injection.
What Conditions Do Amniotic Injections Help
Essentially, amniotic injections help with wound care, controlling pain, and orthopedic uses like facilitating repair of tendons, fasciae, capsules, and ligaments. They can help chronic tendinopathies, synovial surfaces, tendonitis, and chronic fasciitis.
To break it down still further, amniotic injections can help patients deal with issues like ACL and MCL tears, biceps and triceps tendonitis, tendinosis, epicondylitis, knee scopes, rotator cuff surgery, facet osteoarthritis, foot and ankle arthroplasty, acromioclavicular joint inflammation, ACL revisions, herniated discs, AVN of the hip and other problems with the knees and hips, planar fasciitis, post-operative pain resulting from orthopedic and spinal surgery, and the need for tendon and cartilage repair.
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What Does Amniotic Fluid Injection Cost Is Amniotic Fluid Allograft Covered By Insurance
Until very recently, the answer was no, but Medicare recently announced that it will cover amniotic fluid injections for some conditions.
Additionally, some private medical insurance companies will also cover amniotic fluid injections on a pre-approval basis. Approval depends on the patients condition and whether the injections must be administered using imaging guidance like ultrasound.
Am I A Candidate For Amniotic Stem Cell Therapy
Patients suffering from ligament, joint or tendon pain may be considered candidates. A specialist will be able to determine if amniotic therapy is an acceptable treatment for your condition.
If you have severe degenerative osteoarthritis, an infection or a blood-related medical condition you are most likely not a candidate.
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Injections To Relieve Knee Pain
Knee osteoarthritis is the most common form of osteoarthritis in the United States. It is caused by progressive degeneration of the cartilage in the knee joint, which protects bones in this area from rubbing against each other. While there is no cure for osteoarthritis, also referred to as wear-and-tear arthritis or degenerative joint disease, treatments can help reduce pain and inflammation.
If oral medications do not help with your knee osteoarthritis pain, your healthcare provider may suggest injecting a medication directly into the knee joint. Knee injections used for arthritic pain include corticosteroid , hyaluronic acid , platelet-rich plasma, placental tissue matrix, Botox, and reverse injection .
Amniotic Fluid Injections For Tissue Repair
Stem cells are something that our body naturally uses to repair damaged tissue while playing a significant role in the bodys healing process. Natural stem cells are located within the bone marrow and fat cells. By injecting these stem cells into the area that is affected, they become your new cells and help repair tissue without the use of surgery.
These injections can be used to help arthritis, joints affected by wear and tear, alongside injury to tendons, muscles, and ligaments. Depending on the severity and size of the damage, stem cells can often provide relief very quickly and begin to repair any damaged tissues.
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How Do These Injections Work In Wound Care
In wound care in particular, amniotic injections work well to fight inflammation and promote re-epithelialization, the production and migration of cells to provide temporary protection. Amniotic injections provide a new basement membrane to facilitate the latter process. Additionally, the injections inhibit TGF-beta signaling and thus, in turn, fibrosis.
Do They Carry Other Risks
You may have heard that some patients who received a product called Infuse experienced difficulty with bone growing where it didnt belong. This cant happen with PalinGen amniotic injections because the cells inside them are self-signaling. That means theyll grow bone, but only if and where its needed.
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Benefits Of Amniotic Fluid Joint Injections
Amniotic fluid can be delivered to damaged joints through injection therapy. Since joint cartilage does not heal on its own, amniotic fluid may provide healing factors that can slow cartilage and tissue degeneration, helping to preserve joint function. Some of the benefits of amniotic fluid joint injections include:
- Reduced inflammation
- Improved mobility
- Minimally-invasive and low risk procedure
Amniotic fluid joint preservation treatment can be beneficial for some types of joint damage. Those with osteoarthritis of the knee or cartilage damage from a joint injury may have improved function and reduced pain through injection therapy. In some cases, amniotic fluid injections could delay the need for more invasive procedures to repair or replace damaged joints.
If you suffer from joint pain and dysfunction due to cartilage damage, amniotic fluid injections may be a treatment option. Contact us at DOCS Health to schedule an appointment with one of our orthopedic joint specialists at our clinic in Los Angeles.