What Is The Follow
Your knee may feel tender for a few days after the procedure. For the first 48 hours after the injection, avoid excessive weight bearing on the leg, such as standing for long periods, jogging or heavy lifting. This is to reduce the risk of post-treatment flair.
Depending on your condition we may also suggest driving restrictions. Ice can be used to soothe your joints during the recovery process.
We Estimate That 1 In 10 Patients Who We See In Our Clinic Have Already Received Some Type Of Stem Cell Therapy In Another Office They Are In Our Clinic Because The Treatment They Have Received Has Failed To Meet The Patients Expectations Simply One Injection Stem Cell Treatments Are Not Sustainable Pain Relief
People with knee osteoarthritis pain, probably like yourself, go to the orthopedist and hear over and over about their eventual need for a knee replacement. You may have been given a much more critical, we should schedule this knee replacement now, recommendation because it took you a long time to walk from the reception area to the examination room, and all along the way you may have been reaching and lunging for chairs, walls, and counters to use as support and your doctor saw you do it.
You would like to avoid the knee replacement for various reasons, all equally important to you. In your research, you have come upon stem cell therapy. You read through some websites that suggest this simple, possibly one-time injection, will make all your pain go away. This is unrealistic thinking as this is almost never the case. The reason it is almost never the case is that stem cell therapy, even when most effective, requires a comprehensive approach to treatment that includes multiple treatments or the use of Prolotherapy injections into the knees supportive ligaments.
- Please see this article: Why stem cell therapy did not work for your knee pain. Here we discuss that:
- Degenerative knee disease does not happen overnight.
- Healing degenerative knee disease with stem cell therapy cannot be expected to repair decades of wear and tear as a one-time injection treatment.
Bone Marrow Aspirate Concentrate Or Bone Marrow Concentrate Type Stem Cell Therapy
Using stem cells taken from a patients bone marrow is becoming a therapy of interest due to the potential of these mesenchymal stem cells to differentiate into other types of cells such as bone and cartilage. This is not a new revolutionary treatment, this treatment has been studied and applied for many years. It is a difficult treatment for some doctors to give. You do need experience in all aspects of the treatment to give the patient the best chance at achieving their healing goals.
Bone Marrow is the liquid spongy-type tissue found in the hallow of bones. It is primarily a fatty tissue that houses stem cells that are responsible for the formation of other cells. These mesenchymal stem cells , also called marrow stromal cells, can differentiate into a variety of cell types including osteoblasts , chondrocytes , myocytes , adipocytes , fibroblasts and others when reintroduced into the body by injection. Bone marrow also contains hematopoietic stem cells that give rise to the white and red blood cells and platelets.
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A Scripps Knee Pain Specialist Explains Your Options
Does your knee hurt when you run, climb stairs, walk or even just stand up? Youre not alone. About one in four Americans lives with chronic knee pain that interferes with their ability to move comfortably and limits their quality of life. Knee pain is common, but a variety of treatments can help relieve it.
In this video, San Diego Health host Susan Taylor talks with Jeffrey Wilde, MD, an orthopedic surgeon at Scripps Clinic Torrey Pines and Scripps Clinic Mission Valley, who specializes in treating knee pain. They discuss why knee pain happens and how to treat it.
What causes knee pain?
Knee pain is often due to injury, such as falls, accidents or sports injuries. Overusing the knee joint also can lead to knee pain, especially if you dont allow yourself proper rest between activities.
One of the most common causes of knee pain is osteoarthritis, a progressive form of arthritis that causes the cartilage that cushions the ends of the bones in the knee joint to wear away over time. Early-stage osteoarthritis may simply irritate the knee, but as the disease advances, the damage to the cartilage becomes increasingly more severe as does the pain.
Any number of things can cause knee pain and often a simple X-ray and examination can help sort out whats going on, says Dr. Wilde. Once we know why youre having pain, whether it is an injury or arthritis or something else, we can create a plan to treat it.
Non-surgical treatments for knee pain
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Other Injections: Hyaluronic Acid Botox And More
Some people have used other types of injections for OA of the knee.
However, experts from the American College of Rheumatology and the Arthritis Foundation dont currently recommend using these, as theres not enough evidence that they work.
Examples of other types of injections include:
- hyaluronic acid injections, also known as viscosupplementation
You may not know exactly what type of injection youre receiving or what the effect might be.
Always discuss the pros and cons of any treatment with your doctor before starting, so that you can make an informed decision.
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Amniotic And Umbilical Cord Tissue Injections
- Overview: Amniotic membrane and umbilical cord tissues are often mislabeled as stem cell therapies, however these tissues do not contain viable mesenchymal stem cells processing for sale to doctors offices. Although they contain growth factors, these levels are often lower than those of PRP.
- What the studies say: There isnt much research at this point showing that these treatments help knee arthritis.
- Side effects: The cells used in these treatments are not matched 12 to the patient. Hence, they put patients at risk of Graft vs. Host disease . Early symptoms include skin rash and mouth sores.
- Typically covered by insurance: no
- Out-of-pocket cost per injection: It varies by location and provider and can range from $1,500 to $2,500.
Will It Fix Everything
Unfortunately, no. Hyaluronic acid injections wont cure all painful knee conditions. However, the injections can be extremely effective for osteoarthritis. Hyaluronic acid injections replenish the lining of your knees, which can provide pain relief for up to six months.
However, the treatment isnt as effective with other painful knee conditions, like ligament tears, tendinitis, or sprains. Hyaluronic acid injections restore the lining of your joints they dont repair your tissue.
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What To Expect After The Treatment
Depending on the quality and quantity of the gel used, you might get instant relief from knee pain. It also depends on the number of shots you receive as prescribed by the healthcare experts. Injecting gel into the knee joint may result in minor bleeding and infection, however, all patients do not experience the same effects.
Patients are usually able to get back to regular activity within 24 hours of taking the injection and can start enjoying relief from chronic knee pain. If you have any questions about the treatment, call your doctors office and ask about the side effects and possible complications.
At Oak Brook Medical Group, we are committed to providing you with the best services to reduce the pain and improve the knee joints mobility. Contact us today and book an appointment to determine if you should get gel injection treatment for knee pain.
Prolotherapy For Knee Osteoarthritis
In this video, Danielle R. Steilen-Matias, MMS, PA-C, of Caring Medical demonstrates how we treat a patient with a primary complaint of knee osteoarthritis.
- The person in this video is being treated for knee osteoarthritis as the primary complaint. The treatment takes a few minutes. The person in this video is not sedated and tolerates the treatment very well. For some patients, we do provide IV or oral medications to lessen treatment anxiety and pain.
- The first injection is given into the knee joint. The Prolotherapy solution is given here to stimulate repair of the knee cartilage, meniscal tissue, and the ACL as well.
- The injections continue over the medial joint line making sure that all the tendons and ligaments such as the medial collateral ligament are treated.
- This patient reported the greatest amount of pain along the medial joint line. This is why a greater concentration of injections is given here.
- The injections continue on the lateral side of the knee, treating the lateral joint line and all the tendon and ligament attachments there such as the LCL or lateral collateral ligament.
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Medicare Approved New Technology For Knee Arthritis Treatment
Most seniors worked hard for most of their lives and paid their dues. Many even fought for their country. Now that they have reached retirement, it is time to focus on getting a little back and doing all the things they deserve in return for their service.
For many, the enjoyment of their golden years has been complicated by one big unanticipated problem: the debilitating pain of knee arthritis.
Luckily for seniors in Daytona Beach, Ethos Health Group can provide a solution. Thanks to advances in medical technology and treatments, seniors are now reducing pain, returning to the activities they love and getting to live the real retirement dream.
For many, knee arthritis pain has already become a thing of the past!
One such medical advancement for chronic knee pain is called viscosupplementation. This exciting new option has already helped thousands in Daytona Beach for three very important reasons:
Reason #1: It works
Viscosupplementation is an advanced medical treatment where a highly skilled doctor puts a special FDA-approved lubricating medicine directly into the knee joint. This is not an over the counter vitamin or supplement but an advanced medical procedure. The lubricating and cushioning substances are naturally occurring in the body but have been cleared by the FDA as an injectable to help patients get the best joint treatment possible.
Reason #2: Pinpoint accuracy of the injections
Types Of Gel Injections
Viscosupplementation, commonly referred to as gel injection, is an injection into the knee joint with a gel-like substance called hyaluronate, or hyaluronic acid. Hyaluronic acid is one of the naturally occurring lubricants in a healthy knee. According to the Cleveland Clinic, pharmaceutical companies in the United States have developed three main hyaluronic acid-based gels, known by the brand names Hyalgan, Synvisc and Supartz. Some of the injection gels are made from biological sources, while others are created synthetically. The technique of viscosupplementation was approved in 1997 by the U.S. Food and Drug Administration for use in the knee, according to the American Academy of Orthopaedic Surgeons.
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Are Hyaluronic Injections Low
A research letter in the Journal of the American Medical Association Internal Medicine, with the title: Are Hyaluronic injections low-value health care? Using Medicare Data to Understand Low-Value Health Care: The Case of Intra-articular Hyaluronic Acid Injections, backed that up withbased on high-quality evidence that hyaluronic acid injections were not associated with clinically meaningful improvement in symptoms compared with placebo injections.
This statement paper is from 2014, lets see if we can advance the research forward towards 2021.
The first stop is February 2016 and the journal Clinical Orthopaedics and Related Research. It is an editorial from Seth S. Leopold, MD. Here are the quoted learning points:
Why Dont Some Medical Groups Recommend Hyaluronic Acid Shots
Even though some patients have gotten relief from these shots, some professional organizations, such as the American Academy of Orthopaedic Surgeons, dont recommend them due to the lack of robust scientific evidence of their effectiveness. Some studies have found these injections are not more effective than placebo injections, Dr. Miller says. However patients get a lot of relief from placebo effects of any injection, so this makes it difficult to show the independent effect of the hyaluronan. In addition, given the expense of hyaluronan injections, he says, many insurance companies are reluctant to pay for something only a little better than placebo. I pay for them from Canada because my insurance wont cover, Quina told us on FB.
If youre interested in hyaluronic acid injections for your OA, talk to your doctor and check with your insurance company to see if they may be an option for you.
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What Are The Potential Risks For A Viscosupplementation Procedure
The most common side effect includes pain at the injection site, swelling, heat, redness, bruising. This can be treated with ice. Inflammation may occur after gel injection, though the symptoms are typically mild and temporary. For this reason, restricted activity is recommended for 48 hours after the treatment.
The most severe risks are infection and bleeding. The treatment is contraindicated in patients with hypersensitivity to sodium hyaluronate preparations and patients with known infections or skin diseases in and around the injection site.
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Five Year Follow Up On Adipose
In May 2022, doctors in south Korea writing in the journal Stem Cells Translational Medicine wrote: Although successful short-term results of the intra-articular injection of mesenchymal stem cells for the conservative treatment of knee osteoarthritis have been reported, the mid-term results of the injection of adipose-derived MSCs remains unknown. To add to the research on mid-term results, or in this case five year out study, the researchers assessed eleven patients with knee osteoarthritis who received a single intra-articular injection of autologous high-dose adipose-derived mesenchymal stem cells. The reserarchers found: A single intra-articular injection of autologous, high-dose ADMSCs provided safe and clinical improvement without radiologic aggravation for five years. Furthermore, structural changes in the osteoarthritic knee showed significant improvement up to three years, suggesting a possible option for disease-modifying outpatient treatment for patients with knee osteoarthritis.
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Caring Medical Research Case Studies
Our research team has published research on patient outcomes and case studies using bone marrow aspirate. Here is a sample of those outcomes. Again, we must remind you that this treatment does not work for everyone. Unfortunately, if you are reading this article you are probably very attuned to medical treatments that do not work.
In the medical journal Clinical Medicine Insights Arthritis and Musculoskeletal Disorders, our Caring Medical research team published our findings on seven patients. The patients who were treated for knee pain are featured below:
Patient case Knee pain: A 69-year-old man
A 69-year-old male came into our office with pain in both knees, with his right knee significantly more painful. Pain resulted in frequent sleep interruption and limitation of exercise.
The patient had received Prolotherapy at another office in the previous two years but felt that the treatment has reached its maximum ability to heal.
The patient was diagnosed with osteoarthritis and received five bone marrow/dextrose treatments in each knee at two-month intervals.
- Two months after the final treatment, the patient reported that he was completely free of pain or stiffness in both knees, had regained full range of motion, no longer suffered sleep interruption, and was no longer limited in exercise or daily life activities.
Patient case Knee pain A 56-year-old woman
The patient received bone marrow/dextrose treatments for six visits at 810 week intervals.
Research: Prolotherapy Treatments For Patients With Knee Osteoarthritis Showed Significant Improvement In Scores For Pain Function And Range Of Motion
In February 2020, Lisa May Billesberger, MD a private practice physician in Canada teamed with Duke Anesthesiology, Duke University School of Medicine to offer a current assessment of injectable treatments for knee osteoarthritis. Here are the summary points on Prolotherapy.
- Prolotherapy is a relatively simple and inexpensive treatment with a high safety profile, is something that could easily be performed in the primary care setting, and is thus worth consideration.
- The exact mechanism of Prolotherapy is not well understood, but it is thought to induce a pro-inflammatory response that results in the release of growth factors and cytokines, ultimately resulting in a regenerative process within the affected joint.
- Injection of the hyperosmolar dextrose solution might also hyperpolarize nociceptive pain fibers by forcing open potassium channels, resulting in reduced pain perception.
- In sum, Prolotherapy likely provides at least some benefit, although the quality of available data makes this statement hard to prove and it certainly does not cause harm.
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How Often Do You Need Knee Injections
How often you need a knee injection depends on several factors. Some of them include:
- Medical history
- Stage of your condition
- How long your relief lasts
A corticosteroid injection may provide relief for up to 24 weeks, while a hyaluronic acid injection may last 12 to 24 weeks. Corticosteroid injections can only be administered once every three to four months. Thats because they can break down your cartilage and come with possible side effects including high blood pressure, osteoporosis, and skin atrophy.
In comparison, hyaluronic acid injections may not work for everyone, and how theyre administered varies depending on the manufacturer. To determine the best solution for your osteoarthritis, talk to your doctor about the risks and benefits of each injection.
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What If Knee Injections Dont Work
Knee replacement would be the last step in the treatment process for a patient with knee arthritis. However, this should only come after the patient has tried and failed with injections, bracing, NSAIDs, use of cane/walker, and most importantly a formal physical therapy program to maximize strength, motion, and weight loss, if necessary. When these treatments dont work, or stop working, then the patients options are to live with their current symptoms, or to proceed with knee replacement.
Knee replacement is the only thing that changes what the x-ray looks like and truly gets rid of the arthritis. All of the other treatments control the symptoms. The knee replacement is an open surgery where the ends of the femur and tibia, where the damaged cartilage is, are removed and metal caps are placed on the ends of the bone with a polyethylene spacer in between. This becomes the new knee joint. Patients nowadays typically go home the same day and are walking, with assistance, the day of surgery. Physical therapy ensues and patients typically recover in about 3 months. Knee replacement is a beneficial operation in the right candidate with typically 85-90% excellent outcomes.
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