When Prp Doesnt Work It Is Usually Not The Solution Used During Treatment But How The Treatment Itself Is Given
In the Journal of Knee Surgery, doctors at the Division of Sports Medicine, Department of Orthopedics, at Rush University Medical Center in Chicago wrote:
- Traditionally, treatment options have included lifestyle modifications, pain management, and corticosteroid injections, with joint replacement reserved for those who have exhausted nonsurgical measures.
- More recently, hyaluronic acid, micronized dehydrated human amniotic/chorionic membrane tissue, and platelet-rich plasma injections have started to gain traction.
- PRP has been shown to have both anti-inflammatory effects through growth factors and stimulatory effects on mesenchymal stem cells and fibroblasts .
- Multiple studies have indicated that PRP is superior to hyaluronic acid and corticosteroids in terms of improving patient-reported pain and functionality scores.
- Unfortunately, there are many variations in PRP preparation, and lack of standardization is a factor.
Can You Prevent Knee Pain
There can be many reasons for knee pain. Therefore, there are different strategies to prevent the pain depending on the underlying cause. Running on soft surfaces or decreasing the amount of running can help if the pain is due to overuse. Avoiding any direct injuries to the knee including wearing a seatbelt can prevent traumatic injuries. Weight loss can be helpful for many different forms of knee pain.
Mayo Clinic And Yale University Studies On Your Own Bone Marrow Stem Cells
Doctors at the Mayo Clinic and Yale University published their research on the benefits of Bone Marrow Aspirate Concentrate for Knee Osteoarthritis in the American Journal of Sports Medicine. Here is the summary of that research:
- In their single-blind, placebo-controlled trial, 25 patients with bilateral knee osteoarthritis were randomized to receive Bone marrow aspirate concentrate into one knee and saline placebo into the other. Early results show that Bone marrow aspirate concentrate is safe to use and is a reliable and viable cellular product. Study patients experienced a similar significant relief of pain in both bone marrow aspirate concentrate- and saline-treated arthritic knees.
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You Experience Instability/lack Of Support From The Knee
Knee Instability?
See a doctor.
The knees are one of the fulcrums of stability when it comes to your body. If you are having trouble standing or walking on your knee and experience a loss of stability in the joint, it could be bad enough to warrant a visit to the doctor.
Likewise if you feel as if your knee won’t even support you when you put weight on it.
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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If You Have Swelling That Lasts More Than 48 Hours See A Doctor
48 Hours of Knee Swelling?
See a doctor
When you have suffered an acute injury to the knee, the result will be increased, noticeable swelling about the injury itself.
Soft tissue will swell when there is damage, resulting in pain, loss of motion, and severe limitations in mobility.
Note: sometimes swelling can be observed visually. On other occasions, you can’t see it with the naked eye. Pain, stiffness, or clicking as injured tendons snap over one another are all indications that something is wrong.
Who Can Help With My Joint Pain Or Arthritis
Your PCP will guide you in the right direction regarding which specialist you need to see in further treating your health concerns. Many health insurance plans require that a PCP first refer the patient to a consulting specialist before a visit to this specialist is covered by your medical plan.
If you suffer pain and disability due to arthritis, body trauma, injury, or an accident , an orthopedist can help. The staff at Orthopaedic Associates utilizes both cutting-edge therapies and traditional treatments to address a variety of orthopedic conditions.
For more information or to schedule a consultation, call 892-1440 or fill out our easy-to-use online appointment request form. We look forward to hearing from you.
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Brief Anatomy Of The Knee
The knee is a vulnerable joint that bears a great deal of stress from everyday activities, such as lifting and kneeling, and from high-impact activities, such as jogging and aerobics.
The knee is formed by the following parts:
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Tibia. This is the shin bone or larger bone of the lower leg.
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Femur. This is the thighbone or upper leg bone.
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Patella. This is the kneecap.
Each bone end is covered with a layer of cartilage that absorbs shock and protects the knee. Basically, the knee is 2 long leg bones held together by muscles, ligaments, and tendons.
There are 2 groups of muscles involved in the knee, including the quadriceps muscles , which straighten the legs, and the hamstring muscles , which bend the leg at the knee.
Tendons are tough cords of tissue that connect muscles to bones. Ligaments are elastic bands of tissue that connect bone to bone. Some ligaments on the knee provide stability and protection of the joints, while other ligaments limit forward and backward movement of the tibia .
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 all the tendon and ligament attachments there such as the LCL or lateral collateral ligament.
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Caring Medical Research Prolotherapy For Knee Pain
In published research in the Journal of Prolotherapy, Ross Hauser MD investigated the outcomes of patients receiving Prolotherapy treatment for unresolved, difficult to treat knee pain at a charity clinic in Illinois.
- 80 patients, representing a total of 119 knees, were treated quarterly with Prolotherapy.
- The results of this study showed that patients had a statistically significant decline in their level of pain, stiffness, crunching sensation, and improvement in their range of motion with Prolotherapy.
- More than 82% showed improvements in walking ability, medication usage, athletic ability, anxiety, depression, and overall disability with Prolotherapy. Ninety-six percent of patients felt Prolotherapy improved their life overall.
The Different Types Of Knee Tests Your Orthopedist Performs
May 4, 2018
Knee problems can have a major impact on your life. They can limit your mobility and have a negative impact on essential day-to-day activities such as walking, running, kneeling, and standing. Orthopedists have a battery of tests available to them for the diagnosis of knee problems. In general, orthopedists diagnose knee problems by using:
- Physical examination
- Imaging tests, such as X-rays, CAT scan, or MRI
- Arthroscopic Surgery.
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What Can An Orthopedic Surgeon Do For Your Knee
Depending on the severity of the knee injury, an orthopedic doctor will often explore other, non-surgical options for solving your knee pain before suggesting surgery. These options can include knee braces, physical therapy, weight loss recommendations, standard pain medication, and certain exercises to strengthen the knee.
Knee replacement surgery is an option if severe enough damage to the joint occurred. This major surgery, also called Knee Arthroplasty, involves a resurfacing of the affected joint, capping the bones with metal or plastic parts, and similarly replacing the kneecap. This surgery often requires rehabilitation therapy and has a long recovery time, this is not often the first option.
Do I Need To Go To A Rheumatologist Or An Orthopedist
With so much overlap between medical disciplines and specializations, it is often difficult for an individual to discern which type of doctor to see for their problem.
This is especially true for orthopedics and rheumatology, as both of these types of physicians treat joint pain.
Orthopedists are surgeons who address bone and joint diseases and injuries, such as arthritis, osteoarthritis, and body trauma. Rheumatologists are internal medicine physicians who focus on autoimmune conditions and the non-surgical treatment of such diseases, such as arthritis, where medications and/or physical therapy can provide the proper treatment.
It is important to understand the areas these two specialties cover in order to make an informed decision.
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Diagnosing And Treating Knee Pain
Since knee pain can be caused by a number of conditions or injuries, your first step in diagnosing your pain is to be seen by one of our providers. Your initial appointment will usually be with one of our orthopedic surgeons or sports medicine doctors. The doctor will complete a full evaluation of your symptoms and recent activities. X-rays, and MRI or CT scans may be necessary.
Finding the reason for your pain will help determine your treatment, as well as which provider or providers will be part of your treatment team.
The Efficacy Of Intra
An August 2021 paper from Department of Orthopaedic Surgery, Rush University Medical Center published in The American journal of sports medicine compared the effectiveness of PRP against other knee injections in younger patients and those without severe degenerative changes. The reason? the efficacy of intra-articular injections as a nonoperative modality for treating symptomatic knee osteoarthritis-related pain while maintaining function has become a subject of increasing interest.
In this study the following treatments were compared:
- Hyaluronic acid.
- and plasma rich in growth factors .
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What Are The Most Common Treatments For Knee Pain
When you visit an orthopedic doctor for knees, you will be given a treatment recommendation that corresponds to the nature and extent of your knee injury. The treatment method could be as minor as physical therapy or as major as a total knee replacement.
One common form of treatment is arthroplasty, which essentially means replacement of all or part of the knee joint. Total or partial joint replacement can be an especially effective means of treatment for those who deal with arthritis. ACL reconstruction is also a common surgical treatment.
Is Prp Controversial Yes Is It Effective Also Yes
When it works. Below are many citations and references showing the effectiveness of PRP.
Lets start with the most recent research of the effectiveness of PRP for knee osteoarthritis.
- While an October 2020 study in The Journal of International Medical Research still acknowledges that the clinical efficacy of platelet-rich plasma in the treatment of osteoarthritis remains controversial, their examination of five clinical trials including 320 patients found: intra-articular injection of PRP is an effective treatment for osteoarthritis that can reduce post-operative pain, improve locomotor function, and increase patient satisfaction.
- This is a June 2020 study from the journal Clinical Rheumatology, Here researchers suggested that Intra-articular PRP injection provided better effects than other injections for osteoarthritis patients, especially in knee osteoarthritis patients, in terms of pain reduction and function improvement at short-term follow-up. .
- In a study published in the American medical journal Arthroscopy, medical university researchers suggested that PRP injections were more effective in the treatment of knee osteoarthritis, in terms of pain relief and self-reported function improvement at three, six, and twelve months follow-up, compared with other injection treatments. We are going to show the comparative research below.
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The Region’s Most Comprehensive Knee Care
At the Orthopedic & Sports Medicine Center, our experienced knee doctors and staff are proud to offer exceptional orthopedic care to people throughout the communities of northwest Missouri and northeast Kansas. Our doctors are available at our office in St. Joseph, Missouri, as well as at the Mosaic Medical Center in Maryville, Missouri, the Northwest Medical Center in Albany, Missouri, the Wright Memorial Hospital in Trenton, Missouri, the Benedictine College in Atchison, Kansas, and the Hiawatha Community Hospital in Hiawatha, Kansas.
Our board-certified orthopedic surgeons, Dr. Daniel Smith, Dr. Brett Miller, Dr. Corey Trease, Dr. Brian Duncan, Dr. Blake Peterson, and Dr. Michael Smith, have years of experience in treating patients with a variety of knee injuries or conditions. Our orthopedic knee surgeons have the knowledge and skills to perform a thorough evaluation and provide an accurate diagnosis and viable treatment options. Conservative methods will always be recommended first, but there are some cases when knee surgery is required to help eliminate pain and restore proper function.
If a knee injury or condition is keeping you from living the life you love, schedule an appointment with one of our specialty-trained knee surgeons by requesting an appointment online or calling 233-9888.
Cortisone Knee Injections: In The Past Your Doctor May Have Recommended Against The Use Of Cortisone Because It Was Clear To Him Or Her That There Was Knee Surgery In Your Future
In the past, your doctor may have recommended against the use of cortisone because it was clear to him or her that there was a knee surgery in your future. The concern is if you get cortisone injections into your knee prior to surgery, you will have a greater risk of complications after the surgery. There is a lot of debate around this subject. Some doctors say avoid the cortisone, other doctors are saying it is okay to get one shot to hold you over until you can get surgery or maybe the cortisone will reduce your inflammation enough after the first shot that you will have some degree of pain relief and comfort for a few months, a year, maybe longer.
We are going to start with cortisone because cortisone was the injection of choice. Much has changed.
In a January 2021 paper from doctors at Northwestern University McGaw Medical Center, Rutgers School of Medicine, and Boston College, a current guideline was given for the use of cortisone: The paper appeared in the journal Pain Physician and included the following observations.
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What Kind Of Doctor Do I Need
Some health insurance plans allow you to refer yourself to a doctorthat is, if you know what is wrong, you can go see a medical specialist without having to be referred by your regular doctor. In other plans, you have to be referred to a specialist by your primary care physician . If you are trying to figure out what kind of doctor you need for your health problem or symptoms youre having, then this list will help you out. It tells you what kind of doctor treats what. Then you can find the name of a specialist by calling your local hospital, asking friends or family if they know a good doctor, or asking your primary care doctor to recommend someone.
Type Of Doctor To See For Knee Pain
A lot of people are confused about which doctor to see for knee pain. To get the best possible treatment, choose an orthopedic doctor. Orthopedic doctors have the specialized knowledge and training needed to treat a wide variety of problems affecting the musculoskeletal system bones, joints, cartilage, muscles, and nerves including the knees. Orthopedic doctors can treat acute and chronic knee pain and improve your quality of life. They can also provide preventive care for patients who would like to protect their knees and make them last a long time.
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Corticosteroid Knee Injections Provided No Significant Pain Relief After Two Years Researchers Say: Do Not Give Cortisone For Knee Osteoarthritis
In 2017, doctors from Tufts Medical Center in Boston asked, What are the effects of intra-articular injection of 40 mg of triamcinolone acetonide every 3 months on the progression of cartilage loss and knee pain in patients with osteoarthritis? Writing in the Journal of the American Medical Association, they published their answer:
Among patients with symptomatic knee osteoarthritis, 2 years of intra-articular triamcinolone, compared with intra-articular saline, resulted in significantly greater cartilage volume loss and no significant difference in knee pain. These findings do not support this treatment for patients with symptomatic knee osteoarthritis.
Research Comparing Prp Bone Marrow And Adipose
A July 2020 study published in the journal Clinical Medicine Insights Arthritis and Musculoskeletal Disorders, compared platelet-rich plasma , bone marrow aspirate concentrate, and adipose-derived mesenchymal stem cell injections in the treatment of osteoarthritis of the knee using functional scores.
- Methods: A total of 89 patients with painful knee osteoarthritis were included in this study.
- Patients were assigned to one of the 3 treatments according to the severity of osteoarthritis as indicated by symptoms and radiography to PRP , bone marrow aspirate concentrate , or adipose-derived MSC .
- Clinical assessment was performed using standard scoring systems, Surveys were completed at preoperative, and at 90, 180, and 265 days post-treatment.
Results: They all worked well.
- In a general statement, the PRP worked just as well in stage 1 knee osteoarthritis patients as the bone marrow aspirate worked in the stage 2 knee osteoarthritis patients and the adipose-derived stem cells worked for the stage 3 knee osteoarthritis patients. To quote the researchers: Our findings support previous reports and encourage further research on the use of these cost-effective treatments for osteoarthritis of the knee.
This is also a validation of our policy of not going straight to stem cell therapy in some of our patients. PRP or Prolotherapy, which is discussed below can provide equally good results without the added expense.
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