The Current Literature Demonstrates The Potential Benefits Of Utilizing Concentrated Bone Marrow Aspirate For The Repair Of Cartilaginous Lesions Bony Defects And Tendon Injuries
Doctors in New Jersey at the Department of Orthopedic Surgery, Jersey City Medical Center published their findings in support of this research, in the World Journal of Orthopedics, here is what the paper said:
- The current literature demonstrates the potential benefits of utilizing concentrated bone marrow aspirate for the repair of cartilaginous lesions, bony defects, and tendon injuries in the clinical setting. The studies have demonstrated using concentrated bone marrow aspirate as an adjunctive procedure can result in cartilage healing similar to that of native hyaline tissue, faster time to bony union, and a lower rate of tendon re-rupture.
A June 2018 study in the journal Arthritis and Musculoskeletal Disorders presents the short-term progress of 15 patients with knee osteoarthritis through four bone marrow concentrate treatments.
- Patients underwent four bone marrow concentrate treatments on average 14 days after 1st treatment, 21 days after the second treatment, and 33 days after the third treatment. The last follow-up was conducted on an average of 86days after the first treatment.
Patients experienced statistically significant improvements in active pain and functionality scores after the first treatment.
- On average, patients experienced:
- an 84.31% decrease in resting pain,
- a 61.95% decrease in active pain,
- and a 55.68% increase in functionality score at the final follow-up.
Facts You Should Know About Knee Pain
- Knee pain is a common problem with many causes, from acute injuries to complications of medical conditions.
- Knee pain can be localized to a specific area of the knee or be diffuse throughout the knee.
- Knee pain is often accompanied by physical restriction.
- A thorough physical examination will usually establish the diagnosis of knee pain.
- The treatment of knee pain depends on the underlying cause.
- The prognosis of knee pain, even severe knee pain, is usually good although it might require surgery or other interventions.
Physical Therapists: For Non
Like orthopedic doctors, physical therapists diagnose and treat injuries of the musculoskeletal system.
The difference is that PT treatment focuses on hands-on strategies, exercise, and education. They dont prescribe drugs or perform surgery.
A physio will also teach you the best way to manage your symptoms at home. Theyll also tell you how to prevent future pain episodes.
Physical therapy also specializes in human movement and pain management. This is useful when recovering from the following:
- Acute injuries like sprains or tears, regardless of their severity.
- Joint surgery, like knee replacement.
- Chronic diseases of the joints, including rheumatoid arthritis and osteoarthritis.
- Neurologic conditions, like cerebral palsy, stroke, or Parkinsons disease.
- Pulmonary diseases, like COPD or cystic fibrosis.
- Sports injuries.
Visit a physical therapist if you have pain:
- That doesnt get better with home care.
- After a mild or moderate injury. Like a sprain or a strain.
- After physical activity. Or muscle aches during/after work.
- Without a fracture, a fever, an infection, or any other medical emergency.
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How Are Knee Problems Diagnosed
In addition to a complete medical history and physical exam, other tests for knee problems may include:
X-ray. This test uses invisible electromagnetic energy beams to make images of internal tissues, bones, and organs onto film.
Magnetic resonance imaging . This test uses large magnets, radiofrequencies, and a computer to make detailed images of organs and structures within the body can often determine damage or disease in a surrounding ligament or muscle.
Computed tomography scan . This test uses X-rays and computer technology to make horizontal, or axial, images of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
Arthroscopy. A minimally-invasive diagnostic and treatment procedure used for conditions of a joint. This procedure uses a small, lighted, optic tube , which is inserted into the joint through a small incision in the joint. Images of the inside of the joint are projected onto a screen used to evaluate any degenerative or arthritic changes in the joint to detect bone diseases and tumors to determine the cause of bone pain and inflammation.
Radionuclide bone scan. A nuclear imaging technique that uses a very small amount of radioactive material, which is injected into the patient’s bloodstream to be detected by a scanner. This test shows blood flow to the bone and cell activity within the bone.
What Type Of Doctor Should I See For My Knee Injury
If you suffer a knee injury, should you go to an emergency room or urgent care center, your primary care doctor, or to an orthopedic surgeon? In this Ask Dr. Geier video, I discuss your options if youre dealing with a nagging knee problem that isnt getting better.
Bridget asks:A few days ago, as I was walking in the street, my left leg locked on me twice. At that time, I experienced excruciating pain in my knee. Since then my leg has locked a few times while walking, and the pain is constant at the top of my knee when I try to straighten it out. When it is bent, I do not have pain. I do not have any swelling, just pain and locking. I also feel off balance. Do you think that I should see my GP first instead of an orthopedic surgeon? Or should I just go to see the surgeon for an evaluation?
There are many benefits to seeing your primary care doctor first, even if it is for a bone or joint injury. First, many insurance companies require patients to see their doctor and get a referral. Plus they know you, and you have a long relationship with you. And you might be able to see your personal doctor very quickly.
On the other hand, they are not as familiar with evaluation of musculoskeletal injuries as orthopedic surgeons. In this video, I discuss some of the potential drawbacks of seeing your primary care doctor first and when you might consider trying to see an orthopedic surgeon first.
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Do You Have To Be Referred To An Orthopedic Doctor
Fortunately, if you need to see an orthopedic specialist, theres a good chance your primary care doctor will refer you to one. .
But if you have long-lasting pain or discomfort, you may want to consider making an appointment on your own without a doctors referral.
If this sounds like your situation, it can be helpful to understand what orthopedic doctors do so you know if its beneficial to see one.
What You Need To Know
- The most common causes of knee pain are related to aging, injury or repeated stress on the knee.
- Common knee problems include sprained or strained ligaments, cartilage tears, tendonitis and arthritis.
- Diagnosing a knee injury or problem includes a medical examination and usually the use of a diagnostic procedure such as an x-ray, MRI, CT scan or arthroscopy.
- Both non-operative and surgical treatment options are available to treat knee pain and problems depending on the type and severity of the condition.
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Common Conditions That Rheumatologists Treat:
Rheumatoid arthritis is an autoimmune disease that often affects many joints at once.
Early diagnosis is key to stopping the progression of this disease and rheumatologists are trained to do exactly that.
A rheumatologist can also make referrals to physical and/or occupational therapy. This can reduce pain during flare-ups and improve your quality of life.
Psoriasis muscular pain
Psoriasis is another common autoimmune disease. It affects the skin, speeding up the growth process of skin cells. This forms thick plaques on the scalp, elbows, chest, and/or the face.
Some types of psoriasis also cause joint or musculoskeletal pain.
In this case, dermatologists work in tandem with rheumatologists.
Tick bite joint pain
Ticks can spread several diseases, the most common being Lyme disease.
During the first 30 days after the bite, you may feel some fatigue, headache, and a fever. Most people also develop a rash in the shape of a bulls eye.
If untreated, Lyme disease can cause several health issues, including:
- Joint pain,
A rheumatologist will work with other physicians to help you manage these symptoms.
When To See The Doctor For A Bakers Cyst
Swelling that comes on quickly or doesnt go away may be a sign of infection. Other signs of infection include fever, tiredness, and severe knee pain. You should also call your doctor if you experience shortness of breath along with swelling in your leg.
Pain and/or swelling behind the knee might also be a sign of a blood clot, which is a much more dangerous condition that should be addressed immediately.
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More Surgical Experience Is Associated With Fewer Complications
The National Institute of Arthritis and Musculoskeletal and Skin Diseases4 cites a study that found complication rates to be inversely related to the number of total knee replacement procedures a surgeon or hospital performs each year. The study used data from more than 80,000 Medicare beneficiaries who underwent total knee replacement surgery and found:
- Surgeons who performed fewer than 12 knee replacements each year had an average medical complication rate of 4.0%, compared to 2.9% for surgeons who performed at least 50 knee replacements each year.5
- Hospitals that did fewer than 25 knee replacements each year had an average medical complication rate of 4.6%, compared to 3.0% for hospitals that did at least 200 knee replacements each year.6
Medical complications included post-surgical pneumonia, pulmonary embolism, heart attack, deep infection or death within the first three months after surgery. Other complications, such as the loosening of a prosthetic component in the knee, were not included in this study.
Factors that did not seem to affect complication rates in this study included:
- The number of years since the surgeons graduated medical school
- Whether the surgeries were performed in private or public hospitals, teaching or non-teaching hospitals, or urban or rural hospitals
Learn about how doctors such as Orthopedic Surgeons treat arthritis in Arthritis Treatment Specialists
Knee Pain And Problems
Knee pain is a common complaint among adults and most often associated with general wear and tear from daily activities like walking, bending, standing and lifting. Athletes who run or play sports that involve jumping or quick pivoting are also more likely to experience knee pain and problems. But whether an individuals knee pain is caused by aging or injury, it can be a nuisance and even debilitating in some circumstances.
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What Are Risk Factors For Knee Pain
Biomechanics: The knee joint is complicated in its operation and is used frequently throughout the day. Any change in the movement of the joint can cause subtle changes and cause pain and injuries.
Excess weight: The stress on the knee joint is increased with excess weight. Obesity also increases the risk of knee osteoarthritis as the cartilage breaks down more rapidly.
Overuse during repetitive motions as are found during certain exercises or work conditions can cause breakdown of cartilage and lead to pain.
You Can Delay Knee Replacement Realistically For About 11 Months With Hyaluronic Acid Injections
In September 2020, a study in the journal American Health and Drug Benefits, assessed the value of intra-articular hyaluronic acid injections monetarily. This is a way to determine the effectiveness of the treatment. This is what the study said:
Although limiting hyaluronic acid use may reduce knee osteoarthritis-related costs, in this study hyaluronic acid injection only comprised a small fraction of the overall costs related to knee osteoarthritis. Among patients who had a knee replacement, those who received treatment with hyaluronic acid had surgery delayed by an average of 10.7 months.
Can You Treat A Valgus Knee Without Surgery
A valgus knee is what doctors call knock-kneed. These patients can get arthritis on the outside and when that happens, oftentimes theyre offered invasive surgery. However, does that need to be done? Today well review valgus knee and also follow one patients journey to recovery without surgery.
Getting A Second Opinion For Knee Replacement Surgery
A patient is entitled to get a second opinion or even a third opinion from another doctor. For example, a prospective knee replacement patient may want to try to find another orthopedic surgeon with lower complication rates or who better addresses the patients concerns. Patients should keep in mind that the second opinion may or may not be more accurate than the original opinion.
Getting a second opinion or switching surgeons is not unusual, and patients should not worry about hurting a doctors feelings.
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Another Comparison Of Ozone Prp And Hyaluronic Acid
A February 2021 study compared the short and long-term efficacy of the intraarticular injections of hyaluronic acid, platelet-rich plasma , plasma rich in growth factors , and ozone in patients with knee osteoarthritis.
- 238 patients with mild to moderate knee osteoarthritis were randomized into 4 groups:
- hyaluronic acid ,
- PRP ,
- PRGF , and
- Ozone .
Results: In 2 months of follow-up, significant improvement of pain, stiffness, and function were seen in all groups compared to the baseline, but the ozone group had the best results. In 6 month follow up hyaluronic acid, PRP, and PRGF groups demonstrated better therapeutic effects in all scores in comparison with ozone. At the end of the 12th month, only PRGF and PRP groups had better results versus hyaluronic acid and ozone groups in all scores. Despite the fact that ozone showed better early results, its effects begin to wear off earlier than other products and ultimately disappear in 12 months.
Noninvasive Treatment Almost Always Best For Knee Pain
Knee symptoms are the most common musculoskeletal reason why patients visit their doctors, and in most cases, except when breaks or infection is suspected, physicians should recommend the use of nonsurgical treatments first.
The complexity of the knee as a joint can sometimes make caring for it as much of a pain for primary care physicians as for their patients.
Knee symptoms are the most common musculoskeletal cause of presentation to physician offices in the United States, according to data from the 2012 National Ambulatory Medical Care Survey. And a patient presenting to a physician with knee pain could be dealing with 1 of any number of issues, including osteoarthritis, injury such as sprains or ligament tears, gout, rheumatoid arthritis, or, in some cases, Lyme disease, explained Theodore R. Fields, MD, FACP, professor of clinical medicine at Weill Cornell Medical College in New York.
These are the factors that make evaluation and treatment difficult for primary care physicians, according to Gregory Hood, MD, MACP, an internist with Drs. Borders, Hood and Associates in Lexington, Ky.
The mistake a lot of patients and care providers make is to think of the knee as 2 bones that slap up next to each other at the joint, but the knee is so much more than that, Dr. Hood said. The knee depends on muscles, ligaments, and tendons to be in good balance and properly maintained in order to function properly.
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When Did Bursitis Start In My Right Knee
This condition is called bursitis, and it is most common in hip and knee joints. I began having the symptoms of bursitis in my right knee when I was in my early forties. It started as a very minor pain on the inside of my right knee that came and wentI really didnt notice it much at all. Over time, though, it got worse.
Your Pains Out Of Control
If you hurt so much that you canât do daily tasks, get through your workday, or sleep well at night, itâs time to see your doctor. If over-the-counter pain relievers and home remedies arenât working, you may need prescription medication to ease your pain. Your doctor can also inject a steroid into your joint to help with pain and swelling.
Osteoarthritis may get worse over time. Cartilage wears away, and the bones in your joint rub together when you move. At this stage, you may need to see an orthopedic surgeon to see if you need a total joint replacement or other surgery.
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When To See A Doctor For Leg Pain
The three levels of professional medical care you may need for leg pain are emergency, as quickly as possible , and when you can make an appointment.
You need emergency care if you cant bear weight on your leg or you notice pain, swelling and warmth around the calf of your leg, below your knee. This could be a sign of a blood clot. If the breaks away, it could travel to your lungs causing a pulmonary . Other emergencies include injuries after a trauma or fall:
Obvious deformity of your knee or ankle
A bone has broken through your skin
Loss of sensation in your leg, foot or toes
A grinding or popping sound when you injured your leg
Delaying treatment could cause permanent damage to your leg and foot. If you have leg pain but no obvious injury that needs emergency care, you should see your doctor as soon as possible if the pain is severe or you have trouble moving your leg. You should also see your doctor if you have:
Prolonged pain that wont go away
Pain in the calf after youve been sitting for an extended period, such as after being on a plane
If you have nagging leg pain, it may not be urgent enough for a same-day appointment, but see a doctor to rule out potentially serious causes.