Arthroscopic knee surgery for arthritis.

Discussion in 'Health & Fitness' started by Raul_SJ, Jan 18, 2013.

  1. Raul_SJ

    Raul_SJ Professional

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    http://www.arthritistoday.org/condi...ws-and-research/arthroscopic-knee-surgery.php

    9/11/08

    Arthroscopic knee surgery, the most commonly performed orthopaedic procedure in the United States, may be no better than medical or physical therapy for relieving chronic pain, according to the results of two studies published in the New England Journal of Medicine.

    Researchers at the University of Western Ontario randomly assigned 178 people with moderate to severe osteoarthritis of the knee to either arthroscopic surgery, where the inside of the joint is cleaned and smoothed with the aid of a pencil-sized camera, or to a combination of medications, supplements and physical therapy. After two years, both groups reported nearly the same levels of pain, stiffness and disability.

    In addition to cleaning and smoothing the inside of the knee, arthroscopic knee surgery is commonly performed to repair tears to a wedge of cartilage in the joint called the meniscus.

    “What typically happens is that a doctor will get a patient with knee pain and give them an MRI [magnetic resonance imaging] scan, and they’ll find a meniscal tear,” said David T. Felson, MD, MPH, a rheumatologist with the Boston University School of Medicine.

    But in a separate study in the same issue, Dr. Felson and his colleagues performed MRI scans on 991 people living in Framingham, Mass. They found that meniscal tears were common and often did not correspond to a patient’s pain. In fact, 61 percent of people who had meniscal tears in their knees reported that they had no pain, aching or stiffness during the previous month.

    "I think this shows pretty persuasively that arthroscopy does not benefit osteoarthritis of the knee," Dr. Felson said.
     
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  2. Raul_SJ

    Raul_SJ Professional

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    How is it possible for someone with knee osteoarthritis not to experience pain with a meniscal tear?

    It seems that a meniscal tear would indicate that the knee osteoarthritis has advanced and there would be pain when engaging in physical activity.
     
    Last edited: Jan 18, 2013
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  3. ollinger

    ollinger Legend

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    That arthroscopy is not useful for arthritis in the knee is fairly old news; recent studies have merely confirmed what was known (but what some orthopedists were unwilling to admit). As for a meniscal tear not being painful, imagine a tear in your bed pillow, and imagine your head resting on that pillow. Whether your head pokes through to the bed beneath (and produces pain) depends on where the tear is and where your head is resting. So it is with the knee, bulges of arthritic bone being analagous to your head.
     
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  4. Raul_SJ

    Raul_SJ Professional

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    ================
     
    Last edited: Jan 20, 2013
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  5. corners

    corners Legend

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    That study is very poorly titled. Rather than "arthroscopy", the title should identify "arthroscopic joint resurfacing" as the intervention that does no good. I don't think they're doing this very much anymore - going in with a tool and sanding down your articular cartilage to make it "smooth," probably because of this study. Articular, or hyaline, cartilage is a complex 3D material that is very strong against compression, and when compressed becomes 100 times more slippery than ice, allowing our joints to freely rotate nearly free of friction. But despite this strength under compression, hyaline cartilage has a fragile structure and is vulnerable to shear. Once the surface is torn it doesn't perform as well. I guess the thinking was that if there is a surface tear then why not go in and "smooth" it all over? But the 2008 paper in the OP showed that it didn't work.

    More recently, studies have shown that 1) hyaline cartilage, contrary to long-held belief, is continually repairing itself. Studies on animals have shown that even large defects (tears and divots) can fill in and heal on their own. But it's not clear what conditions favor this. Clearly, young people have a greater capacity to heal, and it may be that we are damaging our joints continually throughout life, but only when we get old does this damage not get repaired. Once the hyaline cartilage stops repairing itself, there seems to be a reversal of fortunes - where the body starts breaking down the cartilage instead of repairing it, and then you've got osteoarthritis. 2) stem cells produced by our own bodies are critical for cartilage regeneration. Young people have more stem cells floating around that can be used for healing, while old people have few. The use of autologous mesenchymal stem cells, harvested from our own bone morrow and then re-injected into our joints, arthroscopically, has shown promise in regenerating hyaline cartilage in veterinary medicine for some time and is being offered by a handful of clinics in the US and around the world for people. This is not well studied and not yet considered a "bona fide" form of medicine. Exercise increases the production of stem cells in our bodies, which may be one of the reasons why people with osteoarthritis do better with more exercise rather than less. 3) pastes made of cartilage, sometimes mixed with stem cells, have also shown promise to regenerate divots in hyaline cartilage. The paste is placed into the defect arthroscopically and apparently will be incorporated into the cartilage in time, healing the defect..
     
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  6. Chas Tennis

    Chas Tennis Hall of Fame

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    Sometimes you cannot ignore a meniscus injury

    I more view arthritis and meniscus injuries separately.

    I read that of people 70 years old about 30% have had a torn meniscus injury. Most don't know that they have had a torn meniscus. Many meniscus injuries apparently don't seriously affecting knee function.

    Recently a friend of mine hurt his knee and was examined. I interpreted this to mean that an injured area of the meniscus was out of place and stopped him from playing tennis. He had a torn meniscus and serious arthritis, with say 5-10% of the area of the articular cartilage worn through to the bone. The Dr said that if he had the operation he would need a second surgery in very few years with the time shortened if he played tennis, that is, another surgery expected in maybe 3 years. He had the operation last year, did OK, and returned to tennis. However, since the first surgery he has required surgery on the other knee with similar arthritis and meniscus issues. He is bow-legged and that is a contributing factor.

    If a meniscus tear over a short time stopped me from playing tennis or otherwise using my knee, arthritis or not, I would give it a few months to heal/remodel. If it did not heal I would probably get surgery.

    I had a meniscus injury in 1999 and gave it 4 months to heal. It did not heal and I had surgery. Good result. I had another meniscus injury 2011 on the other knee and gave it 3 months to heal/remodel? and it did. No surgery. Good result. The degree of arthritis in my knee joints is not bad with good cartilage separation maintained in both knees.

    An important point - there is some risk especially of blood clots after surgery. Some of my friends have had bad experiences after meniscus surgery. The incidence of post surgery problems is something to research and understand.

    If I had serious arthritis and I got a meniscus tear that reduced my knee function even after some months of rest I would consider the surgery to be a big improvement. If my knee recovered function with some months rest - the torn meniscus was no longer affecting function - I would try to avoid the surgery.
     
    Last edited: Jul 14, 2013
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  7. Raul_SJ

    Raul_SJ Professional

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    Yes, I think it's important to make the distinction between a "wear and tear" injury to the meniscus over time due to advanced arthritis vs. a traumatic single-event injury to the meniscus in an otherwise healthy (non-arthritic) knee.

    As I understand the recent medical findings, Arthroscopic surgery does not work well in the presence of knee arthritis and meniscal
    tears. I think the studies show surgery works not much better than physical therapy or placebo.

    I suspect that your friend with arthritis and meniscus tear, would have fared just as well without the surgery.
     
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  8. Chas Tennis

    Chas Tennis Hall of Fame

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    He had to stop playing. After the surgery he was able to play again.

    A torn meniscus can involve a torn piece out of position that, for example, can cause the knee sometimes to lock in a bent position. I don't understand how those issues are factored in the statement 'that after two years both surgery and non-surgery have the similar outcomes'. How would the person get along without bending his knee? Does the study only involve asymptomatic meniscus tears? That might make more sense. ?

    Just reread your first post. It sounds as if the patients were asymptomatic regarding meniscus injury. Seems reasonable. I don't think that a meniscus that is causing problems can be ignored because the surgery may not be effective for arthritis treatment, at the same time surgery may be effective for a meniscus injury with symptoms. Obviously a very complicated problem with both a meniscus injury causing symptoms along with serious arthritis. ? My friend and his Dr discussed exactly this issue and (second hand) the Dr sounded very familiar with dealing with it.

    Here is a recent thread discussing the issues of arthritis and articular and meniscus cartilages. See especially the CF illustrations.
    http://tt.tennis-warehouse.com/showthread.php?t=438433
     
    Last edited: Jan 19, 2013
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  9. Raul_SJ

    Raul_SJ Professional

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    I have been reading the links below and it seems the studies are ongoing, unless I am missing some recent news...

    http://www.mayoclinic.org/medicalprofs/meteor-study.html

    Meniscal Tear With Osteoarthritis Research (MeTeOR) study

    Comparing arthroscopy to nonoperative therapy for meniscal tears in patients with osteoarthritis of the knee

    Each year in the United States, more than 300,000 knee arthroscopies are performed for patients who have both a meniscal tear and osteoarthritis in the same compartment of the knee. Yet the frequency with which this treatment is performed belies significant uncertainty surrounding outcomes associated with its use.

    Ambiguity and arthroscopy

    Mayo orthopedic surgeon Bruce A. Levy, MD, explains that the challenge starts in the consult room, when a patient presents with, for example, medial-sided knee pain. "But if they have a medial meniscus tear and concomitant medial compartment osteoarthritis, it is almost impossible to figure out what is generating the pain," Dr Levy says. "Is it the meniscal tear? Or is it the osteoarthritis in the medial compartment?"

    This ambiguity over the identity of pain origin and generation is problematic because meniscal tears and osteoarthritis tend to respond differently to arthroscopy. Data show that arthroscopy is very effective in treating meniscal tears without osteoarthritis — and highly ineffective for treating advanced osteoarthritis of the knee.

    MeTeOR to clarify treatment

    But what is the best course of treatment when both conditions are present? Currently physicians tell this subset of patients who are contemplating treatment that knee arthroscopy is unpredictable in the setting of meniscal tear and concomitant osteoarthritis.

    MeTeOR at a glance

    Enrollment goal: 340 by February 2011
    Mayo Clinic contribution to total enrollment: ~80 patients

    Centers involved: 7 U.S. advanced orthopedic centers, sponsored by the National Institutes of Health
    Principal Investigator: Jeffrey N. Katz, MD, MS, Brigham and Women's Hospital, Boston
    Mayo Clinic investigators: Bruce A. Levy, MD, Diane L. Dahm, MD, Michael J. Stuart, MD

    Randomized to 2 arms: Arthroscopy vs nonoperative treatments. These treatments may include physical therapy, use of antiinflammatory drugs, intraarticular cortisone injections, activity modification, braces.
    Main inclusion criteria > age 45:

    Presence of symptomatic meniscal tear with mechanical indicators such as locking, buckling, catching
    Presence of mild to moderate osteoarthritis on MRI
    No comorbidities, not pregnant
     
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  10. Raul_SJ

    Raul_SJ Professional

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    I will have to study these threads... but my first thoughts are

    1)
    Did your friend (with serious arthritis and meniscus tear) have surgery to repair the meniscus? or for the articular cartilage damaged by arthritis? or both?

    2)
    When the Doctor advised him that he would likely need surgery again in a few years, what specific surgery is he referring to? to repair the meniscus again?

    3)
    How long had your friend with serious arthritis and meniscus tear wait before having the surgery? Is it possible that physical therapy would have resulted in the same outcome had he given it enough time?... That seems to be what these studies of meniscal tears and concomitant arthritis are suggesting?


    Also note the quote from Ollinger in the other thread:

    "
    You may have seen in some newpapers or magazines reports of a pretty good study recently published on this topic. Conclusion was that if you have any evidence of arthritis in the knee, a meniscus procedure is worthless."

    4)
    If the surgery enabled your friend to play tennis for additional time -- something that would've been impossible with non-surgical
    treatment -- it sounds like the surgery was successful.

    But the successful surgery would seem counter to what Ollinger is saying...
     
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  11. Raul_SJ

    Raul_SJ Professional

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    If there is severe knee osteoarthritis present, then repairing the meniscal tear (caused by wear and tear) will not benefit, because the meniscus will soon be damaged again by the osteoarthritis.

    Is that the reasoning?

    Also, is there a link to the conclusions that arthroscopy is not useful?

    This link indicates the study is still ongoing and does not state any conclusions.

    http://www.mayoclinic.org/medicalprofs/meteor-study.html
     
    Last edited: Jan 20, 2013
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  12. Chas Tennis

    Chas Tennis Hall of Fame

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    Is Ollinger's statement for asymptomaytic meniscus injuries?

    The MeTeOR study dealing with this issue is a future study?

    Many people have meniscus injuries that aren't causing problems as the "61%" of your first post indicates. If the damaged part of the meniscus gets in the way inside the joint in my opinion something has to be done.

    Find a well qualified Dr for these issues.
     
    Last edited: Jan 19, 2013
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  13. Raul_SJ

    Raul_SJ Professional

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    In your case, there was no advanced arthritis coupled with the meniscal tear, and surgery can be effective in these cases.

    In your friend's case, there was advanced arthritis along with the meniscal tear (which I presume was caused by wear and tear over a prolonged time).

    In these cases, surgery (to either treat the articular cartilage or repair the tear) is not effective.
     
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  14. Raul_SJ

    Raul_SJ Professional

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    Is this the typical progression of knee arthritis?

    First, the wearing down of the articular cartilage, followed by the wearing down of the meniscus?

    So a person with a meniscus tear caused by "wear and tear", and not due to an acute injury, can be presumed to be in the advanced stages of knee arthritis?
     
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  15. Chas Tennis

    Chas Tennis Hall of Fame

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    I don't know. I don't know how to grade arthritis. Your word "advanced" might not be appropriate.

    What can you find to support your assumptions about various pathologies? Finds stats as best you can for the various pathologies.

    There is a lot of uncertainty with injuries, pathology and treatments.
     
    Last edited: Jan 20, 2013
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  16. drak

    drak Professional

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    they are now using "adipose" or fat derived stem cells which are much cheaper and easier to harvest (just as effective) and often combining it with PRP therapy. It's a 90-minute out patiend procedure and a local Doc here charges $1750 per treatment. at 57 my knees are still doing fairly well, but I have had 3 scopes for meniscus tears and I am think of getting this done for each knee as a preventative or try to make them last longer option.

    Unfortunately thsese treatments are not covered by insurance at this time, so it's all out your own pockets
     
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  17. Chas Tennis

    Chas Tennis Hall of Fame

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  18. drak

    drak Professional

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    My left knne has started to bother me, saw the Doc who does the knee Stem cell/PRP therapy yesterday and I have some instability and probably another cartilage tear and developing osteoarthritis. I am going to have a the Stem Cell/PRP shot done in the next two weeks. I will report back amd give updates on progress once I have the shot.

    Drak
     
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  19. drak

    drak Professional

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    Just had my stem cell/prp knee treatment this afternoom, the doc said I would be really sore for the first 12 hrs, he was right. The procedure itself was pretty easy, the drawing of the adipose fat cells from the stomach felt "weird" but no big deal. I'll update on progress in the weeks ahead
     
    Last edited: Feb 21, 2013
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  20. Raul_SJ

    Raul_SJ Professional

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    Do you have a tear in the articular cartilage? Or a tear in the meniscus? Or both?

    Des the Stem cell/PRP treatment help for both types of tears?
     
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  21. drak

    drak Professional

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    I have a loose LCL and to a lesser extend a loose ACL a bit of a patellar issue and light to moderate opstearthritis, and maybe a small meniscus tear. The Stem/cell PRP treatment has had promising results in helping significantly in osteoarthritis cases, meniscus repair and has in some cases shown significant cartilage regneration. It can also add collagen growth to the injured areas of the tendons/ligaments and the result is a "tightening" effect.
    My knee was not that bad but was starting to act up more, so I read a lot and decided to be proactive and try this treatment to extend my "active lifestyle" knee life as opposed to waiting for things to get really bad and that is when options are more limited. Note that I had excellent results with chronic achilles tendonis (both legs) treatment via PRP - the only thing that worked!
    Like I said, I will keep the forum ip to date on how it works. This is cutting edge stuff, like PRP was 4-5 years ago.

    Drak
     
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  22. drak

    drak Professional

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    stem cell PRP injection went well, saw Doc today at 8 days after injection. Everything looks good and I can start increasing my workouts and probably start drilling in a week or so, just listen to my knee and back off if necessary. PRP keeps workin for 1-2 months at least and stem cells for up to a year, so it may be a long while before I have final results. Keep in mind I had relatively minor issues and thos was as much preventative as it was "cure now".
     
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  23. jhusein

    jhusein Rookie

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    Hi Drak. I had a scope done to my left knee less than two years ago and my right knee started to act up and I am very interested in PRP. Please keep us updated.

    May I know who and where is your Doctor? Many thanks.
     
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  24. drak

    drak Professional

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    Peyson Flattery, Bend Or. A naturopath who has been doin PRP longer than anyone in Central Oregon - 8 yrs and started doing the stem cell/PRP combo about a yr ago. Good guy and has a good rep in this area.
     
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  25. jhusein

    jhusein Rookie

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    Many thanks.
     
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  26. Raul_SJ

    Raul_SJ Professional

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    Did the Doctor advise going with the combo stem cells/PRP treatment rather than PRP alone? (I've heard some people get improvement with PRP alone)

    Do you need to go back after 2 months for another injection?

    Is it a relatively low risk procedure compared to surgery?
     
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  27. drak

    drak Professional

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    He actually advocated a PRP but I wanted to go stem with PRP based upon research I have been doing into the success of this procedure regarding osteoarthritis - some cartilage regeneration and many successes with people who have very bad knees and were looking at TKR's.

    Some people do go back for another PRP 4-8 weeks after the initial, I am opting for just treatment at this time as my knee was not that bad.

    In the scheme of knee treatments from what I have read it is very low risk, you are using your own stem cells/blood so chance of rejection is nil or minimal, and this is not surgery, it is a mini liposuction of belly fat and a few shots. For the potential "reward" the risk seems very low IMO.
     
    Last edited: Mar 4, 2013
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  28. Raul_SJ

    Raul_SJ Professional

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    PRP looks promising although the fact that years after its introduction, it is not apparently covered by insurance suggests that it has not proven to be medically effective.
     
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  29. drak

    drak Professional

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    Dr. James Andrews who did both Adrian Petersen's knee and recenetly Robert Griffin III used stem cells on both to speed recovery from the ACL surgeries. This guy is cutting edge, here's one link.

    http://www.hogshaven.com/2013/1/23/3899538/rg3-injury-robert-griffin-iii-redskins-dr-james-andrews
     
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  30. Raul_SJ

    Raul_SJ Professional

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    Thanks for the link.

    Were the injections painful?

    http://well.blogs.nytimes.com/2011/01/26/phys-ed-does-platelet-rich-plasma-therapy-really-work/

    “The injections are very painful,” Dr. de Vos pointed out.
     
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  31. drak

    drak Professional

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    Hardly any pain from the injections, they use lydocane to numb it up, the stomach fat withdrawal was more a weird feeling than anything. I had really bad pain (Doc warned me) beginning 1-2 hrs AFTER the injection that lasted 12-14 hrs, I had to load up on the Vicoden, it then went away quickly and then just general soreness that was less and less each day, by day 4 I felt good.
     
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  32. Fintft

    Fintft Hall of Fame

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    It's funny, b/c I got a new meniscus tear on my previous healthy left knee (had one surgery on the right one many years ago, then passed on a second surgery):

    I felt some pain and wobbliness even sitting poorly on a chair at work mid week (that would get better after half an hour walk), then some problems while playing two nights in a row (including a match, when I was tentative to move and lost my serve late in the set and the match).

    And then it got better the next day, DURING an easy tennis lesson (that I've shared with a friend)?!! I've started that lesson with some problems/pain/being tentative and finished almost pain free (well I've also changed my technique a bit, especially on the BH- different rotation and a lower, more relaxed position)...

    That kinda make me even more sure, that moderate movement actually helped my knee, an opinion reinforced yesterday when I've only rode my exercise bike and practiced my serve (no pain anymore- not even that small tinge when going down the stairs). I'll have to see how it holds in another match tomorrow(the last for a couple of weeks) and then in daily practice sessions with better players then me(and lighter weight wise) during the week...

    (Yeah and went back a few weeks ago, after a few months off to glucosamine, Omega 3 and vitamin D).
     
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  33. Chas Tennis

    Chas Tennis Hall of Fame

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    On 4-10 occasions some years ago I would get a pain in my knee during a match. I believe that it occurred over a few year period after I got my first knee surgery. When this happened it occurred to me more than once that I might be playing my last few minutes of tennis as this injury could be the end of my tennis.

    I continued playing the match and deciding what to do. It went away after 2-3 games.

    This knee pain happened about 4-8 times. I attributed it to my meniscus getting out of place and then going back into a stable out-of-the-way place. Who knows?

    I have not experienced this pain in several years.
     
    Last edited: Mar 10, 2013
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  34. Fintft

    Fintft Hall of Fame

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    Exactly...

    Good luck!
     
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  35. drak

    drak Professional

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    Day 18 for me post stem cell/PRP, did my first cross country ski for a hour and a half yesterday then later an hr of pretty hard stationary bike riding. I've noticed the past 2-3 days that my knee is starting to feel strong vs okay, this morning after yesterday pushing it the hardest I have so far it feels fantastic. Playing tennis will be my "acid test", I'll probably get out this week and test it out on the courts.

    Drak
     
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  36. Fintft

    Fintft Hall of Fame

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    Hopefully progressively on the courts!

    Good-luck!
     
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  37. drak

    drak Professional

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    did about 80 minutes of drilling Wednesday, felt pretty good (stable) and no soreness during or after. will likely hit at least a few times next week, taking it gradually

    Drak
     
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  38. Raul_SJ

    Raul_SJ Professional

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    How are you quantitatively measuring the before/after result with regard to tennis activity?

    I believe you mentioned that the injection treatment was mainly a proactive step and you were experiencing relatively minor symptoms on the court.

    Given this, is there some standard you will use to determine if treatment has provided pain relief? e.g., you could play 3x a week prior vs 5x a week post-treatment.
     
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  39. drak

    drak Professional

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    I have two objectives two measure. One is my knee instability, doc evaluated it and it was there vs my good right knee, it was likely caused by a ski accident last March and I weakened my LCL and MCL - I will see if the tenotomy combined with the injection fixes this thru tendon healing and hence tightening.
    Secondly I have had some pain/discomfort when I fully extend or fully bend the knee, I believe I have a small medial meniscus tear (i have had three before so I know how they feel). I will evaluate whether this diminishes or goes away to judge effectiveness of treatment.
    In addition I know how my knee feels after playing 2 or 3 days in a row - not so good. In fact playing singles because of the instability was not something i have been doing. So as time goes by and I play more I will evaluate that. Yes it is subjective but I have some good yardsticks to judge by IMO.
     
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  40. drak

    drak Professional

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    Time for a 8-9 week update: had a bout of medial soreness at weeks 5-6 after I increased my tennis and got somewhat bummed. Thought I might have a patella issue and started wearing a patella strap and doing some incline (toes to floor) body weight squats. The results since have been dynamic, knee is now 9 out of 10 and the tendon tightening seems to have worked as well, with full staightening (or bending) it feels just like the other knee - no issues. Also knee stability is now very good, same as non injured knee.
    The issue I have is I can't be sure/confident my dramatic improvement is from the Stem/Cell PRP or the Patella strap/exercise, or some combo of each. In any case the knee is way better then before the stem cell/PRP injection and seems to be getting stronger.

    Drak
     
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  41. charliefedererer

    charliefedererer Legend

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    Thanks for providing updates.

    It is great to hear you are doing well.
     
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  42. drak

    drak Professional

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    Thanks! I still wear a knee sleeve for warmth and a little support (mostly mental I think). I forgot it yesterday and just had the patella strap during 3 sets of hard dubs, knee felt great during and after, So far so good

    Drak
     
    #42
  43. Raul_SJ

    Raul_SJ Professional

    Joined:
    May 19, 2011
    Messages:
    1,286
    Location:
    San Jose, California
    Thanks for the update and congratulations on your progress.

    It seems that full straightening and bending of the knee means that the medial meniscal tear has been resolved...

    Did you have an MRI to confirm the initial meniscal tear and would another
    MRI show meniscal tear healing?
     
    #43
  44. drak

    drak Professional

    Joined:
    Feb 20, 2004
    Messages:
    1,255
    I would and I did not, simply too much money, therefore I can not provide any definitive answers, only best guesses.
     
    #44
  45. RogueFLIP

    RogueFLIP Semi-Pro

    Joined:
    Mar 23, 2013
    Messages:
    779
    Good to hear that you're feeling better. And in the end, that's all that really matters, feeling better.
     
    #45
  46. drak

    drak Professional

    Joined:
    Feb 20, 2004
    Messages:
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    My wife just went in for what the MRI showed was a modest meniscus tear, unfortunately the operating Doc found lateral articular cartilage damage on the femur and tibia. I just scheduled her for a stem cell/PRP treatment in about 10 days (with my Stem cell Doc), should help with the healing and give here the best chance for a decent result on the articular damage. Next step after 2 months or so will likely be an unloading brace for when she begins to play again. Cost on prodedure has now dropped to $1150 (from $1750) from the only Doc who does it locally.

    Her operating Doc suggested (for later discussion) one of the "Synvisc" type treatments but I have researched that and frankly don't think they are worth it.

    Given the positive results I have had so far with the Stem cel/PRP we will go that route. Bottom line is it can't hurt and possible very good upside.

    Drak
     
    #46
  47. drak

    drak Professional

    Joined:
    Feb 20, 2004
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    Played back to back USTA 9.0 55+ matches yesterday and skied all morning today, knee fells great. Half the guys were iceing their knees after the two matches, I did not need to at all.

    Drak
     
    #47
  48. adventure

    adventure Banned

    Joined:
    Aug 1, 2011
    Messages:
    509
    Straight up baller!

    I can't believe stem cell therapies are suddenly mainstream AND affordable. It seemed like sci-fi just 5 years ago. Please do report back on the effectiveness of the treatment for your significant other. :)
     
    #48
  49. drak

    drak Professional

    Joined:
    Feb 20, 2004
    Messages:
    1,255
    will do, it just got delayed a few weeks but she will have it done within the next few weeks. I would say PRP by itself is somewhat mainstream but stem cell is where PRP was 3-4 years ago IMO. I will likely have my twice "scoped" right knee stem celled/PRP'ed in the next 9-12 mos just for preventative osteoarthritis purposes.

    Drak
     
    #49
  50. adventure

    adventure Banned

    Joined:
    Aug 1, 2011
    Messages:
    509
    Best wishes to both of you! My hope, expectation even (?), is that these procedures will become even more effective within 2 years. I'm already astonished at how affordable it is.
     
    #50

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