Arthroscopic knee surgery for arthritis.

I am also considering PRP for knee OA and trying to learn more about it.

Thus far, there does not appear to be any medical studies that conclusively prove its effectiveness, which is probably why it is not covered by insurance.

Given that PRP injections have been commonly used for at least the past several years, I would have expected a verdict by now...

Although some studies such has the one below, indicate that it has potential, but again, nothing definitive.

Raul_SJ said:

I am also considering PRP for knee OA and trying to learn more about it.

Thus far, there does not appear to be any medical studies that conclusively prove its effectiveness, which is probably why it is not covered by insurance.

Given that PRP injections have been commonly used for at least the past several years, I would have expected a verdict by now...

Although some studies such has the one below, indicate that it has potential, but again, nothing definitive.

http://www.sciencedaily.com/releases/2013/02/130212171957.htm

Feb. 12, 2013 — A study by researchers from Hospital for Special Surgery has shown that platelet-rich plasma (PRP) holds great promise for treating patients with knee osteoarthritis. The treatment improved pain and function, and in up to 73% of patients, appeared to delay the progression of osteoarthritis, which is a progressive disease. The study appears online, ahead of print, in the Clinical Journal of Sports Medicine​

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PRP alone IMHO, based on a ton of research I have done is unlikely to do much for Osteoarthritis - STEM CELL is where the promese is. think of stem cell as the "seed" for regeneration and PRP the fertilizer. The fertilizer does very little without the seed, PRP alone for tendons and ligaments is great, osteoarthritis is an entirely different animal.

drak said:

PRP alone IMHO, based on a ton of research I have done is unlikely to do much for Osteoarthritis - STEM CELL is where the promese is. think of stem cell as the "seed" for regeneration and PRP the fertilizer. The fertilizer does very little without the seed, PRP alone for tendons and ligaments is great, osteoarthritis is an entirely different animal.

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The Hospital for Special Surgery study suggests that PRP alone can halt the progression of knee OA, which would be very significant.

For those with mild OA, PRP may be their best option, considering that stem cell treatments can be much more expensive and are still unproven.

Raul_SJ said:

The Hospital for Special Surgery study suggests that PRP alone can halt the progression of knee OA, which would be very significant.

For those with mild OA, PRP may be their best option, considering that stem cell treatments can be much more expensive and are still unproven.

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PRP is likely a positive and better than nothing for OA but EARLY stem cell results are IMO much more promising, do a search and it's apparent.

My wife had stem cell treatment today and she has stage III OA, she is an excellent candidate for stem cell/PRP, we'll see how she does - I'm very positive about here outcome.

Drak

drak said:

PRP is likely a positive and better than nothing for OA but EARLY stem cell results are IMO much more promising, do a search and it's apparent.

My wife had stem cell treatment today and she has stage III OA, she is an excellent candidate for stem cell/PRP, we'll see how she does - I'm very positive about here outcome.

Drak

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Great news! talktennis should have a cheerleading gif.

drak said:

PRP is likely a positive and better than nothing for OA but EARLY stem cell results are IMO much more promising, do a search and it's apparent.

My wife had stem cell treatment today and she has stage III OA, she is an excellent candidate for stem cell/PRP, we'll see how she does - I'm very positive about here outcome.

Drak

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Stage III OA in a single knee?

What is the current level of pain and restriction of activity level (she is active in sports?) and the desired result?

Will it take about a year for cartilage to regenerate and see if the treatment was successful?

Raul_SJ said:

Stage III OA in a single knee?

What is the current level of pain and restriction of activity level (she is active in sports?) and the desired result?

Will it take about a year for cartilage to regenerate and see if the treatment was successful?

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She was scoped 3 weeks ago and what we thought was just a meniscus tear turned out to be a lot of articular damage on the lateral tibia and femur of the right knee, so we decided for her to get stem cell/PRP to give her the best shot for recovery and perhaps some enhanced healing and hopefully some regeneration. Stem cells work for up to a year and healing begins right away but it is a long process. Some patients with very bad OA have almost immediate relief since they have a very high level of pain to begin with, it varies a lot patient to patient and there are several different variations of the treatment.
Probably will also get her an unloading brace for tennis in the future and the best chance for healing over the next several weeks and months ahead.

drak said:

.....................................
Probably will also get her an unloading brace for tennis in the future ........................................................

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What is an unloading brace?

^^ a brace that grips firmly above and below the knee, in the hope of offering some vertical support (unloading of the knee) as well as lateral support.

questions on the unloading brace

El Diablo said:

^^ a brace that grips firmly above and below the knee, in the hope of offering some vertical support (unloading of the knee) as well as lateral support.

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I have always had trouble seeing how that type of brace can work very well. How can anything grip the soft tissues of the leg and reduce the movement/pressure inside the knee joint, pressure on the menisci and articular cartilages? Pressure might build up with just a millimeter or two of compression between the upper and lower leg bones. How can a brace stop that small a motion? Does that type of brace irritate the leg muscles or tendons, etc.?

Do you have any information, personal endorsements, etc. on how effective this type of brace is? Do you have a link or brand name that I could search?

Awesome info and news. Any updates?

drak said:

She was scoped 3 weeks ago and what we thought was just a meniscus tear turned out to be a lot of articular damage on the lateral tibia and femur of the right knee, so we decided for her to get stem cell/PRP to give her the best shot for recovery and perhaps some enhanced healing and hopefully some regeneration. Stem cells work for up to a year and healing begins right away but it is a long process. Some patients with very bad OA have almost immediate relief since they have a very high level of pain to begin with, it varies a lot patient to patient and there are several different variations of the treatment.
Probably will also get her an unloading brace for tennis in the future and the best chance for healing over the next several weeks and months ahead.

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adventure said:

Awesome info and news. Any updates?

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I am doing great, playing 4-5 times a week with no brace, no restrictions, and nothing but a normal strong feeling knee, I am 5 months post procedure and my wife is about 5 weeks post stem cell and 8 weeks post her scope. She really had a much different, stronger and longer "reaction" to the PRP/Stem cell shot. She had an uncomfortable throbbing for almost 3 weeks and then a duller ache that's finlly gone away. My "guess" is that since she had a lot more damage and was healing from a surgery her "healing response" was way stronger and longer than mine. I did not start feeling really strong and able to pla tennis like I am now till almost 3 months post procedure, it's a gradual process and I hope she has similar results.

It looks like an amazing result for you, and I hope your wife has excellent results also. Best!

adventure said:

It looks like an amazing result for you, and I hope your wife has excellent results also. Best!

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she hit today for only the second time since the stem cell shot and said she felt a lot better then the last hit a few weeks ago, just groundstroked for about 45 minures, we'll see now it feels tonight and tomorrow

If she was able to hit without discomfort, that's already a good sign. Being the cautious person that I am, I always recommend icing after a session--but I'm sure you guys are familiar with all of that.

I am really pulling for you guys: this could be an amazing breakthrough for a lot of people in a lot of different areas.

Best.

adventure said:

If she was able to hit without discomfort, that's already a good sign. Being the cautious person that I am, I always recommend icing after a session--but I'm sure you guys are familiar with all of that.

I am really pulling for you guys: this could be an amazing breakthrough for a lot of people in a lot of different areas.

Best.

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appreciate it, I'm in SoCal for 10 days and she's back home, talked to her this morning and she said knee felt good after yesterday's hit. For now no conseutive days playing and just a very gradual increase in court time and backing off if any significant discomfort occurs. She's trying to be ready for Sectionals in late August

drak said:

PRP alone IMHO, based on a ton of research I have done is unlikely to do much for Osteoarthritis - STEM CELL is where the promese is. think of stem cell as the "seed" for regeneration and PRP the fertilizer. The fertilizer does very little without the seed, PRP alone for tendons and ligaments is great, osteoarthritis is an entirely different animal.

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Some interesting advanced stem cell research involving the retina. In this case, a group from University College London have grown retinal cells and transplanted them into mice.

http://www.natureworldnews.com/articles/3090/20130722/lab-grown-retina-transplanted-successfully.htm

http://www.ucl.ac.uk/news/news-arti...hotoreceptors-from-retina-grown-in-a-dish-Ali

drak said:

she hit today for only the second time since the stem cell shot and said she felt a lot better then the last hit a few weeks ago, just groundstroked for about 45 minures, we'll see now it feels tonight and tomorrow

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Update (wife): 3 month post Stem cell/PRP injection, 4 months post surgery.

As in my case the 3 month mark from my wife's stem cell/PRP treatment seems to be when it really starts to feel better - as in that normal/good I am back feeling. It's been a real slow and gradual improvement but just in the past week she is starting to feel much better and more sure and confident of her movement, with little or no pain or "awareness" of weakness/soreness where her surgery and articular knee issues were. And the 24 hrs after playing seem to be much improved as well. We have drilled fairly hard 2 of the 3 past few days and she feels good. We play on hard courts all the time BTW.
In her case with much more damage then I had I am very encouraged by the results so far and if they hold through the next 2-3 months of increasing tennis (and skiing this coming winter) it will have been well worth it.
In my case (6 months post stem cell/PRP) I am playing regularly and can go 100%. I do where a light neoprene type brace when I play just to be safe. I have no swelling or pain or discomfort and my knee feels strong, The only time I feel it at all is if I do a full knee stretch where I pull on my ankle wirh my left hand and bring it back toward the back of my thigh - I can feel a slight discomfort but only right at the end of my pull when pulling with effort.
The next key for our results will be when I reach the 1 yr milestone, and my wife the 6 month. So far so good as the results are very encouraging to this point.

Drak

Hi Drak,

I'm so happy to hear you and your wife are doing better.

Can you tell me where you and your wife had the stem cell and PRP knee treatment done. I'm in Toronto, Canada and it's not really available here. I would so appreciate some help in this as I've had to put tennis and sports on hold this summer due to knee pain after meniscus surgery and some resulting signs of Osteo.

Thx.

Chas Tennis said:

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.

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Same here with surgery in 1997(after waiting at least 6 months) and 2012-2013(this winter), when I was afraid that I'd need surgery on the other knee, but the meniscus healed on itself in about 10 days with moderate exercise (less intense tennis movement- aka lessons in two), glucosamine, Omega 3, Vitamin D and aspirin. Finished the hard court season with no problems and then I've played on clay the whole summer with no problems.

Fintft said:

Same here with surgery in 1997(after waiting at least 6 months) and 2012-2013(this winter), when I was afraid that I'd need surgery on the other knee, but the meniscus healed on itself in about 10 days with moderate exercise (less intense tennis movement- aka lessons in two), glucosamine, Omega 3, Vitamin D and aspirin. Finished the hard court season with no problems and then I've played on clay the whole summer with no problems.

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In my cases that you quoted, I should point out that I saw a Dr and got an MRI both times. In 1999 the Dr thought that it was reasonable for me to see if the meniscus would heal and guessed that the chance that I would need surgery was 75%. I did. In 2011, with a meniscus tear again indicated on the MRI, he thought that it did not look too bad and that I could ease back to playing in a few weeks. I knew I was not ready to play that soon, took 3 months, and had to slowly build up my running over another month before any tennis.

Individual injuries are all different - what may happen may depend on the exact location and nature of the damage to the meniscus. Research different meniscus injuries.

This site mentions the possibility of a torn meniscus causing subsequent damage to the articular cartilage - a strong reason why a Dr needs to handle this injury.
http://www.miamisportsmedicine.com/MeniscalInjury.html

blue1 said:

Hi Drak,

I'm so happy to hear you and your wife are doing better.

Can you tell me where you and your wife had the stem cell and PRP knee treatment done. I'm in Toronto, Canada and it's not really available here. I would so appreciate some help in this as I've had to put tennis and sports on hold this summer due to knee pain after meniscus surgery and some resulting signs of Osteo.

Thx.

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Redmond Oregon - 20 miles from Bend where I live, there are clinics all over the place that do this now and how they do it and what they charge varies greatly. The guy that did mine is not an M.D., he's a long practicing prolotherapy guy that now has added stem cell to the prolo quiver. I suggest doing lots of internet research

Drak

Thanks Drak,
Don't mean to bug you but can you give me his name and clinic. I like that you've had success with him. I'm really looking for some help.

Are you both continuing to find the treatment helped and pain improving?

Cheers.

blue1 said:

Thanks Drak,
Don't mean to bug you but can you give me his name and clinic. I like that you've had success with him. I'm really looking for some help.

Are you both continuing to find the treatment helped and pain improving?

Cheers.

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I continue to feel very good, my wife is now 3.5 months post stem cell and is continuing to have gradual improvement, the 3-5 month time frame is when I felt the full and final benefit, she had much more damage then I did. I would again stress researching the different stem cell approaches. Best answer I can give is that I would do it again however I do wonder if the approach my guy used is the best out there (it was cheap as these things go and local) as this is such a new field, for example he uses adipose (stomach fat), some say bone marrow is better. His name is Peyson Flattery at the center for integrative medicine in Redmond, Or.

Thanks Drak,
I hope you both continue to do well.
It's amazing how you can take simple things like walking without pain, let alone being able to hit tennis on any given day. After the doctors "trim" your meniscus and you're still in pain, they tend to let you go and you're on your own to find help. Hopefully their are better options out there.

Raul_SJ said:

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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I have bad arthritis under the knee cap and femur. I had a torn meniscus while playing tennis and I had SX at the end of August because my knee was locked (left). Before the SX I was able to play tennis 2-3 times/week. Over 3 months after the SX and therapy my knee is not locked anymore but the pain and stiffness are still there and there is still fluid in my knee. It is very frustrating. When I ask my doctor/the only answer is because I have the bad arthritis. I am confused/the bad arthritis was there before the SX why it is getting worst after the SX. I am looking for options and second opinion in the coming weeks. Again, it is frustrating guys.