120-Second Quick Summary of Recent Knee Research
Recent research busts knee treatment myths, strongly recommending that patients:
- Avoid arthroscopic knee surgery: unless you’ve had significant trauma or a locked knee, it has not been shown to be effective for meniscal tears or arthritis for anyone over 35,
- Avoid steroid injections: they destroy cartilage without significantly improving pain,
- Reconsider hyaluronic acid injections, which may help you “tread water,” but which don’t provide healing; they are not helpful enough to overcome the risks and costs of the injections.
Instead, research has shown PRP (platelet-rich plasma therapy) to be more effective than both steroid injections and hyaluronic acid in knee arthritis, meniscal tears, and tendon/ligament injuries by:
- Decreasing the markers of arthritis,
- Decreasing the molecules signaling inflammation,
- Protecting cartilage cells from destruction, and
- Encouraging growth and healing.
A series of 2-3 PRP injections have been shown to be more effective than one, and cellular therapies like bone marrow concentrate can be more effective than PRP, particularly in more severe cases. Dextrose prolotherapy can also improve arthritis symptoms and knee function for over 2 years, and has been used in combination with other regenerative therapies to optimize results.
All studies using an arthroscope to directly visualize cartilage have shown new cartilage regrowth in knees treated with cellular therapies, PRP, and even prolotherapy.
Efforts to catch arthritis early have taken central stage. Many of the regenerative treatments we have are best in mild and moderate arthritis, potentially slowing arthritis progression and delaying or avoiding surgery. Consider regenerative treatments in:
- Any injury to the knee that limits walking for 2 days (associated with post-traumatic arthritis)
- Injury to the ACL and meniscus (significantly increases lifetime risk of knee replacement)
- Early MRI knee degenerative changes
- Rapidly progressive arthritis: 14% of arthritis sufferers progress from mild to severe arthritis in 4 years or less and have a 20X higher chance of knee replacement during their lifetime
If your arthritis is already severe, there is still hope–a new study shows that PRP can help severe arthritis in patients >67 years old.
Finally, we now know that the majority of improvement we see with cellular therapies are due to the signaling molecules and bags of RNA (called exosomes) that stem cells release. Concentrated exosome products have been shown to mimic stem cell effects, decreasing pain and thickening cartilage in arthritic joints in early studies.
These are available in the clinic now—they join our line of biologic tissue engineering products, including amniotic and cord tissues, PRP, platelet releasate, and your own bone marrow and fat grafts in our expanding treatment toolbox to help you keep moving, stay in the game, and avoid or delay surgery through personalized, cutting edge regenerative therapy.
Call today to schedule with Dr. Bunyak: 760-632-1090.