Today I saw a middle aged patient with middle aged knee arthritis and he was looking for another option for arthritis pain relief. He had been to two seminars discussing umbilical cord blood, Wharton’s Jelly, Exosomes, and other regenerative medicine injections. His question for me: “How much cartilage will YOUR procedure grow back” Seems that he had been told that he would grow 1 inch of cartilage back at one seminar and about 0.5 inches at the other seminar. I found this funny and interesting and probably a bald faced lie…. because the upper range of normal human cartilage thickness in the knee is 3-4mm…….FAR less than the 25mm promised in one seminar and still far less that the 12mm promised in the other seminar.
The Las Vegas MSK Ultrasound and Orthobiologics Course will be at the Cosmopolitan Hotel January 13-15, 2022. www.orthosono.com
Here is an example of a patient with an unstable meniscus tear. These sort of tears don’t do well with just an orthobiologic injection in the office because the meniscus (the “cushion” or “shock absorber”) in the knee is still unstable and moves around too much to heal in the right place. Many surgeons will just remove the torn portion of the meniscus, But this is like removing one of the shock absorbers from your car, and places more stress on the knee and can lead to earlier arthritis. We can repair the meniscus in a variety of ways in an arthroscopic surgery that takes about 30-45 minutes…. and still use your own body’s PRP or stem cells to improve the success rate….a win-win situation for you and your knee!
PRP injections – or Platelet-rich plasma injections – are a minimally invasive medical treatment that stimulates the regeneration of soft tissues. The injections are a type of regenerative medicine that promotes optimal healing for a person who has sustained injuries and can also be used to help alleviate pain associated with those injuries.
A great deal of research has been done, and experts are now concluding that bone marrow injections can be used to effectively treat arthritis in the knees, as well as other joints throughout the body.
Orthobiologics is steadily becoming more advanced and sophisticated, and many experts agree there will come a time when it is used in favor of more invasive orthopedic surgeries. In fact, because orthobiologics can heal body tissue without all the downtime, risks, and potential complications of full-blown surgery, it may very well become more popular and more prevalent than many kinds of orthopedic surgery.
Every patient wants to know the answer to this question. My answer is partly based on this publication by 4 authors including friend Aaron Calodney, MD. They published a comprehensive analysis in 2015 based on the best evidence currently available. After crunching the data from 24 included studies with a total of 2315 patients...the answer is....pain and function improved for 6 months and at 12 months pain and function scores were still better than preinjection scores. There was a wide range of products injected across these studies. Ongoing research since 2015 suggests that platelet counts above 1000 and total platelet doses above 5 billion give longer and better clinical outcomes.
The low concentration/lower doses of PRP still seem to help too, but for a shorter time.