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Thread: knee pain

  1. #1
    Senior Member loanshark's Avatar
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    knee pain

    The last couple of months I've been experiencing some knee pain. It started as just some discomfort after 10 or so miles. It's been getting worse. I had an MRI that revealed a meniscus tear. Anyone have any history with this?
    Who is John Galt?

  2. #2
    Senior Member TCD's Avatar
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    I went through the same last year. The tear was acute, occurring on a specific day. Interestingly, no pain or other symptom at the time, but I woke up the next morning with pain and limited range of motion in flexion.

    I got an MRI, which revealed a meniscus tear and some arthritis. Ortho was convinced that the pain was coming from the arthritis, but I did not buy that due to the sudden onset, and the specificity of the pain in mid joint at end of range flexion. Ortho tried one cortisone shot, which had no positive or negative effect. A few weeks later, I got a second ortho opinion; that ortho felt the pain was, in fact, from the meniscus. His recmmendation was to get as fit as possible, and keep active. Neither ortho recommended surgery of any kind.

    I continued activity (hiking, climbing, biking, skiing), except for trail running, which I stopped for one year. The injury was in July. It was stable through July and August, got markedly worse in September and October,and then gradually got better. I am back to running as of late summer.

    I "treated" this by continuing as much of my normal activity as possible, and forcing myself to walk normally when my body wanted to limp. I have excellent overall health, and injuries heal very quickly for me, so I may not be a good example. Your mileage (or miracle) may vary. But I think the worst thing you could do would be to become sedentary - that knee would lock up like a rusty hinge.

    (Meniscus injuries are not able to be "repaired" in anyone older than about 16. A repair (sewing together the torn pieces) is only attempted in serious athletes of high school age. After that, you're too old for it to heal back together. The "arthroscoic" procedure that's performed on folks my age (55) is a "menisectomy." This is basically grinding off the rough edges and rounding out the corners of the tear, so it causes less discomfort and may be less likely to tear further. While this is speculative, I think I did my own menisectomy by continuing my normal activities. Again, YMMV. Get multiple opinions.)

    Good luck!

  3. #3
    Senior Member --M.'s Avatar
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    Tremendous response, TCD.

    I am in the midst of such an experience, having had the surgery in May. It's been painful and slow in recovery, and has demonstrated that the tear is just one problem of several (arthritis, tendinitis, muscle issues, the whole thing). I agree with TCD on trying to normalize as much as possible, but have also been forced to admit that things take time, and rest may be a crucial element (paradoxically, along with exercise). I've found that stretching, exercise, rest and rehab are not congruous with work (like carrying groceries up & down stairs), and that sometimes, you have to stop working and go with the rest & rehab. And no one will take care of you better than you; don't be a martyr.

    There are several good threads about this on the board; look 'em up and you'll get all the feedback you need.

    Good luck; let us know how it's going, and file some trip reports from the half-steps you take while getting better.

    It can get better; don't give up.

    --Mike.

  4. #4
    Senior Member DougPaul's Avatar
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    From what I have read (various medical sources), the prognosis for a tear depends on its location. The blood supply is located in the outer rim--thus tears close to the center heal slowly (no blood supply) while tears that are close enough to the outer rim heal faster because they have a blood supply.

    Doug

  5. #5
    Member marti124's Avatar
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    Meniscus Tears and Treatment Options

    I had a complex meniscus tear (an MRI and Orthopedic Surgeon informed me of such) from doing the Cornell Crack in the Catskills on July 2nd. After the MRI I was advised to stop hiking, use crutches (an RX was written out for them) and get a knee brace. I somewhat followed the doctor's advice except I used Hiking Poles instead of Crutches, did get a great knee brace, but I did go on my annual John Muir Trail hike in the High Sierras (central CA near Nevada border), and was able to get in 20 days of hiking on the JMT this summer. My knee came out much better due to working the knee (there was a 3 week interval from the injury before the hike though).

    Since the hike I have researched this to death as I do need to get the knee worked on. I notice the most problem going down ordinary stairs, although I'm far better off now than I was back in July.

    On October 18, 2011, I'm going to have a Stem Cell Bone Marrow Prolotherapy treatment done on my knee at CaringMedical.com clinic in Oak Park, IL, by Dr. Ross Hauser, MD (and who is also the editor in Chief of the Journal of Prolotherapy) and author of the book, Prolotherapy: An Alternative to Knee Surgery by Ross A. Hauser -

    http://www.amazon.com/Prolotherapy-A...7942948&sr=8-1

    This book is fantastic, I recommend getting it and reading it. Hauser is an incredible writer.

    Anyway, here are some informative links -- these blog postings of mine contain many more links:

    Surgically Enhanced Stem cells and baseball (relationship to hiking knee injuries too) (Oct 3, 2011 )
    http://groups.yahoo.com/group/JohnMu...ar/message/217

    Read Dr. Hauser's study results on using Prolotherapy for torn meniscus. Ama... (Sep 30, 2011 )
    http://groups.yahoo.com/group/JohnMu...ar/message/214

    Bone Marrow Prolotherapy for hiking knee injury (Sep 28, 2011 )
    http://groups.yahoo.com/group/JohnMu...ar/message/209

    For the first time back-to-back in the high sierras, my hike this year was incomplete. (My trail report and also about hiking with a torn meniscus.)
    Aug 23, 2011
    http://groups.yahoo.com/group/johnmu.../message/18579

    Pay attention to what Dr. Hauser says about Cortisone (don't use it) and NSAIDS (either don't use or super minimize) and the benefit of inflammation (temporarily needed for heeling)--he does allow Tylenol (but go easy on that to avoid liver problems).

    Conventional Orthopedic Surgery is akin to bleeding back in the middle ages. We're in the stone ages for orthopedic conventional treatments. Look at all the pro athletes going into prolotherapy (including Tiger Woods for his knee).

    It's also called Orthobiologics too: http://orthoinfo.aaos.org/topic.cfm?topic=A00525

    PS, my knee brace is documented in the above links. I got it from Amazon.com - Mueller Hg80 Hinged Knee Brace - Large
    Sold by: Pro Therapy Supplies

    It is a fantastic knee brace with flexible aluminum stays. I wear it every day and did my JMT hike with it too. Comfortable even in desert like heat conditions you'll encounter on parts of a JMT hike.

    PS. I'm the lead moderator of the John Muir Trail Yahoo Group this year, we have over 1240 members, over what is consistently ranked the number one trail in the world. I'm going to do my 5th JMT next summer. It's a super addictive hike and in my mind, only if my legs are amputated will I stop doing the hike (or if I drop dead). I hiked with an 84 year old JMT hiker a year ago (he section hikes the JMT each year). Great way to stay young.

    PPS. I live in Delmar NY now and love hiking in the Catskills and ADKs for weekend hike events (but am now leary of doing hikes that are part rock climbing events, such as the Cornell Crack). One gets spoiled doing high sierra hikes where the trails are highly manicured and maintained so that pack animals can use them--where there are switchbacks instead of rock climbs.

    pps - one of the postings lists the 4 major clinics I know of that engage in stem cell (bone marrow) prolotherapy, for conventional prolotherapy there are numerous providers in the NE USA, including NY. But conventional prolotherapy is considered more appropriate for chronic conditions (long standing issues) than for acute conditions (sudden injuries), although after I have about two bone marrow prolotherapy sessions, I may be advised to have several conventional prolotherapy sessions. Again, read the links and get that book by Dr. Hauser. Also subscribe to the Journal of Prolotherapy for $25 (it's per issue, but once you subscribe, you can download all past issues of the journal, then you could unsubscribe).

    There are You Tube videos of the entire procedure done. I'll update this post after October 18 when I have the procedure done.

    final postscript. I should give my age. I turn 62 October 13. But I've done hiking off and on since 1971 when I did my first 17 day hike in Yosemite National Park (after reading The Complete Walker by Colin Fletcher), and I've hiked every summer in the High Sierras since 2000 (but between 1971 and 2000, my hiking was minimal).

    Another final postscript. Three links for the comment on Tiger Woods and his prolotherapy treatments for his knee (he had PRP Prolotherapy, which was the latest advanced form of prolotherapy prior to the introduction of stem cell bone marrow prolotherapy) -- PRP Prolotherapy is still being used, it's just not the most advanced (expensive) form of it anymore.

    http://abcnews.go.com/Health/Technol...ry?id=10303312
    http://www.nytimes.com/2009/02/17/sp...pagewanted=all
    http://query.nytimes.com/gst/fullpag...f=anthonygalea

    By the way, Dr. Hauser has a great critique on the established insurance companies and medical critics of Prolotherapy who use "placebo" studies to show that the statistical significance is slight (bottom line: Prolotherapy is so close to a placebo technique anyway so to say that both placebo and prolotherapy benefits patients 30-35 % in missing the significance that 65% of the patients got better! Think of prolotherapy as akin to accupuncture with tiny needle liquid injections -- it's as much operative from the accupuncture puncturing/stimulating of nerves/blood flow as it is from the injection liquid (we're talking conventional prolotherapy where the liguids are benign materials anyway--not PRP nor Stem Cell Prolotherapy). See Hauser's comments here: http://www.caringmedical.com/media_a...e_It_Works.htm and http://www.caringmedical.com/media_a...EBO_EFFECT.htm and http://www.caringmedical.com/videos/...le-blind-study
    Last edited by marti124; 10-06-2011 at 06:51 PM. Reason: Add Another final postscript and Typo Correction

  6. #6
    Senior Member loanshark's Avatar
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    Thanks for these wonderful responses. My last 2 hiking trips were 8 of the Maine 4 Ks in a long weekend in August and a recent trip to Colorado. After each hike the pain has gotten progressively worse. Am I going to do more damage with more hiking? I've taken the last 4 weeks off and have only marginal improvement.
    Who is John Galt?

  7. #7
    Senior Member TEO's Avatar
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    Quote Originally Posted by TCD View Post
    (Meniscus injuries are not able to be "repaired" in anyone older than about 16. A repair (sewing together the torn pieces) is only attempted in serious athletes of high school age. After that, you're too old for it to heal back together. The "arthroscoic" procedure that's performed on folks my age (55) is a "menisectomy."
    This isn't entirely correct.

    While age may be a factor in the ability for a repaired meniscus to heal, 16 is not the cut-off. 35 isn't even the cut-off.

    DougPaul is closer to the truth. The blood supply to the meniscus is from the outer edge in. The inner half receives little to no blood supply. Thus, tears on the inner-half are considered unrepairable, and instead a surgeon may perform what TCD calls a menisectomy--basically trimming away any rough edges and/or flaps.

    If the tear is in outer half, and is relatively clean, an orthopedic surgeon may attempt to repair it by suturing it. This is a much more serious surgery than a menisectomy, as you have to protect a sutured meniscus so that it will heal successfully. In other words, it's a more difficult and prolonged recovery. But, the benefits are worth it. If you can repair a meniscus, you keep your body's natural cushioning intact, which leads to more comfort and a reduced the risk of arthritis (and knee replacement).

  8. #8
    Senior Member TEO's Avatar
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    Quote Originally Posted by loanshark View Post
    Thanks for these wonderful responses. My last 2 hiking trips were 8 of the Maine 4 Ks in a long weekend in August and a recent trip to Colorado. After each hike the pain has gotten progressively worse. Am I going to do more damage with more hiking? I've taken the last 4 weeks off and have only marginal improvement.
    You need to be asking an orthopedist and/or a physical therapist this question, not a bulletin board.

    What I can tell you is that when I had a suspected meniscus tear and a partial ACL tear, my PT told me that it was OK to ski conservatively--if I didn't fall I wasn't going to do any further damage. But, this PT knows me and my skiing ability very well.

    Regardless, you should be (in PT?) strengthening your quads and increasingly your flexibility.

  9. #9
    Senior Member loanshark's Avatar
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    I saw an Orthopedic today at the Lahey Clinic. He showed me the MRI and said it was a fairly sizable tear. He wants to trim it. The proceedure sounds like the menisectomy mentioned earlier. He also mentioned he couldn't guarentee all the pain would go away after the surgery. That took me back a bit.
    Who is John Galt?

  10. #10
    Member marti124's Avatar
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    More on Knee Injury

    Some more information. A good journal paper on why cortisone shots are detrimental.

    http://www.journalofprolotherapy.com...rtilage_01.php

    The Deterioration of Articular Cartilage in Osteoarthritis by Corticosteroid Injections

    Ross A. Hauser, MD

    A book (by a conventional Orthopedic Surgeon) to also read is: Heal Your Knees: How to prevent knee surgery and what to do if you need it, revised and updated edition, 2004, by Dr. Robert Klapper, MD and Lynda Huey.

    By the way Hauser and others cite the stats on the relatively poor outcome of meniscus repair surgery (and meniscus (partial or total) removal surgery). When you look at the surgical options out there, there is statistically significant risk with conventional orthopedic surgery, while with the various forms of Prolotherapy, hardly any critic talks of negative surgical outcomes (such as Blue Cross's commentary page on Prolotherapy), while the statistical odds for positive outcome are quite high if the physician is an expert in the procedure (Blue Cross says one of the reasons insurance companies consider this investigational is because of the inconsistent treatment of physicians in the procedure).

    Some more links and excerpts below (including the Blue Cross link):

    “A Pinch of Sugar for Pain” by Johannes, Laura of the Wall Street Journal, 10/19/2010.
    http://online.wsj.com/article/SB1000...236534310.html

    “Treatment of Torn Meniscus:
    http://www.caringmedical.com/conditi...n_Meniscus.htm

    “Not all Prolotherapy Doctors are Created Equal”
    http://www.caringmedical.com/therapi...ated-equal.asp

    “What is Prolotherapy with Platelet Rich Plasma”
    http://www.caringmedical.com/therapi...h-plasma_1.asp

    “Prolotherapy”
    http://www.doctorsofusc.com/condition/document/21357
    http://www.upmc.com/healthAtoZ/Pages...chunkiid=21357

    “Prolotherapy.Org”
    http://www.prolotherapy.org/

    “Scar Away Your Pain? Some Docs Back Prolotherapy”
    http://abcnews.go.com/Health/PainMan...4230591&page=1

    “Ross Hauser, MD, a leading Prolotherapy doctor reviews Prolotherapy research and why there can never be a true double blind study.”
    http://prolonews.blogspot.com/2011/0...hauser-md.html

    “Where is the research on Prolotherapy?”
    http://www.youtube.com/watch?v=lKbZ4...eature=related

    “Dr. Hauser, what is your story and experience with Prolotherapy?”
    http://www.youtube.com/watch?v=UiD53...eature=related

    “What are the risks associated with Prolotherapy?”
    http://www.youtube.com/watch?v=fFsdQxVThU0

    Repair of a complete anterior cruciate tear using prolotherapy: a case report. Grote W, Delucia R, Waxman R, Zgierska A, Wilson J, Rabago D.Int Musculoskelet Med. 2009 Dec 1;31(4):159-165.PMID: 20802815 [PubMed] Free PMC Article Free full text Related citations
    http://www.ncbi.nlm.nih.gov/pubmed/20802815

    Long-term effects of dextrose prolotherapy for anterior cruciate ligament laxity. Reeves KD, Hassanein KM.Altern Ther Health Med. 2003 May-Jun;9(3):58-62.PMID: 12776476 [PubMed - indexed for MEDLINE]
    http://www.ncbi.nlm.nih.gov/pubmed/12776476

    Randomized prospective double-blind placebo-controlled study of dextrose prolotherapy for knee osteoarthritis with or without ACL laxity. Reeves KD, Hassanein K.Altern Ther Health Med. 2000 Mar;6(2):68-74, 77-80.PMID: 10710805 [PubMed - indexed for MEDLINE]
    http://www.ncbi.nlm.nih.gov/pubmed/10710805

    Knee Surg Sports Traumatol Arthrosc. 2010 Apr;18(4):472-9. Epub 2009 Oct 17.
    http://www.ncbi.nlm.nih.gov/pubmed/19838676
    Platelet-rich plasma: intra-articular knee injections produced favorable results on degenerative cartilage lesions.
    Kon E, Buda R, Filardo G, Di Martino A, Timoncini A, Cenacchi A, Fornasari PM, Giannini S, Marcacci M.
    Source: Department of Orthopaedic and Sports Trauma, Rizzoli Orthopaedic Institute, Bologna, Italy. e.kon@biomec.ior.it
    http://www.ncbi.nlm.nih.gov/pubmed/19838676

    “A Promising Treatment for Athletes, in Blood” by Alan Schwarz, Published: February 16, 2009 (about “platelet-rich plasma therapy”, an advanced form of Prolotherapy) – “The technique played its most glaring role with Mr. Ward, a receiver who left that Baltimore game in the first quarter with a sprain of the medial collateral ligament in his right knee. The next day, he was injected with a form of PRP therapy called autologous conditioned plasma, which features different proportions of platelets and other cells. Along with strenuous rehabilitation and hyperbaric oxygen therapy, Ward recovered enough to make two catches in the Super Bowl, in which the Steelers beat the Arizona Cardinals”
    http://www.nytimes.com/2009/02/17/sp...lood.html?_r=2

    “Bone Marrow Aspiration—Stem Cell Therapy” – A Video coverage of Bone Marrow Prolotherapy procedure performed by Dr. Ross Hauser, M.D.
    http://adultstemcell.com/tag/knee-pain-treatment

    “Why does Caring Medical perform in situ Bone Marrow Prolotherapy?”
    http://www.youtube.com/watch?v=jLcSq...000&feature=iv

    “What is the cost of Bone Marrow Prolotherapy?”
    http://www.youtube.com/watch?v=sHrYP...eature=related

    “How does Caring Medical obtain bone marrow and is it painful?”
    http://www.youtube.com/watch?v=GNW3v...eature=related

    “Runner’s World: Forums » Injury Prevention » Injuries » RE: prolotherapy for knee pain?”
    http://www.runnersworld.com/communit...rapy-knee-pain
    (many good comments, including by GraceAudrey)

    “Re: PRP injections are regenerating my knee cartilage & ligaments” [Extensive KneeGeeks Bulletin Board Discussion on PRP Prolotherapy]
    http://www.kneeguru.co.uk/KNEEtalk/i...hp?topic=46074

    http://www.kneeguru.co.uk/KNEEtalk/i...topic=46074.75
    mccartjt
    Re: PRP injections are regenerating my knee cartilage & ligaments
    « Reply #88 on: July 23, 2009, 03:40:53 PM »

    My surgeon who is the team doctor for the famed USC Trojans football team has been giving PRP for both ligaments and cartilage regrowth to the USC team players. His modus operandi has been 1 injection / month for about 6 months. Don't forget that growing cartilage takes time and its not an overnight affair.

    Posted on the ORTHOSuperSite February 5, 2010
    Bioactive nanofiber gel matrix may promote new cartilage growth
    http://www.orthosupersite.com/view.aspx?rid=60655

    “Prolotherapy” – Why it is considered an investigational, non-covered procedure by Blue Cross.
    https://www.bcbsmt.com/MedReview/Pol...rapy/v101.aspx

    “Prolotherapy” – Why it is considered an investigational procedure by UnitedHealthCare.
    https://www.unitedhealthcareonline.c...ndications.pdf

    Doctors reported to do Prolotherapy Stem Cell Injections:
    “Stem cells / Microfracture with stem cells is the latest from Dr Steadman in Vail. Dr Shaw in Kuala Lumpur is doing modified microfracture with stem cells too.” - mccartjt (“JM”) Reply #110 on: October 24, 2009, 05:45:23 PM
    http://www.kneeguru.co.uk/KNEEtalk/i...0035#msg480035

    “DR Alan Lazar who injected me also does stem cell injection in a regular surgery setting ( not in his office). He did tell me starting this Nov he will be doing a combination of PRP and stem cell injections together in his office.”
    -abuiltmale Reply #108 on: October 23, 2009, 12:43:39 AM
    http://www.kneeguru.co.uk/KNEEtalk/i...9860#msg479860

    “I 'll be seeing Dr Centeno on Monday for stem cells. I'll keep you all in the loop..”
    - mccartjt (“JM”) Reply #119 on: November 01, 2009, 02:05:50 AM [LA CA area?]
    http://www.kneeguru.co.uk/KNEEtalk/i...0939#msg480939

    Doctors reported to do PRP Prolotherapy:
    “The Cleveland Clinic is now doing PRP for $300 per area. My pain management does it for $400 per area. Hauser in Chicago does it for a little more but he does PRP + prolo in the same area for added effect.”
    --rob wilson Reply #122 on: November 05, 2009, 08:08:26 PM
    http://www.kneeguru.co.uk/KNEEtalk/i...1502#msg481502
    Last edited by marti124; 10-06-2011 at 07:12 PM. Reason: Add the National Library of Medicine Links

  11. #11
    Member marti124's Avatar
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    Still more links and excerpts on Prolotherapy for Meniscus Repair

    Still more links and excerpts:

    http://www.kneeguru.co.uk/KNEEtalk/i...5454#msg485454

    “I think we are going to see quite a lot of stem cell based treatments suspended within scafolds over the next few years...Off top of my head a company called mesoblast are hoping to release a off shelf stem cell product by 2012 and another company from Canada called BST are releasing a product called cargel in 2010 - results from the trials are coming out late this year and ealry next - the intial results - MRI and Biopsie showed improve cartilage tissue quauilty compard to microfracture - another company called Tringenix also bought a uk company which has a scafold type product which soaks up stem cells from the bone and repairs defects - thats expected to hit european markets next year also.”
    --thevoice Reply #135 on: December 20, 2009, 09:47:52 PM


    http://www.kneeguru.co.uk/KNEEtalk/i...4234#msg524234


    Re: PRP injections are regenerating my knee cartilage & ligaments
    « Reply #210 on: November 23, 2010, 02:11:17 PM »

    ________________________________________

    Nick,

    Prolo with and without PRP has served me very well. I've cured my lower back and shoulder of a lot of pain using the Hemdall Hacket treatment method. However, when it came to my knee, it did about half the job. It stabilized the joint and strengthened the knee ligaments, but wasn't as affective in regenerating cartilage.

    So I looked into Regenexx, spoke with a few on this forum to get their insights and experience with Regenexx, and decided to give it a try.Via MRI, my MD was able to point out that my lateral meniscus, or what's left of it after meniscectomy, was squeezed outside of the joint leaving me bone on bone at the lateral posterial horn of the right knee joint. So no amount of Prolo was going to help and they need to first correct the misplacement of the meniscus before injecting stem cells to regenerate the articular cartilage.

    The clinics suggestion, as a first step, was to correct the misalignment of the meniscus that was squeezed out of position. They inserted a fat graph (which contains adipose stem cells) into the corner of the joint, to hold the meniscus in its proper place and provide cushion between the femur and tibia. I watched the procedure using ultra sound. it was amazing watching on screen, just by positioning my knee a certain angle while laying sideways on my side, the joint opened and I watched the meniscus get sucked back into proper position. then the MD injected the fat graph mixed with their own concoction of PRP (supposedly 3x more powerful than bedside PRP) to hold the meniscus in place. I'm now fitted with a lateral unloader for 6 weeks while it heals.

    So my condition is somewhat unique and required a more complicated solution than what regular prolo could provide.

    My next visit they will do the marrow draw for the Mesenchymal stem cells for regenerating the articular cartilage.

    what's frustrating to me is that no MD ever pointed out this meniscus problem before after analyzing my MRI. My regenexx did find it. doc likes to refer to it as the "money shot" and I got a printout of it, that shows my damaged meniscus sqeezed out of the joint.

    Anyways, time will tell if this hypothetical works. I'll have the ultra sound in 5 weeks that will show if this fat graph procedure was a success.

    gb

    http://www.kneeguru.co.uk/KNEEtalk/i...opic=46074.240


    Re: PRP injections are regenerating my knee cartilage & ligaments
    « Reply #240 on: January 04, 2011, 03:19:35 AM »

    ________________________________________
    ashok_guru

    here's an update on my fat graph.

    Regenexx posted my fat graph procedure results to their website. I guess they were happy with the results and decided to share with the world

    the pic is of an ultrasound snapshot of my knee with commentary, 1 month after the fat graph injection. just follow the link below. that's my knee!

    http://www.regenexx.com/2010/12/rege...raft-survival/

    so far, the integrity of the graph is intact and holding the meniscus in its proper place. ~ roughly 40% of lateral meniscus is all thats left and had spit itself outside the knee joint leaving me bone on bone. Apparently its a common problem with patients who've had a menisectomy. this procedure has fixed it providing me with the cushion between the tibia and femur.

    the stiffness in my lateral joint is GONE. can hardly believe it. but its only been a 2 months, we'll see if it holds up.

    too early to tell if the MSC injections (i had this procedure 1 month after the fat graft procedure) have regenerated cartilage. i'm not allowed MRI on the knee for at least 6 months following the last injection. MRI's are bad for the stem cells. so difficult to tell at this point.

    gb


    http://www.kneeguru.co.uk/KNEEtalk/i...4488#msg544488


    Re: PRP injections are regenerating my knee cartilage & ligaments
    « Reply #268 on: May 04, 2011, 01:11:47 AM »

    ________________________________________
    MTLBAB,

    Just following directions by my MD at Regenexx. I personally don't have any data for you.

    BTW, i'll be providing an update soon. Its been 6 months since my first regenexx procedure on my knees (degenerative knee + a displaced lateral meniscus that was squeezed out of the joint) and the results have been very good. I've experienced many PRP and prolo from the the Hauser clinic in Chicago and 3 visits for the regenexx's stem cell procedure, and in my opinion, for cartilage repair, ie. articular cartilage and meniscus, regenexx is by far the better option. More potent, more powerful and much more acccurate. (very important!)

    gb
    “Study Finds Collagen-Producing Cells Heal Patients Faster Than Only Plasma for Tendinopathy“
    Written by Laura Miller | December 09, 2010
    http://beckersorthopedicandspine.com...ne/item/2646-S

    “Platelet-Rich Plasma Injections Treat the Underlying Cause of Knee Arthritis, Notes Cleveland-area Orthopedist Robert Zanotti, MD”
    http://www.prweb.com/releases/PRP/in...web4706744.htm

    “Tiger Takes Another Shot: PRP Injections Put On the Spot”
    http://www.prweb.com/releases/tigerw...web4135604.htm

    American Journal of Physical Medicine & Rehabilitation: December 2010 - Volume 89 - Issue 12 - pp 961-969
    doi: 10.1097/PHM.0b013e3181fc7edf
    “Injection of Platelet-Rich Plasma in Patients with Primary and Secondary Knee Osteoarthritis: A Pilot Study”
    http://journals.lww.com/ajpmr/pages/...rarticles.aspx
    [click on “Free” icon]
    Critical Review of Prolotherapy for Osteoarthritis, Low Back Pain, and other Musculoskeletal Conditions: A Physiatric Perspective
    Kim, Sunny R. MD; Stitik, Todd P. MD; Foye, Patrick M. MD; Greenwald, Brian D. MD; Campagnolo, Denise I. MD, MS
    http://journals.lww.com/ajpmr/Abstra...apy_for.9.aspx

    “Is Platelet-Rich Plasma an Effective Healing Therapy?”
    By Carina Storrs | December 18, 2009
    http://www.scientificamerican.com/ar...-injury&page=2

  12. #12
    Senior Member DougPaul's Avatar
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    Quote Originally Posted by TEO View Post
    DougPaul is closer to the truth. The blood supply to the meniscus is from the outer edge in. The inner half receives little to no blood supply. Thus, tears on the inner-half are considered unrepairable, and instead a surgeon may perform what TCD calls a menisectomy--basically trimming away any rough edges and/or flaps.
    Thanks for the endorsement...

    I also recall reading that in some cases an inner-half tear can be surgically extended to the outer half which allows the healing to extend into the inner half.

    At least some of this info is from "Knee Pain and Disability", by Rene Cailliet, MD, F. A. Davis Company, 1973.

    Doug

  13. #13
    Member marti124's Avatar
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    Prolotherapists in NY, VT, NJ, MA some of whom treat Knee Meniscus Tears

    I uploaded in Google Documents a PDF of all of the NY, NJ, VT, MA prolotherapists and links to what I could find out about them here:

    http://preview.tinyurl.com/44kqmvc

    I decided because my condition is an acute injury versus a chronic condition that I wanted to go with one of the best physicians. Some of the NY/NJ prolotherapists (such as Magaziner) seem to quite reputable, but the reputations of CaringMedical and Regenexx seem to be the strongest in the nation. The KneeGuru forum I found to be of much help. I spent hours there reading different patients with knee injuries and what they thought of prolotherapy (and in the process, what they thought of conventional orthopedic surgery).

    I think in another 5-10 years that Orthobiologics including advanced Prolotherapy will gain conventional acceptance. We're on the threshold of some truly amazing medical advances, and the biggest hangup I see are the following issues:

    a. new paradigms that are not easily judged by conventional paradigm judging techniques

    b. new paradigms that are about 5% the cost of traditional paradigms threatening the profitability of multi-million dollar status quo medical businesses

    c. the revolving door inter-relationships between insurance companies, government, status quo health industries against a fledgling upstart that threatens their livelihoods

    I think the professional athletes who are bucking the status quo and showing the world just how amazing a recovery they're receiving with the new treatments are going to break through these barriers. Thanks, Tiger!

    ps. I wanted to add one more link to the conventional Orthopedic association's outlook on PRP Prolotherapy and how the downside of it is near zero, medical risk speaking:

    http://orthoinfo.aaos.org/topic.cfm?topic=A00648

    "Many famous athletes — Tiger Woods, tennis star Rafael Nadal, and several others — have received PRP for various problems, such as sprained knees and chronic tendon injuries. These types of conditions have typically been treated with medications, physical therapy, or even surgery. Some athletes have credited PRP with their being able to return more quickly to competition."

    "Even though the success of PRP therapy is still questionable, the risks associated with it are minimal: There may be increased pain at the injection site, but the incidence of other problems — infection, tissue damage, nerve injuries — appears to be no different from that associated with cortisone injections."

    Again, read and view Dr. Hauser's comments on the problem with doing and measuring double blind Placebo studies with Prolotherapy (or for that matter, any surgical treatment).
    Last edited by marti124; 10-06-2011 at 08:30 PM. Reason: Added (no changed) paragraphs.

  14. #14
    Senior Member Stan's Avatar
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    I tore my meniscus and it was so painful that I had to find something to do with less stress on the knee for several days. Ultimately, after a period of light activity, I was able to resume normal activities, including hiking, that stress the knees.

    My "treatment" included rest initially, ibuprofen, wrapping the knee in an ace bandage when undertaking any activity and then careful normal activity ... probably more paddling than hiking but hiking nonetheless.

    Note: I'm not a big proponent of icing as that serves, in my mind only as a temporary relief from pain. It helps reduce inflammation by reducing blood flow to the area. Blood flow is what heals as described in ancient Chinese medicine.

    During this period I had little or no restriction in activity but I would get painful "reminders" to be careful because the knee was a lot more delicate.

    Ultimately, it got too painful, especially when my leg got turnd by a stone, root or any other movement that turned the leg in any position other than in straight alignment with the front of the knee.

    That's when I knew it was time to get it "repaired", well, smoothed out. Whatever is done, a good orthopedic surgeon will better advise you than any of us can.

    Since recovering from that procedure, which is another story in itself, I have had absolutely no restriction or pain from any activity ... just an occasional subtle "reminder" to be careful.

    In addition to the MRI, I suggest an x-ray to help determine the condition of the cartilege. It helps to not only know what is wrong with your knee but also confirm what is not wrong and my othopedist was able to confirm that the cartilege was in good condition from the xray.

    You'll know when surgery is NECESSARY but exhaust other "treatments" first.

    Happy healing.

  15. #15
    Senior Member Tom Rankin's Avatar
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    I agree that you should not seek medical advice on a bulletin board, but at the same time, the experiences of others *MAY* be useful to read.
    Tom Rankin
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    Trail maintainer for the Dry Brook Ridge trail from Mill Brook Road to just past the Lean-to

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