Cartilage regeneration with Prolotherapy
There are now 40 million people in the United States with arthritis and this number is expected to grow to 60 million by the year 2020.
Why Are We In a Cartilage Crisis?
What is the Cartilage Crisis?
Most of the joints in the body are synovial joints, that is movable, lubricated joints which are able to provide normal pain-free movement because of the unique properties of the articular cartilage. See also Articular Cartilage Growth (our research paper) that discusses the ability of Prolotherapy to stimulate cartilage growth and repair. The articular cartilage covers and protects the ends of the bones in joints. The knee is the largest synovial joint.
Dr. Hauser reviews anatomy: At the top of the knee are the massive quadriceps muscles which cause the knee to extend. The hamstring muscles are at the back of the knee and cause it to flex. The knee joint has a synovial membrane, which is tissue that lines the noncontact surfaces within the joint capsule. This tissue secretes lubricating synovial fluid, which nourishes all the tissues inside the joint capsule. The knee has internal ligamentscruciate ligaments) and external joint ligaments (collateral ligaments) which stabilize the joint, especially during movement. The knee also has menisci, pads of fibrous cartilage which help the weight-bearing bones absorb shock. The ends of the tibia, femur, and patellar bones of the knee joint are covered by articular cartilage. This is the structure that we find is in crisis.
Articular cartilage allows near frictionless motion to occur between the surfaces of two bones. Furthermore, articular cartilage distributes the loads on the joint articulation over a larger contact area, thereby minimizing the contact stresses, and dissipates the energy force associated with the load. Articular cartilage is made of specialized protein structures, called Proteoglycans, water, and collagen. The cells (chondrocytes) of articular cartilage are responsible for the synthesis of both the collagen and proteoglycans that make up the cartilage and have the ability to synthesize all the various components of the specialized proteins that make up the proteoglycans.
Can cartilage be repaired non-surgically?
Before and after Prolotherapy x-rays showing cartilage growth in a knee
The above ability of these chondrocytes (see our research paper) to replicate is really the key question when considering the potential of cartilage to proliferate or to repair itself. It has been shown in studies on adult human cartilage that there is no decrease in cell counts, even in individuals of advanced age. This fact alone suggests that chondrocytes have the ability to proliferate and repair. Additionally upon certain injury such as mild compression, osteoarthritis, or lacerative injury, the chondrocytes are capable of mitotic division, indicative of growth and proliferation.
The notion of damaged cartilage having no regenerative properties is responsible for many people being subjected to arthroscopies with subsequent joint replacements. This falsehood or myth occurred because healthy cartilage cells have very little, if any, mitotic activity, thus very little or no ability to proliferate.
Where is the research? Earlier research on articular cartilage regeneration was performed in the 1980s and 1990s. Dr. H.J. Mankin discovered that the chondrocytes reaction to injury was to change into a more immature cell, called a chondroblast, which was capable of cell proliferation, growth, and healing. This key fact is vital to understanding the power of Prolotherapy in proliferating cartilage regrowth. We have published a number of retrospective studies from patients of Caring Medical showing the growth of cartilage, including before and after x-rays, which can be read in their entirety at www.prolotherapy.org.
The Role of Caring Medical’s technique of Prolotherapy in Cartilage Growth
When we perform Prolotherapy in our office, it involves giving many injections to each area using solutions that help heal the body. We utilize the Hackett-Hemwall technique of Prolotherapy. Prolotherapy in our office involves the injection of substances, such as hypertonic dextrose, sodium morrhuate (extract of cod liver oil), various minerals, Sarapin (extract of the pitcher plant), and various other substances including Growth Hormone or PRP, which act by stimulating the structures to repair. (The actual substances injected depend on the individual case and may differ among doctors.) The current theory of cartilage regeneration is that this irritation acts in the same mechanism as above in inducing the chondrocytes into the chondroblastic stage of development capable of proliferation and repair. Our numerous patients, who had no cartilage or were set for hip/knee replacements who never needed them because of Prolotherapy, support this fact.
Ross Hauser, MD, injecting a knee with Prolotherapy.
Can It Be Proven That Prolotherapy Regenerates Knee Cartilage?
It is impossible to do a double-blind study on Prolotherapy because even an injection of sterile water under the skin has a beneficial therapeutic effect. Even if no injection was given on one side, as the control, sticking a needle into a painful area is known to have a beneficial effect (this treatment is called acupuncture). It is very difficult to prove using a traditional scientific model, that Prolotherapy cures chronic pain, sports injuries, and regenerates cartilage tissue. However, radiographic before and after studies, as well as studies measuring pain, crunching, stiffness and levels of performance in activities of daily living certainly document the positive outcomes experienced for our patients here at Caring Medical with Prolotherapy by Dr. Hauser.
If this sounds like your case, give us a call at 708-848-7789 to set up an appointment so we can help you get back to doing the things that you want to do! Want to stay in touch? Join us on Facebook or Twitter!
Stem cell and bone marrow injections now being offered at Caring Medical for severely degenerated conditions. For more information click here.
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