Stem cell therapy for women and older patients
Sadly, many patients experience pain after total knee replacement. The saddest part is that many are told this surgery is their only option due to the severe knee osteoarthritis, so when a total knee arthroplasty fails, hope is lost too. For women and older patients, the chances of a successful knee replacement are lower than that of men and younger patients.
In a study out of London, researchers sought to uncover various predictors of a successful (or unsuccessful) outcome in a total knee replacement1. Looking at 1,991 total knee replacement patients over a three-year period, they discovered various predictors of poor outcomes. Among the findings were that females and older people had worse functional outcomes following the replacement surgery. While women should take this information into account, any Prolotherapist would argue that all knee osteoarthritis patients should seek a second opinion from a Prolotherapist to see if they can avoid surgery and its potential adverse outcomes.
ACL reconstruction revision: poor outcomes with the second surgery
Patients should always take caution when any type of joint surgery is recommended, and reconstruction of the anterior cruciate ligament (ACL) is no different. It is widely known that many patients who undergo ACL reconstruction experience a “giving way” feeling after the surgery and some encounter a re-rupture of the tendon2. These re-ruptures often lead to a second ACL reconstruction surgery. In a study out of Norway, researchers compared 56 patients undergoing a revision reconstruction to 52 patients undergoing a primary reconstruction surgery. The results showed that the patients who had the second surgery had inferior results in almost every category of observation, including greater laxity, less muscle strength, and more severe radiological osteoarthritis2. In other words, the more surgery, the weaker the knee becomes.
Why would the first reconstruction fail in the first place? In an ACL reconstruction, the tendon (often taken from the kneecap tendon or the hamstring tendon) that is supposed to function as the ACL inevitably weakens and can no longer function in the way that the ACL is supposed to. Therefore the knee joint loses stability. Further surgery just weakens the joint even more. An alternative to knee surgery is needed in these cases.
Stem Cell Prolotherapy as an alternative to knee surgery
What is a patient to do when told that a certain knee surgery is the only option? The answer is the get a second opinion from a Prolotherapist. We’ve written at length about the benefits of Prolotherapy for women and men with knee osteoarthritis. We’ve also written about Prolotherapy as an alternative for ACL reconstruction in both the young athlete and athletes in general. Also of note is the increasing use of stem cell therapy in knee pain. Research continues to prove the use of stem cells in knee osteoarthritis. One particular study looked at six female knee osteoarthritis patients who were told that joint replacement was their only option3. The average age of these women was approximately 54 and they all had one stem cell treatment, taking bone marrow from their own iliac crest (hip bone) and injecting it into the affected knee. At the one-year follow-up there were no adverse events to report and all six patients were satisfied. Each woman had good functional status at six months and increased walking distance. Although the results started to decline at six months, the MRI findings did show increased cartilage thickness and repair tissue growth.
Comprehensive Prolotherapy for knee pain and osteoarthritis
When stem cells are used in a Prolotherapy setting, they are often not utilized as a single-dose therapy, as in the study cited above. In fact they are a part of a comprehensive approach that may include platelet-rich plasma (PRP) Prolotherapy and dextrose therapy. Comprehensive Prolotherapy works in that it stimulates the body’s immune system to repair the painful joint, therefore pushing the body into healing phases.
Prolotherapists choose to do treatments every four to six weeks to capture the proliferative phase of healing. Prolotherapy simulates normal healing and the proliferative phase lasts four-six weeks. The use of stem cells, PRP, or dextrose is all dependent on the individual case and the experience of the Prolotherapy doctor. Knee pain and osteoarthritis patients should all seek a second opinion of an experienced Prolotherapist to avoid a costly surgery and to achieve true and long-term healing.
Judge A, Arden NK, Cooper CC, Javaid MK, Carr AJ, Field RE, Dieppe PA. Predictors of outcomes of total knee replacement surgery. Rheumatology. 2012;51(10):1804-1813.
- Gifstad T, Drogset JO, Viset A, Grontvedt T, Hortemo GS. Inferior results after revision ACL reconstructions: a comparison with primary ACL reconstructions. Knee Surg Sports Traumatol Arthrosc. 2012 Dec 14 [Epub ahead of print].
- Emadedin M, Aghdami N, Taghiyar L, Fazeli R, Moghadasali R, Jahangir S, Farjad R, Eslaminejad MB. Intra-articular injection of autologous mesenchyal stem cells in six patient with knee osteoarthritis. Archives of Iranian Medicine. 2012;15(7):422-428.