Why Prolotherapy Is a Better Treatment Option Than Arthroscopy
Injuries are a common occurrence in our active lives, whether we are sedentary, physically active or compete in sports. While injuries such as sprains and strains can happen anywhere, the knee joint is a very likely spot, and no wonder with all the action it gets from walking, climbing, stepping and jumping. In fact, according to the American Academy of Orthopaedic Surgeons, 18.3 million visits were made to physicians' offices in 2001 because of a knee problem, usually the result of an injury.
The traditional modern medical treatment for painful injuries, whether they’ve occurred in the shoulder, the wrist, the ankle or the knee, involves a treatment protocol called RICE. This combination of rest, ice, compression and elevation, typically unsuccessful in healing the injury and relieving the pain, begins the cycle of anti-healing treatments commonly administered by physicians and osteopaths, including non-steroidal anti-inflammatory drugs (NSAIDs), stronger NSAIDs, cortisone shots and, all-too-often, arthroscopy. It’s a treatment path that can lead to arthritis rather than healing. But before we look at the natural medicine options, let’s take a closer look at arthroscopy.
What is arthroscopy?
Arthroscopy is a form of surgery that allows the visual examination of the interior
of a joint, usually a knee, ankle, elbow or shoulder, using a special surgical
instrument. Surgery can be broadly classified into open repair, in which a surgical
incision is made for direct access and visualization of the injury site, and
closed, or arthroscopic, repair, in which a miniature camera is used to look
into the joint through a small hole, and specially designed tools are used to
repair the tissue. Arthroscopy is currently performed with either a spinal block
or general anesthesia. In order to allow one of four instruments to be placed
in the knee, it must be filled with up to 120 ml of fluid as opposed to its normal
5 ml, a dramatic visual demonstration of the invasive nature of this procedure.
And while size and space are restrictive in the smaller joints, such as the elbow
and the wrist, this rarely stops orthopedic surgeons from doing arthroscopic
Although arthroscopy is designed to permit a closer look inside a joint, it cannot actually determine what is causing the pain (neither can X-rays or MRIs). All any of these tools can do is show a picture that is not necessarily the root of the problem. Unfortunately in the case of arthroscopy, the procedure rarely stops at “a look” and usually includes cutting, burning and/or shaving valuable tissue.
A number of different kinds of arthroscopic surgeries are practiced, each with its own set of complications:
- anterior cruciate ligament (ACL) reconstruction, or ligament reconstruction of the knee: can result in hematoma (blood clot), skin necrosis, excessive scar tissue (arthrofibrosis), deep venous thrombosis (vein blood clot), sensory nerve injury and tissue irritation; among these, excessive scar tissue is the most common, and results in loss of flexion, extension or both
- arthroscopic meniscal repair: can lead to nerve injury, infection and injury, irritation or infection of the blood vessels
- lateral retinacular release (a common arthroscopic procedure for chondromalacia patella): can lead to “bad kneecap tracking,” with an unstable kneecap that moves to the center
- partial meniscectomy (one of the most common arthroscopic procedures): has a high rate for development of long-term arthritis
- shoulder arthroscopy: can lead to nerve injury, rotator cuff tears as well as hemarthrosis and infections, especially if the shoulder joint has some instability
How arthroscopy hinders healing
As mentioned above, arthroscopy, which is designed to allow the surgeon to view the affected joint, is commonly accompanied by tissue removal. And this is where the problem lies. Removing any tissue usually has consequences, often unpleasant. For example, the tissues most commonly removed in the knee during arthroscopic surgery are parts of the meniscus and the articular cartilage, both of which are needed to help the femur bone glide smoothly over the tibia. When either of these structures is removed, the bones do not glide properly. Eventually the meniscus and the articular cartilage that have been left behind after the surgery will wear away. Once this occurs, bone begins rubbing against bone and proliferative arthritis begins. This is typically treated with cortisone shots, non-steroidal anti-inflammatory drugs, several rounds of physical therapy and, eventually, another surgery, this time for a knee replacement. Once an arthroscope touches the knee or any other joint, the chance of developing arthritis increases tremendously.
But what f the injury involves a complete tear of the ligament? In this case, surgery is appropriate. However, most injuries don’t involve complete ligament tears, and, in fact, 98 percent of ligament injuries are partial tears, for which Prolotherapy is very helpful (as explained below). We cannot stress enough that for all conditions other than a complete ligament tear, any tissue removal inside the joint, and especially the knee, will most likely result in an increased chance of a future filled with arthritis and the accompanying chronic pain, as well as a lessened ability to engage in sports and even regular everyday activities. Don’t forget what it means when a doctor says “I’m going to scope the knee”: he’ll remove a little tissue here and cut a little tissue there. And this removal of cartilage, ligament or any other soft tissues of the body only makes that body part weaker!
In other words, the arthroscope is potentially far more dangerous than the original injury, usually a sports injury. The procedure itself is fraught with potential complications, including hematoma, or bleeding into the joint, and infection. Studies have shown that joint lavage, or simply flushing the affected joint with a fluid, may be just as effective as arthroscopy at relieving pain, with less expense and less trauma to the knee. This certainly also questions the value of arthroscopy. However, the most dangerous effect is the permanent weakness left in the joint when soft tissue structures, such as menisci, are removed. Fortunately there’s a better option: Prolotherapy.
Why Prolotherapy is the better treatment option
Prolotherapy, which stimulates tendons, ligaments and cartilage to heal, has many advantages over arthroscopy, which include:
- it’s a much safer and conservative treatment
- it works faster
- the procedure does not take long to administer; an individual is usually in and out of the doctor’s office in less than an hour
- it stimulates the body to help repair the painful area; for example, the new collagen tissue formed is actually stronger than it was before the injury
- it reduces the chance of long-term arthritis; with arthroscopy, the chance of long-term arthritis increases
- in the case of athletes, it increases their chances of being able to play their sports for the rest of their lives; arthroscopy significantly decreases those chances
- exercise is encouraged while getting Prolotherapy treatments; one must be very cautious with exercise after arthroscopy
- the procedure is much less invasive; remember that arthroscopy requires the knee to be blown up with about 100 ml of fluid to fit all the scopes into the knee
- it usually costs about $425 per session; arthroscopy costs several thousand dollars, with additional costs for rehabilitation
Prolotherapy has proven its ability to stimulate the body to repair itself time and again. For example, one doctor newly trained in Prolotherapy discovered he performed 80 percent fewer arthroscopies of the knee and almost no back surgeries since using Prolotherapy to treat his patient. Pretty impressive! But not surprising. The reason for all the suboptimal outcomes of arthroscopy is simple: arthroscopy does not heal anything. Only Prolotherapy stimulates the actual proliferation, or growth, of normal collagen tissue, which starts the normal repair process of the injured ligaments and tendons.
In summary, traditional orthopedic surgery treatments with anti-inflammatories, cortisone shots and arthroscopy (and often, unfortunately, additional surgery) do nothing to repair injured areas, but instead weaken them. Anti-inflammatories and cortisone shots stop the natural healing mechanisms of the body, thus diminishing the chances of healing. When enough deterioration occurs in the tissue, sports medicine specialists, whose treatments encouraged the degenerative process in the first place, will recommend surgical (arthroscopic) cleaning and scraping of the area—removing such vital structures as articular cartilage and menisci. The result: some 400,000 knee and hip replacements are done in the United States annually, with a good percentage of the patients being former athletes. The choice: arthroscopy and possibly additional surgery that involves the removal of bone, ligaments and tendons or Prolotherapy, which involves the repair, growth and healing of these structures.
To learn more about the advantages of Prolotherapy and find complete documentation for this article, check out the book Prolo Your Sports Injuries Away! Order it today!