Prolotherapy knee cartilage regeneration20.11.2020
Hauser R, Cukla J. Journal of Prolotherapy. This article on documented regeneration of knee cartilage first appeared in the Journal of Prolotherapy in Since that time new research is confirming the effectiveness of Prolotherapy and Comprehensive Prolotherapy which features blood platelets as used in Platelet Rich Plasma Prolotherapy and stem cells as used in Stem cell Prolotherapy.
We have added links to this article to take you to the latest research.
Ross A. Cukla, LPN. Degenerative joint disease is the most common form of arthritis. The condition is marked by progressive destruction of the articular cartilage which is easily documented by standard X-ray studies.
The regeneration of this articular cartilage in clinical practice has been difficult.
The Benefits of Prolotherapy Injections for Knee Osteoarthritis
Five knees with articular cartilage degeneration were treated with Prolotherapy in this report. It is suggested that before and after X-ray studies can be used to document the response of degenerated joints to Prolotherapy. Osteoarthritis is one of the major problems affecting our aging population. It has been estimated that two to three percent of the adult American population suffers from regular pain from osteoarthritis, and approximately one-third of adults in the US between the ages of have radiological evidence of osteoarthritis in at least one of the major joints.
Osteoarthritis is the most common form of knee arthritis and can involve any or all three compartments in the knee: the medial compartment medial tibial plateau and medial femoral condyle ; the lateral compartment lateral tibial plateau and lateral femoral condyle ; or the patellofemoral compartment patella and femoral trochlear notch. The increasing number of joint complaints and radiological osteoarthritis is matched by the rising number of major joint replacements.
In one state alone the total number of total knee replacements increased by The current conservative treatments for osteoarthritis including medications, exercise, physical therapy, corticosteroid injectionsweight controlSynvisc and Hyalgan injectionsand operative treatments including knee arthroscopy often leave people with residual pain.
Prolotherapy, also known as regenerative injection therapyinvolves the injection of substances into degenerated or injured areas to stimulate healing.
Dean Reeves and associates have demonstrated beneficial effects of Prolotherapy on including some X-ray changes. This report documents the results in five degenerated knees treated with Prolotherapy. Before and after X-rays were available to document articular cartilage regeneration with Prolotherapy.
Each patient underwent standard Hackett-Hemwall Prolotherapy to the knee. A total of 5 to 10cc of Prolotherapy solution was injected into the joint at each visit. Four hundred milligrams of glucosamine sulfate was added to one of the 10cc syringes. A total of 30 to 40cc of Prolotherapy solution was used per knee at each visit. This represented 20 to 30 injections per knee per visit.
She rated her knee pain on the visual analogue scale VAS at a level of 6 on a scale of 0 to She experienced daily pain throughout the whole knee and noted that the severity of the pain was also increasing. Her other symptoms were increased pain upon sitting for long periods of time, difficulty with stairs, and increased pain with walking.
She was not exercising. She had no previous history of trauma or knee surgery. Three previous hyaluronic acid treatments provided diminishing relief. She used the oral pain relievers, tramadol hydrochloride and acetaminophenas needed.
X-rays done in showed osteoarthritis, marked loss of joint space medially, subchondral sclerosis and osteophyte formation. CW was told by an orthopedist that she needed a total knee replacement.Prolotherapy knee cartilage regeneration in Novi MI can fix a multitude of conditions thanks to this knee reconstruction and regenerative joint injection solution that does not require surgery.
As you already know, surgery comes with painful recovery times that last many months and medication is often addictive. Prolotherapy knee cartilage regeneration in Novi MI may be a better fix. Also known as proliferative therapy, it is quickly gaining attention over other methods that may simply mask pain like injections of cortisone, addictive medications and invasive surgeries.
We can help you find out why that instability is happening in order to strengthen the weakened sites and generate new collagen tissue. When ligaments that are under stress or that have started to tear and stretch, they can make the attached joints fall victim to instability and pain. Permanent knee stabilization and the lack of living with pain: this is the ultimate goal of prolotherapy knee cartilage regeneration in Novi MI.
To learn more about prolotherapy knee cartilage regeneration in Novi MI, call the Michigan Center for Regenerative Medicine for your free consultation at First, a little background: As you age, bones will start to rub against other bones, which leads to stiffness, pain and swelling.
Over time, the knee cartilage can lose strength and pain becomes chronic. The success rate of prolotherapy knee cartilage regeneration in Novi MI will depend on your history, rate of healing, and the specific solution used for treatment. In general, the success rate for prolotherapy for knees is rated at nearly 90 percent. The knee is subject to a lifetime of repetitive movements, and can end in injury and pain.
Prolotherapy is designed to address knee pain due to knee cartilage degeneration, but it can also treat:. Do you suffer from osteoarthritis in any of its various forms? You could be a candidate for this procedure. Prolotherapy makes new tissues in weak areas — in this case, the knees. The body can begin to repair itself after you receive an injection into the injury site. Then, as the restored ligaments and tendons heal, the site will naturally become inflamed, which is all normal.
To learn more about prolotherapy for knee cartilage regeneration in Novi MI, call The Michigan Center for Regenerative Medicine now for your free consultation at All Rights Reserved.
X-rays Document Cartilage Regeneration in Knees After Prolotherapy
Client Satisfaction 4. No Addictive Medications. Medical Breakthrough. Advanced Technology. Treat Inflammation. Clinically Proven. For All Ages. Prolotherapy Knee Cartilage Regeneration in Novi MI Prolotherapy knee cartilage regeneration in Novi MI can fix a multitude of conditions thanks to this knee reconstruction and regenerative joint injection solution that does not require surgery.
What Can I Expect? You may have some mild swelling and stiffness afterwards, but we recommend taking over-the-counter pain relievers to ease any discomfort.David N. Woznica, MD. In this article, we will examine the research and the clinical application of stem cell therapy for articular cartilage repair.
Stem cell therapy will be explained in the various videos embedded in this article. If you have questions about cartilage repair and injectable stem cell treatments, please get help and information for our Caring Medical staff. The full range of limitations and possibilities, with respect to clinical application of various stem cells, remains to be established, but the advantages of stem cells seem obvious.
In a landmark study from the Department of Orthopaedics, Case Western Reserve University School of Medicine, University Hospitals of Cleveland, doctors found that osteochondral progenitor cells in simple terms stem cells that accelerate and enhance bone and articular cartilage repair could be used to repair large, full-thickness defects of the articular cartilage that had been created in the knees of rabbits. The researchers concluded: The current modalities in knee cartilage surgery and conservative care, medications, and painkillers for the repair of defects of the articular cartilage have many disadvantages.
The transplantation of progenitor stem cells that will form cartilage and bone offers a possible alternative to these methods. InDr. Shinya Yamasaki who lead the above cited study twenty years earlier, lead another study, this time from the Department of Orthopaedic Surgery, Sinshu University School of Medicine, Japan. In this study again, the doctors found that there is no widely accepted method to repair articular cartilage defects.
Bone marrow mesenchymal cells have the potential to differentiate into bone, cartilage, fat and muscle. Bone marrow mesenchymal cell transplantation is easy to use clinically because cells can be easily obtained and can be multiplied without losing their capacity of differentiation.
The objective of this study was to apply these cell transplantations to repair human articular cartilage defects in osteoarthritic knee joints. Not only was there evidence of marked regeneration of meniscal tissuebut the usual progressive destruction of articular cartilage, osteophytic remodeling and subchondral sclerosis hardening of the bone beneath the cartilage commonly seen in osteoarthritic disease was reduced in MSC-treated joints compared with controls.
Part of the excitement was the discovery that stem cells could control various healing mechanisms that enabled articular cartilage repair. They release important cytokines such as epidermal growth factor EGFtransforming growth factor beta TGFBvascular endothelial growth factor VEGFas well as other cytokines and new cartilage proteins that are essential in combating osteoarthritis and degenerative processes. It has also been suggested that stem cells could release cytokines and proteins that could help combat neurogenic pain, which would have numerous benefits in treating osteoarthritis pain.
The authors were not trying to prove that direct bone marrow injection stimulates articular cartilage defects to heal, because they used the direct mesenchymal stem cell injection as a control. The study went as follows: full-thickness osteochondral defects 5mm x 5mm wide, 3mm deep were created in the trochlear groove of the femurs in adult rabbits.
The defect was filled with synovial mesenchymal cells suspension and then as controls, some of the cells were directly injected into the joint or nothing was done at all.
They were examining the results of directly filling the defect compared to just injecting mesenchymal stem cells intra-articularly versus doing nothing at all. In the control group of animals where nothing was done, the articular cartilage defect remained, but in the intra-articular group as well as the group of animals where the mesenchymal stem cells were placed directly on the wound, the defects were completely covered by new articular cartilage tissue.
In the directly placed group, the regenerated cartilage matrix was well developed. Hauser R, Eteshola E. Rationale for using direct bone marrow aspirate as a proliferant for regenerative injection therapy prolotherapy.Download PDF. Ross Hauser, MD. The regeneration of articular cartilage with prolotherapy.
Journal of Prolotherapy. Note: Since this article first appeared in the Journal of Prolotherapy innew research has continued to support the use of Prolotherapy for articular cartilage repair. In my opinion, Prolotherapy should be the treatment of choice for most cases of pain involving the degeneration of a joint. It is common knowledge that even the most effective current treatments for osteoarthritis do not restore the joint.
Conservative treatments such as exercise, medications, physical therapy, and lifestyle modification can decrease symptoms and improve mobility, but they do not reverse the disease. I believe if Prolotherapy were utilized to its fullest in the treatment of knee, shoulder, and other peripheral joint degenerative conditions, it would be shown to be the one treatment that does restore some, or most, of the degenerated structures, as well as the functions of the joint.
What most people may not realize is that chondrocytes, the cells that make articular cartilage, are metabolically active. In normal cartilage, there is a strict regulation of cartilage turnover, a delicate balance between synthesis and degradation.
The problem is, for those suffering from osteoarthritis, the system is imbalanced. There is more cartilage degeneration than rebuilding. In osteoarthritis, both degradation and synthesis of articular cartilage are enhanced.
The anabolic cytokines substances that build up IGF-1, TGF-B1, 2, and 3, fibroblast growth factors FGFs 2, 4, and 8, and the bone morphogenetic proteins act to stimulate extracellular matrix synthesis. It is well known that in osteoarthritis, chondrocytes retain their proliferative activity. In the natural history of the disease, despite this increased activity, a net loss of proteoglycan content extracellular cartilage matrix is one of the common features of all stages of osteoarthritic cartilage degeneration.
One of the main hallmarks of osteoarthritis in a joint is the development of prominent osteochondral nodules known as osteophytes.
These are also called osteochondrophytes or chondroosteophytes. Most of us know them as bone spurs. Indeed, the presence of osteophytes in a joint, more than any other pathological feature, distinguishes osteoarthritis from other arthritides. The purpose of osteophytes is presumed to be the stabilization of joints affected by osteoarthritis. When larger osteophytes are examined from human patients, areas of hyaline cartilage can be seen to extend to the surface of the osteophyte.
These cartilaginous tissues resemble genuine articular cartilage in chondrocyte morphology and in extracellular matrix. Table: Physiology of osteoarthritis. While articular cartilage is stimulated in osteoarthritis, the net result is degeneration in part because of the increase in catabolic cytokines.What most people may not realize is that chondrocytes, the cells that make articular cartilage, are metabolically active.
Chondrocytes proliferate and actively make articular cartilage. Osteoarthritis is an example of this, in that both the degradation and synthesis of articular cartilage are enhanced. It is well known that in osteoarthritis, chondrocytes retain their proliferative activity. Osteophytes or bone spurs are an example of this activity.
In this condition the body produces an excessive amount of human growth hormone and with it, articular cartilage. Acromegalics often suffer from joint abnormalities caused by proliferation of chondroytes in articular cartilage. In other words, they produce too much cartilage. When a healthy articular cartilage cell is injured, it demonstrates an enhanced reparative response and can replicate its DNA to form new cells.
The rate of formation of articular cartilage can be enhanced by such stimuli as altered hydrostatic pressure, varied oxygen tension, growth factors, as well as nutrient and substrate manipulation. In this scientific editorial, the author makes the case for using Prolotherapy as the treatment of choice for degenerated joints. Journal of Prolotherapy. In my opinion, Prolotherapy should be the treatment of choice for most cases of pain involving the degeneration of a joint.
It is common knowledge that even the most effective current treatments for osteoarthritis do not restore the joint. Conservative treatments such as exercise, medications, physical therapy, and lifestyle modification can decrease symptoms and improve mobility, but they do not reverse the disease.
I believe if Prolotherapy were utilized to its fullest in the treatment of knee, shoulder, and other peripheral joint degenerative conditions, it would be shown to be the one treatment that does restore some, or most, of the degenerated structures, as well as the functions of the joint.
In normal cartilage, there is a strict regulation of cartilage turnover, a delicate balance between synthesis and degradation. The problem is, for those suffering from osteoarthritis, the system is imbalanced. There is more cartilage degeneration than rebuilding. In osteoarthritis, both degradation and synthesis of articular cartilage are enhanced. The anabolic cytokines substances that build up IGF-1, TGF-B1, 2, and 3, fibroblast growth factors FGFs 2, 4, and 8, and the bone morphogenetic proteins act to stimulate extracellular matrix synthesis.Bone on bone arthritis refers to a severe narrowing of the joint space associated with osteoarthritis and is a condition that patients frequently have questions about.
Osteoarthritis is characterized on x-ray by a thinning of the joint space between two bones and this thinning is related to a destruction of the joint cartilage. Other findings of osteoarthritis on the X-ray can include boney spur formation and increased whiteness at the joint, as the body tries to stabilize the deteriorating joint.
Although there is no consensus as to why osteoarthritis occurs, influencing factors include sex women, especially after entering menopauselow hormone levels, nutritional factors, obesity, ligament laxity, joint misalignment, and trauma. Although any joint in the body can potentially become bone on bone, the most common joints I find with this degree of degeneration are the knees, hips and shoulders. Traditional Treatment Injections of steroids and prescriptions of Nonsteroidal anti-inflammatory NSAIDS drugs are the traditional approaches for the treatment of osteoarthritis.
Even though, numerous studies have shown the detrimental effects of each of these treatments, there use has increased since they were first prescribed. As the use of these treatments has increased, there has also been an exponential increase in knee, hip and back surgeries performed. Other traditional treatments for osteoarthritis include physical therapy and hyaluronic acid injections for the knee, referred to a Rooster Comb injections.
Even though each of these injection types have been shown to provide significant relief to patients suffering from osteoarthritic joints, including bone on bone conditions, this type of medicine is normally not practiced by most traditional orthopedic doctors. In fact, some doctors will tell their patients that these injections will not help and would be a waste of their money. We recently had this exact situation happen when a patient received two prolotherapy regenerative injection therapy injections was told by her family medicine doctor and an orthopedic doctor that the regenerative injections would not help her.
The patient was told this after she had received benefit from the injections. When patients receive incorrect conflicting medical advice this can be very confusing and prolong a painful condition resulting in the patient never receiving proper care for their condition. Ross Hauser, documents five degenerated knee cases, some with bone on bone, treated with Prolotherapy regenerative injection therapy.
Before and after X-rays were available to document articular cartilage regeneration. In this study, there is significant improvement in the bone on bone joint space. There is obvious improvement in joint space narrowing in the before and after Prolozone pictures. According to Dr. Writing in the medical journal Arthroscopy, researchers documented improvement with stem cell injections in patients with knee osteoarthritis.
They noted significant reduction in pain, significant improvement in function and MRI documented cartilage growth. Case History We had a nice lady report to our office with knee pain and she was told that she needed knee replacement surgery because she had bone on bone. Her x-rays clearly demonstrated a severe narrowing of the joint space; however, she could walk with very little to any pain and she could perform her daily activities well.
She was treated with prolotherapy, responded well, and did not need surgery. It is not uncommon, for patients to be told they need surgery for osteoarthritic conditions, even though they have very little pain or discomfort. I do not understand why someone should have surgery for their arthritic joints if they are doing well.
Conclusion Regenerative injections therapies are outpatient procedures that have the potential to reverse degenerative joint osteoarthritis, including bone on bone joint conditions. Despite the opinion of some medical professional, these procedures are successful in treating bone on bone conditions.
RIT procedures promote regeneration of ligament, tendon and cartilage involving bone on bone conditions. RIT studies have documented joint repair, joint stabilization, improvement of radiographic studies, and improved quality of life for patients with osteoarthritis.
Since RIT procedures provide long term solutions for degenerative joints and not just tempory pain relief, they should be considered prior to long term narcotic therapy, steroid injections or surgical intervention. Fred G. Articles by Dr. Arnold Health articles by Dr.
Fred Arnold focus on prolotherapy, pain rehabilitation and natural healing.When stressed-out ligaments or start tearing and stretching, the attached joints can fall victim to instability and pain.
Permanent stabilization of the knee and no more pain: this is the goal of prolotherapy knee cartilage regeneration in Michigan. Conversely, surgery comes with painful recovery times that last many months and medication is often addictive. In regards to relieving chronic knee pain, prolotherapy knee cartilage regeneration in Michigan could be an ideal solution.
Prolotherapy knee cartilage regeneration in Michigan finds out why this instability is happening in order to strengthen the weakened sites and generate new collagen tissue.
The knee is subject to a lifetime of repetitive movements, and can result in injury and pain. Prolotherapy can help with many conditions, considered an ideal knee reconstruction and regenerative joint injection solution without surgery. Also known as proliferative therapy, it is quickly gaining acceptance over more traditional methods such as cortisone injections, addictive medications and invasive surgeries.
To inquire about prolotherapy knee cartilage regeneration in Michigan, call the Michigan Center for Regenerative Medicine for your free consultation at As bones start to rub against other bones, stiffness, pain and swelling can result. Over time, the knee cartilage can lose strength and pain becomes chronic. The body can begin to repair itself after you receive an injection into the injury site.
Prolotherapy makes new tissues in weak areas — in this case, the knees. Then, as the restored ligaments and tendons heal, the site will naturally become inflamed.
This is common. You may experience some mild swelling and stiffness afterwards, but we recommend taking over-the-counter pain relievers to ease any discomfort.
Stay away from anti-inflammatory drugs, such as aspirin and ibuprofen, which can add to healing time. The treatment itself does not hurt, but you may experience some discomfort at the site due to the needle. You are a great candidate for this procedure if you suffer from osteoarthritis in any of its various forms. While prolotherapy is a good solution for knee pain due to knee cartilage degeneration, it can also help those who suffer from:. First, you will be evaluated as part of a consultation and complete exam.
During this exam, we will discuss the risks and results with you, which vary by patient. In general, the success rate for prolotherapy for knees is rated at nearly 90 percent. The success rate of prolotherapy knee cartilage regeneration in Michigan will depend on your history, how fast you tend to heal, and the specific solution used for treatment.
To inquire about prolotherapy for knee cartilage regeneration in Michigan, call The Michigan Center for Regenerative Medicine now for your free consultation at All Rights Reserved. Client Satisfaction 4. No Addictive Medications. Medical Breakthrough. Advanced Technology. Treat Inflammation. Clinically Proven. For All Ages. Prolotherapy Knee Cartilage Regeneration in Michigan When stressed-out ligaments or start tearing and stretching, the attached joints can fall victim to instability and pain.
Contact The Michigan Center for Regenerative Medicine To inquire about prolotherapy for knee cartilage regeneration in Michigan, call The Michigan Center for Regenerative Medicine now for your free consultation at