KNEE PAIN

Arthritis of the knee is very common in the United States. Among adults 60 years of age or older the prevalence of painful knee OA is approximately 10% in men and 13% in women. The number of people affected with painful OA is likely to increase due to the aging of the population. Knee arthritis is also increasing in younger patients who have an active lifestyle. 

Unfortunately, most of these patients do not respond to anti-inflammatory medications [Advil, Motrin, Naprosyn etc] or Opioids [Vicodin, Percocet etc]. Steroid and hyaluronic acid [chicken shots] injections usually provide only short term relief. Physical therapy is also not very helpful in this patient population.

It’s no surprise that most of these patients resort to a total knee replacement.

There are problems with knee replacement. It is a very aggressive procedure where the knee joint is amputated and replaced with a prosthesis. Only about 75% of patients are satisfied with this treatment. The extensive painful rehab needed after replacement surgery is not palatable for many patients.Complications from surgery like infection and dangerous blood clots in the leg is another concern. Anesthesia complications although rare are also an issue. Even if the knee replacement is successful, it lasts for only 10-15 years. Some patients need a second knee replacement when the first one fails. 

Is there a better alternative to treat knee arthritis pain?

Stem cell therapy seems to be answer.

Are stem cells an alternative to back surgery?

Back pain is one of the most difficult conditions to treat. This is because traditional medicine which includes drugs, physical therapy and injections has failed to relieve back pain. This leaves the patients with only option. That is surgery. Unfortunately, surgery helps only for a few years or in some cases doesn’t help at all. An extensive review of all the fusion surgeries done to treat back pain was performed. It revealed that when compared to conservative treatment, fusion surgery was not any better. Moreover, there were more complications reported in the fusion surgery group. In an elegant study done by Dr.Pettine, 76% of patients were able to avoid fusion surgery because they got excellent pain relief from bone marrow stem cell injections. This has been our experience too. Disc is the most common culprit causing low back pain. Fusion is the only surgery that treats it. To get the best results stem cells have to be injected into the disc. We are one of the very few centers performing this procedure in the disc.

Are stem cells an alternative to back surgery?

Back pain is one of the most difficult conditions to treat. This is because traditional medicine which includes drugs, physical therapy and injections has failed to relieve back pain. This leaves the patients with only option. That is surgery. Unfortunately, surgery helps only for a few years or in some cases doesn’t help at all. An extensive review of all the fusion surgeries done to treat back pain was performed. It revealed that when compared to conservative treatment, fusion surgery was not any better. Moreover, there were more complications reported in the fusion surgery group. In an elegant study done by Dr.Pettine, 76% of patients were able to avoid fusion surgery because they got excellent pain relief from bone marrow stem cell injections. This has been our experience too. Disc is the most common culprit causing low back pain. Fusion is the only surgery that treats it. To get the best results stem cells have to be injected into the disc. We are one of the very few centers performing this procedure in the disc.

stem cell studies for knee pain

Are there any clinical trials showing that stem cells relieve knee pain?

There are many studies showing that stem cells help with reducing pain and increasing function in patients suffering from knee arthritis pain. No complications were reported in these studies. The best study is from Dr.Hernigou in France. He is an orthopedic surgeon who has been doing stem cell treatment for joints for more than 30 years and is considered the godfather of stem cell therapy. In this study, he compared stem cell therapy to knee replacement. He found that 70% of patients who had stem cell therapy were satisfied with the treatment. In contrast, only 30% of patients who had knee replacement were satisfied. Moreover 20% of patients who had knee replacement needed a second surgery. Also, there were more complications among patients who had knee replacement. Other studies have shown that stem cell therapy works in patients suffering from knee pain.  We have summarized all the currently available studies in the table below.his complication.

Why is stem cell therapy superior to knee replacement?

We have compiled the top 10 reasons why stem cells are superior to knee replacement. These are summarised in the infographic below.

The 10 th reason is the most important.

What knee conditions can be treated by stem cells?

The following diagnoses of low back pain can be treated with stem cells.

  1. Knee arthritis 
  2. Meniscus tears 
  3. Anterior Cruciate Ligament Tears [ACL Tears]
  4. Posterior Cruciate Ligament Tears [PCL Tears]
  5. Medial Collateral Ligament [MCL] Injuries
  6. Lateral Collateral Ligament [LCL] Injuries

What knee conditions can be treated by stem cells?

The following diagnoses of low back pain can be treated with stem cells.

  1. Knee arthritis 
  2. Meniscus tears 
  3. Anterior Cruciate Ligament Tears [ACL Tears]
  4. Posterior Cruciate Ligament Tears [PCL Tears]
  5. Medial Collateral Ligament [MCL] Injuries
  6. Lateral Collateral Ligament [LCL] Injuries

What to expect from stem cell therapy for Knee pain?

On the day of the procedure, you will be given hydromorphone [strong opioid] by mouth followed by sedating medication [midazolam] in the muscle. This will help with the pain and anxiety during the procedure. Antibiotics are given intravenously to prevent infections. Depending on the patient response, additional sedative medication is given if necessary. The iliac crest [back of the hip] is generously numbed with a local anesthetic. Using a smaller needle, small amount of bone marrow [about a teaspoon] is aspirated at a time until 60 ml [2 ounces] is obtained. The extracted bone marrow is then placed in a concentrating device and 6-10 ml of fluid is collected. This liquid which has a lot of stem cells is then injected into the knee joint, bones and ligaments very precisely under x-ray guidance. If required sometimes an ultrasound machine is used. Before the injection, and epidural or nerve block is done to minimise pain. Patient is then discharged after making sure that the patient has tolerated the procedure well. Some patients may have increased pain for 2-3 days after the procedure. Additional strong painkillers are given to tackle this pain. By 1-2 weeks patients original pain begins to subside and by 1-2 months the maximum pain relief is achieved.

Does the procedure have to be repeated?

No. It is a one time procedure. In our experience, most patients do well as we have a special technique to maximise the number of stem cells extracted. Additionally, multiple pain generators are targeted precisely with stem cells.

What are the risks involved with stem cell therapy for knee pain?

This is a safe procedure. No complications were reported in the studies so far. Some patients have increased pain for 2-3 days after the procedure. Occasionally, this pain may last for 1-2 weeks. We treat this post procedure pain aggressively with painkillers. After the first week, patients start noticing pain relief. It takes about 2 months to get the full benefit from stem cell therapy

Is stem cell therapy for knee pain, the right treatment for you?

If the pain is severe enough that is affecting your lifestyle and if you have failed conservative therapies like medications, physical therapy, etc, you should consider stem cell therapy. If the pain is tolerable or minimal, you are not a candidate. Stem cells “sense” inflammation and get activated. If there is no pain, they will not get activated.

If you are having Chronic pain [pain for more than 6 months] consider stem cell therapy. If pain is less than 6 months, it is preferable to wait and see as pain may get better on its own.

Why are bone marrow stem cells the best?

Firstly, they are the only stem cells that seem to be allowed by the FDA. Fat stem cells like SVF are clearly not allowed. In fact the FDA has shut down 2 stem cell franchises from using SVF. Umbilical cord and Amniotic tissue stem cells are also not allowed by the FDA. Many independent studies have shown that umbilical and amniotic tissue vials that are available commercially do not contain any stem cells. These tissues contain very few stem cells. It is not surprising that these few stem cells don’t survive the collection, storage, processing, freezing and shock thawing process. They only have growth factors. They should be called growth factor therapy and not stem cell therapy. 

Secondly, bone marrow stem cells have been used for 30 years and their safety has been established. Umbilical cord stem cells have caused infections in many patients requiring long term hospitalization. Fat stem cells have caused blindness. This is from the enzymes used to process the fat stem cells. 

Thirdly, most of the clinical trials regarding the efficacy of stem cells to relieve pain have been done with bone marrow stem cells.

Lastly, since are coming from the patient, there is no risk of allergic reactions or infections. 

What do our patients say about stem cell therapy for knee pain?

Kris had severe knee arthritis [bone on bone] and was suffering from knee pain for many years. She underwent stem cell therapy on her left knee. She was extremely pleased with the results and had the same therapy on the right knee. Now her pain is significantly better and is able to be more functional

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