Degenerative joint conditions such as osteoarthritis are extremely common and cause huge problems. The use of Regenerative Medicine procedures such as Stem Cell Treatments and Platelet Rich Plasma (PRP) are finding a role in this common problem. Traditional treatment measures such as anti-inflammatory arthritis medications and steroid injections have not been shown to deter the arthritis degenerative process. Other joint injections and lubricants are also commonly used to treat arthritis but have not been able to show the long term benefits on arresting the development of degenerative arthritis. The knee is the most frequent joint encountered. Unsurprisingly, the number of total joint surgeries performed has the highest frequency for total knee joint replacement.
Stem Cell Treatments and Platelet Rich Plasma (PRP) are not only of interest to a wide variety of clinical trials, there use as well as in a spectrum of Regenerative and Tissue Engineering applications is being considered. It is not uncommon for both knees to be affected with degenerative arthritis. Women have smaller joint surface area than men, and thus biomechanical forces are more directed and overload the joint in women greater as weight gain occurs. The addition of multiple joints on one extremity such as the hip and knee are not infrequent, especially if prior trauma occurred.
Our aim at Dynamic Regenerative Medicine is JOINT PRESERVATION. It is not possible to create and growth new cartilage, however, we do know it is possible to slow the progression and degenerative changes and preserve our joints. Because lets face it no body wants joint replacements, right?! The procedure is huge and results are mixed. However, when our joints have gone through severe degenerative changes, replacement happens to be our only option. So why not do something about this in the early stages of management?
Platelet Rich Plasma (PRP) Injections
PRP Injection Therapy is a natural and cost-effective alternative to surgery. PRP injection treatment is used to help rebuild cartilage, repair torn meniscus and ligaments, and reduce swelling and pain. It works by stimulating the natural immune repair mechanisms and supplying the building blocks necessary to build tissue.
PRP injections deliver a high concentration of your own platelets to the knee where arthritis may is present. Blood is composed of plasma, red blood cells, white blood cells, and platelets. It’s these platelets that are the injury’s “first-responders” and help re-vascularize an injured area, construct new tissue, and stop the bleeding. Platelets play a significant role in the healing of tissue, reintroducing a high concentration of platelets directly into the injured area may enhance the healing process.
In November 2017, researchers reported on the benefits of PRP in knee osteoarthritis and reduced muscle strength in that knee. Published in the American journal of physical medicine & rehabilitation, the study showed PRP treatment significantly improves pain, stiffness, and disability in patients with knee osteoarthritis compared to normal saline (placebo) treatment. Additionally, to enhance PRP recovery muscle strength training was recommended. Also, the International journal of rheumatic diseases, researchers reported a summary of the most recent findings on the benefits of PRP for knee osteoarthritis. This study performed an overview of the research to provide recommendations for PRP use in knee osteoarthritis. They concluded that PRP is an effective intervention in treating knee osteoarthritis without increased risk of adverse events.
In the medical journal Arthroscopy, a journal devoted to obviously arthroscopy, surgeons are told that Platelet Rich Plasma injections (PRP), offers better symptomatic relief to patients with early knee degenerative changes (than hyaluronic acid or placebo), and its use should be considered in patients with knee osteoarthritis. This is a verification of early research which came to the same conclusion – PRP showed better improvement than hyaluronic acid injection and placebo in reducing symptoms and improving function and quality of life. The list goes on.... At minimum PRP prevented further knee deterioration.
Autologous Protein Injections (API)
This is a single protein injection which reports are claiming could replace the need for knee surgery for osteoarthritis sufferers
Protein is harvested from patient’s and the injections led into the knee
Could vastly reduce the need for keyhole surgery for osteoarthritis of the knee
85 per cent of patients had huge pain relief in their knee following procedure
The new 20-minute procedure sees blood drawn from the patient’s arm, separated in a centrifuge, after which part of the fluid is then injected into the arthritic knee similar to PRP treatment. The surgeon who brought the treatment to the UK believes it can stop the need for keyhole surgery for osteoarthritis of the knee altogether.
Osteoarthritis is the most common type of arthritis, particularly affecting people aged 65 and over. The degenerative condition affects the cartilage – the joint’s connective tissue – causing pain, stiffness and inflammation. A trial study in the Netherlands published earlier this year showed that 85 per cent of patients had little to no pain in their knee six months after new procedure, which is called the NStride Autologous protein injections.
The theory behind the new procedure is that the inflammation caused by arthritis can be combated by injecting healthy proteins straight into the joint.
About 5ml of blood is taken from a vein in the patient’s arm, mixed with an anticoagulant and centrifuged at high speed for 15 minutes, causing the blood to separate into three layers – a yellow blood plasma; a red blood cell concentration; and a ‘platelet-rich plasma’, a solution comprising platelet cells and some white blood cells.
The platelet-rich plasma is extracted and centrifuged again for an additional two minutes until we end up with a 3ml protein liquid, which is then injected into the knee.
Vikas Vedi, consultant orthopaedic surgeon and specialist in hip and knee reconstruction at BMI Bishops Wood Hospital in Northwood, North-West London, was the first consultant to perform the procedure in the UK.
‘The aim is a clinical improvement in the patients’ osteoarthritis as well as an improvement in quality of life,’.
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