If you watched the Los Angeles Lakers play the Chicago Bulls over the Christmas weekend, you would have heard the story repeated many times during the broadcast of how Kobe Bryant had traveled to Germany for a Platelet Rich Plasma treatment for his arthritic knee and how PRP is not available in the United States. My congratulations to Kobe Bryant and his doctors, it looks like the treatment worked although the Bulls did win. He played well and there was no visible sign of the bone-on-bone arthritic knee affecting him. To correct the announcers though, you should be aware that platelet rich plasma injection, not unlike that used in the case of Kobe Bryant, is widely available in the United States and FDA approved. Since April of this year, I have personally treated 28 patients with Platelet Rich Plasma including the knee, hip and shoulder. Improvement in arthritic symptoms and increased function has been observed in about 70% of those patients so far. That’s a reasonable improvement for arthritic impairment but is there something better? Might a non-surgical stem-cell treatment for people suffering from knee pain due to common injuries or other degenerative problems be a substitute treatment for arthroscopy or total knee replacement?

 Original Article

Incidental Meniscal Findings on Knee MRI in Middle-Aged and Elderly Persons

Martin Englund, M.D., Ph.D., Ali Guermazi, M.D., Daniel Gale, M.D., David J. Hunter, M.B.,B.S., Ph.D., Piran Aliabadi, M.D., Margaret Clancy, M.P.H., and David T. Felson, M.D., M.P.H.

N Engl J Med 2008; 359:1108-1115September 11, 2008

Results

The prevalence of a meniscal tear or of meniscal destruction in the right knee as detected on MRI ranged from 19% among women 50 to 59 years of age to 56% among men 70 to 90 years of age. Among persons with radiographic evidence of osteoarthritis, the prevalence of a meniscal tear was 63% among those with knee pain, aching, or stiffness on most days and 60% among those without these symptoms. The corresponding prevalence among persons without radiographic evidence of osteoarthritis was 32% and 23%. Sixty-one percent of the subjects who had meniscal tears in their knees had not had any pain, aching, or stiffness during the previous month.

Conclusions

Incidental meniscal findings on MRI of the knee are common in the general population and increase with increasing age.

Because of the aforementioned scientific study, I have determined the following Inclusion criteria for the Bone Marrow Concentrate Pilot Study

1. Age over 50. For patients with an osteoarthritic defect on MRI

2.  Near normal knee alignment

3.  Symptoms referable to the cartilage defect:

          Swelling

          Pain

          Giving way

          Locking

          Crepitation

4.  Early OA with no evidence of inflammatory arthritis

5. >2mm residual joint space on X-ray

6. Unicompartmental osteoarthritis

    a. ROM >-10 to 110

    b. Mechanical axis <12 degrees varus or valgus

    c. Minimal involvement of patella femoral joint

    d. No >2-3mm laxity in any plane

To find out if you qualify for the study, call and make an appointment. For those who don’t qualify for inclusion in the Pilot Study, you still may be a candidate for Bone Marrow Concentrate treatment of your arthritic joint.

Mitchell B. Sheinkop, M.D.

1565 N. LaSalle Street

Chicago, Illinois 60610

847-390-7666

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