Options for treating patients with osteoarthritis of the knee are limited to pain medication, anti-inflammatories, viscosupplementation (gels), steroids, physical therapy, braces, chiropractic care or any combination thereof, and ultimately, a Total Knee Replacement. Arthroscopic Debridement (clean out) has no place in the management of arthritis. All of these treatments provide palliative care for the symptoms, but do not provide therapeutic benefit in the treatment of the degenerative condition itself. Pain medication and steroids do not have a long-lasting positive impact on healing of the articular cartilage in an OA-joint, but help with pain management. Without a regenerative therapy, the OA will continue to progress, and ultimately could result in surgical intervention as the only option to abate pain. A treatment that could slow the degenerative process, or ideally reverse it, that also reduces or significantly delays the need for surgery would be valuable. Attention reader, I am speaking to those of you who fall under the category of Aging Athlete or in medical parlance, Kellgren-Lawrence OA-1 to OA -3. If you have advanced osteoarthritis with one or all of the following:
1) Body Mass Index of over 30
2) Varus(bowed leg) over 12 degrees or knock knee (valgus) over 15 degrees
3) laxity of greater than 2-4 mm
4) Knee Society Score of under 65
you are a better candidate for a joint replacement than a stem cell intervention. Stem Cell intervention at this time does not offer a biologic arthroplasty for advanced arthritis. While some day it may, the standard of care for advanced arthritis is a joint replacement.
Let’s get back to advances in the care of the aging athlete. The theoretical risk of a Bone Marrow Aspirate Concentrate Stem Cell intervention is infection and pain. To date, in over 700 procedures at Regenexx and the Regenerative Pain Center, we have not seen an infection. The only pain noted was during the 15 minutes required for the aspiration in those who did not chose intravenous sedation. The potential benefit is prompt recovery and a reasonable long-term outcome allowing for return to or continuation of skiing, cycling, fly fishing, etc., etc., etc., and pursuit of your fitness goals as well as any recreational interest while facilitating the inherent improved health benefits of exercise.
I don’t fully understand why cellular orthopedics might slow the degenerative process or ideally reverse it; but our outcomes data confirms satisfactory results in over 75% of cases at five years. There are biochemical and cellular explanations.We know from our outcomes studies that BMC therapy may be able to slow the progression of the patient’s OA. Autologous concentrated plasma with platelets contains a variety of growth factors and proteins that serve as an adjunct. Before you try undergoing that joint replacement, give stem cells a chance