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Knee Pain

In the Journal of Knee Surgery doctors from the Department of Orthopaedic Surgery, University of Pittsburgh had this to say about regenerative medicine:

  • Biologic agents (stem cells and blood platelets or PRP therapy) are gaining popularity in the management of bony and soft tissue conditions about the knee. However, what they don’t say is that these therapies have risks! I encourage patient’s to start with non-invasive, non-operative therapy in the athletic and aging population.

I agree that Platelet-rich plasma (PRP) and stem cells have shown promise in the treatment of various conditions. I see improved outcomes following shockwave therapy and or laser therapy in early osteoarthritis of the knee, as well as in chronic patellar tendinopathy conditions. My feeling is to start with non-invasive regenerative therapies such as laser and shockwave and then go with injections on an as-needed basis.

  • There is evidence that supports PRP in the augmentation of anterior cruciate ligament (ACL) reconstruction. But there is research for shockwave too. Shockwave therapy research exists for collateral ligament and meniscal injuries as well. I’m especially excited about the results we see with knee osteoarthritis using the laser and shockwave devices.
  • …As the volume and quality of evidence continue to grow, biologic agents are poised to become an integral component of comprehensive patient care throughout all orthopedic specialties. (2) I completely agree with this statement.
  • The use of stem cells as a biological approach to treat cartilage lesions and osteoarthritis has widely increased. The same is true for Laser and Shockwave therapy.
  • Different sources have been investigated for clinical application, especially targeting knee or ankle cartilage disease.(3) I continue to be especially excited about the results we are seeing with the shockwave therapy and laser combination treatment.

I think athletes or high activity people with joint pain need to learn about the choices between stem cell injections and non-invasive laser and shockwave treatments to restore damaged cartilage, and also to act as a protector against future deterioration of the knee joint.

1 Kopka M, Bradley JP. The Use of Biologic Agents in Athletes with Knee Injuries. J Knee Surg. 2016 May 20. [Epub ahead of print]

2 Filardo G, Perdisa F, Roffi A, Marcacci M, Kon E. Stem cells in articular cartilage regeneration. Journal of Orthopaedic Surgery and Research. 2016;11:42. doi:10.1186/s13018-016-0378-x.

3 Yang X, Zhu TY, Wen LC, Cao YP1, Liu C, Cui YP, Meng ZC, Liu H. Intraarticular Injection of Allogenic Mesenchymal Stem Cells has a Protective Role for the Osteoarthritis. Chin Med J (Engl). 2015 20th Sep;128(18):2516-2523. doi: 10.4103/0366-6999.164981.

  1. Nyland J, Mattocks A, Kibbe S, Kalloub A, Greene JW, Caborn DNM. Anterior cruciate ligament reconstruction, rehabilitation, and return to play: 2015 update.Open Access Journal of Sports Medicine. 2016;7:21-32. doi:10.2147/OAJSM.S72332.

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