Stem cell injections for the knees

Discussion in 'Physical Fitness, Rehabilitation, and Infirmary' started by PTskier, Aug 24, 2017.

  1. PTskier

    PTskier Been goin' downhill for years.... Skier

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    Regenerative medicine. Regrow damaged cartilage or ligaments. Hmmm.....

    I did it. Dr. Mark Wagner, M.D., in Seattle did me. He says,
    "The Procedure in a Nutshell -A sample of bone marrow, along with adipose tissue, is removed from the patient in a simple, relatively painless procedure. These samples are then spun in a centrifuge to isolate and concentrate the stem cells, which create solutions of concentrated bone marrow and adipose stem cells.

    "PRP
    is obtained by a simple blood draw. The blood is spun down to pure Platelets."Platelets are small, colorless, disk-shaped cell fragments lacking a nucleus that are found in blood and play an imperative role in clot formation. They also have antimicrobial properties and growth factors, which are also important in the healing of injuries. Platelets act as nutrients for the stem cells, promoting further growth. All three of these concentrated solutions are injected together into the damaged joint.


    "The entire procedure is performed under local anesthesia, in-office, in about 90 minutes. There’s is little down time for the patient, and they can assume their daily life immediately. Results are normally seen at approximately three months and can progress up to a year.


    "Possible candidates for this procedure include people experiencing persistent arthritic pain, who’ve been diagnosed with mild to moderately severe osteoarthritis."

    I had a deteriorated meniscus in the left knee. Not a candidate for surgical correction. I had kneecap bone-on-femur bone in the right knee. Not a candidate for a total nor partial knee replacement. The strong anti inflammatories worked great, until...diclonefac (Voltaren) gave me hives. Meloxican (Mobic) gave me a bad skin rash. Allergic to them. Celebrex is in the same family and would likely have the same result.

    First of July. Went to the day surgery center, got it done. The doc, his certified medical assistant, and a tech from the centrifuge company were there. One valium pill, one hydrocodone pill, things were just fine.... A big blood draw to be centrifuged to the PRP. Bone marrow from the hip bones and fat tissue extractions, then they were centrifuged. The needle into the knee got a wince (lidocaine deadens the skin but if into the knee would kill the stem cells), then they injected the three vials of stuff in turn. Ditto for the other knee. About 20-25 cc into each knee. Doc said that the Harvard studies showed that the more the better. The Mrs. drove me home.

    At home the next day--I was hobbling around from the trauma of the injections. Two walking sticks. No pain (took 6 prescribed hydrocone tabs over the days), but the knees didn't know whether to lock or to fold. It got better each day, and by day four or five things were OK. Inflammation provides growth factors (or something like that) so anti inflammatories were not allowed starting a week before the injections. Kinda tender. Ice and acetaminophen were OK. Walking or swimming was good. No stress allowed on the knees. No hiking, no heavy biking, no squats or lunges or kneeling. I didn't ride my motorcycle in case of getting off balance or anything. He prescribed physical therapy for range of motion and core strengthening that I really didn't need. I did the stuff, but my regular exercises were better.

    Week by week I can do more with less discomfort. It might be working. It's a slow process, 3 or 4 months, and I'll follow directions. Now at seven weeks I'm doing light bicycling, squats to 45°, more walking. Gliding motions...light biking with a high spin rate or an elliptical machine...and walking or swimming are good.

    If this doesn't work enough, what's left...naproxen plus acetaminophen isn't enough. CBD might help. Tumeric plus SAM-e is no better than naproxen, costs more, easier on the gut. Maybe stick to green runs???

    If the stem cell injections work.....:daffy::daffy:

    I asked about the chiropractors that take out the big newspaper articles selling amniotic fluid stem cell injections. Dr. Wagner said that the amniotic stem cells (from the fluid around a fetus) have been treated to prevent transmission of disease, and that kills the stem cells. The process does provide some growth factors that give temporary relief. The chiropractors hire a nurse-practitioner for a day to do the injections.
     
    Last edited: Aug 24, 2017
  2. neonorchid

    neonorchid Out on the slopes Skier

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    Good luck with it. I hope the procedure works for you :crossfingers:
     
  3. AmyPJ

    AmyPJ Let's go! Pugski Ski Tester

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    Interesting! I have OA in both knees that has made hiking downhill this season hideously painful. Keep us posted on how it works! What's the duration supposed to be? The procedure doesn't sound particularly fun, but neither does surgery!
     
  4. graham418

    graham418 Getting off the lift Skier

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    Very interesting. I hope it works out for you. A couple of questions.. Is this a permanent repair or temporary relief? Do the stem cells grow to become new meniscus?
    Good Luck!
     
  5. Jilly

    Jilly Lead Cougar Skier

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    I'm interested too, because like AmyPJ I've OA too. So far, so good, but what's down the road.

    This whole stem cell stuff is great. My cousin's daughter's Crohn's is almost cured using a stem cell transplant. She's recently had some issues.
     
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  6. Pete in Idaho

    Pete in Idaho Getting off the lift Skier

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    Interesting, keep us informed of your progress and how much did it cost you ?
     
  7. Tricia

    Tricia The Velvet Hammer Admin Pugski Ski Tester

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    This procedure fascinates me. Looking forward to hearing how it works out for you, long term.
     
  8. Marty McSly

    Marty McSly Putting on skis Skier

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  9. agreen

    agreen Getting on the lift Skier

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    I just started performing these at my clinic. Was doing primarily HA injections before but I have more hope for the stem cells. Too early to tell yet but I have had one success story of a severely arthritic toe that has improved significantly in 2 weeks. Haven't seen the 5 patients that had the knee injections back yet but will keep you all posted.
     
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  10. PTskier

    PTskier Been goin' downhill for years.... Skier

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    2-1/2 month update... Every week I can do more with less discomfort.

    Getting a lot better. I can walk everywhere without pain or even discomfort. I can walk up fairly steep hills. I'm riding my bike at a pretty good clip, high spin rate, for an hour or more including hills. The only guaranteed wince is when I'm weighted on the right leg and twist to the right. I know I shouldn't, but sometimes I do it. I walk the dogs daily on a sloped beach, sometimes on rocks (depending on whether the wave action brought in sand or took it away during the night), and no discomfort. No meds. Rarely any need for icing the knee. Weights with 45° squats and lunges are OK. Kneeling is not a good idea, but once or twice is not problem.

    I think something good is happening. I know that it is a 6 month or more process. I'll ski easy in November if we have snow by then. I'll ski moderately easy in December. January I'll ski more and more. If I need some meds to ski, I'll try CBD oil. It is an extract from either marijuana or hemp that provides anti inflammatory and pain relief. The CBD from hemp is federally legal but is illegal in states that prohibit hemp or hemp products. CBD oil should contain no more than 0.3% THC and won't get one high, but if I was subject to drug testing, I wouldn't bet losing a job on it.
    https://www.deadiversion.usdoj.gov/schedules/marijuana/m_extract_7350.html

    Permanent? I don't know. Whatever caused the cartilage to wear out the first time is still there (my natural misalignment? Just old age & usage?) The stem cells grow to replace whatever is damaged--meniscus cartilage, back of my kneecap cartilage, partly torn MCL ('cuz it is inside the knee capsule where the stem cell goop was injected). Not ACL, because we didn't inject it there.

    My local orthopod's wife is a general surgeon. She is the one who told him about Dr. Wagner, then he told me. I happened to see Dr. Mrs. in the grocery store, told her about my experiences. She said that her hubby has his own knee problems and was now injecting PRP (platelet rich plasma) into his knees. He wanted to know how my stem cell injections worked out. I'm his crash test dummy! (If he calls me, how much should I charge him for a consultation?)

    Wagner's price was $6200 for one large joint (ankle, knee, elbow, hip shoulder), $9300 for two. $4800 for one small joint (thumb, big or 2nd toe). Wagner doesn't do spines. He said that an MD in Portland does spines, the results aren't as good, and the cost is higher. As soon as the FDA approves it, insurance may pay some of the costs. High cost, but my only alternative was to dial way back on the skiing and other exercise, and my wife really wants me to hike with her. I told her OK as long as there were no downhill sections.
     
    Last edited: Sep 13, 2017
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  11. graham418

    graham418 Getting off the lift Skier

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    Your report sounds very encouraging, and you sound like you're getting good results . Seems like a cheap price if you get your mobility back. This is very interesting stuff.
     
  12. Tricia

    Tricia The Velvet Hammer Admin Pugski Ski Tester

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    Are stem cells sticky? :huh:
     
  13. Fishbowl

    Fishbowl A Parallel Universe Skier

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    PT, just to put the condition of your knees into perspective with the procedure, why were you not a candidate for either surgical meniscus repair or knee replacement?
     
  14. RuleMiHa

    RuleMiHa Getting on the lift Skier

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    FYI-Surgical Management of Meniscus injuries are now being shown to be no better than aggressive PT/Placebo Surgery.
     
  15. dlague

    dlague Waitin' for Wintah Skier

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    That is what concerns me!

    I had and ACL replacement and when my knee buckled it tore my inner left miniscus and they had to remove 30% of it. 90% of the time it is fine but while trying to surf and half board in California it messed me up pretty good for a few weeks - right now it feels good. These types of procedures interest me but for now I am better off learning how to use my legs to not cause issues. BTW Skiing with a brace does not bother my knee at all.
     
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  16. PTskier

    PTskier Been goin' downhill for years.... Skier

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    I was told that I did not have a meniscus tear, I had deterioration. It was a location that gets poor blood flow, so it won't heal, and no surgeon who saw my MRI said that cutting would do any good. One surgeon who saw my images said, "There's nothing we can't make worse with surgery."

    The other knee had patellofemoral arthritis. Knee cap bone against femur bone--the cartilage was gone on one half of the knee cap. The rest of that knee was good. I could walk OK. Many total knee replacements turn out great. Not 100% are fully successful, and some that are otherwise successful have some limits of movement. The surgeons wouldn't replace my knee at the condition it was in. Partial replacements are possible, either side or the knee cap, but I've been told that those have a lower rate of success and perhaps also a shorter functional life.

    This is what the American Academy of Orthopedic Surgeons says:
    When Surgery Is Recommended

    There are several reasons why your doctor may recommend knee replacement surgery. People who benefit from total knee replacement often have:

    • Severe knee pain or stiffness that limits your everyday activities, including walking, climbing stairs, and getting in and out of chairs. You may find it hard to walk more than a few blocks without significant pain and you may need to use a cane or walker
    • Moderate or severe knee pain while resting, either day or night
    • Chronic knee inflammation and swelling that does not improve with rest or medications
    • Knee deformity — a bowing in or out of your knee
    • Failure to substantially improve with other treatments such as anti-inflammatory medications, cortisone injections, lubricating injections, physical therapy, or other surgeries
    That does not describe my knee. It only hurt when I was doing something fun.
     
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  17. surfandski

    surfandski Putting on skis Skier

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    This is something I've been very curious about and I'm very intrigued by your experience so far. My insurance doesn't cover this procedure and I haven't been able to find a good ortho where I live in Florida so I've been told, just wait until your ankle gets so painful that you can't stand it and then we'll fuse the ankle. There has to be an option! I realize my ankle is jacked but even if I could find something to buy me another couple of years. However, just in the last month my ankle has gotten significantly worse so I'm just hoping to get thru this ski season. If I knew stem cells would work I'd bight the bullet and pay for it myself but it seems fairly new still so I'd hate to spend several grand on an experiment. Please keep us posted! 6-23-15 APe.jpg
     
  18. Fishbowl

    Fishbowl A Parallel Universe Skier

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    It's a dramatic headline, but not a universal truth when you examine the detail. As always in medicine, people and circumstances are highly individual, and all options should be evaluated.
     
  19. RuleMiHa

    RuleMiHa Getting on the lift Skier

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    How long after your injury were these films taken?
     
  20. RuleMiHa

    RuleMiHa Getting on the lift Skier

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    Very, very, true!

    What I find the most interesting is that this is not restricted to meniscus surgeries. There are a series of chronic pain surgeries that when done without the 'fix' part of the procedure are still being shown to cause pain remission in (at least one study) 37% of cases. Which begs the question of whether it's ethical to do sham surgeries or how to ethically trick the brain in thinking it had sham surgery.

    Mostly what I meant is that it is a complicated topic and the views on it are in flux within the orthopedic surgery field.
     

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