Are Traditional Knee Osteoarthritis Treatments Hurting More Than They’re Helping?
Traditional orthopedic approaches may do more harm than good for all osteoarthritis sufferers (32.5 Million in the US), including the majority who have knee osteoarthritis.
Knee Osteoarthritis Symptoms and Incidence
Knee osteoarthritis is a joint disease in which the cartilage surrounding the bones of the knee breaks down. When cartilage breaks down, there is less cushion for knee movement which can be extremely painful for the affected person. Knee osteoarthritis can be caused by a number of factors, for instance, being very overweight, genetic predisposition, crooked joints, or frequent stress on the knee. Symptoms include a stiff knee, or conversely, a knee that feels unstable, like it would give out, knee cracking during movement, and/or a swollen knee (1).
According to the Centers for Disease Control (CDC) in 2020 32.5 Million in the US have Osteoarthritis (2). Many estimates say knee osteoarthritis represents about 80% of that total.
What Do We Mean When We Say “Traditional Orthopedic Approaches”
Most patients experiencing knee pain consult their PCP. Often, the PCP will recommend the patient see an orthopedic surgeon, a doctor who specializes in surgery of bones, joints, and muscles. We’re advocating that the patient consider a non-orthopedic musculoskeletal physician that specializes in non-surgical solutions to osteoarthritis as a first course of action.
How Is A Regenexx Doctor Different Than A Traditional Orthopedic Doctor?
Both traditional orthopedic doctors or Regenexx doctors may offer the same first options–such as anti-inflammatory medications and physical therapy. If those nonoperative options fail or are not warranted, a traditional orthopedic surgeon may recommend other NSAIDS, cortisone injections and then when out of options, surgery.
Orthopedic surgeons are not trying to lead you astray, but rather to utilize their specialty to help you. Surgery is sometimes the best option. But you may want to consider non-surgical orthopedic options, particularly if those options involve the most advanced regenerative procedures in the world.
Traditional Treatment Approaches
Here are the traditional orthopedic approaches that may do more harm than good for knee or other osteoarthritis patients:
- Corticosteroids
Corticosteroids are a type of drug injection commonly used to treat arthritis. The man-made drug is designed to dampen the activity level of the immune system in a targeted area, which can reduce inflammation and pain from arthritis (3). Corticosteroids are generally used to treat knee osteoarthritis, but new information surfaced that shows that they may not be the best option. Research from the University of California San Francisco, presented in 2022 at the Radiological Society of North America conference, shows that the injection of corticosteroids actually worsened osteoarthritis in the knees of some patients (4). Taken from a sample group, 44 patients were injected with corticosteroids, and 30 were injected with hyaluronic acid (4). Both injections were shown to provide temporary, short-term pain relief, but imaging technology depicted cartilage that was more broken-down than before at the follow-up treatment in the knees of patients who received corticosteroid injections (4).
- NSAIDs
Non-steroidal anti-inflammatory drugs (NSAIDs) are medicines that are widely used to relieve pain, reduce inflammation, and lower and elevate temperature, and are sometimes prescribed by medical specialists (usually as an oral tablet) to treat osteoarthritis in the knee (4). Ibuprofen is an example of a NSAID. NSAIDs are a temporary solution – they help mitigate the pain a patient feels from osteoarthritis, but whether or not they actually reduce inflammation in the knee or what the effects of long-term usage of these drugs are mostly unknown (5). Dr. Luitjens at the University of California San Francisco decided to investigate how the use of NSAIDs affects synovitis, or inflammation of the synovial membrane, in the knee (4). 277 patients received MRI scans of the knee over a four-year period (5). The NSAID drugs did almost nothing to help slow the effects of osteoarthritis – it just kept progressing over time for most of the patients (4). Further, the synovitis in the patients typically worsened – either because the NSAIDs were not working correctly, or because the patients felt a false sense of security from their pain relief and decided to put stress on their knees (5). - Meniscus or Knee Replacement Surgery
Meniscus surgery is an operation to remove or repair a torn meniscus, a piece of cartilage in the knee. Most meniscus surgeries (95%) are partial meniscectomies where part of the meniscus is actually removed, not just repaired. Therefore, the remaining meniscus is now smaller and does not perform as well. The knee now has a significantly increased chance for developing arthritis since part of the cushion-providing meniscus was removed. A study looking at knees 18 months after surgery showed 60% of knees treated with meniscus surgery had developed arthritis compared to 33% and patient’s only receiving physical therapy. See our recent blog for more details.
There are cases where knee replacement is the right option. However, surgery has its risks, it’s invasive, and there is a long recovery time (8). Knee replacement should be considered as a final option after trying other remedies.
Doctors at Regenexx Pittsburgh have performed nearly 20,000 non-surgical procedures using PRP or bone marrow concentrate. Our research has shown that 87% of patients told they needed knee replacement surgery did not undergo it after a Regenexx treatment.
Non-Invasive Surgery-Free Options
So, whether you start with your PCP for a referral or not, you should insist that you see a doctor who specializes in non-surgical procedure options as a first course of action.
Regenexx doctors say: “let’s stop cutting stuff out. Instead, inject orthobiologic agents that can help tissues heal.”
Non-invasive regenerative treatment, such as bone marrow concentrate procedures, might be the option for you. During Regenexx-SD BMC procedures, specialists would harvest a portion of bone marrow that contains live stem cells from an area on the back of the patient’s own pelvic bone housing their hip (6). The bone marrow concentrate would then be precisely re-injected into the problem area using precise imaging technology (6). Since the BMC treatments are designed to treat degenerating bone, these would be a good option for patients suffering from knee osteoarthritis (6).
Patients who received the Regenexx-SD BMC treatment for knee osteoarthritis report overall improvement after just one month, and after six months, a 55% improvement in overall knee function (7).
Regenexx Maintains a Patient Outcomes Database
There are more than 11,900 patient knee procedure outcomes tracked in the Regenexx database. You can see actual Regenexx patient results for Knee Osteoarthritis, ACL Tears and Meniscal Tears here.
The above chart shows that after a Regenexx treatment for a knee meniscus tear, patients feel their joints are, on average, already 36% better after only 1-month, and continue to improve from there.
Find out if you’re a candidate for Regenexx’s non-invasive, surgery-free orthobiologic orthopedic procedures.
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SOURCES:
- https://my.clevelandclinic.org/health/diseases/21750-osteoarthritis-knee
- https://www.cdc.gov/arthritis/basics/osteoarthritis.htm#:~:text=Osteoarthritis%20(OA)%20is%20the%20most,hands%2C%20hips%2C%20and%20knees
- https://my.clevelandclinic.org/health/drugs/4812-corticosteroids
- https://www.prnewswire.com/news-releases/steroid-injections-worsen-knee-arthritis-301685584.html
- https://www.prnewswire.com/news-releases/nsaids-may-worsen-arthritis-inflammation-301681834.html
- https://regenexxpittsburgh.com/bone-marrow-concentrate-procedures/
- https://regenexxpittsburgh.com/patient-outcome-data/
- https://www.mayoclinic.org/tests-procedures/knee-replacement/about/pac-20385276
