Julie is no stranger to orthopedic problems. In fifth grade, she had her first knee surgery. Her meniscus was ripped, flipped and separated from the bone. Her orthopedic doctor told her that she was probably born with a misshapen meniscus and, through dance and softball, she injured it.
Since that point, she never seemed to have great luck with her knees.
Year in and year out, she would be in physical therapy, in a brace, on crutches, or at the doctors with some ache or pain or swollen joint. In middle school, her orthopedist ran out of ideas and suggested she see a rheumatologist.
One rheumatologist brushed her off, while the other one said she may have Psoriatic Arthritis. The rheumatologist suggested treating her flare ups as they came, instead of putting her on heavy duty medication. It was the mid 90’s, biologics were just hitting the scene, and since Julie was still going through puberty, no medication was even discussed.
The diagnosis was suggested, but because Julie and her family didn’t understand the severity of the condition, it wasn’t taken seriously. Julie remembers fighting with her mom off and on about it.
“I was a teenage, not a Grandma! How could I have arthritis? Every time my knee would swell up or I’d have pain, my mom would bring up the psoriatic arthritis diagnosis. But I wouldn’t believe it. I would get so mad!”
Swollen joints. Mobility Issues. Not participating in gym class. Braces for knee cap tracking. Crutches. These just became par for the course in Julie’s world.
By the time she was 27, she ended up having to go out on disability because of her psoriatic arthritis, complex regional pain syndrome, and avascular necrosis in her femur bone. Dietary and lifestyle changes helped her manage her autoimmune and nerve issues, but her avascular necrosis solution came in the form of a Regenexx Stem Cell procedure. When Julie needed the procedure, it was not offered at Regenerative and Performance Specialists yet. (Since then, they’ve not only started completing this treatment, but have helped numerous patients here in the Pittsburgh area!) She ended up traveling out to the Centeno Schultz clinic in Colorado to have it done. Dr. Pitts completed the procedure for her and she stayed in close contact with him during her recovery.
Julie has blogged her entire stem cell treatment journey on her own blog. If you’d like to learn more, check it out here.
At her one year virtual follow-up with Dr Pitts, Julie brought up her concern that her knee was making a crunchy/clicking noise when she went to bend or straighten it. This was not a new issue, as she had been experiencing this for a few years, but the clicking seemed to be getting louder and louder. The summer before, while in therapy after her stem cell treatment, her therapist had noticed the noise and identified it as a kneecap tracking issue. Because it did not cause her pain, like the AVN did, she never went looking for a permanent solution.
Dr. Pitts suggested that she have it looked at by the doctors at Regenerative and Performance Specialists. Julie made an appointment with Dr. Lieber and went in to have it checked out.
After hearing her backstory, a quick look at her x-rays, and an examination of her knee, Dr. Lieber suggested that Julie would benefit from Regenexx-SCP / PRP. Regenexx-SCP is a next generation form of PRP / Platelet Rich Plasma treatments. Platelet Rich Plasma, also known as PRP, has been shown to help relieve pain by assisting the healing process of musculoskeletal conditions. Injecting Julie’s platelets would help strengthen her medial patellofemoral ligament, allowing the muscles, tendons and ligaments in her knee to go back to functioning as they should. After the treatment, she would be required to go to physical therapy to help strengthen and build up her knee.
She was able to make her appointment for the platelets treatment that day! No prep was required, except for an x-ray which would allow Dr. Lieber to know exactly where to inject the platelets.
“I know it sounds crazy, but I was really excited for the treatment. After having such success with my AVN and my stem cell treatment, I have full faith that the Regenexx procedures truly can make a difference in patient’s lives. I have been to therapy so many times, and have had countless braces, to help my knee cap track correctly, but nothing ever seemed to be a long term solution. Harnessing the power of my own body, I was truly excited to get the injections and then to start physical therapy.”
What’s Involved In The Regenexx-SCP / PRP Treatment?
The treatment happened in two appointments. In her first appointment, Julie came into the office to have her blood drawn. She remembered having her blood drawn for the stem cell procedure, so she felt like she knew what to expect.
“The blood draw was extremely easy. I went into the office, had a few vials of blood drawn and then was on my way! The hardest part was getting to the office since it happened to be the Penguin’s Stanley Cup parade day!”
Having her blood drawn, Julie left the office in preparation of her re-injection the next day. That’s when the Regenerative and Performance Specialists team went into action. Regenexx-SCP contains concentrated platelets like PRP, but also contains blood circulating stem cells capable of tissue repair. It is created by a technician, rather than a simple bedside centrifuge. The patient procedure is the same as PRP, but far more care goes into ensuring the PRP mixture is as pure and effective as possible. Regenexx-SCP patients rarely experience the post-injection flare ups that are sometimes seen with standard PRP. For a more complete overview of why Regenexx-SCP is a superior form of Platelet Rich Plasma when compared to the typical PRP created using a standard bedside centrifuge, click here.
The following morning, Julie arrived at the office to have her platelets injected back into her knee. Sitting up on the table, Julie was excited to get the treatment underway!
“Dr. Lieber made sure to take extra precautions, making sure everything was in order. He drew on my knee a few places where he would inject and then he got started.”
Using an ultrasound machine, Dr. Lieber made small injections on both sides of her kneecap.
“At first the injections didn’t phase me. But as he got deeper on the medial side of my knee, it did get a little tender. It wasn’t anything excruciating, but I had some discomfort. I may have said “owwww!” a few times. But once it was over, I didn’t have any pain.”
Making several injections sites, the whole thing took about 10 to 15 minutes. Once she was done, her knee was wrapped and told to rest it that day. Dr. Lieber advised she should take it easy the next few days since her knee would probably be pretty sore and stiff and that she may experience a flare up of inflammation since the platelets would be calling in the healing cells to come and heal the area. A script for physical therapy was written, a follow up appointment a month out was scheduled and she was done!
After having her stem cell procedure, Julie had a few rough days. It was painful, her knee swelled up pretty badly, and she spent most of her time in bed. She anticipated her knee to have a similar reaction to the platelets.
“The best way to describe how my knee felt was “full”. For a few days after my stem cell procedure, my knee blew up. After seeing how swollen it became, I remember my parents saying “what have we done!?”. But, that’s part of the process and it dissipated within a few days. I anticipated my knee swelling up after this treatment, especially since I have autoimmune issues, but it really wasn’t too bad. It was a bit swollen, but nothing that hindered me from walking or going about my day. Dr. Lieber had mentioned that I may need my crutch for a day or two, and I didn’t even feel like I needed it. Within three or four days my knee looked completely normal again. For a few days it was a little achy, but I wouldn’t say it really bothered me. I took a pain pill the first night to help stay ahead of the pain and I think that made me feel worse than the achy knee!”
Pleasantly surprised that it didn’t impact her too much, she was back to normal, started therapy and continued her yoga within a week. Julie will now attend physical therapy twice a week for six weeks. Her primary focus will be to strengthen the muscles around her knee to help stabilize and regain normal function of her knee cap.
How Did Julie Feel The Treatment Went?
“It was easy! Dr. Lieber and his staff made it effortless, I knew exactly what I needed to do, and truly didn’t have a lot of downtime. I’m looking forward to strengthening my muscles in physical therapy and look forward to reporting back positive results!”
Stay tuned as we follow Julie’s healing journey after her Regenexx-SCP / PRP treatment for her medial patellofemoral ligament.
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