Oct 22, 2011 at 10:01 am #1280961
Today is day 5 after having a Stem Cell Bone Marrow Prolotherapy done for a torn Meniscus. I had it done in Oak Park, IL at CaringMedical.com by Dr. Ross Hauser, M.D. It was for a complex torn meniscus (a MRI confirmed this) due to an injury incurred doing the Cornell Crack on July 2nd, 2011.
I discussed the hiking injury before getting the MRI here.
The whole procedure is detailed, photographically here.
Of all the things that encouraged me ahead of time about the procedure was this report of its high success rate.
The summary quote is here:
"Patients stated that the response to Prolotherapy met their expectations in 27 out of the 28 knees (96%). Only one out of the 28 patients ended up getting surgery after Prolotherapy. Based on the results of this study, Prolotherapy appears to be an effective treatment for meniscal pathology. While this is only a pilot study, the results are so overwhelmingly positive that it warrants using Prolotherapy as first-line therapy for meniscal pathology including meniscal tears and degeneration."
I was really impressed with the doctor, his clinic and nurses. The lobby was full of patients, almost all of whom had seen the doctor before and who raved about the doctor's ability. One was a female hiker from Colorado.
I was very impressed with the diagnostic skills of the doctor. He spent about 20 minutes with me before the procedure (the nurse about 50 minutes before, during the procedure, and about 20 minutes after the procedure, and she called me up at home the following day). The whole procedure once it is started takes about 15 minutes.
The anesthesia, only local (procaine), was not even felt as anesthesia, and I did not fully realize I was under anesthesia until it wore off about 9 hours later. By the time I landed back in Albany NY, I did have to limp to the terminal entrance and drive home (thank goodness it was my left knee).
The next day I was so sore, I used old crutches to get around. However, the following day, I was able to walk without crutches, and do three separate 1/2 mile walks around the block.
The subsequent day (yesterday), I did a two mile walk around town, no problem at all.
The doctor told me he's thinking my knee will get back 80% as good as it was pre-injury within 2 months. And he says until it gets back 100% as good as it was pre-injury, he recommends a second procedure about 2 months from now (I scheduled it in January for insurance reasons, ie: my HSA account gets an infusion of $1,000 each year from my company and I can pay for the procedure with it).
CaringMedical.com expects full payment the day of procedure and I was very pleasantly surprised the cost was $800 less than I had anticipated, they recently reduced the price of the procedure. The procedure was $1375 but a mandatory first office visit was added on for $250, but the next time, there will be no first office visit fee. I had thought with the medication/supplements for a 2 month period (recommended), the flight, the cabs, the procedure, the office visit, I'd be spending $2900 but I got by with $2100, of which caringmedical.com's payment was $1375 for the procedure/office visit and $300 for two months worth of their special supplements for post-procedure use.
I am already able for the first time since the injury to slowly walk down the stairs without feeling the twinge/weakness I have consistently felt since the injury. In fact the major problem I had with the knee before the surgery was the problem walking down ordinary stairs (I found it easier to hike down a mountain trail than ordinary stairs). My knee does not feel completely like it was July 1st, but I think Dr. Hauser's prediction of 80% recovery towards the pre-injury goal is completely reasonable.
In his diagnosis, he felt, in contrast to the MRI report, which said there was no evidence of a tear in the ACL, that the ACL in my left knee was weaker than that in my right knee, and he thinks that was a contributing factor to the original injury. So in his prolotherapy procedure, he treated not only the torn meniscus, but the ACL.
They took the bone marrow (which has stem cells) from the healthy right knee to put in my left knee. There was zero pain in the right knee after the surgery.
I'll keep the board posted but so far I am 100% satisfied with the money spent and the way things are going.
By the way, one more link in favor of Prolotherapy. It is from the former US Surgeon General, Dr. Edward Koop.
p.s., I have posted a lot of research on Prolotherapy in this thread in the forum, Views from the Top.Oct 22, 2011 at 10:18 am #1793754
Thanks for the quick education. I wasn't aware of the option.
I like having as many tricks in my bag as possible for whatever my next injury adventure might include.
DarylOct 22, 2011 at 1:17 pm #1793800
Roliegh, I.m glad you seem to be doing so well. Keep us updated, OK?Oct 22, 2011 at 1:33 pm #1793802
Chris MorganBPL Member
@chrismorganLocale: Southern Oregon
>> In his diagnosis, he felt, in contrast to the MRI report . . .
Ha! – diagnostics humor.Oct 22, 2011 at 1:45 pm #1793805
Wow, that's about cool!Oct 22, 2011 at 2:35 pm #1793822
Gary DunckelBPL Member
That certainly is impressive, Roleigh. I wasn't aware that stem cell technology was used this way. Thanks for sharing your experience, and good luck with the healing process.Oct 22, 2011 at 6:41 pm #1793893
Can I use your words: "due to an injury incurred doing the Cornell Crack on July 2nd, 2011" next time I injure myself?
It sounds sooooo much better than my typical "due to an injury incurred doing the front steps on Saturday night, after a night of drinking."Oct 22, 2011 at 7:21 pm #1793901
Daryl, Wikipedia has a web page on the Cornell Crack. It's a wicked first step, you have to lift your left foot up about 28-30" and put it into a toe-hold that has room for 1/3rd of the foot, then kind of jump/lift yourself up and grab a much high ledge with your right arm and then find a footing for your right foot. Way too much stress on the left knee. I should have scouted for about 1/8th of a mile for a walk-a-bout which I later learned after the fact existed or turned around and give up the hike. I was so stupid continuing on the hike.
I've been spoiled hiking in the Sierras all these years, federal tax dollars on trail making and maintenance. Trails all manicured, switchbacks going up mountains. Really, really spoils you for a hike is always 100% a hike, never a climb. Such is not the case in the ADKs or the Catskills.
Anyway, sure, use that excuse. It's a good one!Oct 22, 2011 at 8:25 pm #1793919
I think I'd try to work a hostage rescue and outlaw biker game into the injury story.Oct 23, 2011 at 12:02 am #1793948
Dale WambaughBPL Member
@dwambaughLocale: Pacific Northwest
Amazing procedure and best of luck with the results.Oct 23, 2011 at 6:58 am #1793969
"you have to lift your left foot up about 28-30"
I strained my knee because of a similar big step a few years ago and another backpacker I know of reported an injury doing the same. I've been working hard to avoid such moves since my injury. I know you will be too.
Perhaps others can avoid the injury altogether by reading our experiences. Puts way too much stress on the machinery.
DarylDec 29, 2011 at 6:46 pm #1817275
Two super fantastic links were found about Prolotherapy today by me. I have more links at my Google Profile.
I am going for my second Stem Cell Prolotherapy treatment for my knee January 10. I am 100% happy and satisfied with my progress so far. I suspect I'll need it only 3 times to get back to pre-injury state. Dr. Hauser suspected I'd need it 3-4 times but at my progress, I think it will only need 3 treatments.Dec 29, 2011 at 8:42 pm #1817316
Doc thinks I may have torn my meniscus lifting weights the other day. I bet I'm a long way from anyone who does Prolotherapy.Dec 29, 2011 at 8:55 pm #1817319
Joe, check out my Google Profile for the link entitled "Shopping for a good Prolotherapist" — there are multiple national directories of prolotherapists, including one for Britain. Check them out!Dec 29, 2011 at 9:38 pm #1817336
eric chanBPL Member
im recovering fairly well from a ACL surgery last year …
the only thing i can say is that the recovery can be a painful process … but once you get the OK, the more you use the leg, the less stress itll place on the other knee … and the more itll strengthen
climbing is actually quite a good recovery activity … and you might get some more skill to destroy that cornell crack next time ;)Dec 29, 2011 at 9:46 pm #1817340
@b-g-2-2Locale: Silicon Valley
I had one that was completely torn, so the surgery removed it without replacement over 25 years ago. Now I can barely tell which knee it was on. It saves weight that way.
–B.G.–Mar 12, 2012 at 10:58 am #1852500
Rusty BeaverBPL Member
As one who has had ~30% of the meniscus removed, and continues to have knee issues, I am keen to learn of any new info in this realm. Any new revelations to report back on?
rustyMar 12, 2012 at 3:50 pm #1852628
Jolly Green GiantBPL Member
Ditto. Roleigh, you and I had our medical procedures done at roughly the same time. I had about 40% of my meniscus removed. Today, my knee sucks and is uncomfortable 100% of the time. I'm looking forward to an update to see if you're doing any better.Mar 12, 2012 at 4:05 pm #1852634
@b-g-2-2Locale: Silicon Valley
With most of these knee injuries, the meniscus tears first, and the various ligaments tear second.
For some weird reason, both of my knees were the other way around. Ligaments tear first, and then the meniscus tears not at all or very little.
I don't know how many more miles I have left on the original factory warranty.
–B.G.–Mar 12, 2012 at 8:20 pm #1852761
Funny you two should post on this today. I just flew back in from Chicago after having my third Stem Cell Prolotherapy treatment done today. Before I report on that, the latest issue of the Journal of Prolotherapy is the best documented research summary to present to any medical board or insurance board to justify the use of Prolotherapy written to date. Check it out. It is free, the entire issue is in PDF format.
I consider my knee 95 percent healed to pre-injury level insofar as walking or hiking goes. I consider it 75 percent healed to pre-injury level insofar as being able to run. What does this mean? In practice if I do a mountain hike of an Adirondack High Mountain Peak, I won't notice any problem in my knee except on the way down for about 2% of the time, I'll notice that my left knee is not as healthy as my right knee. I no longer limp going down hill. My hiking partners are amazed at this. However I can not hike downhill fast without occasionally favoring the right knee. But if I walk at a moderate pace, I can avoid favoring any knee. It's only when I attempt to run that I find myself limping to some degree. I asked Doctor Hauser today if having 1-2 more sessions of Stem Cell Prolotherapy if I could get back to pre-injury level for running purposes. He thinks it is possible. I have had so much success so far I'm tempted.
Check out my Google Profile for many more links. See my Shopping for a Prolotherapist Advice Document if you want a local prolotherapist.
I am 100% thrilled with how I'm doing and other than perhaps maybe once or twice a month feeling a very tiny give in the knee, there are no problems felt in ordinary walking or hiking anymore. It takes about 2 months of optimal benefit from each procedure so I won't know how this third procedure will be. From the start the doctor told me I'd need 3-4 procedures done. The cost is about $1,100 per procedure for the Stem Cell Prolotherapy (it would be only $350 if it was standard prolotherapy only).
Some Prolotherapists charge more, some less. I know for Stem Cell Prolotherapy, Dr. Hauser is most competitive in his costs.
Dr. Ross Hauser has treated patients who have first had conventional surgery done.
If money is no problem for you, I'd consider Regnexx.com as they have patented procedures for doing really tough situations (anyone who has had conventional surgery done first, makes their case tougher to get new cartilage grown than if they only have the Stem Cell Prolotherapy done as the first recourse). If money is a problem, I'd contact Dr. Hauser. Take a look at my links and this latest JOP issue above. If you want your knee back to being good enough to do comfortable hiking I'd definitely do it.Mar 12, 2012 at 10:36 pm #1852847
I spent about 2 hours updating my "shopping for a good prolotherapist" paper, linked to at my Google Profile tonight.Mar 13, 2012 at 3:05 am #1852877
Several hospitals are getting the seperation equipment in their labs. My brother just had some damaged foot cartilage (from a construction accident) done. He is healing well after three weeks. The pain while walking is reduced to below pre-treament levels already and he is cursing at his crutches…a good sign.
jdmMar 13, 2012 at 6:07 am #1852892
Please elaborate, James, by "separation equipment". Are you talking about putting one's bone marrow in a centrifuge, isolating the stem cells, culturing it and letting it grow/multiply exponentially, then later re-inserting it in the donor's body? (The process is never done in one day.)
There are two main styles of Stem Cell Prolotherapy, the one described above, and the much more simpler, affordable one, where the donated bone marrow (typically from either the tibia or hip) is what is injected immediately back into the injured part (except that the syringe needle used to do the extraction is disposed of (the syringe is kept, but a brand new, sterile needle is used for the re-injection in the injured part of the body).
Caring Medical used to do the more elaborate procedure but very quickly switched to the simpler, much more affordable procedure.
The FDA is making it very risky to do the isolation/culture method in the USA. See these 3 articles for more on this.
One of Regenexx's procedures they do in the Cayman Islands (Regenexx-C-(Cultured)).
By the way, Regenexx's has a fantastically interesting, free e-book, all are recommended to download and read. Free E-book: Orthopedics 2.0-How Regenerative Medicine will Create the Next Generation of Less Invasive Orthopedics – by Dr. Chris Centeno, M.D.Mar 13, 2012 at 11:33 am #1853052
Roleigh, I believe it was a variation of the first technique you mention. The seperation took about 2 hours. After marrow extraction (a matter of less than a half hour) he waited and was then reinjected in a few (not sure how many) areas.There was no regrowth cycle; I am not sure how a short duration seperation could result in any growth cycle. The ammount of marrow removed was higher, he is supposed to be carefull about any nasty wounds for about 6-12mos. I did not ask hoy many locations were used, but he was complaining about the pain of the procedure, apparently they could not use local anesthetics, probably wouldn't work on bone penetrations all that well, anyway. Last I talked to him he was doing fine with the whole thing. His foot was sort of crushed (lots of damaged cartlidge, but, no broken bones.) He has been wearing orthotic liners for several years.Mar 13, 2012 at 12:00 pm #1853072
Thanks James. Going back to the Regenexx's page, I see there are multiple variations of same-day procedures.
I took a pain medication an hour before the procedure but even then the actual sucking out of the bone marrow is the most painful part of the whole procedure. I was holding two rubber balls as hard as I could and even then I muttered "ouch". The drilling into the bone was almost instantly and didn't hurt at all. It was the extraction of the 1/3rd ounce of bone marrow. The actual prolotherapy injections did not hurt much at all. The doc said the extraction of the bone marrow is what bothers everyone.
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