New Knees (Stem Cells)

MJH – nice article in your link !

Thanks.  I too have a rheumatologist as a former boss.  (Not the one in the article).

Jscott, re: “As for signing a waiver–this is standard procedure. It’s not nefarious.”

My earlier post should not be given credence if incorrect.  I did not use the word, “waiver,” but was speaking of a total release from liability in the event of harm resulting from malpractice, and the discussion with the surgeon made it clear that was the intent of the release form that was presented to me to sign.  Such releases from liability have been held to be invalid in many jurisdictions.  Finding another doctor turned out well, though.

Glad to hear about the positive results from your treatment.  I think that treatment from capable doctors may be considered as a form of hiking gear.  It has made it possible for many of us to continue benefitting  greatly from hiking in the wilderness.

Story on local news about a procedure just approved by FDA to replace the cartilage so that bone doesn’t rub against bone.  A shock absorber they called it.  Is cartilage the write word?

Google OHSU knee shock absorber

I assume other hospitals do this

Maybe you don’t want to be one of the first people to use a new procedure

https://news.ohsu.edu/2023/04/12/ohsu-clinical-trial-validates-new-fda-cleared-technique-for-knee-repair

Thanks Jerry.  Great news!

“Now 63, Hunt said the implant made an immediate difference.”

Yep. this sounds very cool. It’s an outpatient procedure, although I was home the same day from my knee replacement. Recovery time for the new procedure is similar to a TKR. My recovery was harder than I expected–in terms of pain. But well worth it! My  surgeon put in a ‘spacer’ between my bones and yes, I could feel the difference immediately, as in, as soon as I stood up after the surgery. The bone on bone pain was gone; the recovery pain was something else.

on the TV news story, the guy was back to running a few days later.  Much faster recovery than alternatives.

Of course, my response (what I yelled at the TV) was why the hell is he doing just what caused his knee to fail in the first place – quit running!!!   (But his knee could have failed for some other reason.  I’m sure he got advice from the doc saying just what running was safe.)

Poking around google provided more info:  “The MISHA system looks like a pint-sized version of a car shock absorber. Measuring just three-tenths of an inch by two inches, it has a steel piston on top that slides in and out of a polymer cylinder. Titanium plates attach it to the inner (medial) part of the thigh and shin bones outside the knee joint.”

Sounds more like a mechanical device than expected, but not one that can be carried in a backpack.  Since an annual visit for my unreplaced knee revealed the doctor’s concern about that knee, will confer with both him and the doctor who did the right knee TKR about the Misha procedure.  It was encouraging to know that unlike the stem cell procedures, Misha has been approved by the FDA.  As was noted, for many of us it all depends on what the insurance will pay for.  Misha sounded a little creepy to me, especially knowing that the other knee was in much worse shape before TKR, which is not a picnic either.  Will see how it all pans out next year.  Thanks, Jerry and jscott, for telling us about this possible new option.

I just wanted to echo some of the experience above and add a little info.

Dietary change to reduce inflammation has worked very well for me. Gluten, sugar, alcohol, meat, dairy, fried foods, etc. Since I cut out all of the above and more all at once, I don’t know which items make the most difference.

I saw PRP mentioned a number of times in this thread but, surprisingly, no mention of Prolotherapy. In my case, prolo has been essential to pair with PRP.

Ross Hauser’s clinic in Florida maintains a website that explains a lot of the procedures discussed in this thread. Here’s the link to the page on Prolotherapy. He also discusses stem cell therapy. Doctors in the US with whom I talked all hold Hauser in high respect.

PRP is way cheaper in Europe than in the US, but they use small test tubes to harvest the platelets, not the massively huge ones that Hauser and people influenced by him use. Prolotherapy isn’t available in France at the moment, so I’ve done mine in Germany, at a fraction of the cost in the US.

Bob and Brad’s short video Top 7 Exercises After Meniscus Tear is also useful.

Sorry is this has already been posted.  Can’t recall everything that has gone into this thread so far.

Met with my sports medicine Dr. today.  He said a recent study showed that stem cells and cortisone shots were about equal in effectiveness.

I think I remember reading that cortisone shots have side effects so aren’t used so much anymore

“I think I remember reading that cortisone shots have side effects so aren’t used so much anymore”

In terms of knees, once you look at your own x ray, and see that there’s nothing separating your two major bones (there should be a meniscus at least) the notion that cortisone or excersize will ‘cure’ that quickly fades.

The hope with stem cell therapy was that it could quickly grow back the natural meniscus. It  hasn’t happened. Again, a simple x ray will tell why. How do you grow back a meniscus when weight bearing bones are grinding against each other literally at each step?

Inserting an artificial spacer between the knees–“total knee replacement”–can be very effective. I don’t know that there are other options at the moment.

Jerry,

Kaiser in Seattle stopped using cortisone for hips.  Found that it was eating away at the bone.

They are still using cortisone for knees but are cautious.   So far it has worked for me.  Had 3rd shot over a 2 year period yesterday.  Kicks in within a few hours to 3 days and continues to eliminate most of the pain for 4 months to a year.  I have osteoarthritis of left knee.  Without the shots I can barely walk.  With the shots, so far, I can still backpack but days are numbered.  Turn 79 next month.  Friend of mine cheered me up by saying 79 is the new 78.

My brother in law at Kaiser is getting cortisone for “trigger finger”.  Maximum = 3 shots then surgery.

My sports medicine Dr. is going to switch me to the lubricating fluid if we can make that work.  Doesn’t work for everyone and is fairly expensive.

I’m hoping the surgery you posted a few messages above continues to work.   Has a funny name. Easier for me to remember it as Jerry’s Joint Surgery.

That’s what I thought about cortisone

I’m 69.  People that are a few years older than me backpacking give me inspiration.  Hopefully I can go a few years more : )

Good to hear you had success with stem cells in your knee joints. I may try it for my L4 and L5 discs.

I’ve been told by two people who had stem cells injected into their disc areas that it works very well – for about 2 years. Heck, I can go back every two years if it works well.

I’m 80 now with good knees but needing back help B/C my toes are all numb (from the back problem) and now the soles of my feet are beginning to get involved too.

P.S. I guess stem cells can be considered “gear” since they are added “stuff”.

Cortisone knee injections have stopped working for me.  Here’s a summary of my experience for those fascinated by this exciting topic.

4/12/21`relieved all pain for 1 year

4/6/22 relieved all for 9 months

5/8/23 relieved all for 3 months

11/24/23 relieved some for 1 month

Currently-Hurts when I use my left leg to stand or walk.  Using crutches.

Trying leg brace.  Pulls left leg slightly outward to reduce pain on inner side of left knee.

Considering hyaluronic acid injection (knee lubricant).  If used, one must wait 3 or more months before surgery.

I’m still trying non-surgical treatments (ice, tylenol, rest, crutches, etc.) because space between bones has narrowed but I’m not yet to the bone-on-bone stage.

Surgery probably in my future.

Daryl & Daryl reporting from Seattle.

My friend waited too long to get her knee surgery, probably bone on bone for a while. She had quite a bit of necrotic bone that had to be removed making the recovery much more painful and difficult. She has mostly recovered now though, 1 year later and can hike 8-10 miles, ski classic style, and thinks she can backpack again (although hasn’t). At only 67!

Take care of those joints! ouch.

“Considering hyaluronic acid injection (knee lubricant).  If used, one must wait 3 or more months before surgery.”

My Kaiser sports medicine knee doctor had me try this, although it was clear that she expected this not to work. I had three injections over a month; no real help. Tried it again. No help. Before the second treatment I said, “when this doesn’t work can I finally have a knee replacement?” and she said yes. And so I did. Kaiser seems to require that ALL available treatments are used before surgery, and I did them all. Again, when an x-ray reveals that you’re down to bone on bone, ain’t nothin’ gonna help but a knee ‘replacement’. And earlier intervention is better than later, as Ak Granola mentioned.

p.s. knee replacement isn’t what it sounds like. It’s an extremely common surgery that merely introduces a spacer between the two knee bones, top and bottom, that are rubbing on each other. It’s a meniscus replacement, I guess.

My friend has issues with her new knee parts being sensitive to cold. other than overall good warm gear, is there anything special she can do for her knee? Maybe I should start a new thread.

p.s. knee replacement isn’t what it sounds like. It’s an extremely common surgery that merely introduces a spacer between the two knee bones, top and bottom, that are rubbing on each other. It’s a meniscus replacement, I guess.

Well, there is meniscus replacement (or transplantation), and there is total knee replacement.  Both are, to my mind, pretty much what they sound like.  Disclaimer:  I’m fortunate–so far–to not speak from experience.

If you search ‘Total knee replacement XR images’ on Google it is clearer what total knee replacement involves. It does include the replacement of the articular surfaces (‘bone ends’) as well as menisci. The implants have improved over time, and the surgical techniques. 🙂