Knee Injuries & Chronic Pain
For most patients suffering with debilitating knee damage and/or osteoarthritis, the treatment options are usually limited to masking the pain with cortisone steroid injections, risky joint replacement surgery or simple physical therapy which does not target the root cause.
With current medical advancement, a powerful non-surgical alternative to knee replacements using a combination stem cells, growth factors along with PRP is readily available. The procedures uses clinical grade stem cell injections for people suffering from degenerative knee arthritis induced pain or for those looking for an effective alternative to knee replacement surgery or for those with common ligament, tendon and bone injuries from playing sports or degenerative arthritis.
Stem Cells repair Meniscus Tears, Ligament & Tendon Tears and Injuries
The human body consists of billions of very specialized cells that differentiate into specific purposed organs such as skin,muscle, brain, heart, ligaments, tendons, bones and connective joints. These specialized cells are constantly circulating through the body as part of our natural regenerative process. Typically, when older cells die ( apoptosis ), new cells are created from our circulating stem cells that have the capability of creating multiple types of cell lineages.(Turajane et al. 2013)* When tissue in the human body is injured, the degenerative effects exceed our natural regenerative process, resulting in joint structures becoming weaker, less functional and painful. This is especially true for middle-aged and older patients who get injuries in areas like the knees that are isolated from continuous blood circulation ( vehicle for stem cells ).
There are several specific types of stem cells in our body, however only a few cell types are beneficial for musculoskeletal applications such as hip injuries and shoulder repairs. Mesenchymal stem cell markers (MSCs) offer the highest potential for articular cartilage regeneration. MSC cells used in this treatment are isolated from a select group of cell rich tissues, then expanded in the stem cell lab to enhance their differentiation potential.(Kasemkijwattana et al. 2011)*
The positive cell markers used in the isolation and expansion include: STRO-1, CD146,CD73, CD166,CD105 and CD106.
The negative MSC cell markers include: CD45, CD11b, CD31,CD34 and CD117.
The Bioactive factors that are secreted by the enhanced MSC cells inhibits any tissue scarring, suppress the apoptosis phase, stimulate angiogenesis, and also enhance mitosis of stem and progenitor cells. The Enhanced Mesenchymal cell protocols provides patients with many practical advantages of engineered cartilage cells that can be used to repair osteochondral and chondral lesions and also to initiate endogenous regenerative capacity in the knee joints.
Non-surgical repair for injuries and chronic knee pain from below conditions :
- ACL (Anterior Cruciate Ligament) Non-Retracted sprain or tear
- MCL (Medial Cruciate Ligament) sprain or tear
- PCL (Posterior Cruciate Ligament) sprain or tear
- Rheumatoid arthritis of the Knees
- Knee Tendonitis or Tendinopathy
- Patellar Tendinosis or Tendonitis
- Bone on bone Osteoarthritis
- Runner’s Knee aka Chondromalacia
- Pes anserine Bursitis
- Patelofemoral syndrome ( PFS )
- Iliotibial band syndrome ( ITBS )
- Osgood-Schlatter Disease ( OSD )
- Synovial plica syndrome & Medial plica syndrome
- Knee Meniscus Injury & Tears
- Bursitis of the Knees
- Baker’s cysts
Treatment for Non-Retracted Full or Partial ACL Tears
The ACL repair protocol is a combination therapy using enhanced cells and PRP to heal partially torn Anterior cruciate ligaments and complete non-retracted ACL tears. A safe non-surgical alternative to repair ACL is a very viable option for those considering surgical intervention because of a partial ACL tear or complete non-retracted tear.
Stem Cell knee therapy can help you avoid extended downtime and the painful rehabilitation process that traditionally follows after anterior cruciate ligament surgery.
Stem Cells for Treating Meniscus Tears
Stem Cell therapy for meniscus tears is the most common type of knee injury treated. Surgically repairing a meniscus tear should be considered the last option. Meniscus tear repairs work by surgically removing some (partial meniscectomy) ,or all of an very important structure in the knee. For most cases, a minimally invasive combination of stem cells, PRP and post therapy physical rehabilitation is usually a safer and better option. (T Turajane et al. 2013)*
Meniscus is a crescent-shaped fibrocartilaginous structure that acts as both spacer between the femur and tibia while also providing shock absorption capabilities for the knee joint. It is able to be an effective shock absorber by equally distributing any blunt forces across the knee joints. A meniscus is comprised of living fibro-cartilage tissue and each knee has 2 menisci.
- A medial meniscus (closer to the inside)
- A lateral meniscus (closer to the outside)
For various bio-mechanical reasons most injuries occur on the medial meniscus.
Types of Knee Meniscus Tears
The medical meniscus is usually the most injured part of a knee. Most acute traumatic meniscus tears we treat happen due to sudden and traumatic twisting of the knees. For some elderly patients traumatic injuries and meniscus tears are caused over gradual weakening of the meniscus as a result of degenerative and/or arthritic knee joints. Meniscus tears are usually described by the position/location of the tear (posterior or anterior) and which one of the 2 meniscus that was injured (lateral or medial) Some examples for meniscus tears include:
Meniscus Flap Tears or unstable meniscus tears: This type of meniscus injuries/flap tears occur in the inner rim and usually involve a small part of the meniscus. This type of injury is not able to heal without intervention since the area in the knee does not have adequate blood supply. Most traditional orthopedic surgeons like to “trim” or “shave” (remove) the meniscus that leads to other long term knee issues. Use caution if considering surgical intervention as stem cells are a better alternative to repair the tear and bring back stabilized full range of motion.
Bucket Handle Meniscus Tear: Bucket handle meniscus tears are usually more painful then other types of tears. When the entire inner rim of the medial meniscus is torn it is called a “bucket handle tear” due to it looking like a handle bucket. These types of tears usually always occur in an area with good blood supply and if caught early, they can be sutured back into place. Alternatively, an enhanced cell injection with PPP can also be used to accomplish the same repair without any risk and downtime associated with surgery.
A Medial Meniscus Tear: The Medial menisci can be found in the inner side of our knee joints. The torn medical meniscus diagnosis usually describes a tear on the medial meniscus that is often caused by traumatic injury or sudden change of force and direction that occurs in sports such as skiing, basketball, football, soccer and volleyball. This type of injury can also occur due as a result of repetitive use injuries like long-distance running, track and field and cycling along with long term degenerative knees in older patients. Stem cell therapies can treat Medial Meniscus Tears very efficiently and without need of surgical intervention.(Davatchi et al. 2015)*
Complex Degenerative Meniscus Tears: Degenerative meniscus tears are most commonly found in middle-aged or elderly patients due to decades of repetitive stresses that have severely weakened the meniscal tissue. Unlike Acute Traumatic Tears, Degenerative meniscus tears are not sudden and are more symptomatic in nature. Common symptoms of degenerative meniscus tears include:
- Pain along the joint line
- Catching and locking
Degenerative meniscal tears in the knees are usually associated with osteoarthritis and degenerative joint diseases. These types of tears are commonly associated with osteoarthritis of the knees and cause the menisci to tear or fray in multiple directions. With that many tears most surgeons do not try to surgically repair since it likely will cause more harm than good. If traumatic meniscus tears are left untreated they can often lead to arthritis. For such degenerative knee injuries, an aggressive stem cell protocol with PRP and growth factors to heal the area using our bodies natural repair mechanisms is suggested.
Recent published studies have shown that meniscus removal surgeries are no more effective than not having surgery or just having physical therapy. Surgical meniscus removal creates much higher impact forces inside the knees and it is estimated that removing as little as 10% of the knee meniscus tissue can increase overall knee joint stress about 65%%. When more that half (50%) of the menisci is surgically removed through surgery, the stress levels increases exponentially leading to more failure and more knee surgeries and ultimately left with the option of a total knee replacement surgery which normally lasts only 15-20 years before needing to be replaced yet again with another surgery.
Multi stage approach for knee Stem Cell Therapy
Please note this treatment protocols need proper isolation, expansion and multi-stage delivery of stem cells that will require 10-14 days. The entire process does not require surgery or overnight hospital stays and patients are able to return to their normal activities following the week long procedure and also avoid the risk of lengthy and painful rehabilitation needed after invasive knee joint surgeries. This stem cell injections help promote naturally anti-inflammatory agents, such as cytokines and contain essential growth factors, which help stimulate tissue growth. Proper rehabilitation is recommended after treatment to help restore the strength, range-of-motion and mobility of the knee joints to pre-injury levels.(Uth and Trifonov 2014)*
Are Stem Cell Infusions Safe?
Hematopoietic Mesenchymal stem cell therapies have been used for over 45 years now and are very safe and effective. The cells are 99.99% Immunocompatible and there is virtually no threat of patient rejection. With several thousand injections already been performed by our medical team, we have never had a single case that reported adverse side effects.
Using Stem Cells Injections for Knee Arthritis & Knee Joint Repair
Number of Cell Injections for Knee: 2-6 Injections of Cultured and Purified Mesenchymal “MSCs” Cells
Type of Cells Used and Injection Locations: For most patients, this protocol will use Clinical Grade Mesenchymal cells that are Autologous (from the patient) Peripheral Blood or Adipose Tissue derived. For older patients or people with multiple conditions and/or severe degeneration we will use immunocompatible and HLA Matched Allogeneic cells derived from Cord blood, Amniotic Membrane or Placenta cells. The cell therapy to repair knee joints does not require surgery and can be delivered through a Guided imaging (when necessary) or more commonly through Direct injection in injured site, Intrathecally with Intravenous Drip “IV Drips”
- Turajane, Thana, Ukrit Chaweewannakorn, Viroj Larbpaiboonpong, Jongjate Aojanepong, Thakoon Thitiset, Sittisak Honsawek, Juthatip Fongsarun, and Konstantinos I Papadopoulos. 2013. Combination of intra-articular autologous activated peripheral blood stem cells with growth factor addition/ preservation and hyaluronic acid in conjunction with arthroscopic microdrilling mesenchymal cell stimulation Improves quality of life and regenerates articular cartilage in early osteoarthritic knee disease.Journal of the Medical Association of Thailand = Chotmaihet thangphaet, no. 5. http://www.ncbi.nlm.nih.gov/pubmed/23745314.
- Kasemkijwattana, Channarong, Suradej Hongeng, Suraphol Kesprayura, Visit Rungsinaporn, Kanda Chaipinyo, and Kosum Chansiri. 2011. Autologous bone marrow mesenchymal stem cells implantation for cartilage defects: two cases report. Journal of the Medical Association of Thailand = Chotmaihet thangphaet, no. 3. http://www.ncbi.nlm.nih.gov/pubmed/21560849.
- Uth, Kristin, and Dimitar Trifonov. 2014. Stem cell application for osteoarthritis in the knee joint: A minireview. World journal of stem cells, no. 5 ( 26). doi:10.4252/wjsc.v6.i5.629. http://www.ncbi.nlm.nih.gov/pubmed/25426260.
- Davatchi, Fereydoun, Bahar Sadeghi Abdollahi, Mandana Mohyeddin, and Behrooz Nikbin. 2015. Mesenchymal stem cell therapy for knee osteoarthritis: 5 years follow-up of three patients. International journal of rheumatic diseases, no. 3 ( 20). doi:10.1111/1756-185X.12670. http://www.ncbi.nlm.nih.gov/pubmed/25990685.
- Turajane, T, T Thitiset, S Honsawek, U Chaveewanakorn, J Aojanepong, and K I Papadopoulos. 2013. Assessment of chondrogenic differentiation potential of autologous activated peripheral blood stem cells on human early osteoarthritic cancellous tibial bone scaffold. Musculoskeletal surgery, no. 1 (November 1). doi:10.1007/s12306-013-0303-y.http://www.ncbi.nlm.nih.gov/pubmed/24178764.