Many times, we have patients who are experiencing bone on bone, or Osteoarthritis, and believe that a total replacement is their only option and that regenerative medicine or other injections at Rejuv Medical will not help. As PA-C Terrence Keller would say, “oh yes they can!” The treatment for each area of the body is different; in this example, Terrence will explain the process of injections for knees, shoulders, and hips.
KNEE. In the medial or lateral compartment of the knee, we can get an unloader brace to open the joint space that is bone on bone. Once the compartment is opened up, with a combination of injections, we can both calm down the pain, possibly lubricate the joint space, as well as add stem cells to help the body create new cartilage and a better joint surface. Studies have shown growth of new cartilage with regenerative conditions, even in bone-on-bone arthritis (OA). With regenerative procedures, we are also strengthening the supportive structures to limit additional wear and tear to the joint once new growth commences. Adding Physical Therapy to this will also help support the joint health.
SHOULDER. If we are talking about a shoulder, it would be similar, though we don’t have a brace to offload the joint. Usually being a non-weight bearing joint, this is less important. Physical Therapy is going to be very important and stressing the joint stabilizers (rotator cuff) that will be enhanced and strengthened, with the combination of Physical Therapy and a regenerative procedure.
HIP. For the hip, there are many factors. If it is quite severe OA, hips can be stubborn responders in regenerative therapy, because we can’t take the weight bearing away completely. Though, it is an option that is not replacement surgery. If it works, you avoid all the high risks of hip surgery, while potentially having many more years of pain relief and increased function. If it doesn’t work, you can still have surgery in the future. Surgery is permanent and patients can’t change what doesn’t work afterwards. With regenerative medicine, the injections are not foreign to the body; so, worst case scenario, the body doesn’t respond and it simply doesn’t work.
Following these discussions, if a patient is having doubts about regenerative medicine, I will discuss how often I look at x-rays where one joint looks horrible– bone on bone arthritis– but the patient is not having any pain in that joint. So, working on the pain generators in the joint may be significantly helpful. A lot of pain is coming from the nerves surrounding the joint, which we can treat.
While regenerative medicine works quite often for most of our patients, there are some out there that don’t respond as well as others, but no one has gotten worse from such treatments. At Rejuv Medical, we guarantee that we will do everything we can to help patients feel better.
Side note – if a patient has had cortisone injections that no longer work, or don’t work at all; I mention that cortisone just blocks inflammation and pain from inflammation but doesn’t turn down pain reception in general. Our injections treat the pain while limiting inflammation, effectively treating both.
Written By: Terrence Keller