KNEE PAIN
Ross Hauser, M.D.

When we ask patients the reasons for their surgery, the typical response is "to shave cartilage" or "I don't know."

The best treatment, as long as it is a partial tear, is to help the body repair the injured area. Remember, removing any tissue that God has put in the body will have a consequence. The tissues most commonly removed during arthroscopic surgery in the knee are parts of the meniscus and the articular cartilage. Both of these structures are needed by the body to help the femur bone glide smoothly over the tibia. When either of these structures are removed, the bones do not glide property.       

When other tissue is removed, eventually, whatever meniscus or articular cartilage is left after the arthroscopic surgery is worn away. Once this occurs, bone begins rubbing against bone and proliferative arthritis begins. After a course of cortisone shots, nonsteroidal anti-inflammatory medications, and several trials of physical therapy, the patient is again under the knife, this time for a knee replacement. Once an arthroscope touches the knee, the chance of developing arthritis in the knee tremendously increases. 

In our opinion, before letting an arthroscope touch you, it is imperative to have an evaluation by a physician familiar with Prolotherapy (a non-surgical alternative.) Prolotherapy will begin collagen formation both outside and inside the knee joint, depending on the structure(s) that are injected. Prolotherapy stimulates the body to repair itself. Surgery in the knee is appropriate when a ligament is completely torn, such as would occur from a high velocity injury. Prolotherapy will only helpful to regrow ligaments if both ends of the ligament remain attached to bone. Remember, 98 percent of ligament injuries are partial tears for which Prolotherapy would be helpful. 

DIAGNOSIS OF KNEE CONDITIONS 
In diagnosing the cause of knee pain, it is important to carefully examine the knees. A patient whose knees cave inward has a condition known as knocked-knees. This stresses and weakens the medial collateral ligament on the inside of the knee. Prolotherapy will strengthen this ligament. Alternately, knees with an outward curvature is a condition known as bow legs. This position applies additional strain on the outside knee  ligament, the lateral collateral ligament.     

It is important to understand the referral patterns of these two ligaments. The medial collateral ligament refers pain down the leg to the big toe and the lateral collateral ligament refers pain to the lateral foot. The ligaments inside the knee are called the anterior and posterior cruciate ligaments. These ligaments help stabilize the knee preventing excessive forward and backward movement. When these ligaments are loose, even in a young person, degenerative arthritis begins to form. Prolotherapy causes a stabilization of the knee after these ligaments are treated. The feeling of a loose knee is reason enough to suspect ligament injury. The cruciate ligaments are the power horses that stabilize the knee. They refer pain to the back of the knee. Posterior knee pain may be an indication of ligament injury.

Meniscal injuries are suspected if the patient reports a "catching sensation" in the knee or if the knee must be "jiggled" to produce full range of motion. Articular cartilage injuries exhibit similar symptoms making it difficult to clinically differentiate them. However, they can be differentiated using X-rays.

Prolotherapy is indicated regardless of whether the injury causing the knee pain is due to a meniscal or articular cartilage injury. Prolotherapy injected into a joint requires a more concentrated solution because the joint fluid has a diluting effect.
 

RELATED ARTICLES
Prolotherapy and Pes Anserinus Tendons
Knee Cap - Patella Disorders and Prolotherapy
Knee Injury and Cortisone 
Knee Braces