| Prolotherapy for Chronic Pain and Sports Medicine in Oak Park, Illinois, a suburb of Chicago Hope Practiced Here | |
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PROLOTHERAPY APPOINTMENT INFO |
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| Prolotherapy for Chronic Pain and Sports Medicine in Oak Park, Illinois, a suburb of Chicago Hope Practiced Here | |
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PROLOTHERAPY APPOINTMENT INFO |
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Knee
Replacement-
The Cartilage Crisis Why Are We In a Cartilage Crisis? This is not too
difficult to figure out just from the figures of the number of people needing
joint replacement surgery as directly correlated to the number of people who
are developing arthritis, which is directly related to the number of people
who have received
cortisone injections,
arthroscopy,
RICE treatment, and
anti-inflammatory
medications over the past 40 years. These treatments
accelerate cartilage breakdown tremendously, and thus also accelerate the
arthritic process. What is the Cartilage Crisis? Most
of the joints in the body are synovial joints, that is movable, lubricated
joints which are able to provide normal pain-free movement because of the unique
properties of the
articular cartilage. The articular
cartilage covers and protects the ends of the bones in joints. The knee is the
largest synovial joint. At
the top of the knee are the massive quadricep muscles which cause the knee to
extend. The
hamstring muscles are at
the back of the knee and cause it to flex. The knee joint has a synovial
membrane, which is tissue that lines the noncontact surfaces within the joint
capsule. This tissue secretes lubricating synovial fluid, which nourishes all
the tissues inside the joint capsule. The knee has internal
ligaments
(cruciate ligaments) and external joint ligaments
(collateral ligaments) which stabilize the joint, especially during movement.
The knee also has
menisci, pads of fibrous
cartilage which help the weight-bearing bones absorb shock. The ends of the
tibia, femur, and
patellar
bones of the knee joint are covered by articular cartilage. This is the
structure that is in crisis.
Articular cartilage allows near frictionless motion to occur between the
surfaces of two bones. Furthermore, articular cartilage distributes the loads on
the joint articulation over a larger contact area, thereby minimizing the
contact stresses, and dissipates the energy force associated with the load.
Articular cartilage is made of specialized protein structures, called
Proteoglycans, water, and
collagen. The cells (chondrocytes)
of articular cartilage are responsible for the synthesis of both the collagen and proteoglycans that make up the
cartilage and have the ability to synthesize all the various components of the
specialized proteins that make up the proteoglycans. This ability of these
chondrocytes to replicate is really the key question when considering the
potential of cartilage to proliferate or to repair itself. It has been shown
in studies on adult human cartilage that there is no decrease in cell counts,
even in individuals of advanced age. This fact alone suggests that
chondrocytes have the ability to proliferate and repair. Additionally upon
certain injury such as mild compression, osteoarthritis, or lacerative injury,
the chondrocytes are capable of mitotic division, indicative of growth and
proliferation. The notion of damaged
cartilage having no regenerative properties is responsible for many people
being subjected to arthroscopies with subsequent joint replacements. This
falsehood or myth occurred because healthy cartilage cells have very little,
if any, mitotic activity, thus very little or no ability to proliferate. A bulk of research on
articular
cartilage regeneration was performed in the 1980s and 1990s. Dr.
H.J. Mankin discovered that the chondrocytes reaction to injury was to change
into a more immature cell, called a chondroblast, which was capable of cell
proliferation, growth, and healing. This key fact is vital to understanding
the power of
Prolotherapy in proliferating cartilage regrowth. The Role of Prolotherapy in Cartilage Growth Prolotherapy involves
the injection of substances, such as hypertonic
dextrose,
sodium morrhuate
(extract of cod liver oil), various minerals,
Sarapin (extract of the pitcher
plant), and various other substances including
Growth
Hormone, which act by
stimulating the structures to repair. (The actual substances injected depend
on the individual case and the physician.) The current theory of cartilage
regeneration is that this irritation acts in the same mechanism as above in
inducing the chondrocytes into the chondroblastic stage of development capable
of proliferation and repair. The numerous patients, who had no cartilage or
were set for hip/knee replacements who never needed them because of
Prolotherapy, support this fact. Can It Be Proven That Prolotherapy Regenerates Knee Cartilage? It is impossible to
do a double-blind study on Prolotherapy because even an injection of sterile
water under the skin has a beneficial therapeutic effect. Even if no injection
was given on one side, as the control, sticking a needle into a painful area
is known to have a beneficial effect (this treatment is called acupuncture).
It is very difficult to prove using a traditional scientific model, that
Prolotherapy cures
chronic pain,
sports injuries, and regenerates cartilage
tissue. One doctor trying to
validate the treatment of Prolotherapy is
K. Dean Reeves,
M.D., Physical
Medicine and Rehabilitation Specialist, in private practice in Kansas City,
Kansas. He has just completed three double-blind studies on using 10 percent
dextrose versus water injections on finger/thumb arthritis,
knee
arthritis,
and anterior cruciate ligament injured knees. Injections were given every two
months of dextrose or water. After three injections, all patients were given
the dextrose proliferant for three more injections. In the knee studies, only
one intra-articular (inside the joint) injection was given per knee at each
session. As of this writing, the x-ray readings at one year had just been
completed. In the finger/thumb arthritis study there was a 53 percent
improvement in pain, and eight degrees of improvement in flexibility. In the
knee arthritis study there was a 44 percent improvement in pain, 63 percent
improvement in swelling, and a 14-degree improvement in flexibility. There was
an 85 percent reduction in knee buckling episodes. The loss of cartilage not
seen on x-rays by one year and bone spur measurements showed improvement. Of
interest was the fact that those without cartilage did nearly as well. In the
knee laxity (ACL) study, pain improved 27.5 percent, swelling by 51 percent,
and knee buckling episodes by 54 percent. X-ray studies at one year showed
improvement in two measures of bone spur and near-significant improvements in
thickness of cartilage in the knee. One should remember that this study
involved just one knee injection per session and articular cartilage growth
was seen. Typically in actual practice, a person with laxity in the
knee
ligaments may get 20 injections per visit. Dr. Reeves summarized the findings
as "...these double-blind studies with objective and measurable endpoints
all show that simple injection of arthritic fingers or knees, or knees with
ACL laxity, with non-inflammatory levels of
osmotic stimulants can bring about
favorable responses in pain, flexibility, and x-ray findings." Cartilage Regeneration with Human Growth Hormone Despite the majority
of Orthopedic Surgeons doubting that cartilage can be regenerated, one
physician in their own ranks has shown that cartilage growth is possible. Alan
Dunn, M.D., is an orthopedist in private practice in North Miama, Florida, who
has been studying cartilage regeneration for 30 years. His innovative approach
involves the injection of Human Growth Hormone into the deteriorated joint. He
reports, "In the rabbit studies that I conducted, just one injection grew
back the whole patello-femoral surface of the knee in five to six weeks. These
studies were biopsy confirmed."
He is currently conducting a study on human knees using monthly
human growth
hormone (HGH)
injections into knee joints with cartilage deterioration. Dr. Dunn says,
"Over half of the knees show major cartilage growth, and most of the rest
have a good result. The most amazing findings have been the near-complete
relief of pain in these degenerated knees." Dr. Dunn has been giving a
total of three HGH injections into the knees at monthly intervals. RELATED
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The Journal of Prolotherapy
is unique in that it has a
target audience of both physicians and patients. The purpose of this
journal is to provide the readers with new cutting-edge information
on Prolotherapy, as well as provide a forum for physicians and
patients alike to tell their stories.Your membership fee includes a 1 year subscription to this quarterly journal, and unlimited access to the journal archives online! Premiere Issue scheduled to be released for Spring 2009! Learn more |
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The information on this website is presented as
information only and not a self-help guide NOR AS SPECIFIC HEALTH
RECOMMENDATIONS. Never alter or change your health management or begin
any new health plans without first consulting your personal health care
provider.
Some statements on this site regarding the value of
nutritional supplements have not been evaluated by the FDA.
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