KNEE SURGERY CAUSES ARTHRITIS

BY FRED G. ARNOLD, NMD

In a recent study, it was shown that a common type knee surgery can increase arthritis and cartilage loss. Knee surgery repairs tears by removing a piece of cartilage called the meniscus in the knee joint that acts as a shock absorber and provides stability to the knee. In the study, the scientists used MRI scans to evaluate 355 knees with arthritis and compared them to a similar number of knees without arthritis. The average age of the patients was 60 years and two-thirds were women. In the study group, 31 knees were operated on to repair meniscal tears and all of these patients, 100 percent, developed arthritis within a year. In the patients who had meniscal damage but did not have surgery, 59 percent of the knees developed arthritis. The study found that cartilage loose occurred in nearly 81 percent of knees that had meniscal surgery, compared with 40 percent of knees with meniscal damage that did not have surgery. The research was presented at the annual meeting of the Radiological Society of North America (RSDA). 4

It makes perfect sense that when you remove knee cartilage arthritis would occur. In our cars, we have coiled shock absorbers to absorb weight bearing forces as the car travels down the road. Imagine what would happen, if you removed one of the shock absorbers and continued to drive your car as usual. The increased weight bearing forces on the side of the car where the shock absorber was removed would start to wear out the tires and mechanical attachments would loosen resulting in damage to parts of the car. When surgery is performed to a knee and part of the meniscus is removed, abnormal weight forces develop and arthritic changes are accelerated in the knee.

Other traditional medical treatments
There are a variety of other traditional medical treatments used to treat knee conditions:
Nonsteroidal Anti-inflammatory Medications are among the most commonly used drugs in the world for the treatment of arthritis and are frequently given to patients with knee pain to reduce pain and inflammation. Nonsteroidal anti-inflammatory medication has been shown in scientific studies to accelerate the articular cartilage breakdown in arthritis. 4
Rooster Comb Injections (synvist) cushions and lubricates the knee the same way synovial fluid — secreted naturally by the lining of the joint — does. These injections do not cure osteoarthritis, stop the progression of the disease or heal worn cartilage.
Physical Therapy may strengthen associated muscles of the knee joint, it does not change the condition of the damaged cartilage in the knee.
Knee Replacement surgery may be recommended when the knee fails to respond to steroid injects, synvist injections, physical therapy and meniscus surgery.

Regenerative Medicine
Regenerative medicine is the "process of replacing or regenerating human cells and tissues to restore or establish normal function". Some of the current and effective regenerative injection medicine techniques includes prolotherapy, prolozone, platelet rich plasma (PRP), and stem cell therapy:
Prolotherapy is a proven treatment for painful knee conditions. A natural substance such as dextrose is injected with an anesthetic to purposefully provoke mild localized inflammation.
Numerous scientific studies clearly illustrate the benefits of prolotherapy for painful knees to repair knee meniscus, reduce joint pain, improve range of motion and even repair a anterior cruciate ligament (ACL) tear. 3,5,8
Prolozone is a regenerative therapy developed by Dr. Frank Schallenger that uses ozone, a naturally occurring form of oxygen and an anesthetic, such as procaine. Prolozone may used to stimulate cartilage growth in the treated joint. 7
Platelet Rich Plasma (PRP) uses the body’s own platelets and growth factors to stimulate healing. PRP is also a proven treatment to repair and improve function in painful knees. According to a recent orthopedic article “treatment with PRP injections can reduce pain and improve knee function and quality of life with short-term efficacy”. 2
Stem Cell Therapy is probably the most complicated regenerative procedure that involves the collection of adult stem cells, usually from the abdomen adipose (fat) tissue or bone marrow contents, frequently from the lower leg. Dr. Centeno has demonstrated increased meniscus volume of the knee by 24% after injections of stem cells. 1

Other Conditions Treated with Regenerative Medicine
Although regenerative medicine addresses treatment of knee conditions, these injections can also be used for most joints in the body such as the shoulder, spine, pelvis, hips, hands and feet.

CONCLUSION
Knee surgery that removes the cushion in the knee, called the meniscus, causes arthritis of the knee. The removal of this natural shock absorption in the knee leads to early wear and tear which may latter lead to total knee replacement. Nonsteroidal Anti-inflammatory Medications also cause a breakdown of knee cartilage and accelerate degenerative changes in the knee. Other treatments such as physical therapy and synvist injections do not repair damaged knee cartilage.

Regenerative medicine injection treatments provide safe, reasonable and proven orthopedic procedures and provide significant relief to patients for painful knee conditions. Regenerative medicine treatments treat the cause of the problem: damaged and weakened cartilage, ligament and tendons. Strengthening these structures slows down and even reverses the degenerative changes associated with painful knees. Regenerative medicine treatments should be considered for the treatment of arthritic and painful knees, and especially when other treatments have failed and surgery has been recommended.

REFERENCES:

1. Centeno CJ, Busse D, Kisiday J, Kechan C, Freeman M, Karli D., Regeneration of meniscus cartilage in a knee treated with percutaneously implanted autologous mesenchymal stem cells. Medical hypotheses, 2008, Dec, 71(5):900-8.
2. Filardo G, Kon E, Buda R, Timoncini A, Di Martino A, Cenacchi A, Fornasari PM, Giannini S, Marcacci M., Platelet-rich plasma intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis, Knee Surg Sports Traumatol Arthrosc. 2011 Apr;19(4):528-35. doi: 10.1007/s00167-010-1238-6. Epub 2010 Aug 26.
3. Fullerton, BD, Arch Phys Med Rehabil, 2008 Feb;89(2):377-85
4. Hauser, Ross A. MD, The Acceleration of Articular Cartilage Degeneration in Osteoarthritis by Nonsteroidal Anti-inflammatory Drugs, Journal of Prolotherapy, 2010;(2)1:305-322.
5. Reeves, Kenneth D, MD, and Hassanein, Khatab PhD, Randomized Prospective Double-Blind Placebo-Controlled Study of Dextrose Prolotherapy for Knee Osteoarthritis with or without ACL Laxity, Alternative Therapies, March 2000, VOL. 6, NO. 2
6. Roemer, Frank W., M.D., Common Knee Surgery May Lead to Arthritis and Cartilage Loss, RSNA.org Copyright © 2015 Radiological Society of North America (RSNA)
7. Shallenberger, Frank MD, HMD, ABAAM, Prolozone – Regenerating Joint and Eliminating Pain, Journal of Prolotherapy, Volume 3: Issue 2: May 2011
8. Walter Grote, Rosa Delucia, Robert Waxman, Aleksandra Zgierska, John Wilson, David Rabago, Repair of a complete anterior cruciate tear using prolotherapy: a case report, Int Musculoskelet Med. 2009 Dec 1;31(4):159-165