My brother Geoff and I are now in our early 60’s and have had the same knee problems born from years of active use. We both have had to manage bouts of knee repair starting with torn meniscus, floating cartilage and eventually, degrees of osteoarthritis. Geoff, however, avoided a total knee replacement (TKR) by investing himself in ‘Advanced Orthobiologics’ or ‘Regenerative Medicine’ by using his own adult stem cells to repair. I, on the other hand and starting long before adult stem cell therapies were accessible, took the now well worn path leading to a total knee replacement, as the rest of my blog site details.
What are the differences between approaches? Many.
Which approach is better? There is no doubt that there is no comparison. Use of adult stem cells to manage joint damage is the preferred route to take, if your joint passes an applicability exam offered by orthopedic surgeons certified in Advanced Orthobiologics or Regenerative Medicine.
I am now into my sixth month recuperating from a revision TKR and recently progressed to walking about 100 meters without needing a cane. My brother, on the other hand, one week after his second stem cell therapy in 6 years, returned to wind surfing, cross country skiing, and biking, among other activities. He plans to participate again in the American Birkebeiner cross country ski race this winter and will once again return to the Columbia River Gorge in Colorado to leap and skim waves with his windsurfer, knees bent, taking all the shocks and torques my body cringes to think about. The benefits of regenerative medicine are very real starting and ending with less or no pain, a more active quality of life, more natural resources to draw from for a longer period of your adult life, no invasive surgical procedures and thus total avoidance of any risks associated with TKR surgery.
So, what is it like to actually experience adult stem cell therapy? Let my brother, the real author of this article, tell you his story.
- What was happening to your knee at the time that you first sought orthopedic attention?
I first tore my right lateral meniscus in the early 80’s playing tennis on a freshly refinished court that had a surface like 60 grit sand paper. The pain and swelling was pretty immediate. I recall limping around for a few days, maybe weeks before seeing a sports medicine doctor. Their recommendation was to avoid surgery until the injury interfered with my quality of life. For the next 6 months or so I tried running and playing tennis only to realize my mileage and agility were diminishing and the pain was increasing.
- What kind and how many doctors did you visit?
Over the course of the next 20 years I had 2 more arthroscopic surgeries for torn meniscus, one each for both knees. I recall seeking the opinion of a couple of orthopedic surgeons before settling on a surgeon who was the team doctor for many professional sports teams in Minnesota and traveled with the U.S. Winter Olympics team to Japan. Both surgeries were done by this same surgeon.
- How did you feel about your (mobility and life-style) future with each diagnosis/prognosis that was made?
After the first surgery my knee did not feel quite aligned for about a year…I think persistent running and tennis help pound or grind it into submission…Today, I would choose a softer approach to aligning one’s body. The recovery from the second surgery was much quicker due in part to a better surgeon and improved techniques. My mobility was pretty good for roughly 10 years. When I reached age 45 my legs started springing apart. I was always in some sort of recovery from pulled leg muscles. According to my current Osteopath, I did not have enough body work done for the level of activity I was doing. My body structure was out of alignment and my soft tissues were like dried out leather. To top it off, I tore a meniscus again and had a joint mouse (cartilage chip) floating around that would stop me in my tracks if it lodged in the joint or under my knee cap. I eventually had to have a third surgery to remove cartilage chip and clean up the meniscus tear.
- What or who led you to look into stem cell therapy?
Ms. Deanne Aronson, Osteopath and certified Acupuncturist. She is also my fiancé of 18 years.
- What features to stem cell therapy appealed to you?
It’s regenerative rather than invasive and extractive. It uses your own cells to assist your body in healing itself…no machinery. Minimal pain throughout the procedure and recovery. It is a small scale personal outpatient treatment alternative to those more impersonal complex procedures and protocols offered through the medical industrial complex. It makes the complex simple.
- Tell us about your first stem cell treatment.
Six years ago torn meniscus, a torn ACL and budding osteoarthritis compelled me to find a certified stem cell orthopedic practice. I found that practice in Colorado at the Regenexx clinic, the first to use adult stem cells for orthopedic injuries (www.regenexx.com/our-approach). I flew to Colorado, rented a hotel room and began the week long process. In those days, it took about 5 days for the complete treatment, including initial prolotherapy, blood draws, processing, and then stem cell and PRP injections. I was on a strict recovery program for 6 weeks which included immobilizing my knee with a brace and slowly increasing activity. The Doctor (Schultz) was only able to harvest enough stem cells at the time to treat my torn ACL and meniscus. There were not enough stem cells to treat the budding arthritis on the medial side of my knee. This is the only spot that had presented any concern since the procedure was completed. My knee for the most part was doing fine up to about 2 months ago when it clearly had degenerated to the point of prompting the second treatment. Besides windsurfing, I had roller skied and biked far too much and these activities set the arthritis on fire.
- How has the procedure changed since your first treatment?
The procedure has changed significantly over the last 6 years. Apparently they have refined the bone marrow extraction methods from the hip bones and have been able to harvest several times the amount of stem cells than were possible in the past.
- What features of stem cell therapy are difficult?
Not much…if you like needles. There is a lot of poking around involved with blood draws, prolotherapy, bone marrow extractions, prp and stem cell injections. However, I remember being a bit anxious with my first treatment in anticipation of the bone marrow extraction. In fact, Dr. Schultz paused the procedure and asked why my pulse was so high. I told him his literature talks about bone marrow extractions with no indication of the pain level one may experience. I had conjured up in my head that it would be on a par with bone cancer treatments or spinal taps. I was happy to find out the pain level is not much more than a typical shot. Their literature has since been revised.
Also, I received 3 rounds or approximately 10 injections each for prolotherapy treatments in Minneapolis prior to going to Boulder for the stem cell treatments. This was torture…and unnecessary. The local doctor that performed the treatment was pretty unsophisticated and did not use imagery devices to guide the horse needles into my knee…he was flying blind.
A good doctor will utilize fluoroscopy and/or ultrasound imagery in real time to guide injections into the joint capsule. If done well, the pain level isn’t much more than acupuncture. Doctors may offer a sedative to relieve anxious patients. However, I found just breathing deep and going to my happy place works just fine.
- What are the features of a knee replacement that are difficult for you to accept?
I would consider knee replacement for those people whose joints are damaged beyond the point where stem cell treatments are a reasonable solution. I have also experienced firsthand the profit motives of the orthopedic industrial complex and doctors who reject the idea of stem cell treatments and prematurely recommend knee replacement. As you know, a book could be written about the hideous lobbying by our western medical system and their efforts to obstruct FDA approval of stem cell treatments and detour any advancement of alternative medical treatments that would cut into profits.
- Under what conditions would you urge people to have a knee replacement?
When they have exhausted all other alternatives.
- What advice would you give people with acute knee pain?
If you go to a standard orthopedic surgeon they will figure out a way to use a knife to fix your pain. Instead, begin with the basics and consult professionals that specialize in noninvasive biomechanical and structural body work such as osteopaths, acupuncturists, chiropractors, or rolfers, etc. These treatments should be the first line of defense… structure governs function.
- How would you advise people who want stem cell therapy but cannot afford it?
Good question. Since adult stem cell treatments are not yet approved by the FDA, the costs are typically out of pocket. I was fortunate enough to have an Health Savings Account (HSA) and used pretax dollars to pay for my procedures. I also tried to bundle medical and dental expenses in a year in order to reach the threshold for income tax deductions.
I would also consult with providers to see if they would accept installment payments for treatments.
- Are there any elements of stem cell therapy that need improvement? (method of care, location, cost, unsure outcomes, chronic pain, lack of easy access…etc) ?
Yes. Approval by the FDA so the treatments can be paid for through insurance.
- Six years ago, stem cell therapy was not that common. It seems to me that it took some courage to have agreed to this kind of therapy. What gave you the courage to fly away from your home, rent a hotel room and subject yourself to this newish form of treatment?
Deanne Aronson. If it was not for my forward thinking insightful partner I would not have known about stem cell treatments. I also knew that if I had another arthroscopic surgery most of my remaining meniscus would be removed and I would be heading toward full knee replacement within a few years. Full knee replacement would also limit certain activities that I was not willing to eliminate from my life quite yet. I also realized that I was at an age when I would probably outlive the initial artificial knee and have to have that replaced in the future as well.
The more we researched stem cell therapy the more I was intrigued with the possibilities of regenerative medicine and was willing to give it a try.
- What personal traits are required of a person to have stem cell therapy?
A heartbeat. Six years ago at 58 years of age, I was considered a marginal candidate. The thought was that the older you are the fewer stem cells you produce. It is my understanding that this notion has been disproved. In fact, Deanne Aronson referred an 86 year old patient to a certified Stem Cell therapist, (Dr. Hanson) and is now receiving stem cell treatments. Apparently, good nutrition plays a larger role in the quantity and health of your stem cells than age.
- What personal traits are required of a person to heal from stem cell therapy and protect their knees from further damage?
Patience, a positive attitude and an understanding of the body’s ability to heal with proper nutrition, exercise, and biomechanics.
- What physical activities are you doing now?
Windsurfing, cycling, roller skiing, downhill skiing and freestyle skate skiing. Over the course of the last 6 years I have done over ten, 50 plus kilometer skate ski events and competitions including the American Birkebeiner and the Minneapolis Loppet.
- How long will your second stem cell injection last?
We will have to wait and see. The first treatment (6 years ago) never degenerated.
- Do you anticipate further degradation of your knee?
Well, through the process of the second treatment we discovered I have a budding bone spur located below the medial side of my knee cap. This apparently cannot be cured by stem cells. I am hoping to keep the spur at bay through biomechanical therapies.
- Do you anticipate possibly needing a metal knee replacement sometime in your future?
I hope that regenerative medicine will continue to advance to the point that I can avoid metal knee replacements.
- If so, will you allow it to happen?
I may have no other choice if I have exhausted all other possibilities. Hopefully the metal knee replacement industry will also make some advancements to minimize risk and improve outcomes.
- If you have to have a TKR, what options will you foresee having?
Learning how to embrace a more sedentary lifestyle.
END of interview.
Am I jealous of my brother? No, though envy slides in occasionally. I am happy for his sustained level of activity. Even if he chose to live a more sedentary lifestyle I would be happy for his absence of chronic pain. But, more so, I am haunted. Something is wrong, terribly wrong, in the medical field of Orthopedics when reliance on highly invasive partial and total metal implants are on the rise, with all of their associated risks (Blog 7), while the far less invasive regenerative medical therapies remains side-lined, stubbornly out of reach by insurance companies and held at a long arm’s reach by the US Food and Drug Administration (FDA) for reasons that remain persistently suspect. While a future blog will elaborate on this declaration, I encourage you to add these below information sites to your research list. When it comes to managing our health, researching our options can be only a click away for a less complicated, less painful, lifetime.