CMC Arthritis

Knee Surgery Rehabilitation

 

Knee surgery rehabilitation varies on the type of surgery performed.

Knee surgery rehabilitation is often minimal in patients who undergone knee arthroscopy.

Knee surgery rehabilitation is extensive for patients who undergo microfracture or total knee replacement. Knee surgery rehabilitation is often painful and requires large amounts of time at a physical therapy office.

Repair of damaged knee cartilage or meniscus does not always require surgery. The benefit of arthroscopy, a surgical procedure in which the surgeon places a small camera into the knee joint through small incisions has recently been questioned. Kirkley et al in the New England Journal of Medicine published a study that demonstrated knee arthroscopy in patients with osteoarthritis had no better outcomes that those that were treated with physical therapy and medicine.

Englund et al also questioned the utility of surgery on the meniscus when most meniscal tears are not associated with pain and only increase in prevalence with age.

Regenexx affords patients with knee pain and damaged cartilage and meniscus a non-surgical option. Regenexx utilizes a patients own stem cells to grow knee cartilage. Centeno et al demonstrated on MRI an increase in knee cartilage in patients who had undergone the Regenexx procedure. Patients are not exposed to the inherent risks of general anesthesia or surgery. The Regenexx procedure is a simple needle in, needle out procedure where a patients own stem cells are injected under x-ray guidance to the area of damage. Please review our patient testimonials.

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Epidural Use for Knee Replacement Surgery

Epidural use for knee replacement surgery is a common practice.

Epidural use for knee replacement surgery can avoid the use and risks associated with a general anesthetic.

Unfortunately epidural use for knee replacement surgery still exposes the patient to the risks of a regional anesthetic including but not limited to infection, spinal headache, nerve damage and failure which may require the administration of a general anesthetic.

Epidural use for knee replacement surgery also exposes the patient to the risks inherent in knee surgery which include failure, infection, nerve damage, pulmonary blood clots and death.

Regenexx offers patients an alternative to the risks of both surgery and anesthesia, Regenexx is option in lieu of knee replacement surgery. Regenexx allows the patient to grow knee cartilage through implantation of their own stem cells. Centeno et al demonstrated on MRI the regeneration of knee cartilage in patients who had undergone the simple needle in, needle out Regenexx procedure. No general anesthetic or epidural is needed. The only anesthetic used is lidocaine to numb the skin. No surgery or hospitalization is required. After a given patient’s stem cells are expanded in our cell laboratory they are injected directly into the area of damaged cartilage under intermittent x-ray. No extensive rehabilitation is required.

The risks of epidural use for knee replacement surgery can now be eliminated through the use of expanded stem cell therapy at Regenexx.

Benefits of Back Surgery and Nonsurgery

Benefits of Back Surgery and nonsurgery are controversial and a topic of much debate among physicians and patients.

Benefits of Back Surgery and Nonsurgery have been examined and Weber et al demonstrated that at 4 years there was not a significant difference in outcome between those patients who underwent surgery vs conservative non operative management.

Benefits of Back Surgery and nonsurgery is complicated but several  pearls can make it easier to understand.

First and foremost surgery should be the option of last resort in the absence of incontinence or motor weakness.  Surgery is a one way gate.  Once you enter and undergo a given procedure it can not be undone.  The tissue,  muscles and possible disc that is removed is gone.  This in itself causes an entire host of other problems including failed back syndrome.

Secondly, all conservative therapies should be undertaken.

Third:  The disc needs to be identified as the principal generator of pain.  At the Centeno-Schultz Clinic highly selective nerve blocks are performed with the use of intermittent x-ray to identify whether or not a given lumbar disc is the source of pain.

Fourth:  Lumbar discs which are painful can be repaired utilizing your own stem cells.  At Regenexx we perform a simple needle in, needle out procedure that does not expose the patient to the risks of general anesthesia and surgery.  Below is an example of a patient who had severe leg and back pain due to a L5/S1 disc protrusion which was corrected through Regenexx stem cell therapy.

RX Back Disks Without Surgery

RX Back Disks Without Surgery is essential and will be the cornerstone of  regenerative medicine.  RX Back Disks Without Surgery is essential to the avoid the complications and risksassociated with back surgery.  Four year follow up study by Weber  demonstrated no significant difference between patients who underwent surgery and those who had conservative therapy

The lumbar spine has five discs which function to absorb the forces of daily activity.  The disk is made up of two principal parts:  the nucleus populous and the annulus fibrous. 

The annulus can be thought of as the sidewall of a tire.  It provides the essential strength to the disk.  When there is weakness is the annulus the disc can protrude or herniate.

A protruding disc can compress a nerve root thereby causing back and leg pain.  At the Centeno-Schultz Clinicanti-inflammatory medications are injected  with the assistance of  x-ray adjacent to the damaged disc and irritated nerve root with the intent of reducing the inflammation and pain.

 

RX Back Disks Without Surgery is an integral part of Regenexx  where one’s one stem cells are injected into the disc with the intent of strengthening the sidewall of the disc, reducing the compression of the disc on the nerve root and reducing the pain.  Our patients have the benefit of RX Back Disks Without Surgery by utilizing their own stem cells to regenerate their damage disc tissue.  Please see the MRI of our patients prior to and following stem cell therapy. Note the reduction in the L5/S1 disc bulge which was accompanied by elimination of the patients leg pain.

Chondroplasty with microfracture knee surgery

Chondroplasty with microfracture knee surgeryis a common surgical procedure for patients with loss of cartilage in the knee joint.  Chondroplasty  involves smoothing of  the roughened articulate cartilage with the intent of decreasing the friction inside the join. Microfractureinvolves making a grid like pattern of fractures in the cartilage and subchondral bone with the intent of stimulating the formation of new cartilage. The cartilage that is formed is fibrocartilage as opposed to the intrinsic cartilage which is hyaline.  Fibrocartilage is not as good mechanically as the original hyaline cartilage; it is much denser and isn’t able to withstand the demands of everyday activities as well as hyaline cartilage and is therefore at higher risk of breaking down.

Chondroplasty with microfracture knee surgery exposes patients to the inherent risks associated with both surgery and anesthesia.

Chondroplasty with microfracture knee surgery is not the only option for those patients who have loss of knee cartilage.  Regenexx offers patients the opportunity to use their own stem cells to generate cartilage in the knee joint.  As opposed to Chondroplasty with microfracture knee surgery, Regenexx is a simple needle in needle out procedure and therefore the patient is not exposed to the inherent risks associated with surgery and anesthesia. 

 

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Cartilage arthroscopic knee surgery

Cartilage arthroscopic knee surgery is utilized in patients with knee pain who have a reduction in the cartilage on the femoral condyle or tibial plateau.

 

 

 Reduction of cartilage in the knee joint can arise from many sources including osteoarthritis, trauma, degeneration or surgical removal of the meniscus and excessive wear due to biomechanical imbalances.

 

Cartilage arthroscopic knee surgery can refer to several different types of surgeries. The most common is microfracture surgery in which the surgeon through a scope creates a grid like pattern of small fractures of the  knee cartilage that extend into the subchondral bone.  Bleeding occurs along with release of stem cells which  form a delicate clot.  The intended result is to initiate the formation of new cartilage.  Unfortunately the cartilage that is formed is fibrocartilage rather  than the intial hyaline cartilage which covers the joint.  In addition, the fibrocartilage is not as good mechanically as the original hyaline cartilage; it is much denser and isn’t able to withstand the demands of everyday activities as well as hyaline cartilage and is therefore at higher risk of breaking down. Rehabilitation involves following microfracture is typically 6-8 weeks of non-weight bearing followed by extensive physical therapy.

 

Regenexx uses a patient’s own stem cells to regenerate knee cartilage without the need for surgery or the extensive physical restrictions and rehabilitation associated with microfracture.  At  Regenexx a patient undergoes a simple x-ray guided needle procedure in which their own stem cells are placed along the area of damage.  No anestheis is required. Centeno et al published a study which demonstrated an increase in knee cartilage following stem cell therapy.

Muscel weakness after knee surgery

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Muscel weakness after knee surgery is a serious complication that is often not mentioned to patients who elect to proceed with surgery. Muscel weakness after knee surgery can arise from a number of factors including damage to a nerve, inappropriate positioning and severe pain which impedes rehabilitation.

There are many risks associated with knee surgery including but not limited to bleeding infection, failure, pulmonary embolus, complications associated with anesthesia and possible death. Muscel weakness after knee surgery along with the other common complications raises significant concern about knee surgery. The New England Journal of Medicine published a study that demonstrated that knee arthroscopy in patients with osteoarthritis is no better than physical therapy and medical management.

Utilizing your own stem cells to regenerate cartilage in the knee is now an alternative to surgery. Regenexx enables the patient to use their own stem cells to regenerate cartilage.

Centeno et al reported significant cartilage growth following stem cell therapy as measured by MRI. Patients who have undergone stem cell therapy have been able to have a reduction in their pain and an increase in their function. This allows patients to forgo the risks of surgery and anesthesia. Regenexx is a novel technique utilizing a patients own stem cell for the regeneration of knee cartilage so muscel weakness after surgery does not occur to anyone.

Patella Tendon Repair and Rehabilitation

The patella tendon connects the knee cap ( patella) to the shin bone (tibia). It serves to stabilize the knee and allows the quadriceps muscle group to straighten the leg.

The patella tendon is prone to rupturing in individuals with a history of patella tendon injury such as jumper’s knee or osteoarthritis. Injuries of this type  weaken the patella tendon and in the event of strong contraction of the quadriceps  such as landing from jump, the patella tendon may tear or rupture.

Corticosteroid injections given to address the inflammation seen in patella tendon injuries are also known to predispose the individual to ruptures.  At the Centeno-Schultz Clinic patella tendon inflammation and pain has been successfully  treated with prolotherapy .  This therapy does not predispose patients to patella tendon rupture.

Patella tendon repair most commonly involves surgery.  Following surgery rehabilitation for patella tendon repair normally involves little or no weight-bearing on the affected knee and wearing a knee brace or cast prevent the knee from bending. This may be required for more than 6 weeks.

Rehabilitation from a patella tendon repair is extremely slow and it may take between 6 and 12 months before the patient is able to return to sports.

Patient now have the option to utilize their own stem cells to regenerate the tendon and forgo surgery through Regenexx.  Repair of torn tendons has already been achieved through this unique technique.  See our patient testimonials on the success of using stem therapy for the repair of tendons.

Patella Tendon Repair and Rehabilitation

The patella tendon attaches the lower part of the knee cap (patella) to the tibia.  It functions to stabilize the patella.

When the patella tendon ruptures, the patella loses its stabilization and support.  A patient will not be able to straighten the knee or  stand on the affected limb.  Typically  the knee will usually buckle and give way because the body is no longer able to hold the knee straight.

Diagnosis consists of palpating the patella tendon and the patella. Usually, when the tendon ruptures, the patella moves up which can be seen on x-ray.

The most common treatment for patella tendon repair is surgical. The tendon ends are identified and then sewn together. Postoperatively a  cast is used to protect the repair. The length of time required for casting  is usually a minimum of 6 weeks followed by several weeks of rehabilitation.

The risks of surgeryare involved including: infection, stiffness, suture reaction, risks of anesthesia, phlebitis, pulmonary embolus and chronic knee pain or weakness .

Regenexx through the use of a patients own stem cells now offers an alternative to surgery to those who have patella tendon tears.  Patella tendon repair can be performed by regenerating the tendon via ones own stem cells thereby preventing the need for surgery and its inherent risks. Regenexx offers patients non surgical alternative.