Knee Replacement vs Stem Cell Therapy
Which is better for the management of osteoarthritis of the knee, total knee replacement or stem cell therapy?
Although we use regenerative medicine for many different orthopedic problems, the purpose of this video is to focus on the number one condition we see in our clinic which is arthritis of the knee.
In a typical medical practice, the first therapy often rendered for bone on bone knee or osteoarthritis of the knee is corticosteroids. It is a well-known fact that the effect of corticosteroids on inflammation is profound, but at what cost!
The pharmacology of corticosteroids is such that it will greatly reduce inflammation on a very temporary basis but immediately starts to break down the structure of the joint. In essence corticosteroids does much more harm than it does good. Another pharmaceutical approach are opioid medications. In the united states the use of Vicodin or hydrocodone and oxycodone has gone up from 76 million prescriptions in 1991 to 207 million in 2013 according to the International Narcotic Control Board. Along with this the incidents of opioid addiction has increased to critical levels in the United States.
The United States represent 5% of the worlds population yet we consume 72% of the world’s pharmaceuticals.
After the failed approach of corticosteroids and various medications, usually surgeries are then recommended. The first surgery is usually called a “clean up surgery” where the surgeon will go in and remove pieces of the damaged meniscus or ligaments. Once the arthritic process has developed to the point where the femur is resting on the tibia or bone on bone knee, a knee replacement is recommended.
If and when knee replacement is not successful then the patient is recommended pain management which is usually just more pharmaceuticals and opioid medications.
A British Medical Journal study showed that the rate of total knee replacement in the United States had doubled since the year 2000. This can be explained in part by the aging population but due to the fact that this is currently a 40-billion-dollar industry there are many who suspect the rise in surgeries is due to financial gain. This study showed that up to one third of patients receiving total knee replacement have chronic pain post operatively.
It also showed that also a third that have a total knee replacement may not even be appropriate candidates for this procedure because their arthritis symptoms are not severe enough to merit aggressive interventions. This was also found in another study in the Journal of Arthritis and Rheumatology.
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