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Articular Cartilage Regeneration
Prolotherapy offices who employ Comprehensive Prolotherapy use a different approach to treating chronic pain. This means that based on the individual patient, following a physical examination and patient history, we can determine which variants of Prolotherapy can provide the best chance at fulfilling the patient’s expectations and goals. These variants of Prolotherapy may include Platelet Rich Plasma Therapy or Stem Cell Therapy or traditional dextrose solutions boosted by Human Growth Hormone, minerals, or fatty acids. Our first choice is usually the simplest choice of treatment that is dextrose Prolotherapy.
Doctors and researchers have long thought that cartilage is unable to heal itself. Despite this belief, articular cartilage regeneration has become one of the main focal points for joint pain researchers.
The rush to regenerate cartilage can be seen in the failure of steroid injections and anti-inflammatory medications. These treatments have been shown to do more damage than good. Although cortisone shots and anti-inflammatory drugs have been shown to produce short-term pain benefit, both result in long-term loss of function and even more chronic pain by actually inhibiting the healing process of soft tissues and accelerating cartilage degeneration.
Another, more recent, treatment approach involves the use of Synvisc, a synthetic derivative of hyaluronic acid, a normal component of joint fluid, which acts as a temporary, and very costly cushion. The obvious problem with this approach is that not only is it temporary, but it also does nothing to deal with the underlying cause of the problem – cartilage damage. And when all else fails, patients who experience chronic joint pain are usually referred to a surgeon. Unfortunately, surgery often makes the problem worse. Surgeons will use X-ray technology as a diagnostic tool, which does not always properly diagnose the pain source. Decisions to remove cartilage tissue will most commonly result in arthritis.
The use of Prolotherapy
In the inaugural issue of the Journal of Prolotherapy, we introduced research that confirmed articular cartilage regeneration in five patients with osteoarthritis. Here is our summation: “Prolotherapy improved the pain and function in five knees with osteoarthritis. All five degenerated knees showed evidence of articular cartilage regeneration in their standard weight-bearing X-rays after Prolotherapy. It is suggested that before and after X-ray studies can be used to document the response of degenerated joints to Prolotherapy.” (1)
Prolotherapy is the only treatment found to stimulate cartilage repair and regeneration, as is shown by the X-rays. Furthermore, Prolotherapy offers the most curative results in treating chronic pain. It effectively eliminates pain because it attacks the source: the fibro-osseous junction, an area rich in sensory nerves. What’s more, the tissue strengthening and pain relief stimulated by Prolotherapy is permanent!
The use of Bone Marrow/Stem Cell therapy
In more difficult, or advanced cases of osteoarthritis, we utilize Stem Cell Therapy, along with traditional dextrose Prolotherapy. New research published in July 2012 suggested exciting finding with the use of Bone Marrow stem cells. Here is what the researchers wrote: “Osteoarthritis (OA) is a degenerative disease of the connective tissue and progresses with age in the older population or develops in young athletes following sports-related injury.
The articular cartilage is especially vulnerable to damage and has poor potential for regeneration because of the absence of vasculature within the tissue. Normal load-bearing capacity and biomechanical properties of thinning cartilage are severely compromised during the course of disease progression.
Although surgical and pharmaceutical interventions are currently available for treating OA, restoration of normal cartilage function has been difficult to achieve. Since the tissue is composed primarily of chondrocytes distributed in a specialized extracellular matrix bed, bone marrow stromal cells (BMSCs), also known as bone marrow-derived ‘mesenchymal stem cells’ or ‘mesenchymal stromal cells’, with inherent chondrogenic differentiation potential appear to be ideally suited for therapeutic use in cartilage regeneration.” (2)
Ideally suited, that is our clinical observations as well.
Do you have questions about Articular Cartilage Regeneration? Ask us.
1. Hauser RA, Cukla JJ. Standard clinical X-ray studies document cartilage regeneration in five degenerated knees after Prolotherapy. Journal of Prolotherapy. 2009;1:22-28.
2. Gupta PK, Das AK, Chullikana A, Majumdar AS. Mesenchymal stem cells for cartilage repair in osteoarthritis. Stem Cell Res Ther. 2012;3(4):25. [Epub ahead of print]