A Scientific Editorial - Articular Cartilage Regeneration

Prolotherapy: The Treatment of Choice for Degenerated Joints

George S. Hackett, MD coined the term Prolotherapy. As he describes it, “To the treatment of proliferating new cells, I have applied the name Prolotherapy from the word prolix (Latin), meaning offspring; proliferate-to produce new cells in rapid succession. My definition of Prolotherapy as applied medically in the treatment of skeletal disability is ‘the rehabilitation of an incompetent structure by the generation of new cellular tissue.’”^{Pain Away! Third Edition. Beulah Land Press, 2007;p.32.</p>', 230)" onmouseout="hideddrivetip()" href="/prolotherapy/call-to-action#Resources">[37]} While traditionally used for ligament and tendon repair, Prolotherapy has a long history of being used for degenerative joint disease.^{Hackett G. Joint stabilization. American Journal of Surgery. 1955;89:968-973.<br><br>39. Reeves K. Prolotherapy: present and future applications in soft tissue pain and disability. Physical Medicine and Rehabilitation Clinics of North America. 1995;6:917-925.<br><br>40. IBID. Randomized prospective double-blind placebo-controlled study of dextrose Prolotherapy for knee osteoarthritis with or without ACL laxity. Alt Ther Health Med 2000;6(2):37-46.<br><br>41. IBID. Randomized, prospective, placebo-controlled double-blind study of dextrose Prolotherapy for osteoarthritic thumb and finger (DIP, PIP, and trapeziometacarpal) joints: evidence of clinical efficacy. J Altern Complement Med. 2000;6(4):pp.311-320.</p>', 230)" onmouseout="hideddrivetip()" href="/prolotherapy/call-to-action#Resources">[38-41]} Like the chronic knee pain study published in February 2009 issue of the Journal of Prolotherapy,^{pain at an outpatient charity clinic in rural Illinois. Journal of Prolotherapy. 2009;1:11-21.</p>', 230)" onmouseout="hideddrivetip()" href="/prolotherapy/call-to-action#Resources">[42]} Prolotherapy has remarkable pain-relieving effects. But when a person with degenerative knee arthritis reports less stiffness and crunching in the knee, as well as improved motion, are we to assume that there has been cartilage repair? I would answer the question with an emphatic “yes” in most cases. But some would remain skeptical. This is why the February 2009 issue of the Journal of Prolotherapy also presented five before and after X-rays of knees showing cartilage regeneration.^[43] Does this prove that all Prolotherapy treatments on degenerated knees stimulate cartilage regeneration? Absolutely not! But it surely shows that Prolotherapy treatments to human knees do have the potential to regenerate articular cartilage. For those who have had numerous treatments and have seen the function, signs, and symptoms of their degenerated joints reverse with Prolotherapy, is it reasonable to assume that the articular cartilage is being stimulated to repair? How else would you explain a decline in stiffness, clicking, and crunching in the person’s knee treated with Prolotherapy? How do you explain the inability to walk or do any athletics, but yet with a number of Prolotherapy injections into and around the knee, the person regains his walking ability and is now able to perform athletics? How about improvement with Prolotherapy in those patients who have been told they need knee replacements, or those whose doctors say there is no other treatment available for them? What about in these cases? If the person receives Prolotherapy to their end-stage osteoarthritic joint and not only do they not need a knee replacement, they are back to dancing, how do you explain it? Placebo? I think not. Something has changed. Their joint architecture has changed. There has been some rebuilding inside their joints. In essence, they have a regenerated joint. The chondrocytes have been activated to start making cartilage and that cartilage has been laid down.

I believe in changed lives. I believe a changed life is enough. In other words, if a person cannot walk much because of a degenerated knee and has been told by an orthopedist that he needs a knee replacement, but he refuses and decides instead to get Prolotherapy, and if after Prolotherapy treatments he can walk well with virtually no symptoms, I am satisfied. Their life was changed with Prolotherapy. I believe the patients when they tell me that it was the Prolotherapy that turned their lives around. I believe that the Prolotherapy regenerated the injured tissues. I believe that the person can now have a full life. That full life is because of Prolotherapy. Prolotherapy worked for them. I do not need an MRI or X-rays or a biopsy of cartilage cells to know that Prolotherapy worked!

The bottom line is you can’t have it both ways. If the orthopedist is saying to a patient that your knee pain, grinding, crunching, pain upon bending your knee, and your inability to walk without a limp is from your cartilage degeneration and you need a knee replacement, then the opposite must also be true. If that same patient, after receiving Prolotherapy to the knee, has no more, or very little, pain, grinding, etc., can walk unlimited and does hiking and climbing, then it must mean that their degenerated cartilage has been regenerated! To put it bluntly, Prolotherapy regenerated their cartilage! This is my main point!

I know there are a lot of skeptics out there. They want “evidence” that Prolotherapy works. They need to see before and after X-rays and MRIs. Well, that is part of the purpose of the Journal of Prolotherapy. The goal is to educate the world on the life-changing effects of Prolotherapy. Some of the people in the world who need educating are the traditional doctors who treat pain patients. They need to know of the life-changing effects of Prolotherapy on degenerated joints. One of the effects of Prolotherapy is to change a degenerated joint without much cartilage to a joint that has more cartilage. How will that appear to the physician examining the joint? The doctor would notice a smooth-gliding joint instead of a joint that makes grinding, clicking, and popping sounds while the physician puts the joint through its range of motion. It is definitely noticeable and demonstrable. To the patient, the joint after Prolotherapy will produce much less crunching or clicking sounds when the knee or joint is moved, as well as when going up and down stairs. As a given, he will experience less pain and stiffness.