The Knee Cartilage Debate
The average Prolotherapy office sees patients with various degrees of knee degeneration. Some patients attribute their knee problems to the wear and tear of a lifetime of sports while other patients insist that their training keeps their knees feeling good. Whose claim is true?
Research Opposing Exercise and Knee Health
In one recent study, researchers clearly pointed out that physical activity damages the knee cartilage. They stated that prior to their research the effects of long-term vigorous physical activity on knee cartilage was unclear and may have been dependent on the state of knee health. They examined the association between vigorous physical activity and changes in knee cartilage among healthy adults over a ten-year period. They then examined whether this effect differed in those with and without bone marrow lesions (BMLs).1
The researchers recruited 297 health adults between the ages of 50 – 79, assessed their activity history and then asked them to undergo an MRI. Side note: here is a problem already – the MRI is looking for problems in asymptomatic “healthy” patients. MRIs are notorious for misdiagnosing causes of pain and finding defects in perfectly functioning knees. The researchers concluded that activity was bad for the knees: “Persistent participation in vigorous physical activity was associated with worsening of medial knee cartilage defects…”1
Research for Exercise and Knee Health
Other researchers say just the opposite. Activity is good for the knee! In a study of over 28,000 participants, researchers said “There was no significant overall association between leisure time physical activity and risk for knee or hip replacement due to osteoarthritis over the 11-year (study). For women, higher leisure time physical activity may have a protective role for the incidence of hip replacement. Walking may have a protective role for hip replacement, specifically for women.”2
Given the choice, most patients want to have vigorous activity and healthy joints. When a patient comes to a Prolotherapy office fearful of activity it is because they have advanced osteoarthritis and loss of range of motion, crunching in their knees, and a clear loss of cartilage. Prolotherapists can put that fear at rest by suggesting that Prolotherapy, as based on research, can regenerate the cartilage.
Research for Prolotherapy and Knee Health
Motion and exercise are good for joints, they keep the joint healthy. Bottom line is that sports injuries are a normal part of exercise, but injury and pain should not sideline any type of athlete – from leisure athlete to elite. Sports injuries and chronic pain can be simply and effectively healed with Prolotherapy.
A 2009 Journal of Prolotherapy article stated, “…we investigated the outcomes of patients undergoing Hackett-Hemwall dextrose Prolotherapy treatment for unresolved knee pain at a charity clinic in rural Illinois. We studied a sample of 80 patients, representing a total of 119 knees, that were treated quarterly with Prolotherapy. On average, 15 months following their last Prolotherapy session, patients were contacted and asked numerous questions in regard to their levels of pain and a variety of physical and psychological symptoms, as well as activities of daily living, before and after their last Prolotherapy treatment. The results of this study showed that patients had a statistically significant decline in their level of pain, stiffness, crunching sensation, and improvement in their range of motion with Prolotherapy. More than 82% showed improvements in walking ability, medication usage, athletic ability, anxiety, depression, and overall disability with Prolotherapy. Ninety-six percent of patients felt Prolotherapy improved their life overall.”3
Prolotherapy involves the injection of substances, such as hypertonic dextrose and various other substances including growth hormone, that stimulate joint structures to repair. The actual substances injected depend on the individual case and the physician. The current theory of cartilage regeneration is that this irritation acts in the same mechanism as above in inducing the chondrocytes into the chondroblastic stage of development capable of proliferation and repair. Bottom line, the proof is in the pudding. Countless patients who had no cartilage or were set for hip/knee replacements never needed them because of Prolotherapy.
Questions about cartilage repair and regeneration? Ask us.
1.Teichtahl AJ, Wluka AE, Wang Y, Forbes A, et al.Effect of long-term vigorous physical activity on healthy adult knee cartilage. Med Sci Sports Exerc. 2012 Jun;44(6):985-92.
2. Ageberg E, Engström G, Gerhardsson de Verdier M, Rollof J, Roos EM, Lohmander S. Effect of leisure time physical activity on severe knee or hip osteoarthritis leading to total joint replacement: a population-based prospective cohort study. BMC Musculoskelet Disord. 2012 May;13(1):73. [Epub ahead of print]
3. Hauser RA, Hauser MA, A Retrospective Study on Dextrose Prolotherapy for Unresolved Knee Pain at an Outpatient Charity Clinic in Rural Illinois Journal of Prolotherapy. 2009;1:11-21.