I will be real interested to read the responses. I too am a late 50's athlete who had major reconstruction in my knee in 1979, before the advent of sports medicine. For the past 12 years, I have been getting synvisc injections every 1-2 years depending upon my run mileage and how my knee feels after runs. I can definitely tell when I need an "oil change". I have always held out hope that someday I could have this treatment and eliminate the aggravation that comes with bone on bone rubbing.

I've been getting Orthovisc (similar to Synvisc) for the last 3 years - 1 series of injections every six months. It's worked well for me.

However, my insurance company is now refusing to pay for them - they say the scientific evidence is that they are not effective beyond the first two series (that's not my experience at all but don't get me started on insurance companies...)

So to continue the injections, I'd now be forced to pay out of pocket, which is going to cost me $2000 a year.

Stem cell treatment is not covered by any insurance company at this time. But if I'm going to be forced to pay out of pocket anyway, I may as well look at it as an option.

One of my business partners paid for this out of pocket about six months ago. To watch him hobbling around work I would say that it hasn't done much for him. I'll try to ask him on Monday if he thinks that he is any better and get back to you.

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Jason
None of the secrets of success will work unless you do.

I am a physician who primarily focuses on musculoskeletal/nerve injuries with regenerative medicine (prolotherapy, PRP, stem cells) being my primary tool. So, I'm obviously pretty biased on this, but have seen a lot of success when done correctly on qualified patients. Like everything in medicine, it's not a panacea. But, it's fairly safe and generally pretty effective. Typically, the worst case scenario is that you've spent a lot of time/money and didn't get better. This treatment typically doesn't limit your options going forward and studies have shown that it actually improves surgical outcomes if things come to that.

Things to consider about the facility/docs:
-do the doc's focus on regenerative medicine, or do they dabble in it?
-is there an in-house laboratory at the clinic?
-are the doc's qualified to use guidance (ultrasound, fluoroscopy, etc)?
-price
-functional goals
-timeframe for recovery (could take multiple treatments)
-patience with the process
-tolerance for post-procedure flare-up (don't do this the day before a race)

Hope this helps. let me know if you have other questions...

Thank you so much for sharing your expertise. For me I have recently gotten a bit more concerned about my "creakiness". I'm 56, been racing triathlons consistently for 35+ years, and still rather competitive . . . but, clearly I have gotten creakier in the last couple of years. No real "pain" but certainly some knee sensation/stiffness at times. I have NOT had anything looked at and no real need I suppose. However, I'm seeing athletes 10 years my elder getting knee replacements and being very limited (compared to what I want to be). So my question is whether it is prudent to do anything now so I can keep going later. Thanks.

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David
* Ironman for Life! (Blog) * IM Everyday Hero Video * Daggett Shuler Law *
Disclaimer: I have personal and professional relationships with many athletes, vendors, and organizations in the triathlon world.

Again, it's reasonable to consider regenerative medicine because of what you mentioned your goals to be in relation to your concerns.
I see professional and olympic-level athletes who don't "need" to do anything, but want to optimize what they have because their goals necessitate such a high level of function. From the sounds of it, stem cells may be overkill for you, where PRP or even dextrose prolotherapy may provide significant improvement in your symptoms.

Had menicus surgery on right knee in 2006 at 58. Took 60% of medial posterior horn. Startred running slowly in about 4 months but compensated with left leg.

Fast forward to 2013 and went back to same doctor for left knee which i could hardly bend fully. Thought i had same type of bucket tear. But it proved to be more degenerative small tears, potholes so doctor said not good candidate for surgery. Luckily they were now doing stem ceell & prp so being no spring chicken i went for it at emory university ortho practice in atlanta @ 65. Did it in september and doc told me no running for at least 9 months to give it a chance. It consisted of taking marrow from hip (not painful) and mixing with blood and injecting in knee with use of florascope of some sort. That hurt. Spent about 2 hours there if i remember correctly. Followed six weeks later with just prp. Cost in 2013 was $2500 no insurance.

I waited like i was supposed to, but i could tell the knee seemed better after only couple of months as i could get on the floor and do mobility work without any knee pain and i could bend it fully though slowly. After nearly 9months i started running ( i was biking and swimming long before). I also changed my diet to be more ketogenic and less inflammatory to aid as well. Between bulletproof coffee, primal endurance, ben greenfield and mobility wod podcasts i addressed many of my limiters. I have raced triathlons off and on since1986 with lots of down time do to injuries and just racing antraining too hard. The mobility really helped the recovered knee my making sure there was proper alignment of skeleton and muscles more in balance and not plagued with what i would deem as trigger points.

Bottom line i raced in nov '14 and all went well. It was sprint but i was back. Trained and raced 2015 and all went well though again i limited my running to only about 10 miles a week. Now 68 i can see a rosier future and will try one more ironman/KQ at age 70 if all goes well as my swim and bike seem fine; just need to build on run that is only at 40 minutes now.

I cannot tell u what percentage to assign the stem cell/prp, diet, or mobility, but i feel as good as i was a decade ago.

Be glad to answer questions.....but emory has info, just google emory stem cell & dr. Mautner. They have short vieo too.

Best of luck.

OP here - thanks to all for some great feedback!

As I mentioned, I have bilateral ACL reconstructions and nothing like my full complement of meniscus in either knee. I have mild to severe OA in both knees. I'm still biking and running, courtesy of the Orthovisc injections, but I know that I have knee replacements in my future.

Do I sound like a good candidate for stem cell therapy?

If so, would they do the therapy at the same time in both knees? Or do one first, wait (how long?) then do the other?

How long post-therapy before I could return to biking, then running?

And would it be a single treatment or many?

Thanks!

@smallard Regenexx (Regenocyte) is fraudulent. They were a coffee company that got into stem cell 'research'. Check the company registration/disclosure at SEC dude.

thattriguy, thank you for the input!

I'm wondering what makes a patient a "good candidate" as I have OA in both knees and just had a lateral release on my left, waiting about the right. According to the surgeon's notes, my patellofemoral joint was severely arthritic and there was 20% loss of the medial meniscus but now has a stable base. everything else is in good shape when it comes to ligaments etc.

I've also been starting to hear about patella replacements, wondering what your thoughts are around this procedure.

Thanks in advance,
mandy

Hi Mandy, patellofemoral arthritis is very difficult to treat no matter what intervention you employ. I'm obviously biased, but I believe in the ability of degenerative tissues to heal with regenerative medicine like PRP and, in your case, probably stem cells. Oftentimes, the problem with patellar tracking issues isn't resolved with cutting tissue, like with a lateral release. It's improved with changing mechanics through repairing and tightening injured tissues. I'll often see a deficiency of the medial patellar retinaculum when people present with this type of problem. So, not only do I address the arthritis, but also try to fix the biomechanical abnormalities that contribute to the structural problems. Probably a little esoteric, but essentially, it sounds like you'd perhaps benefit from an evaluation from a non-surgeon to discuss all of your options.

Best of luck to you.

Thanks for the reply! Appreciate your time and opinion.

I took the non surgical route for years following a rehab protocol for strength using Durolane and Synvisc injections none of which helped long term, short term partial relief with Durolane. MRI and additional x-rays indicated the out of place patella and flare up after flare-up I was left with no other options (at least that's how it felt at the time). I saw multiple Dr's about it and honestly I'm happy so far with the release. I can see a difference in my knees when comparing them and the one that's done is feels like it's clicking less. It's early still but I'm optimistic.

I was curious about the stem cell injections, specifically frequency and success rate with arthritis such as mine.

Thanks again,
Mandy

Timely post. After battling patellar tendinopathy for over 8 months now I had a PRP/ Live amniotic stem cell injection this week. Had previously had a prp only injection. Had it done in Florida. Not cheap, $2500 but at this point was willing to try anything. Happy to report back in on progress.

Yes please do! Very interested in stem cell injections. Wondering if you know how often or how many are required for results.

Sorry to highjack the thread. I am interested in knee treatments as well.


thaitriguy - Do you have any experience healing arthritis from patients with Lyme Arthritis? I am a 27 year old male that developed severe arthritis starting in February and figured out it was Lyme disease in May. Before I began treatment my right knee swelled up and is still causing me discomfort, even when walking or standing. I am probably going to get the knee imaged after I speak with my doctor. Would love to hear what you or anyone else recommends. Thank you.

I had it done just over 3 weeks ago and the pain of the past year is just about gone, have been biking with no pain at all, I did a couple of slow jogs, one 45 minutes with just a touch of soreness. Told the doc from lab that did the work and he asked me to back off a bit. Said the are is still regenerating. I have been happy and shocked at how well I feel. Cost is an issue, I used my own cells which is the only way to go, beware of a lot of the scams out there, read up and researched it a lot and I work for well known rheumatologist who had some experience with this Bio-Tech company that grew my cells. Good luck

Trirat what so of issues were you dealing with prior to the injections?

Sounds like results are what you are looking for! amazing, so happy for you.

How many do they expect to do and where did you have them done ans by whom?

To add my two cents on knee issues, I have patellar tendonitis and mildly degenerating meniscus in one knee. Physio, strengthening, anti-inflams did not help (admittedly, I could have been better at them). So after about three months of rest with no improvement, I had a cortisone shot to try to bring down the inflammation once and for all.

It was a long shot, but didn't improve things.

I just has PRP this morning. The shot under the knee cap was fine, but the shot into the meniscus was pretty painful. Hours later, it is still really tender and sore. That is apparently normal. Protocol here is to do three treatments all together, spaced by about a month. Total cost about $1200 bucks.

I will keep you posted in case it works.

Hello tyrod1, I'm considering stem cell therapy at Emory. It's been about a year since you shared your story. How are you now?

Thank you

i am doing well. right after shots got on low inflamation diet (ketogenic sorta of) and upped my collagen and amino acid intake to help to rebuild if at all possible.

doc said give it time to see if works and it did as i raced about a year after the stem cells and prp.

that was now back in 13 i think. the knee is fine except for some minor patella tracking issues due to muscle imbalances and likely some deterioration of the meniscus(height and potholes)

but no arthritis (which was the main reason to get stem cells and prp. i could not bend knee without pain.

at 69 i have kept my mileage way down, only about 10 miles per week. but i have raced successfully since '13 with high age group places.

funny you should ask now. i think i have one more IM in me as i age up. because my swim and bike are pretty solid i will test this thanksgiving a half marathon and if no problems will head to IMFL in '18. i will likely use the galloway method of run/walk but we'll see.


i had mautner do mine (dr x took a big chunk of meniscus out of other knee in '06). think the cost is up. i had to pay out of pocket as insurance would not cover.

knowing the results i WOULD DO AGAIN. but your weight, diet, and training regimen (include muscle imbalance/mobility exercises) are integral to any success.

if you have any more questions holler.