Monday, April 7, 2014

Second Knee Surgery is in my Future but trying PRP First

Those following along on my journey know that about a year and half ago I had a partial knee replacement on my left knee.  At the time of the replacement my other knee was in pain as well but not nearly as much as the one that I had replaced.   Arthritis is progressive.  You may be able to slow it down but its not ever going to get better.

May 2013 X-Ray
While its still not nearly as bad as my left knee, the right knee is getting worse and I can't walk now without limping and its starting to cause my hip, ankle and back on that side to hurt.    I had xrays taken last May and then again on March 30th and there is definite progression.   Besides the narrowing of the space, my leg is collapsing on the inside so I am getting more bowlegged which is causing some of the limping.

I'm also including an xray of a normal knee so you can see what it should look like without arthritis.

When there is this much damage there are very limited options available.  My doctor said I could try the unloader brace but I tried that on the right knee and it only caused bruising and ripped the skin off my knee and didn't improve the pain any  Not trying that again.
March 2014 X-Ray

I could also try OrthoVist again but it generally does not work well when there is so little cartilage left.

And there is knee replacement which has a fairly extensive recovery process but was very successful on my right knee.

But there is ONE other option that is fairly controversial at this point but has shown some promising results -- PRP or Platelet Rich Plasma injections.  PRP is where they remove blood from your arm, remove the platelets from the whole blood and then inject it directly into the knee with the hopes of stimulating growth and healing.  Despite it showing some decent results, its not currently covered by insurance and there are not many doctors who are using it for arthritis.  I had been reading about the studies using the technology so when my doctor mentioned it was something he would like to try, I jumped at being his first patient.

Being his guinea pig wasn't as risky as it sounds.  He has been using the process in surgery for soft tissue repair quite awhile with very good results.

Normal Knee
So last week I became his first arthritis patient to receive PRP.  He removed 30 cc of blood from my arm, centrifuged it, and then injected the resulting 7 or so cc of platelets into my knee using ultrasound to guide the needle.   The injection itself was not painful but about halfway through the pressure of all that liquid behind my knee WAS painful.  Not unbearable though and well worth it if I get good results.

Its been a few days now and it may be just having more fluid in there but I do feel there is less pain so I am hopeful.  I know my knee is pretty far gone though so the chances are lower but one can hope.  If it works then I will get another injection in about six weeks and potentially one more.

Crossing fingers and toes that it works.

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