October 5, 2017
I have degenerative arthritis otherwise known as osteoarthritis which affects my lower extremities — both hips now and in the past it affected both knees. The knee pain was bad enough at times to require consultation with the orthopedic surgeon and MRI testing and I have had a total of 3 arthroscopic surgeries to remove or “shave” the cartilage.
Almost 4 years ago I had such severe arthritis of my right knee that I was barely able to walk without pain. So I did Synvisc injections as well as corticosteroid injections which helped only temporarily. Then in a bold (and desperate) move I decided to try something much more natural — my own platelets taken from my blood and concentrated and then activated with calcium and injected into my own knee. Over weeks I improved and today (almost 4 years later) I have no knee pain. The procedure is called PRP which is the abbreviation for platelet rich plasma. I also made dramatic changes in my diet (anti-inflammatory diet) which I will detail later.
About the same time I did my PRP procedure of my knee, the following study came out which finds no real benefit to surgery for knee pain and degenerative knee disease.
Raine Sihvonen, M.D., Mika Paavola, M.D., Ph.D., Antti Malmivaara, M.D., Ph.D., Ari Itälä, M.D., Ph.D., Antti Joukainen, M.D., Ph.D., Heikki Nurmi, M.D., Juha Kalske, M.D., and Teppo L.N. Järvinen, M.D., Ph.D., for the Finnish Degenerative Meniscal Lesion Study (FIDELITY) Group
N Engl J Med 2013; 369:2515-2524December 26, 2013DOI: 10.1056/NEJMoa1305189
Arthroscopic partial meniscectomy is the most common orthopedic procedure performed in the United States.1 The aim of the procedure is to relieve symptoms attributed to a meniscal tear by removing torn meniscal fragments and trimming the meniscus back to a stable rim. Most treated meniscal tears are associated with degenerative knee disease, which can range from mild chondral changes not visible on a radiograph to established knee osteoarthritis.2,3 The number of arthroscopic surgical procedures performed to treat established knee osteoarthritis, with or without a concomitant meniscal lesion, has decreased dramatically in the past 15 years.4,5 This trend has been attributed to two controlled trials6,7 showing a lack of efficacy of arthroscopic surgery. However, the number of arthroscopic partial meniscectomies performed has concurrently increased by 50%.4 Approximately 700,000 arthroscopic partial meniscectomies are performed annually in the United States alone,1 with annual direct medical costs estimated at $4 billion. A recent randomized trial8 showed that arthroscopic partial meniscectomy combined with physical therapy provides no better relief of symptoms than physical therapy alone in patients with a meniscal tear and knee osteoarthritis. We conducted a multicenter, randomized, double-blind, sham-controlled trial to assess the efficacy of arthroscopic partial meniscectomy in patients who have a degenerative tear of the medial meniscus without knee osteoarthritis.
Currently my advice for patients with knee pain from degenerative arthritis is to consider use of PRP and change your diet.
Diet is huge! Basically eliminate meat. Meat causes inflammation and when I say meat, I mean beef, pork, chicken, turkey, fish, dairy and eggs — basically anything that comes from an animal. The absolute worst food and the one to eliminate immediately if you have knee pain is dairy. Dairy has a protein molecule in it called casein which promotes inflammation.
An anti-inflammatory diet consist of fruits and vegetables, whole grains and beans, peas, legumes and lentils plus seeds and nuts. Studies now also show that some spices are equally effective as NSAIDS (like Advil, Aleve, etc) for decreasing inflammation and pain. Ginger and turmeric 1/2 teaspoon each (or more) daily.
Don Fisher D.O.
Medical Director/ Physician
The BEST Program, Inc.