Knee Arthritis - Treatment and Joint Preservation with PRPRegenerative Medicine andJoint Preservation Center of Santa RosaRaymond Severt, M.D.1144 Sonoma Avenue, Suite 121Santa Rosa, California, 90025(707) 978-4322

OrthoRegenSR.com

Heal Naturally

Knee Arthritis is a BIG Problem

10 million in US have knee arthritis

$30 billion spend yearly on knee replacements

Should we keep treating it with the “traditional” methods?

Or should we treat it in a way that can use the body’s own healing ability without all the typical side-effects?

Regenerative MedicineOffers groundbreaking techniques to treat and control arthritis

Avoid more invasive treatment options

Normal KneeKnee is a critical joint

Commonly damaged

Commonly develops arthritis

Cartilage is smooth and strong/resilient

Ligaments maintain stability

Meniscus provides cushioning

Good viscosity of fluid

Knee ArthritisCartilage wears out often to bone

Inflammation develops in joint

Reduced lubrication/cushioning - hyaluronic acid

Knee deforms and becomes unstable

Knee becomes painful, swollen, and stiff

“Traditional” TreatmentWhat is typically offered to patients

Rest, Ice, Braces

Physical Therapy

Medications

NSAID

Corticosteroid Injections

Surgery

Is There Something Wrong With These “Traditional” Treatment Methods?Rest, Ice, Braces - NO

Physical Therapy - NO

Medications - YES

Corticosteroid Injection - YES

Surgery - YES

Rest, Icing, BracingCertainly helpful

No negative effects

Comforting

Reduces pain

Patient can do these on their own at their own discretion

Physical TherapyCertainly helpful

Strengthens

Mobility

Home Exercise Program

Prevents further injury

Often invaluable for prevention and to help in recovery

Medications- NSAIDsPrescription and OTCHave MANY side effect

Ulcers

Bleeding

Heart Attack

Stroke

Kidney

Liver

One of highest causes of hospitalization and death in elderly

Expensive

Many pulled off market because of safety issues (Vioxx, Bextra)

Corticosteroid InjectionsDepo-Medrol, Kenalog, Celestone

Do reduce inflammation - but for a very limited timeframe

COMPLICATIONS - not trivial!

“flare reaction”

soft tissue damage - ligaments, tendons

cartilage deterioration - decreased cartilage cell viability - softens cartilage

osteoporosis - softens bone

skin atrophy - depigmentation

These complications produce effects that are completely contrary to what the patient needs and wants!

Medications - Oral and Injectables

Produce effects in the body that are completely “unnatural”

Produce effects that are damaging

Block normal inflammatory cascades

Block healing mechanisms

Block biological pathways that are necessary for proper healing of damaged tissue

SurgeryMay be needed in some situations - with proper indications!

Significant risks

Invasive

Once done is “irreversible”

Long recovery

Complications

Surgery - CostKnee Replacement $40K - out of pocket cost - several $100’s or $1,000’s

Is surgery done too often?

Knee arthroscopy - indications, findings, results?

Repeat/Revision Surgery

What About Platelet Rich Plasma Treatment - PRP

A natural way to stimulate the body to heal damaged tissue

How Does PRP Work For Arthritis?Stimulates body's natural

healing process

Balances inflammation/anti-inflammatory cascades

Reduces inflammation and pain

Stimulates chondrocytes to strengthen cartilage

Increased hyaluronic acid secretion and superficial zone protein

Inhibits and reverses osteoarthritis pathogenesis pathways (interleukin, aggrecan, nuclear factor B)

PRP Stops and Reverses the Arthritic Process

Strengthens cartilage - increases cartilage cell viability

Improves protective viscosity of joint fluid

Reverses osteoarthritic pathways

MRI and functional studies have shown that PRP halts the progressive thinning of cartilage and improves function. Halpern, et al., Clin J Sport Med, 2013

PRP AdvantagesAutologous

Natural

Safe

Stimulates/activates the normal healing pathways that the body already has

Does not have the inherent negative effects seen with medications (oral or injectable)

Can avoid or delay surgery

PRP AdvantagesCompletely outpatient setting

Can initiate rehabilitation quickly

Long lasting results

Can be safely repeated if needed

PRP for Knee ArthritisNot all PRP’s are alike

Intra-articular PRP must be appropriately prepared

Reduce inflammation, stimulate chondrocytes, increase hyaluronic acid production

Proper experience and equipment needed

Reduce erythrocyte and granulocytes in preparation

Maintain high platelet and growth factor levels

PRP for Knee ArthritisA natural way to treat the symptoms of knee arthritis and to help preserve the structure and function of the knee in its natural state for an extended period of time.

Regenerative MedicineandJoint Preservation Center

1144 Sonoma AvenueSuite 121Santa Rosa, CA 95405(707) 978-4322

OrthoRegenSR.com

Maintain. Preserve. Sustain.