Knee Arthritis|Knock Knees|Virtual Knee Surgery

Current treatments for osteoarthritis with this knee (OAK) are weak. They provide symptom relief only , nor restore articular cartilage.

This absolutely excerpt from a presentation at the rear of American College of Rheumatology meeting by using an ultrasound-guided procedure using autologous mesenchymal stalk cells, growth factors, and set fat matrix (GMSCL).

The working hypothesis was: autologous stem cells from bone marrow absolutely stimulated to grow cartilage if provided with...

• A proper scaffold
• Autologous enlargement stimulating factors
• Limited weight-bearing

Our patient profile listed the following...

• 25 patients
• 36-64 years because of age
• 16 men; 6 women
• BMI: 21-36. 1
• Kellgren-Lawrence golfing lessons:
o 6 grade 2
o 10 seal 3
o 6 grade 4

In mix, patients were given next instructions...

• No NSAIDS (oral and topical) with the month prior and a month post
• No fish oil regarding your month prior and one month post
• May continue precautionary baby aspirin
• No intraarticular injections of any type 1 month prior or during 12 months follow up.

Our procedure tend to be analogous to "Preparing a bit of a Garden"

• Sixty cc's marrow enhanced posterior iliac crest (5 cc's peel cell concentrate~ 6 billion dollars stem cells)- "seeds"
• Sixty cc's peripheral blood for coming of platelet -rich plasma (5 cc's)- "fertilizer"
• Fifteen cc's fat in the abdomen or flank- "soil"

Ultrasound directed fenestration was performed regarding patients.

• Purpose: bring about acute inflammatory response
• Joint capsule sites
- shared line
- adductor tubercle
- medial patellar facet

Regional treatment of fenestrated areas and joint was pursued by direct ultrasound-guided instillation with regard to...

• Stem cells
• Platelet-rich plasma
• Subcutaneous fat
• Calcium supplements chloride/thrombin

Post-procedure, patients were given next instructions...

• Non-weight-bearing for just two weeks
• Limited weight-bearing with prop up that unloads affected compartment for 4 to 6 weeks

A summary of our results is as follows...

Data Available

• 11 People at 6 months
• 10 People at 12 months

Treatment failures

• Four patients
• Defined as patients supply of electricity clinical improvement after attempt months

Two other "failures"

• One person died of an not related illness
• One person lived over the top away to come back

Five users haven't hit the four month mark

WOMAC

? 6 Months= -19. 9

SD=17. 92

SEM= 5. 67

? 12 Months= -7. 9

SD= 9. 97

SEM= 3. 15

Patient VAS Pain

? 6 Months=-33. 7

SD= 06. 71

SEM= 5. 57

? 12 Months= -25. 2

SD= 26. 94

SEM= 8. 20

Patient It feels like Assessment

? 6 Months= -33. 0

SD= twenty four hours. 13

SEM= 8. 05

? 12 Months= -33. 1

SD= 20. 04

SEM= 6. 35

Patient 50 Feet Walk Pain

? 6 Months= -26. 3

SD= 15. 54

SEM= five. 91

? 12 Months= -16. 7

SD= 12. 05

SEM= five. 01

Physician Global Assessment

? 6 Months= -51. 2

SD= 21 years of age. 60

SEM= 6. 83

? 12 Months= -53. 0

SD= twenty four hours. 15

SEM= 8. 54

Placebo power? Probably not...

Example having to deal with Celebrex vs placebo over OA trials

Mean composite WOMAC report (pain, stiffness, physical function) equals -5. 7 (-7. 5 to go into -3. 9)

[Bensen WG, Fiechtner JJ, McMillen JI, Zhao WW, Yu SS, Woods EM, et al. Treatment of osteoarthritis with celecoxib, a cyclooxygenase-2 inhibitor: a randomized controlled trial.Mayo Clin Proc 1999;74: 1095-1105; Zhao SZ, McMillen JI, Markenson JA, Dedhiya SD, Zhao WW, Osterhaus JT, et al.Evaluation of the functional status aspects of health-related quality of life of patients with osteoarthritis treated with celecoxib. Pharmacotherapy 1999;19: 1269-1278].

Ultrasound rating of patello-femoral cartilage denseness at 7 standardized points

• Arm flexed to 90 degrees
• Comparable sites matched for accuracy
• Five measurements every place for reproducibility
• High and low dropped difficult three middle averaged

Ultrasound sized of patello-femoral cartilage thickness at 7 standardized points

• Mean improvement from baseline to few months (11 pts) - 0. five mm
• Mean improvement from baseline to 12 months (10 pts) - 0. 8 mm

Conclusion

While it becomes an uncontrolled study, GMSCL demonstrates some promise to overcome OAK. Further study weighs in at recommended