Knee arthritis and stem cells

[igkya]

I searched the site and researched Regenexx, but this is mostly older stuff (2014-2017). Anyone have any new info on this, maybe 1st hand experience they can share?

 

Edit: I've done the Synvisc, Orthovisc, and other HA injections along with the other typical stuff to help delay a TKR or PKR.

[Rednucleus]

Still no good science/studies especially long term (more than a year). IMO as a veterinarian, stem cell is still mostly a profit center for those performing the procedures. Lots of unsupported claim on what it will fix - maybe someday it will be worth doing but not there yet - despite personal testimonials that say otherwise. And I have a hip that would love to try it if I thought there was even a small chance it was worth doing.

[Martin]

I have used synvics for years and it was helping a bunch. I talked to surgeons that are close friends and they have not had good experience so far with stem cells.

[packski]

There is a gel injection. Maybe someone can chime in on this as I do not know much about it.

[DanE]

Do synvisc or durolane as long as it helps along with excercise.

After that it's TKR which I'm scheduled for one month from now.

[dbojan]

Anyone else with arthritis in their knee experience pain in the Achilles in that leg? Did you find anything that helps?

[A_B]

My friend's wife had stem cell in one hip when she had the other one replaced. It gave her 5-years before she had it replaced. It was not covered by insurance and guessing somewhere between $5K-$10K, and they said it was probably worth it. (they have a few bucks).

 

I would love to see something that works to really regenerate meniscus for my two high-mileage knees and help my rotator cuffs. I just don't think there is a magic bullet yet.

[igkya]

@A_B Thanks. A buddy of mine recently had the stem cell procedure on his knee, primarily for for his meniscus and also some arthritis. It's only been 6 weeks and he still has some pain, so too early to tell how well this is working and if his relief is coming from the meniscus or arthritis.

[cougfan]

@DanE I have had both knees replaced. The right in 2014 and the left in 2016. Was back skiing in 4 months. The rehab was grueling but well worth the effort! I went to PT twice a week and did my own at home 7 days a week. I treated it as my full time job so spent many hrs in my home gym everyday. Set goals and work hard to get there. I have NO PAIN what so ever in my knees now and am physically active. Best thing I ever did. One of my ski partners had a hip replacement and is skiing better than ever! Good luck with your procedure. After it is all over you will wonder why you waited so long.

[bsmith]

@cougfan Are your knees as stable as they were before the replacements such that you can hit the wakes hard and leaned over with no worries? Or do you have to ski a lot more gentle now?

[cougfan]

@bsmith my knees are better then ever! No worries crossing the wake or on my turns. Don’t even think about them when skiing just go for it. My Dr. Said they are structurally as sound as you can get.

[Ed_Johnson]

@cougfan ... One of the things that caused my knee problems was jogging 5 miles, 3 times a week. Now having injections, which helps, but running is out of the question...Is it possible to ever run again after the knee replacements ?? THX

 

 

[cougfan]

@ Ed Johnson I use a treadmill to do my running and walking on now. Mine has springs and gives a nice soft landing. I also ride my bike. I put my 10 speed on a trainer and ride in my gym in the bad weather. My rehab was done from December to April and the weather in the PNW can be quite nasty that time of year. My Dr said to “use “ my knees as much as I want can’t really damage them structurally. Love modern medicine!

[escmanaze]

@cougfan Can I ask how old you are?

[cougfan]

@escmanaze sure I am 60. Had my first knee replacement when I was 55 and my second at 57. I have a very physically demanding job, umpire baseball, hike with my wife and generally am an active guy. No knee problems anymore???

[bsmith]

@cougfan Your experience is very encouraging to all of us old skiers heading towards our own knee replacement. I get synvisc one injections every six months in my left knee. I lift hard 5 times per week, bike everyday, and play soccer once per week (I limp afterwards), but skiing 2-3 times per week is also very hard on it. I guess I am still not skiing front footed enough. Thank you for posting. It is encouraging to hear that when the battle is finally lost, a TKR (total knee replacement) can save the day.

[igkya]

For anyone thinking of a TKR, check with your oath first to see if a PKR (partial) may be a better option, less damage to the knee and quicker rehab, plus I was told that once the PKR wears out, I may be able to get another PKR or at the worst a TKR.

[cougfan]

@bsmith glad to help out. My knees were so painful and restricting my daily life so I decided to go for it even though the “experts” said I was too young. My Dr was very encouraging and I told him I wanted to be back skiing in 4 months and he said “no problem” as long as you do the PT. Had some painful days during rehab, muscle pain not joint pain. A lot of the the rehab is mental as well as physical. Positive attitude with a goal in mind really helps. Good luck to you!

[A_B]

My wife had dual knee replacements about 4-years ago. She had bone on bone and was hobbling around and in a lot of pain. She says best thing she ever did. Make sure you have good help at home if you do both at the same time!

 

Dr says my shoulder is beyond repair and would replace it. Anyone ski after shoulder replacement? Dr says skiing over after replacement. So I just ski with a weakass down arm on my offside lean. Better than not skiing I guess. But not much better.

[6balls]

@A_B after a shoulder replacement you are done skiing. Might be done with shoulder pain, but done skiing.

 

As for knees...this BS about too young jerks my chain. So you are 55 and knees are shot, pain every day, limits life/mobility and therefore health and a surgeon is saying "yeah but these will wear out one day and we have to replace 'em again" So what? What if you get hit by a bus in 5 or 10 years and because you were still hobbling your ever more out of shape butt across the street.

 

Gotta live for today, tomorrow not given. As for stem cell...not great evidence. For gel injections like synvisc I do them a lot, and patients seem to benefit for the most part, tho formal evidence also isn't great.

 

As for partial and total knee replacements...anecdotal from my practice but I see people do better with totals.

 

@cougfan go get 'em, man!

[bsmith]

@6balls Based on your experience with TKR patients, is @cougfan an outlier in his ability to ski hard after a TKR? You mention that a shoulder replacement is an absolute no go for future skiing, but would you say that in general a competitive 60 year old 3 event skier would be able to resume 3 event competition after rehabbing a TKR?

[Rednucleus]

@cougfan & I occasionally ski with a surgeon that routinely does TKR - in fact did one for my wife a couple months ago. I asked him about post THR & TKR skiing - he says as long as you are in control and not pushing it (like really competitive shortline) he is comfortable with his patients skiing. His concern is if you have a bad crash, you can have a catastrophic implant & bone failure and possibly really tough surgery recoveries and use of leg in the future.

[packski]

I know of a fella running 32/35 off with TKR in both knees. Don't think he has had an issue for the last five years.

[Stewpro]

Haven't had a total knee replacement but I managed to go out the front coming off ball 3 and somehow my ski came around and smashed my left knee completely breaking the patella in half. Operation put two screws to hold the patella back together with some added tension provided by surgical wire or string across the screws while healing. Physical therapy looks pretty much the same as a TKR but with some obvious differences in structure. Wonder has any other skiers had this type of operation and if so how does it fair when it gets back to skiing the course ?

[bkreis]

the reality is we need to eat anti inflammation foods and drinks 90% of the time, stay lean, strong, and moblile with keeping joint space a priority..then none of the "itis's" are an issue....consultations, training, etc... www.skyfitness.com or dm me

[skierjp]

@Ed_Johnson , Get a Spin Bike and not a cheap one. Southeastern Fitness Equip in Orlando. Lifecycle GX will be around 2k. When you buy a Peloton you’re actually getting less Bike for the money because of the large monitor screen plus the membership every month. Then buy a My Zone chest strap heart monitor for $145 and you will be addicted. A 1 hour ride with your heart rate in the red and you will burn over 1500 calories. Google My Zone and check it out. Awesome, such a motivator.

[Ed_Johnson]

@skierjp ... Thanks for the info. I have a regular road bike and a stationary bike. It is just so hard to get motivated to push it at full throttle. Running outside was so much better for me. Especially when I got 3 miles from the house, I HAD to turn around and come back. When I'm on the bike, after a half hour, it is just so easy to find an excuse to stop. Just being honest.

Right now it's skiing and Yard Work...Lots of Yard Work!!!

 

[WaterSkier12]

An wise old sage once told him me, the only 2 things in life that are undefeated are Genetics and Gravity!

Agree that diet, weight, smoking etc all play a role in the anti-inflammatory process, BUT your genetic makeup and injury history will more than likely trump all of that.

Hopefully, someday-we can trump genetics??

[igkya]

Did someone just say Trump? :D

[WaterSkier12]

Mayb......;-)

[packski]

Anyone had the Euflexxa shots?

[igkya]

@packski I’ve had them. Very similar to Synvisc, Orthovisc and the other HA injections.

 

FYI - even if your insurance will pay for the HA injections, I found it to be much much cheaper to use a Canadian Pharmacy and pay cash.

[bsmith]

@igkya Have you tried an "unloader" knee brace such as from Breg https://www.breg.com/osteoarthritis/ or Ossur https://www.ossur.com/unloader-braces/body-in-motion-nj?utm_medium=cpc&utm_campaign=oa-knee-bim&utm_source=google&utm_content=unloader-knee-braces&gclid=CjwKCAjwldHsBRAoEiwAd0JybaPYBYGw-BfP473shKH7Jrn2E2IdrfhUKAAEfD4i5hFYzjd4CAQVthoCeCwQAvD_BwE

 

Conventional knee braces are intended to aid joint stability which is not really the problem for an osteoarthritic knee. An OA knee usually has pain on either the medial or lateral side where the bones contact. Most people wear out the articular cartilage on their medial side first while the lateral side still has a good thickness of articular cartilage left on the surface of the bones.

 

This is the case I have and thus an unloader brace for me shifts more load to the lateral side and takes pressure off the medial side which reduces pain. I just learned of these type braces from a post by @Ed_Obermeier here https://www.ballofspray.com/forum#/discussion/comment/68807

 

These unloader braces are expensive so I decided to try a used one off ebay for $100 just to see if it would do any good. I found a Ossur Unloader One that was my size. Skied with it yesterday and was very impressed with how well it worked. I finished the session without any noticeable soreness like I usually have. The brace is hinged on one side only and the straps pull toward the hinge side. You can feel the effect of your knee being pressured to spread the side (medial for me) that hurts.

 

I think for these type of braces to help much, you can't already be in a total knee replacement (TKR) condition. You must have one good side left and even your bad side can't be completely bone on bone. My bad side (medial) has a very thin layer of articular cartilage left so it gets sore easily from running and skiing, but I can do lots of other stuff like squats, power cleans, etc. without any pain.

 

In @Ed_Obermeier's case I read where braces and HA injections had all run their course and were providing no more relief such that he was set to get a TKR. I don't think Ed has posted in quite awhile, but I would like to thank him for mentioning the unloader brace in past posts and I hope that his TKR was successful and that he is back skiing again.

 

[MatadorMaine]

@packski I did have Euflexxa. Waste of time and $. I was soooo hopeful it would help. 46 years old...-28 skier with a few passes at -32. Knee is toast. Cartilage loss under knee cap, bad bone bruise. I've been doing a ton of PT since September for hip and knee. Also taking fish oil, glucosamine, Chondrotin, etc. Anything natural that I read that might help. Euflexxa was a waste. If it helped 10% I can't tell. Had PRP injection yesterday. Does hurt as they say...time will tell for me but I reading every stem cell, PRP, Euflexxa, TKR, RKR post I can. Crushed. Glad to hear there are TKR guys out there that are still skiing. @cougfan I too am hobbling up stairs. I'll take any advice out there.

[thager]

@igkya I destroyed my left knee playing football back in the 70's. No cartilage, and 3 ligaments retied. Over time bone on bone wore the joint down with severe arthritis, bowing, and instability. Tried braces, therapy, and shots but nothing seemed to work. My skiing became so unstable that I often scared my friends and myself running on the ragged edge @ -28,-32 and -35 if I was lucky. This November I threw in the towel and had total knee replacement. Wish I had done it 10 years ago! Stability is 100x better, and the pain is gone. My formal knee therapy is complete and I am really looking forward to this spring even though I have much to strengthen this winter when the Doc clears me to lift unrestricted.

[cougfan]

@mmadore21 both my knees were wore out from old injuries. Had surgery on each one back in high school way before arthroscopic surgery. Rehab was hard and long back in those days (late 70’s). Also played baseball from age 9 to 20 as a catcher can’t imagine how many squats I did over that time.

In 2014 I had my right knee replaced and in 2016 had my left one replaced. Even though I was only 55 at the time and most people think that is too young to have them replaced. My Dr advised to go ahead with the procedure as the technology and parts used for the replacements had advanced a lot over the old materials. I discussed with my Dr that I was a skier and wanted to continue skiing after surgery. He was 100% on board with my skiing afterward.

The rehab is tough but so worth it in the end! Both surgeries were done in December and I was back skiing in March.

My advise is to find the best surgeon you can check to make sure they know that you are a skier and plan on skiing afterward and go at your rehab full bore.

I went to pt twice a week and worked out at home 7 days a week from the time of the surgery til the time I started skiing again.

I have zero regrets about having both knees replaced. I have no pain in either of them and they don’t affect my skiing negatively in the least. Walking downhill used to be unbearable now i don’t think twice about it.

If you decide to go this route GOOD LUCK and keep us posted on your progress

[MatadorMaine]

Thanks @cougfan . Hoping @thager @igkyas @packski @bsmith @Ed_Obermeier can all give updates to this thread as it relates to how they are today, braces, other knee experiences as they relate to skiing. I'll let you know how PRP goes.

 

Being only 46 I feel I'm too young for replacement (right now, not ruling out at all) so I'm going to try everything first. Probably goes without saying that I was VERY active until about June/July when it all came crashing down. (proficient runner (2 marathons), road races, basement gym, college soccer, 100 sets a year h20 skier, multiple FLA trips a year to ski, snow skier, hiker, etc).

 

The pain actually started in the hip and I thought my hip was broken or something (lol)...then then knee started in BAD as I addressed the hip strength and some IT band issues. (you know why hip hurt if on this thread...over compensation, mechanics, etc).

 

Sort of related: Has anyone seen this vid? Dr. Andrew Pearle - Robotic PKR -

 

Anyway, I'm constantly researching, stressing, overthinking. 3 OA doctors (2 knee surgeons, 1 PT/PRP/shot doctor) have told me I might need to be done in the course because of the repetition it takes each season to make progress. Can't believe all 3 said pretty much same thing. I even went to Boston! Paraphrasing here but consensus was "If you want to ski a few times a year we can shoot you up, but skiing and hammering 5X a week is a whole other ballgame."

 

Then I come on BOS and read about guys with TKR and PKR. My wife is probably sick of my talking about it so venting on BOS. - Thanks!

[sltrju]

@Packski... I had the Euflexxa shots in both knees. They worked well in both knees for a while. One knee was primarily a cartridge problem the other primarily arthritis. The shots didn't help the knee with cartridge problems after a few year, but I felt it helped the other knee right until I had the knee replaced.

@IGKYA... I agree with considering partial knee replacement. I have a partial and a total. Both work, but the partial gave me less problems and responded to rehab faster. I think either work in the slalom course.

[Rs350zak]

Had both knees replaced 3 yrs ago and 2.5 years ago. My dr told me to give up skiing completely, so I did: ski nautique with a private man made lake, all sold. I play hours of tennis and or Pickleball everyday with no knee issues. Now I'm thinking of giving skiing another try. Maybe not the course but hanging out behind the boat getting a workout and doing some turns. Running and stopping for tennis/pickleballs can cause knee discomfort, the knees are not perfect, and I can see where a fall behind the boat thru the wake where 1 foot might come out of the binding and the other leg getting jerked around with the ski still attached. That can't be good for the knee. Thoughts?

 

[igkya]

@Rs350zak Many years ago, when my knees where young and strong, I had that kind of fall (rubber boots and rear toe), it caused severe damage to the ankle, not the knee. Double boots ever since and never had that issue again. Unless your doc is a sports related ortho and has good knowledge of what slalom skiing is, I'm not sure I'd listen to him about not skiing, especially since tennis and pickleball are ok.

[Rednucleus]

@cougfan is skiing with double TKR's and is a painfree happy camper. I'll bet he will chime in here soon!

[cougfan]

@Rs350zak like @Rednucleus said I have had both knees done one in 2014 the other in 2016. My Dr told me I would be able to ski again with no worries. All I had to do was some serious PT every day for 2 1/2 months to get back on the lake. Rode a stationary bike a bunch along with lots of strengthening exercises. Before I was in constant pain after no pain at all. Best decision I ever made it have me back my active lifestyle back without having to be in pain. Do some research find a Dr who is a sports guy and go for it you won’t regret it! When I ski I never worry about my knees I just go out and ski. Good luck ?

[Rednucleus]

One of my friends is an orthopedic surgeon, did a TKR for my wife. I asked his opinion re skiing after a knee replacement - his concern was if the skier continues to "really push it to the limits" a bad fall could cause a catastrophic failure. If the skier recognizes he needs to protect the knee(s), then a decent skier staying in control should not have a problem.