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RELIEVING THE PAIN OF OSTEOARTHRITIS

What is osteoarthritis?  Arthritis is a general term that means inflammation of the joints. There are dozens of types of arthritis. Osteoarthritis is the most common type.

OA can be caused by a range of factors that include excess weight, joint injury, and aging (usually after 40). Any joint can be affected by OA, but it occurs most frequently in the hands, knees, hips, and spine.

The place where 2 bones meet is normally covered with a rubbery material called cartilage. This material allows the bones to slide over each without causing pain. When osteoarthritis sets in, the cartilage begins to break down. As it wears away, the bones in the joint start to rub against each other. This can cause pain, stiffness, and swelling.

 

OA is a chronic condition that gradually worsens over time; however, there are several measures that may slow its progression and control symptoms. Diagnosis of OA by a sports medicine specialist or orthopedist is the first step in ensuring the appropriate treatment of OA.

 

AREAS OF CARE

KNEE

The knee is a target site for OA and worldwide is the commonest single cause of lower-limb disability.  It is a degenerative, “wear-and-tear” type of arthritis that occurs most often in people 50 years of age and older, but may occur in younger people, too.  While age is a major risk factor for osteoarthritis of the knee, young people can get it, too. For some individuals, it may be hereditary. For others, osteoarthritis of the knee can result from injury or infection or even from being overweight

HIP

Patients who have osteoarthritis of the hip sometimes have problems walking, pain, aching, stiffness, and restricted movement. Diagnosis by a sports medicine specialist or orthopedist is necessary because it can be hard to diagnose as pain can appear in different locations, including the groin, thigh, buttocks, or knee. The pain can be stabbing and sharp or it can be a dull ache, and the hip is often stiff.

SHOULDER

Osteoarthritis of the shoulder most often occurs in people who are over age 50. In younger people, osteoarthritis can result from an injury or trauma, such as a fractured or dislocated shoulder. This is known as posttraumatic arthritis. Osteoarthritis may also be hereditary.

The shoulder is made up of two joints, the acromioclavicular (AC) joint and the glenohumeral joint. The AC joint is the point osteoarthritis is more commonly found in, where the collarbone, or clavicle, meets the acromion, which is the tip of the shoulder blade.

Osteoarthritis Treatment Plans and Options

Our OA treatment is tailored to you and based upon how severe your pain and stiffness are, which joints are affected, how much difficulty you are having with daily activities, and your preferences.


COMPLETE ARTHRITIS TREATMENT PLAN

What is it?
The complete arthritis treatment plan is an individualized six-week program to maximize relief and decrease pain from osteoarthritis.

Who can benefit from this program?
Anyone suffering from joint pain due to arthritis, especially those looking for a structured, routine program will benefit.  This program is also specific for those who are looking for non-operative management of their OA, or are not able at this time to have a joint replacement.

Will my insurance cover the treatment plan?
This program is designed to be covered by almost all insurances, has lots of research to support the use, and is the primary go-to treatment for OA.  Insurance coverage verification is recommended prior to beginning treatment.


Platelet-rich plasma therapy, sometimes called PRP therapy or autologous conditioned plasma (ACP) therapy, attempts to take advantage of the blood’s natural healing properties to repair damaged cartilage, tendons, ligaments, muscles, or even bone.

What Is Platelet-rich Plasma (PRP)?

Although blood is mainly a liquid (called plasma), it also contains small solid components (red cells, white cells, and platelets.) The platelets are best known for their importance in clotting blood. However, platelets also contain hundreds of proteins called growth factors which are very important in the healing of injuries.

PRP is plasma with many more platelets than what is typically found in blood. The concentration of platelets — and, thereby, the concentration of growth factors — can be 5 to 10 times greater (or richer) than usual.

To develop a PRP preparation, blood must first be drawn from a patient. The platelets are separated from other blood cells and their concentration is increased during a process called centrifugation. Then the increased concentration of platelets is combined with the remaining blood.

 

How Does PRP Work?

Although it is not exactly clear how PRP works, laboratory studies have shown that the increased concentration of growth factors in PRP can potentially speed up the healing process.

To speed healing, the injury site is treated with the PRP preparation. This can be done in one of two ways:

  • PRP can be carefully injected into the injured area. For example, in Achilles tendonitis, a condition commonly seen in runners and tennis players, the heel cord can become swollen, inflamed, and painful. A mixture of PRP and local anesthetic can be injected directly into this inflamed tissue. Afterwards, the pain at the area of injection may actually increase for the first week or two, and it may be several weeks before the patient feels a beneficial effect.
  • PRP may also be used to improve healing after surgery for some injuries. For example, an athlete with a completely torn heel cord may require surgery to repair the tendon. Healing of the torn tendon can possibly be improved by treating the injured area with PRP during surgery. This is done by preparing the PRP in a special way that allows it to actually be stitched into torn tissues.

What Conditions are Treated with PRP and Is It Effective?

Research studies are currently being conducted to evaluate the effectiveness of PRP treatment. At this time, the results of these studies are inconclusive because the effectiveness of PRP therapy can vary. Factors that can influence the effectiveness of PRP treatment include:

  • The area of the body being treated
  • The overall health of the patient
  • Whether the injury is acute (such as from a fall) or chronic (an injury developing over time)


Experts are continually researching ways to use stem cells to treat arthritis in the knee and other joints. Many sports medicine physicians and orthopedic experts, like Dr. Matt Dwyer, Dr. Alexandra Matthews, and Dr. Chris Phelps with the Orthopedic Performance Institute already use stem cell therapy to treat arthritis.

Why Are Stem Cells Special?

Stem cells are located throughout the body. What makes stem cells special is that they can:
1. Divide and duplicate themselves, and
2. Develop into different types of cells. A stem cell itself does not serve the body in any way, but it can develop into a cell that does, such as a cartilage cell or a bone cell.
Advocates of stem cell treatments hypothesize that, when placed into a certain environment, stem cells can transform to accommodate a certain need. For example, stem cells that are placed near damaged cartilage are hypothesized to develop into cartilage tissue.

How Are Stem Cells Used to Treat Arthritis?
Stem cells can be applied during a surgery (such as the surgical repair of a torn knee meniscus) or delivered through injections directly into the arthritis joint.
When administering stem cell injections, many physicians use medical imaging, such as ultrasound, in order to deliver cells precisely to the site of cartilage damage.

Where Do the Stem Cells Come From?
The most common type of stem cells used for treating arthritis are mesenchymal stem cells. Mesenchymal stem cells are usually collected from the patient’s fat tissue, blood, or bone marrow.
The process of collecting cells is often called harvesting.
• Adipose (fat) stem cells are harvested using surgery or liposuction.
• Peripheral blood stem cells, found in the bloodstream, are harvested by taking a blood sample from the patient.
• Bone marrow stem cells are harvested from one of the patient’s bones.
Bone marrow is usually taken from the pelvic bone using a needle and syringe, a process called bone marrow aspiration. The patient is given a local anesthetic and may also be given a sedative before the procedure.

Who Can Get Stem Cell Therapy for Arthritis?
There are no professional medical guidelines for who can and cannot receive stem cell therapy for arthritis. For now, the decision about who gets stem cell therapy is up to patients and doctors.

There is some evidence that people with severe arthritis can benefit from stem cell therapy. 1 Most research indicates that younger patients who have relatively mild osteoarthritis or cartilage damage see the most benefit.2

Stem cell therapy is a promising but still unproven treatment, and will not be covered by most insurance companies.

Most stem cell therapy using adult stem cells is considered safe because the stem cells are collected from the patient, minimizing the risk of an unwanted reaction. The most common side effects are temporary swelling and pain.

Stem Cell Therapy Cost and Insurance Coverage
The cost for stem cell therapy at the Orthopedic Performance Institute is very competitive at $600 per treatment. It is usually not covered by insurance.