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Has anyone had Platelet Rich Plasma and Hyaluronic Acid Blend Injections?

 Poster: A snowHead
Poster: A snowHead
Stem cell therapy- I am writing this as a few people on the forum have asked me to share my experience, so here goes. I have suffered from knee issues since my thirties (I am 62), but the past few years have seen a significant worsening in both the cartilage loss and the amount of oedema and inflammation as a result of the bone on bone patella/femoral wear. To add to the problem, I sprained my MCL two tears ago resulting in a 1cm hole in the ligament near where it fixes on to the tibia.

The knees have generally worsened to the point that they were permanently swollen and going downhillI is a real problem. I have had numerous cortisone injections over the past 10 years or so which worked well initially but had reducing effectiveness with each one. I also tried Ostinel injections but I found no difference at all with them. I was told five years ago by a surgeon that I probably had “about three years left on the knees before I would need a TKN”. I skied on Ibuprofen and paracetamol, sometimes diclofenac.

By the end of last season I was in a bad way after about 50 days on skis- struggling to go downstairs and in pain at night.

I went to see my usual muscular skeletal doctor to see what he could suggest.

As it happened, he had cartilage issues himself and researched stem cell therapy extensively, opting to have treatment earlier that year. He suggested I look into it. He went with a particular company who, he felt, had the most extensive information available. They have only one practitioner in Europe who has a clinic in Brussels.

I did my own research and established that:

The process is considered experimental and there is limited and sometimes conflicting evidence of success;

Each patient is different and there is no guarantee that any given individual will have sufficient stem cells to treat the affected area, or even if they do, that the outcome will be successful;

The process demands a high level of commitment from the patient, including going on a very strict Paleo diet for 4 weeks before and 12 weeks after the treatment, taking a number of supplements ( Chrondatin, turmeric, various vitamins, etc.) for at least 12 weeks, and undertaking a 16 week physio rehab programme after the procedure.

The first stage was a Skype consultation with the doctor in Brussels which lasted an hour. Before setting this up, I had to send them recent MRI scans of both knees. During the consultation, the doctor talked through the actual process, whether he thought I was a good candidate and what sort of chance of success I may have. He gave me 50%.

Even with these provisos, I decided to risk it and see what happened. I started the strict diet, and booked an appointment for four weeks from the initial consultation. The process is a combination of PRP injections, the actual stem cell procedure, and then more PRP, spread over a week. The stem cell procedure involves harvesting bone marrow from the pelvis, separating out the stem cells, and injecting them into the bone. This part all happens on the middle day of the week. I was effectively house bound for three days, non weight bearing on crutches, until the 7th day when I had the final PRP injections and I left to come home the following day.

I was initially in an unloader brace on my knee with the MCL issue and a soft brace on the other for 6 weeks. I worked with my physio on the rehab process, slowly building up to full activity over 16 weeks. This involved swimming 3x week, weight training in the gym 2x week and exercises at home every day.

I had the treatment in June and finished the rehab in October.

By then, I had virtually no swelling in either knee. I have lost 20lbs which was an unexpected outcome, but this has been a result of keeping to such a strict diet and as such had been generally therapeutic for the knees.

I have skied 6 weeks so far this season, one week, a break over Christmas, then four, a two week break, and I am one week into my final four week block. I have kept to an overall ratio of one days rest for each two days of skiing. I have not taken any painkillers or anti-inflammatories since last winter. I am just starting to feel some discomfort in my left knee, and I will start doing shorter days and add in rest days if it worsens.

I remain cautiously optimistic but am under no illusion that this is a miracle cure-I am pleased I went ahead with it but I know there are no guarantees as to how long it will last. I don’t even know if the improvement is due to the PRP injections, the stem cell treatment, the weight loss, the supplements, or a combination of all of the above.

I would never recommend either way to people, I can only relate my experience. Everyone is different and it’s uncertain territory for sure. The only thing you can do is research the process and all of the providers in order to make an informed decision. The main thing to bear in mind is that it is unproven and classed as experimental.

If anyone wants to talk about it in more detail feel free to PM me.
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
@lynnecha, thanks for that. Great to hear some real life experience. I'm a living PRP advocate having had a positive experience on my knee. I've been viewing stem cell as the "next level" treatment and, at least in theory, a repair rather than a natural painkiller. Had no idea it was so involved - a very holistic treatment - but that may just be down to this guy in Brussels wanting a belt and braces approach.

I got the impression from the American specialist who treated me for PRP (who is licenced for stem cell in the US but not where I was treated so I just had PRP with him) that stem cell was a very similar day patient treatment to PRP. From a personal perspective, I would find the very intensive regimen that you undertook almost impossible with my day job so it would have to wait until I'm retired.

One thing I will say (from a personal PRP perspective) is that it continues to improve with time so even if you have some issues this season, you will probably find next season better still. Please keep us updated on your progress and good luck with it.

Sorry, one more thing having just re-read your post. I found that resting my knee when skiing didn't help. I skied without anti-inflammatories for 23 days straight the year after I was treated. After about 8 days it started to be quite sore but with very minimal swelling. It would hurt for the first 3-4 turns of every run and then the adrenaline would mask the pain. However, some time between the second and third week it stopped hurting and it's never really come back. I very much feel that the exercise made it stronger rather than weaker, as if the knee had to be re-programmed to what it was capable of after years of protecting it. Of course, that's a bit of a gamble and a stubborn approach so I can't advocate it for everyone but it may reassure you that a little pain is not necessarily a real issue and can be overcome with persistence.
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
I have had PRP procedures on my right elbow as part of a UK wide NHS trial. The specialist required 30 Guinea pigs for a paper he had to send to the Lancet medical journal. To cut a long story short, they remove some of your blood, clean the crap out of it via centrifuge and inject it straight onto the inflamed area. Out of the 30, it didn't work for 3, had a total pain removal on 10, and the rest had various degrees of success. I was one of the 10 so happy days.
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@Raceplate, yes, the whole experience pretty much dominated my life for several months- my physio said they could never do work like this with NHS patients as the time commitment required would just be unrealistic. I sort of enjoyed the focus, and it’s great being 55kg! All the better for general health I think.

Interested to hear your comments re: rest. I absolutely feel that the joints have been reprogrammed and I can see the argument that exercise makes it stronger. I will continue to monitor it with that perspective.

Will Report back as to how it feels in April!
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Anyway, snowHeads is much more fun if you do.
For me it took several months to be cured. I would 'tweek' it lifting and feel some pain then question whether the procedure had worked. But, each time I jarred it subsequently, the pain would lessen until it disappeared.
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@Paul Chelski, how long ago did you have the treatment?
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there is a new version of stem cell therapy, which just reading it makes me cringe and feel ill. Am I just being nesh or is this as gross as it sounds?

https://www.cnet.com/news/celularity-uses-stem-cells-from-placentas-to-try-extending-life/
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After all it is free Go on u know u want to!
lynnecha wrote:
@Paul Chelski, how long ago did you have the treatment?


I had prior cortisone injections which worked for a couple of months but the pain returned with a vengeance. I then had two PRP procedures, a few months apart, and I was 'cured' within two months of the second.

Cortisone coats the outside of the inflammation and tries to penetrate the tendons to commence the healing process whereas PRP is injected directly into the tendon to heal from within!!
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@lynnecha, That is a really useful tale, thank you for sharing. If you can ski with a 20lb pack on with the same improvement that would be amazing. Probably better not though eh
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@motdoc, Very Happy I think I will give that idea a miss!
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managed an hour of telemark skiing today after my last set of injections and last year it would have been no way Jose... Smile
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