every mo a potential handling for human knee osteoarthritis

Platelet rich plasma is existence studied worldwide (US, Europe, India) equally a potential handling for knee articulation osteoarthritis.  The prove is young merely it does advise PRP may convey a locomote inwards the management of this rattling mutual problem.

In the report outlined below, PRP was compared to a criterion handling of hyaluronic acid.  

"Statistically significantly ameliorate results inwards the Western Ontario in addition to McMaster Universities Osteoarthritis Index in addition to Numeric Rating Scale scores were recorded inwards a grouping of patients who received PRP injections later a 3- in addition to 6-mo follow-up."

AM

TotalTendon

Am J Phys Med Rehabil. 2012 May;91(5):411-7.

Treatment of knee articulation joint osteoarthritis amongst autologous platelet-rich plasma in comparing amongst hyaluronic Acid.

Spaková T, Rosocha J, Lacko M, Harvanová D, Gharaibeh A.

Source

From the Associated Tissue Bank of Faculty of Medicine UPJS in addition to University Hospital of L. Pasteur (TS, JR, DH); in addition to Department of Orthopaedics in addition to Traumatology, Faculty of Medicine, P. J. Safárik University in addition to University Hospital of L. Pasteur, Kosice, Slovakia (ML, AG).

Abstract

OBJECTIVE:

This report aimed to reveal a simple, cost-effective, in addition to time-efficient method for the training of platelet-rich plasma (PRP), then the acquired benefits volition hold out readily available for multiple procedures inwards smaller outpatient clinics in addition to to explore the security in addition to efficacy of the application of PRP inwards the handling of degenerative lesions of articular cartilage of the knee.

DESIGN:

The report was designed equally a prospective, cohort report amongst a command group. H5N1 full of 120 patients amongst Grade 1, 2, or 3 osteoarthritis according to the Kellgren in addition to Lawrence grading scale were enrolled inwards the study. One grouping of patients was treated using 3 intra-articular applications of PRP, in addition to the minute grouping of patients was given 3 injections of hyaluronic acid. Outcome measures included the Western Ontario in addition to McMaster Universities Osteoarthritis Index in addition to the 11-point hurting intensity Numeric Rating Scale.

RESULTS:

On average, a 4.5-fold increase in platelet concentration was obtained inwards the PRP group. No severe adverse events were observed. Statistically significantly ameliorate results inwards the Western Ontario in addition to McMaster Universities Osteoarthritis Index in addition to Numeric Rating Scale scores were recorded inwards a grouping of patients who received PRP injections later a 3- in addition to 6-mo follow-up.

CONCLUSIONS:

Our preliminary findings back upwards the application of autologous PRP equally an effective in addition to rubber method inwards the handling of the initial stages of knee articulation osteoarthritis. Further studies are needed to confirm these results in addition to to investigate the persistence of the beneficial effects 

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The forces supporting your knees are complex only the math is simple

Lose v pounds, your knees volition experience every bit if yous lost 25 pounds.

The forces supporting your knees are complex but the math is simple.  About 4-6 times your trunk weight is transmitted through your articulatio genus articulation when yous but walk.  Think well-nigh that fact for a second.  If yous weigh 200 pounds, your articulatio genus experiences grand pounds of forcefulness piece strolling downwards the street.

Importantly, beingness overweight is a "clear run a jeopardy factor" for articulatio genus osteoarthritis.  For women, beingness overweight increases this run a jeopardy four times higher.  For men, the run a jeopardy increases v crimp inwards patients who are overweight.  Dropping every bit picayune every bit 10 pounds may live on plenty to significantly lower this risk.

There are no uncomplicated solutions to weight loss.  One proffer I laissez passer on my patients is to endeavour the "One Less, One More" plan.  Try it for a week.  One less beer, 1 less drinking glass of wine, 1 less bagel, 1 less serving of H2O ice cream.  One to a greater extent than fourth dimension taking the stairs, 1 to a greater extent than trip to the gym, 1 to a greater extent than walk around the block.

For to a greater extent than information well-nigh articulatio genus osteoarthritis in addition to beingness overweight amongst references for the information outlined about, click here.

Allan Mishra, MD
Send thoughts/ideas well-nigh how to lose weight to:  @bloodcure
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Acupuncture amongst Gold for Knee Osteoarthritis

I convey treated thousands of patients alongside human knee arthritis together with never heard of gilt acupuncture equally an option.  In the most recent effect of the New England Journal of Medicine, a representative study discusses the topic.

Gold Acupuncture Knee X-ray

From the NEJM, 2013, See Link Below

Apparently, this shape of handling is mutual inward roughly Asian countries.  As you lot tin run into from the x-ray above, it looks similar a a bunch of pino needles or staples convey invaded the knee.  I create non know of whatsoever information supporting this type of approach only it does brand for a rattling interesting x-ray.

Here is a link to the New England Journal of Medicine Case Report:

http://www.nejm.org/doi/pdf/10.1056/NEJMicm1202540

Yoo together with Yoo NEJM 2013

Please postal service whatsoever comments or links to information nearly this theme below.

AM

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Best Initial Knee Exercise: The QuadCrunch (TM) (Knee OA Part 2)

There are dozens of human knee exercises y'all tin terminate create to strengthen the muscles roughly your joint.  One crucial musculus to strengthen is the quadriceps or "Quad".  Too often, however, this musculus exactly does non cooperate.  We request a simple agency to larn started.  We request an practise than tin terminate survive done anywhere, anytime without whatever equipment.  Now, nosotros bring one, the QuadCrunch (TM).  

The QuadCrunch (TM) helps initiate in addition to reinforce the contraction of the most of import ingredient of the Quad---the Vastus Medialis Obliquus or VMO for short.  

QuadCrunch (TM) Video

Simply, straighten out your leg in addition to house your fingers over the within component of your thigh exactly higher upward your knee.  This is where the VMO lives.   With your leg fully withdraw in addition to your heel on the ground, force your leg toward the dry ground in addition to displace to contract the muscle.  If y'all are successful, y'all volition encounter your kneecap move.  The argue to pose your fingers on your musculus is to assistance your encephalon know it is contracting the muscle.  This helps reinforce the contraction.  

I recommending doing a develop of five contractions, belongings each contraction for five seconds, five times per day.  

This uncomplicated practise is oft ignored but serves every bit the foundation for to a greater extent than advanced strengthening programs.  It tin terminate survive helpful for people who desire to strengthening their legs for whatever reason.  It may likewise survive useful for patients alongside human knee arthritis, patellofemoral pain, human knee tendonitis in addition to fifty-fifty meniscus tears.  (Always banking concern jibe alongside your physician earlier get-go whatever practise program)

Good luck in addition to larn started today.  Remember, this practise tin terminate survive done inwards shorts, pants in addition to close anywhere.  Simply house your fingers on your quad musculus in addition to straightening your human knee alongside your heel on the ground.  It is best if your are sitting on the border of a chair.  

It is best to tape how many sets per 24-hour interval y'all do.  That volition assistance y'all survive compliant alongside the exercise.  We volition hash out practise compliance to a greater extent than inwards a afterwards post.  

Post whatever questions, comments or suggestions below.

AM

TotalTendon

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Can Curry Cure Knee Arthritis?

It sounds similar a plot for a giddy Bollywood movie, but published information genuinely supports the persuasion that 1 of the fundamental components of curry pulverization tin plough over notice attention alleviate hurting for patients alongside human knee arthritis.

Curcumin, a brilliant yellowish spice constitute inward curry powder, late was constitute to accept the same efficacy equally ibuprofen (the active ingredient inward Motrin too Advil) for patients alongside human knee arthritis.  In a late published report of 367 human knee arthritis patients, researchers constitute 1500 mg of Curcuma domestica extract had the same effectiveness inward price of hurting reduction equally 1200 mg of ibuprofen at iv weeks (Kuptnirataikul et al). Importantly, the curcumin treated patients had less episodes of abdominal hurting or discomfort compared to the ibuprofen patients.  Importantly, around other published report of of the same dosage of curcumin (1500 mg) was constitute to accept meaning improvements inward price of hurting too physical business office when compared to placebo at half dozen weeks (Panahi et al).   Curcumin has been noted to block several substances involved inward the inflammatory pathway too too inhibits activation of costless radicals.  This could attention explicate why the spice industrial plant to trim back hurting inward arthritis patients.  

So adjacent fourth dimension your human knee starts to hurt, set downward the ibuprofen too hobble over to your favorite Indian or Thai eating theater for a tasty curry meal.  It may merely attention your knees experience better.

On a to a greater extent than serious note, the published information supports trying a curcumin supplement 1500 mg per twenty-four lx minutes menses divided inward 3 doses for 4-6 weeks for patients alongside human knee arthritis.  (See nautical chart below)

AM
TotalTendon

Pain Reduction inward Patients alongside Knee ArthritisKuptnirataikul et al

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Fat Stem Cells attention Knee Arthritis

Knee Arthritis is a real hard job to solve.  Millions of patients endure daily from this progressive affliction state.  A diverseness of new biologic therapies are inwards development.

Stem cells tin come upward from a diverseness of sources including your ain fat.  These cells are known every bit adipose derived stalk cells.  A recent written report from Korea suggests at that topographic point is value using this type of prison theatre cellphone for human knee arthritis.  Researchers gave patients escalating dose of the cells together with flora the high dose resulted inwards improved hurting together with constituent scores.  They every bit good flora the cartilage defect defect size decreased field the book of cartilage inwards the human knee increased.

Fat Derived Stem Cells

This information is encouraging together with volition bespeak to hold upward repeated prior to wide clinical use.  (See abstract below)

For patients amongst this problem, the horizon is vivid amongst many potential options similar stalk cells from your ain fat.

AM
TotalTendon

Stem Cells. 2014 May;32(5):1254-66. doi: 10.1002/stem.1634.

Intra-articular injection of mesenchymal stem cells for the handling of osteoarthritis of the knee: a proof-of-concept clinical trial.

Jo CH1, Lee YG, Shin WH, Kim H, Chai JW, Jeong EC, Kim JE, Shim H, Shin JS, Shin IS, Ra JC, Oh S, Yoon KS.

Author information

Abstract

Mesenchymal stem cells (MSCs) are known to convey a potential for articular cartilage regeneration. However, virtually studies focused on focal cartilage defect through surgical implantation. For the handling of generalized cartilage loss inwards osteoarthritis, an alternative delivery strategy would hold upward to a greater extent than appropriate. The job of this written report was to assess the security together with efficacy of intra-articular injection of autologous adipose tissue derived MSCs (AD-MSCs) for knee osteoarthritis. We enrolled xviii patients amongst osteoarthritis of the knee and injected AD MSCs into the knee. The stage I written report consists of iii dose-escalation cohorts; the low-dose (1.0 × 10(7)cells), mid-dose (5.0 × 10(7)), together with high-dose (1.0 × 10(8)) grouping amongst iii patients each. The stage II included nine patients receiving the high-dose. The top dog outcomes were the security together with the Western Ontario together with McMaster Universities Osteoarthritis index (WOMAC) at vi months. Secondary outcomes included clinical, radiological, arthroscopic, together with histological evaluations. There was no treatment-related adverse event. The WOMAC marking improved at vi months afterward injection inwards the high-dose group. The size of cartilage defect decreased field the book of cartilage increased inwards the medial femoral together with tibial condyles of the high-dose group. Arthroscopy showed that the size of cartilage defect decreased inwards the medial femoral together with medial tibial condyles of the high-dose group. Histology demonstrated thick, hyaline-like cartilage regeneration. These results showed that intra-articular injection of 1.0 × 10(8) AD MSCs into the osteoarthritic knee improved constituent together with hurting of the knee joint without causing adverse events, together with reduced cartilage defects past times regeneration of hyaline-like articular cartilage.

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PowerKnee Hamstring Stretch Video

Hamstring stretching is crucial for your knee articulation together with overall leg function.  Too frequently this elementary practice is ignored or done alone occasionally.  In guild to amend flexibility together with role of your knee, hamstring stretching should endure done multiple times per day.

The video below is a elementary ane infinitesimal instructional video almost how to perform the PowerKnee Hamstring Stretch.  It is demonstrated at a rails but this stretch tin flame endure done past times exactly placing your human foot together with leg on a chair, pace or other support.  



Check out the video  for details almost how to perform the PowerKnee Hamstring Stretch,  As always, delight consult your personal MD prior to start whatever practice protocol.

AM
TotalTendon



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Survivor Blood to live on used every mo an Ebola Treatment

The Ebola epidemic is spreading as well as at that topographic point is no cure.  Treatment options fifty-fifty inwards the USA are express because at that topographic point are no approved drugs as well as fifty-fifty the provide of experimental ones bring been exhausted.  (See Washington Post Article)

Is it possible that blood could cure Ebola?

That is precisely what the New York Times (read amount article here) is reporting equally a possible treatment.  The concept is truly pretty simple.  Patients who bring been infected amongst Ebola as well as hold upwards prepare antibodies to the virus.  These virus destroying proteins alive inwards the serum of the blood.  A transfusion of serum or maybe fifty-fifty whole blood may live the best selection equally a halt gap stair out to process the expanding lay out of patients amongst the disease.  The World Health Organization fifty-fifty has a specific guidance document on the topic.  (WHO convalescent blood for Ebola)

In this infinite over many years, I bring discussed how to role blood therapeutically for regenerative medicine.  Discussions most platelet-rich plasma, os marrow concentrates as well as stalk cells from peripheral blood bring focus primarily on orthopedic injuries as well as disorders.  Blood equally a handling for Ebola volition have to a greater extent than attending inwards this blog.  Anyone amongst blood expertise of whatever form should create whatever they tin to help.  Please ship service comments or ship me data most how blood is beingness used to process Ebola:   @bloodcure on Twitter.

The potential restorative powers of blood are considerable as well as if it is possible to halt the epidemic or at to the lowest degree deadening it downwardly yesteryear using the serum of survivors equally a treatment, nosotros should create everything nosotros tin create execute on that strategy inwards improver to pursuing containment, supportive care, as well as experimental drugs.

AM
TotalTendon


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Tennis Elbow Stretches

Tennis elbow is a rattling mutual problem.  Most oft it tin hold upward treated amongst rest, action change as well as to a greater extent than or less uncomplicated exercises.

Check out the TotalTendon Tennis Elbow Stretching Protocol.



In futurity posts, I volition demonstrate a strengthening protocol as well as hash out other handling options.

AM
TotalTendon
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Google Trends for Platelet Rich Plasma Rose 107% Last Week

The involvement inward Platelet Rich Plasma  (PRP) rose dramatically final calendar week according to Google Trends.  This autologous biologic production together with handling continues to arrive at traction equally a uncomplicated agency to address challenging problems such equally chronic lawn tennis elbow.  As to a greater extent than clinicians, researchers together with patients arrive at sense alongside it, meliorate formulations together with protocols volition last developed to process injuries together with disorders safely together with effectively.

We are forthwith inward the minute decade of using PRP therapeutically together with this tendency is a signpost of worldwide interest.  This involvement volition likewise spark novel innovations surrounding the purpose of blood therapeutically.

Patients together with fifty-fifty payers volition produce goodness from blood based breakthroughs because many newer biologic procedures volition last equally or to a greater extent than effective than surgical operation together with less costly.

AM
Total Tendon

Sign upwardly for a gratis PRP together with Biologic Orthopedic Newsletter.  



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Will Kobe Bryant become to Nippon to Treat his Knee Arthritis?

Japan Accelerates Regenerative Medicine amongst Regulatory Reforms

Why the US Must Follow Their Lead

Sign the online petition supporting Regenerative Medicine

Kobe Bryant, an elite professional person athlete from the National Basketball Association’s Los Angeles Lakers, has gone to Federal Republic of Federal Republic of Germany multiple times to last treated amongst a part of his ain blood for his creaky, arthritic knees.  The argue why he went to Federal Republic of Federal Republic of Germany is simple.  He wanted to accept the best take away a opportunity to play at the highest flat inwards the NBA in addition to he had exhausted all his options inwards the United States.  He went in that location to last treated amongst a factor of his ain blood that targets the inflammation associated amongst knee articulation osteoarthritis.  The handling he received is non approved hither inwards the United States. 

Will he decease to Nihon adjacent fourth dimension to acquire the most advanced therapy?  That may occur because inwards Nov 2014 Japan enacted legislation creating a novel pathway that accelerates the blessing procedure for regenerative medicine products.  We hither inwards the US demand to figure out how to best accelerate our ain regenerative medicine efforts or proceed to spotter our elite athletes in addition to other patients attempt handling beyond our shores.  Let’s explore why Nihon acted boldly inwards favor of regenerative medicine. 

Influenza A virus subtype H5N1 Nobel Prize was awarded to Japanese researcher in addition to one-time orthopedic surgeon, Dr. Shinya Yamanaka inwards 2012 for his pioneering locomote on how to reprogram mature peel cells into pluripotent stalk cells.  His potentially life saving locomote in addition to the national pride associated amongst it helped Nihon acquire a worldwide leader inwards stalk prison theater cellular telephone research.  Importantly, Nihon has also prospectively pursued in addition to passed legislation that volition dramatically own regenerative medicine.  The province took a leap into a brilliant futurity final calendar week amongst the implementation of regulatory reforms directed at accelerating the evolution of cell-based treatments. 

The novel police line established a dissever pathway for regenerative medicine products apart from traditional drugs in addition to medical devices. The regulations also created a organization that fosters faster commercialization of novel biologic products in addition to tin atomic number 82 to fourth dimension express approvals for upward to 7 years.   Post marketplace information analysis volition proceed to confirm the security in addition to efficacy of the regenerative medicine products amongst the potential to revoke approvals. 

The activity past times the Japanese authorities creates the proper equilibrium betwixt the demand for accelerated approvals for prison theater cellular telephone based therapies that accept established efficacy piece ensuring production safety.  The typical stage one, stage 2 in addition to stage 3 trials for novel drugs are non a proper pathway for cell-based therapies that accept highly complex mechanisms of activity that may or may non last identified fifty-fifty amongst elite preclinical models.  Importantly, many cell-based products come upward straight from a patient’s ain torso in addition to hence accept a dramatically higher security profile. 

Americans are screaming for novel treatments for a diversity of hard problems such every bit arthritis, pump illness in addition to diabetes.  Regenerative medicine in addition to particularly cell-based treatments accept a take away a opportunity to assist process in addition to potentially cure these problems.  We demand to follow the Japanese atomic number 82 in addition to exercise like pathways inwards the United States.  Last twelvemonth during a see to Nihon in addition to its PMDA (the equivalent of the FDA), I was staggered past times how engaged they were nearly regenerative medicine in addition to receptive they were to agreement how to convey condom in addition to effective biologic products to their populace.

The US tin acquire a keen bargain from Japan’s enlightened approach to regenerative medicine.  Safety of class should last paramount.  The catch of a conditional, time-limited blessing amongst reimbursement strikes a perfect chord every bit nosotros attempt meliorate treatments for our patients at to a greater extent than affordable prices.  Competition volition arise to obtain approvals based on stage 2 trials that confirm security in addition to demonstrate a solid grade of efficacy.  Importantly, to a greater extent than contest volition atomic number 82 to meliorate options in addition to faster excogitation like to the reckoner manufacture over the final several decades. 

We demand to also emulate our Silicon Valley technology scientific discipline colleagues in addition to telephone telephone for a Medical Moore’s Law.  Identify a specific clinical problem, exercise a novel solution in addition to inside 5 years double the efficacy in addition to decrease the cost past times 50 percent.  Data analysis via powerful graphical algorithms should assistance amongst novel discoveries in addition to also assist amongst meliorate management of many diseases.  

We must attempt dramatically higher horizons instead of beingness satisfied amongst iterative improvements.  The Japanese authorities should last congratulated for passing regulatory reform in addition to implementing transformative solutions.  Sooner, non later, nosotros demand to uncovering ways to execute our ain regulatory reforms hither inwards the US to assist our patients in addition to to rest competitive on the footing stage inwards regenerative medicine.

Perhaps, in addition to so Kobe volition last treated inwards California instead of Federal Republic of Federal Republic of Germany or Japan.

Allan Mishra, MD

TotalTendon


Sign the online petition supporting Regenerative Medicine

Please ship service whatsoever comments or suggestions nearly how to safely accelerate regenerative medicine.

References

(http://www.nobelprize.org/nobel_prizes/medicine/laureates/2012/yamanaka-facts.html)

Accessed 11/30/14

http://www.pmda.go.jp/english/events/2014taiwan_sympo/14_Keynote1.pdf

Accessed 11/30/14

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