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Knee

I am a single mother of two with a very demanding career, who was told I would be disabled due to my knee and back injuries. So thanks is really not enough for what Dr. Garg and his team have done for me.I was able to stop living in pain and start a better future with Dr. Garg and his staff.

Shani H.

Knee

The SmartChoice® Joint Procedures offer non-surgical, stem cell and Platelet-Rich Plasma (PRP) procedures for the patients who are suffering from knee pain or may be facing knee surgery or total knee replacement from tendon, ligament or bone injuries, arthritis and other medical conditions.

At SmartChoice® Stem Cell Institute, we are leading non-surgical specialist for chronic knee pain and injuries from :

 

KNEE ACL

If you have an injury to the knee meniscus, cartilage, ACL or MCL ligaments, or if you have chronic knee pain due to osteoarthritis (which is also known as “degenerative joint disease” or “wear and tear” arthritis of the knee), or due to other medical conditions, you may be a candidate for our SmartChoice® Joint Procedures.

These SmartChoice® Joint Procedures may provide a simple, out-patient, natural alternatives to many patients so as to avoid the costly and risky orthopedic surgeries that also require long recovery periods.

The knee is the joint where the bones of the upper leg meet the bones of the lower leg, allowing hinge-like movement while providing stability and strength to support the weight of the body. Flexibility, strength, and stability are needed for standing and for motions like walking, running, crouching, jumping, and turning.

The knee joint is made up of bone, cartilage, ligaments and fluid. Muscles and tendons help the knee joint move. When any of these structures is hurt or diseased, you have knee problems. Knee problems can cause pain and difficulty walking.

KNEE OA

The most common disease affecting the knee is osteoarthritis. The cartilage in the knee gradually wears away, causing pain and swelling.Knee problems are very common, and they occur in people of all ages. Knee problems can interfere with many things, from participation in sports to simply getting up from a chair and walking. This can have a big impact on your life.

Injuries to ligaments and tendons also cause knee problems. A common injury is to the anterior cruciate ligament (ACL). You usually injure your ACL by a sudden twisting motion. ACL and other knee injuries are common sports injuries. Treatment of knee problems depends on the cause.

Traditional options for patients suffering from the knee or hip injury, arthritis or pain include arthroscopic joint surgery, total knee or hip joint replacement. Besides the cost and the risks of those orthopedic surgeries, several months of rehabilitation is usually needed after the surgeries.

For many patients these intense orthopedic surgeries may not be an option due to their younger age especially considering the fact that we are living longer and more active lifestyle and the Joint Replacement may not last for more than 10 to 15 years. Also, the injuries may not be serious enough to require any surgery.

As an alternative to the knee and hip (and other joints) surgery or replacement, SmartChoice® Joint Procedures may help alleviate joint pain, arthritis and other medical conditions that caused it with a simple office injection procedure. We encourage the patients to walk the same day and most experience almost no downtime after our procedures whatsoever.

And if you are considering a knee, hip or other joint replacement, you might want to learn about how the adult stem cells and PRP procedures stack up against these risky Orthopedic surgeries.

Traditionally – a Total joint replacement of the hip or knee is often considered to be a accepted approach to treatment for patients suffering from significant arthritis or injury in their knee and hip joints. Over the years, due to aging baby-boomers and active lifestyle causing more sports injuries, these procedures have become more common. It has now become something that almost seems inevitable for us as we age.

But what about an alternative that could be just as successful as joint replacement and may be a better option for many of the patients before even considering joint replacement. And, all of this with significantly lower risk and cost.

When comparing two options - a treatment that involves simply an injection of your own natural cells in an outpatient setting may be significantly more attractive option for many patients than undergoing risky orthopedic surgery and replacing your entire joint with artificial material.

We play a key role in this cutting-edge stem cell medical field. While many types of stem cells are currently used in orthopedic healing, the most common are mesenchymal stem cells and hematopoietic stem cells to help regenerate tissue and rebuild cartilage, muscles, tendons and ligaments.

Because it is now possible to induce pluripotency in cells that have not come from embryos, the controversial use of embryonic stem cells has fallen on the way side and in the favor of the accessible cells found within the patient’s own body.

Patients coping with arthritis, sports injuries, tendon strains, sprained ligaments, muscle injuries and more, will be comforted to know that surgery is not the only option of treatment available to them. Faster healing as well as improved functionality both are possible with innovative, cutting- edge adult stem cell and PRP procedures.

 

MEDICAL LITERATURE - PRP AND STEM CELLS IN KNEE INJURIES

1.     Treatment of Knee Osteoarthritis with Autologous Mesenchymal Stem Cells:A Pilot Study. Orozco L, Munar A, Soler R, Alberca M, Soler F, Huguet M, Sentís J, Sánchez A, García-Sancho-  J. Transplantation. 2013 May 15.
 
2.     Current clinical therapies for cartilage repair, their limitation and the role of stem cells. Dhinsa BS, Adesida AB. Curr Stem Cell Res Ther. 2012 Mar;7(2):143-8. 2.
 
3.     Mesenchymal stem cell-based treatment for cartilage defects in osteoarthritis. Qi Y, Feng G, Yan W.  Mol Biol Rep. 2012 May;39(5):5683-9.
 
4.     Mesenchymal Stem Cell Injections Improve Symptoms of Knee Osteoarthritis. Koh YG, Jo SB, Kwon OR, Suh DS, Lee SW, Park SH, Choi Y.  J. Arthroscopy. 2013 Jan 29.
 
5.     Intra-articular injection of autologous mesenchymal stem cells in six patients with knee osteoarthritis. Emadedin M, Aghdami N, Taghiyar L, Fazeli R, Moghadasali R, Jahangir S, Farjad R, Baghaban Eslaminejad M. Arch Iran Med. 2012 Jul;15(7):422-8.
 
6.     Developments in stem cells: implications for future joint replacements. Proc Maclaine SE, McNamara LE, Bennett AJ, Dalby MJ, Meek RM. Inst Mech Eng H. 2013 Mar;227(3):275-83.
 
7.     Current surgical options for articular cartilage repair. Peretti GM, Pozzi A, Ballis R, Deponti D, Pellacci F.   Acta Neurochir Suppl. 2011;108:213-9.
 
8.     Mesenchymal stem cell-based treatment for cartilage defects in osteoarthritis Qi Y, Feng G, Yan W.   Mol Biol Rep. 2012 May;39(5):5683-9.
 
9.     Prospects of stem cell therapy in osteoarthritis. Roberts, Genever, McCaskie & De Bari; Regen. Med. (2011) 6(3), 351–366).
 
10.  Viscosupplementation for Osteoarthritis of the Knee: A Systematic Review and Meta-analysis. Rutjes AWS, Jüni P, MD; da Costa BR, et al. Ann Intern Med. 2012 Jun 11.

11. Comparative Effectiveness of Platelet-Rich Plasma Injections for Treating Knee Joint Cartilage Degenerative Pathology: A Systematic Review and Meta-analysis. Chang KV, Hung CY, Aliwarga F, Wang TG, Han DS, Chen WS. Arch Phys Med Rehabil. 2013 Nov 27.
 
12.  A Randomized Clinical Trial Evaluating Plasma Rich in Growth Factors (PRGF-Endoret) Versus Hyaluronic Acid in the Short-Term Treatment of Symptomatic Knee Osteoarthritis. Sánchez M, Fiz N, Azofra J, et al.    Arthroscopy. 2012 Aug;28(8):1070-8.
 
13.  Platelet-rich plasma intra-articular injection versus hyaluronic acid viscosupplementation as treatments for cartilage pathology: from early degeneration to osteoarthritis. Kon E, Mandelbaum B, Buda R, Filardo G, Delcogliano M, Timoncini A, Fornasari PM, Giannini S, Marcacci M.  Arthroscopy. 2011 Nov;27(11):1490-501.
 
14.  Treatment of Knee Osteoarthritis with Autologous Mesenchymal Stem Cells: A Pilot Study. Orozco L, Munar A, Soler R, Alberca M, Soler F, Huguet M, Sentís J, Sánchez A, García-Sancho J.  Transplantation. 2013 May 15.
 
15.  Current clinical therapies for cartilage repair, their limitation and the role of stem cells. Dhinsa BS, Adesida AB. Curr Stem Cell Res Ther. 2012 Mar;7(2):143-8.
 
16.  Mesenchymal stem cell-based treatment for cartilage defects in osteoarthritis. Qi Y, Feng G, Yan W. Mol Biol Rep. 2012 May;39(5):5683-9.
 
17.  Platelet-rich plasma: intra-articular knee injections produced favorable results on degenerative cartilage lesions. Kon E, Buda R, Filardo G, Di Martino A, Timoncini A, Cenacchi A, Fornasari PM, Giannini S, Marcacci M.    Knee Surg Sports Traumatol Arthrosc. 2010 Apr;18(4):472-9.
 
18.  Treatment of knee joint osteoarthritis with autologous platelet-rich plasma in comparison with hyaluronic acid. Spaková T, Rosocha J, Lacko M, et al.  Am J Phys Med Rehabil. 2012 May;91(5):411-7
 
19. Therapeutic effectiveness of intra-knee-articular injection of platelet-rich plasma on knee articular cartilage degeneration]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2011 Oct;25(10):1192-6.
 
20.  Growth factors in the treatment of early osteoarthritis. Civinini R, Nistri L, Martini C, Redl B, Ristori G, Innocenti M. Clin Cases Miner Bone Metab. 2013 Jan;10(1):26-9.
 
21.  Treatment of knee chondropathy with platelet rich plasma.Preliminary results at 6 months of follow-up with only one injection. Torrero JI, Aroles F, Ferrer D.   J Biol Regul Homeost Agents. 2012 Apr-Jun;26(2 Suppl 1):71S-78S.
 
22.  Intra-articular injection of mesenchymal stem cells for the treatment of osteoarthritis of the knee: A proof-of-concept clinical trial. Jo CH, Lee YG, Shin WH, Kim H, Chai JW, Jeong EC, Kim JE, Shim H, Shin JS, Shin IS, Ra JC, Oh S, Yoon KS. Stem Cells. 2014 Jan 21.
 
23.  Mesenchymal stem cells in joint disease and repair. Barry F, Murphy M. Nat Rev Rheumatol. 2013 Jul 23.
 
24.  Treatment of Knee Osteoarthritis With Autologous Mesenchymal Stem Cells:A Pilot Study. Orozco L, Munar A, Soler R, et al. Transplantation. 2013 Jun 27;95(12):1535-1541.
 
25. Autologous bone marrow concentrate: review and application of a novel intra-articular orthobiologic for cartilage disease.Sampson S1, Botto-van Bemden A, Aufiero D Phys Sportsmed. 2013 Sep;41(3):7-18.
 
26.  Clinical outcome of autologous bone marrow aspirates concentrate (BMAC) injection in degenerative arthritis of the knee, Jae-Do Kim, Gun Woo Lee, Gu Hee Jung, Cheung Kue Kim, Taehun Kim, Jin Hyung Park, Seong Sook Cha, Young-Bin You, European Journal of Orthopaedic Surgery & TraumatologyJanuary 2014
 
27.  Regenerative injection therapy with whole bone marrow aspirate for degenerative joint disease: a case series.Hauser RA1, Orlofsky A.   Clin Med Insights Arthritis Musculoskelet Disord. 2013 Sep 4;6:65-72. 
 
28.  Treatment of chronic patellar tendinopathy with autologous bone marrow stem cells: a 5-year-followup. Pascual-Garrido C, et al. Stem Cells Int. 2012; Epub 2011 Dec 18.
 
29.  Safety of autologous bone marrow aspiration concentrate transplantation: initial experiences in 101 patients. Hendrich C1, Franz E, Waertel G, Krebs R, Jäger MOrthop Rev (Pavia). 2009 Oct 10;1(2):e32
 
30. Stem cells and cartilage development: complexities of a simple tissue. Hollander AP, Dickinson SC, Kafienah W, Stem Cells 2010, 28:1992-1996. 
 
31.  Cartilage tissue engineering: towards a biomaterial assisted mesenchymal stem cell therapy. Vinatier C, Bouffi C, Merceron C, Gordeladze J, Brondello JM, Jorgensen C, Weiss P, Guicheux J, Noel D.  Curr Stem Cell Res Ther 2009, 4:318-329.
 
 32. REVIEW - Mesenchymal stem cells in arthritic diseases. Faye H Chen and Rocky S Tuan,  Arthritis Research & Therapy 2008, 10:223
 
33. Mesenchymal stem cells for cartilage repair in osteoarthritis. Pawan K Gupta1, Anjan K Das2, Anoop Chullikana1 and Anish S Majumdar. Stem Cell Research & Therapy 2012, 3:25
 
34.  Stem Cell Prolotherapy in Regenerative Medicine -Background, Theory and Protocols,  Donna D. Alderman, DO, Robert W. Alexander, MD, DMD, FICS, Gerald R. Harris, DO, Patrick C. Astourian, MS, PA-C, JOURNAL of PROLOTHERAPY | VOLUME 3, ISSUE 3 | AUGUST 2011
 
35.  Chondrogenesis and cartilage tissue engineering: the longer road to technology development.  Mahmoudifar N1, Doran PM.  Trends Biotechnol. 2012 Mar;30(3):166-76.
 
36. Concise Review: The Clinical Application of Mesenchymal Stem Cells for Musculoskeletal Regeneration: Current Status and Perspectives. Andre F. Steinert, Lars Rackwitz, Fabian Gilbert, Ulrich Nöth and Rocky S. Tuan. Stem Cells Trans Med 2012, 1:237-247.

37.  Adult mesenchymal stem cells for tissue engineering versus regenerative medicine.  Caplan AI ,  J Cell Physiol 2007, 213:341-347.
 
38.  Different populations and sources of human mesenchymal stem cells (MSC): a comparison of adult and neonatal tissue-derived MSC. Hass R, Kasper C, Bohm S, Jacobs R  - Cell Commun Signal 2011, 9:12
 
39.  Stem Cells and other innovative intra-articular therapies for osteoarthritis: What does the futurehold? Singh A Jasvinder. BMC Medicine 2012, 10:44
 
40. Marrow stromal cells as stem cells for nonhematopoietic tissues.  Prockop DJ. Science. 1997 Apr 4;276(5309):71-4.
 
41.  Multilineage potential of adult human mesenchymal stem cells. Pittenger MF, Mackay AM, Beck SC, Jaiswal RK, Douglas R, Mosca JD, Moorman MA, Simonetti DW, Craig S, Marshak DR . Science 1999,284:143-147.
 
42. Stem cell therapy for cartilage regeneration in osteoarthritis.Koelling S1, Miosge N. Expert Opin Biol Ther. 2009 Nov;9(11):1399-405.
 
43. Intraarticular treatments for osteoarthritis: new perspectives. Chevalier X.Curr Drug Targets. 2010 May;11(5):546-60.
 
44.  Mesenchymal stem cell-based HLA-independent cell therapy for tissue engineering of bone and cartilage. Niemeyer P1, Krause U, Kasten P, Kreuz PC, Henle P, Südkam NP, Mehlhorn A.  Curr Stem Cell Res Ther. 2006 Jan;1(1):21-7.
 
45.  Repair of articular cartilage defects in the patello-femoral joint with autologous bone marrow mesenchymal cell transplantation: three case reports involving nine defects in five knees. Wakitani S1, Nawata M, Tensho K, Okabe T, Machida H, Ohgushi HJ Tissue Eng Regen Med. 2007 Jan-Feb;1(1):74-9.
 
46.  Autologous bone marrow-derived mesenchymal stem cells versus autologous chondrocyte implantation: an observational cohort study. Nejadnik H1, Hui JH, Feng Choong EP, Tai BC, Lee EHAm J Sports Med. 2010 Jun;38(6):1110-6.
 
47. Mesenchymal stem cell therapy for knee osteoarthritis. Preliminary report of four patients. Davatchi F1, Abdollahi BS, Mohyeddin M, Shahram F, Nikbin B.  Int J Rheum Dis. 2011 May;14(2):211-5.
 
48.  Intra-articular injection of autologous mesenchymal stem cells in six patients with knee osteoarthritis. Emadedin M1, Aghdami N, Taghiyar L, Fazeli R, Moghadasali R, Jahangir S, Farjad R, Baghaban Eslaminejad MArch Iran Med. 2012 Jul;15(7):422-8.
 
49.  Autologous bone marrow mesenchymal stem cells implantation for cartilage defects: two cases report. Kasemkijwattana C1, Hongeng S, Kesprayura S, Rungsinaporn V, Chaipinyo K, Chansiri K.   J Med Assoc Thai. 2011 Mar;94(3):395-400.
 
50.  Increased knee cartilage volume in degenerative joint disease using percutaneously implanted, autologous mesenchymal stem cells. Centeno CJ1, Busse D, Kisiday J, Keohan C, Freeman M, Karli D.  Pain Physician. 2008 May-Jun;11(3):343-53.
 
51.  The Clinical Use of Human Culture-Expanded Autologous Bone Marrow Mesenchymal Stem Cells Transplanted on Platelet-Rich Fibrin Glue in the Treatment of Articular Cartilage Defects: A Pilot Study and Preliminary Results. Haleem AM1, Singergy AA, Sabry D, Atta HM, Rashed LA, Chu CR, El Shewy MT, Azzam A, Abdel Aziz MT.   Cartilage. 2010 Oct;1(4):253-261.

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