Regenerative Medicine vs Knee Replacement


 

Regenerative Medicine vs Knee Replacement

 

The knee is the biggest and the most complicated joint in the human body. A lifetime of walking and jumping causes wear and tear, on top of that, arthritis eating away at these bones can cause the joint to break down.

Many times, the interarticular cartilage that separates the bones can wear away, causing the bones to touch and which can be very painful. This can cause a decline in quality of life by the inability to walk, play sports, or dance and leads to a life of restricted motion.
This leaves the patient with three choices:

(1) continue to suffer
(2) get a total replacement
(3) try regenerative medicine
 


 


How Long Does it Take to Complete the Surgery?

Orthopedic surgeons who specialize in knee replacements say it takes only an hour of operating room time, and the patient is on his feet within 24 hours and begins physical therapy almost immediately.


General Positive Results

There have been over 600,000 full implants in the US, with a high degree of good results and pre-operative pain being reduced significantly. Ten percent require revision within ten years.  It won’t last forever. Over time, the metal and plastic parts wear out. Overweight people or those who take part in high impact activities are more likely to experience problems.


Quote From Healthline


According to the American Academy of Orthopedic Surgeons, 90 percent of people who have a knee replacement have a lot less pain. Most of these people are able to perform daily activities and stay active. In many cases, they’re able to resume activities like golf and walking that their arthritic pain made them give up years ago.


Success Rates

The device usually lasts well over a decade. The procedure is being used more and more for younger people with osteoarthritis (OA) and other degenerative knee conditions. About 85 percent of artificial knees still work after 20 years. Their endurance is one reason that this procedure is so popular.

Most people who undergo knee replacement are between the ages of 50 and 80. The average age is about 70. About 60 percent of the recipients are women. The procedure has a high success rate and is considered relatively safe and effective.


Safety and Complications

The safety of total knee replacements (TKRs) is well-documented. According to the American Academy of Orthopedic Surgeons, “Serious complications, such as knee joint infection, occur in fewer than 2 percent of patients.” Blood clots can be a risk, as they are with all orthopedic procedures, but the risk is low.
 

Prosthesis Problems and Implant Failure

Another risk with any joint replacement surgery is the improper placement or a malfunction of the implant. For example, the artificial kneecap may not track correctly after surgery — in other words, your new knee might not bend properly.

Another possible implant problem is that the prosthesis might loosen from the bone over the long term. It will require an adjustment if that happens.

Other parts in the artificial knee can also wear or break, including the polyethylene components.

These failures are extremely rare. According to Healthline’s analysis of Medicare and private pay claims data, only 0.7 percent of patients experience mechanical complications during their hospital stay. Most failures occur within weeks of surgery. Follow-up surgery is usually required to fix the problem when this does happen. This surgery is called a revision surgery.

A revision can also be required for reasons other than mechanical failure, including (among others):

  • infection
  • continued pain
  • knee stiffness
  • wear
  • instability
  • loosening of the implant or mechanical components

Analysis of data from Medicare shows that the average rate of revision surgery within 90 days is 0.2 percent. However, the rate increases to approximately 3.7 percent within 18 months.

There can also be long-term wear and loosening of the implant over several years. According to a meta-analysis of worldwide joint registry databases published in The Bone & Joint Journal in 2011, the long-term revision rate is 6 percent after five years and 12 percent after 10 years. HEALTHLINE


Other Considerations

It requires a general anesthetic. The 30-day mortality rate for a total knee replacement (TKR) is about 1 in 400 or 0.25 percent. That means that 99.75 percent of those who undergo this surgery survive the treatment. Researchers in the U.K. reported in The Bone & Joint Journal that they looked at almost 2,500 people who had a TKR over a 10-year span. They found that 99 percent survived at least one year. Ninety percent were alive after five years. Eighty-four percent were still living after 10 years. Overall, mortality rates are highest in the 30 to 90 days following surgery. Yes, it is very low, but it can happen. You could die in the operation or soon after.

As well, you have had serious surgery on your body. The very idea of undergoing the knife may terrify many, and they would rather suffer than face being cut on and parts cut out of you. It would depend on how serious or painful the condition is before one undergoes surgery and takes the inherent chances involved.



What is Regenerative Medicine?

It is just that - It is the process of replacing or "regenerating" human cells, tissues or organs to restore or establish normal function. “Regenerative medicine is a branch of translational research in tissue engineering and molecular biology which deals with the "process of replacing, engineering or regenerating human cells, tissues or organs to restore or establish normal function"Wikipedia The remarkable results from these procedures would make some people consider it black magic, or just magic that heals without surgery or drugs.

 

What is Stem Cell Therapy?

Stem cell therapy is the use of stem cells to treat or prevent a disease or condition. Bone marrow transplant was the most widely used stem-cell therapy, but some therapies derived from umbilical cord blood are also in use.

In stem cell therapy or regenerative medicine, researchers study how stem cells may be used to replace, repair, reprogram, or renew your diseased cells. Cardiovascular diseases, neurological conditions, and diabetes have been extensively studied in stem cell therapy research.
 
 

How Does It Work?

Stem cells are what is called undifferentiated cells, i.e., they are cells that travel to parts of the body that are growing or in need of repair and at that time clone themselves as the cells of the growth or injured area. This is how the body grows. These cells are the magicians that morph or transform into the needed part and repair damaged tissues, replace them, or just add to them as needed as in a child’s growth to adulthood. For that reason, infants and children have many more than the adult whose stem cells become less and less as he ages.



Success Stories

“It is now nearly 30 years since the first successful cord blood stem cell transplant took place and in that relatively short space of time, this groundbreaking form of medicine has contributed to the successful treatment of more than 80 different diseases, including cerebral palsy, leukemia and sickle cell disease. The list of treatable diseases looks certain to rise as researchers report promising results in tests on type 1 diabetes, stroke, multiple sclerosis, autism, Crohn’s disease and other types of cancer.
Stem cells are the building blocks of the blood and immune system and they have incredible capabilities. They can heal and repair cells and tissue, help rebuild the blood and immune system and even transform themselves into other types of cells in order to replace damaged cells.” (Smart Cells)



Sources of Stem Cells

Remember stem cells are just blank cells, like a page with nothing written on it or a block of marble waiting to become a statue. When it is injected into the site of need, it becomes the tissues and needed structures there. The original and probably best source is from embryos, which was outlawed, and is an ethical case of using them. So, the search was on for rich sources. Some use their own cells from the patient’s own fat. Blood is one, marrow another, but the best is umbilical with mesenchymal cells, which can easily be harvested from the umbilical cord and placenta. After harvest, they are processed and injected.

In certain cases, one can direct the destination of the cell, as in the knee or joint areas. If it is intravenously given, the stem cell will seek out the area in the body where it is needed, and hone right in on the area and start to work by transforming itself into the very tissue needed there. It is a miracle. The only problem is the current cost in 2018, as they run from $5,000 to $10,000 per injection.



What is it Like Taking the Injection?

At the point of the material being injected, it is not comfortable, but bearable, which is soon over. Then for a short time, there is some discomfort in the area as the serum begins to start taking effect and then the discomfort dissipates as the cells go to work replicating itself over and over fixing the problem.



Downside

As of now, insurance companies will not pay for stem cell therapy.  Stem cell therapy is still in its infancy as a branch of healthcare, but it is growing with leaps and bounds, with one success story after another of how the injured area is not totally renewed or restored and is now fully functional.
 


 

It’s a Simple Choice

If I had a bad knee, which would I choose? Well, that is a no-brainer. I would definitely go stem cells. Though there are glowing reports for the replacement, why take a chance if there is the remotest possibility of having my knee back, fully functional, without the possible problems inherent in invasive surgery where you are put under general anesthetic.  So, if it doesn’t work you can always go surgery, but going that way first there is no going back.

Written by Dr. Mike Carberry

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