Joint Preservation
What is Joint Preservation?
When cartilage deterioration due to osteoarthritis is causing persistent joint pain that interferes with your daily life, it is our goal to restore normal movement and alleviate pain to your joint – be it your shoulder, hip, or knee.
Joint preservation refers to the use of nonsurgical or surgical means to preserve a deteriorating joint in order to delay or avoid joint replacement surgery. Every patient is different, we will customize your joint preservation strategy with you based on your individual situation, taking into account factors such as your age, expectations, level of joint dysfunction, and activity level.
Nonsurgical joint preservation techniques include:
Joint Injections (Steroid Injections and Visco Supplementation)
Platelet Rich Plasma (PRP) Therapy
Bone Marrow Aspirate Concentrate (BMAC) Injection
Surgical joint preservation techniques include:
Osteotomy – Hight Tibial Osteototomy
Cartilage Restoration Procedures
Micro-fracture
Mosaicoplasty
Autologous Chondrocyte implantation (ACI)
What are Joint Injections?
For patients presenting with joint pain due to arthritis, the first step is usually conservative treatment, which includes but is not limited to medication and physical therapy (or a home exercise program).
If conservative treatment is not successful, you will likely proceed to interventional methods, or joint injections. The most common joint injections both seek to alleviate pain and increase range of motion. They are:
Steroid Injections
Steroid injections (or corticosteroid injections) work to reduce swelling and inflammation in the joint.
They are commonly used in the knee, hip, and shoulder to relieve pain and swelling, but can also be used to treat pain in other joints including the elbow, wrist, and ankle.
There are benefits and drawbacks to steroid injections, including:
Fast Relief – Steroid injections typically offer relief within 24-48 hours of the injection.
Short-Term Relief – Pain relief from a steroid injection can last from 6-12 weeks.
Limitations on Repeat Use – Steroid injections are often most effective the first time, with subsequent injections losing their efficacy. These injections also cannot be given too frequently without a risk of weakening the surrounding structures of the joint.
Speak to your physician to find out if steroid injections may be a good option for you.
Hyaluronic Acid Injections / Viscosupplementation
Hyaluronic acid (or “rooster comb”) injections – Also referred to as viscosupplementation, are used to treat osteoarthritis (most commonly in the knee).
Hyaluronic acid is a natural lubricating component in the lining of your joints. However, as we age, our bodies produce this substance at a lower quantity and quality. In patients suffering from osteoarthritis, the hyaluronic acid thins even further, causing friction and pain as the joint operates.
inject this substance back into the painful joint, coating and lubricating it to reduce friction and pain and increase range of motion.
Currently, the FDA has only approved viscosupplementation for use on the knee, but there is evidence to support its use in the hip and shoulder as well. These injections can be given safely if steroid injections have proven ineffective.
Speak to your physician to find out if hyaluronic acid injections may be a good option for you.
Platelet-Rich Plasma (PRP) Therapy
Platelet-Rich Plasma (PRP) Therapy is a treatment option for several types of orthopedic injuries and joint pain whereby a high concentration of the patient’s own platelets are injected directly into the injury site to promote healing and give patients another treatment option for dealing with orthopedic conditions such as joint pain and several types of injuries.
How Does Platelet-Rich Plasma (PRP) Therapy Work?
In PRP Therapy, a sample of a patient’s own blood is drawn and spun down to collect only the platelets and white blood cells from the sample. The result is a highly concentrated dose of platelets, which are then injected directly into the injury site to promote inflammation and speed the healing process.
Platelets promote clotting through the collection and release of growth factors, which aide in tissue regeneration.
Why Should I Choose PRP Therapy Over Another Treatment Option?
PRP Therapy vs. Steroid Injections – Steroid injections are not considered a long-term solution and frequent steroid injections to control pain can actually weaken tissue in the treated area. PRP Therapy offers the opportunity to heal the affected area, which can be a permanent solution.
PRP Therapy vs. Surgery – If an injury or pain is severe enough to consider surgery, consider PRP Therapy first. Assuming you are a candidate for PRP Therapy, it is a less invasive option which could provide permanent relief. Compared to surgery, PRP Therapy also offers a lower out-of-pocket cost, reduced risk of infection, and shorter recovery period.
What to Expect:
Preparation
In the week prior to your injection, do not take aspirin or anti-inflammatory medications (NSAIDS).
Procedure
PRP Therapy is an OPD procedure.When the injection is done, it will induce inflammation, which causes immediate pain. Swelling and redness at the injection site is common and can last up to 2 days. Pain can last up to 7 days after injection and some patients require the use of crutches of a splint for a couple of days for comfort.
Managing Pain – Cold compresses and acetaminophen may be used for the pain. If your pain persists after injection, you can contact your doctor. However, under no circumstances should you take anti-inflammatory pain medicine (NSAIDS) or aspirin for several months after the injection. These medicines reduce the inflammation the injection has created, thereby interfering with the healing process. Note: If your doctor requires you to take baby aspirin, this regimen can be restarted one week following the PRP injection.
Recovery – Activity is not restricted after a PRP injection. You may return to your normal activities as soon as you feel ready. Healing and improvement in pain can take approximately 6 weeks. A second or third injection may be required, depending on the severity of the problem. Relief from PRP Therapy can last anywhere from 6 months to a lifetime, depending on the patient, condition, and individual response to therapy
Bone Marrow Aspirate Concentrate (BMAC) Injection
Autologous bone marrow aspirate concentrate injections attempt to harness the regenerative power of your body’s own stem cells as a treatment option for degenerative orthopedic conditions.
which embraces the regenerative power of mesenchymal stem cells to give patients another treatment option for dealing with orthopedic conditions such as osteoarthritis and other degenerative joint conditions.
How Does BMAC Therapy Work?
Mesenchymal stem cells (MSCs) are adult stem cells that can be found in bone marrow. TSAOG Orthopaedics performs autologous BMAC therapy, which means that the cells used in your treatment are taken from your own body, not from a donor. Using your own cells for the procedure helps reduce your risk of infection and eliminate the possibility of immune rejection.
In an autologous BMAC procedure, your physician will draw a sample of bone marrow from the iliac crest of your hip. The sample is then filtered and concentrated in a sterile environment, then injected into the area of your body that you are trying to heal. This procedure is done on an outpatient basis while under sedation and leaves no scarring.
The idea behind BMAC therapy is that the injection of these concentrated regenerative cells at an area of your body experiencing degeneration will kick start your body’s ability to heal itself. These injections can be given independently or in conjunction with an orthopedic surgical procedure