Produced by: William Pidwell, M.D.

Lifestyle modifications are recommended for every patient:

  • Maintenance of an active lifestyle with a predominance of low impact activities including cycling and eliptical
  • Weight control and weight loss if indicated. Losing one pound of body weight reduces the stress on knees by 3 pounds
  • Consideration of Physical Therapy
  • Consideration of an ant-inflammatory diet

Oral medications can be beneficial for some patients, including:

  • NSAIDS (Advil, Aleve, Ibuprofen, Naprosyn, Diclofenac, Celebrex) if safe for your to take
  • Glucosamine

Injection Therapy can be very beneficial for patients who find the lifestyle modifications and oral medications to be insufficient. The chart below details the different options, including benefits and drawbacks of each.

*Whereas a complete resolution of symptoms is always our goal, it is not a fair assessment of success. All of the following injections are targeted to get a 50% or greater improvement in pain and functionality.

Corticosteroids
(Cortisone, Kenalog, Dexamethasone)		 Hyaluronic Acid Preparation
(Euflexxa, Synvisc, Hyalgan, Orthovisc)		 Platelet Rich Plasma (PRP) Stem Cell Therapy
How it works: Anti-inflamatory that decreases swelling and pain Viscosupplementation that replenishes the natural hyaluronic acid found in joint, providing lubrication and cushion Concentrated blood, providing high % of platelets and related growth factors which provide an anti-inflamatory affect and accelerated healing Provides all the benefits of PRP, plus a rich concentration of stem cells. The growth factors stimulate the stem cells to regenerate articular cartilage
Benefits:
  • Works quickly
  • Inexpensive
  • No collection of blood or bone marrow
  • Safe for your knee joint
  • No collection of blood or bone marrow
  • Natural healing without medication
  • Longer lasting
  • Typically a better result than with medication
  • Only option which can regrow cartilage
  • Natural healing without medication
  • Longest lasting treatment option
  • Often works with only 1 injection
Drawbacks:
  • Detrimental to natural cartilage in knee, increasing arthritis if used regularly
  • Can influence blood glucose in diabetics
  • Wears off quickly
  • Slight risk of allergic swelling
  • Requires 3 injections, one per week
  • Requires in office blood draw
  • Expense not covered by insurance
  • Exact frequency of injections is undetermined, currently recommended as two injections, 1 month apart
  • Requires in office bone marrow collection
  • Expense not covered by insurance
  • Stem cells less effective as you age and if you are a smoker
Duration: Up to 3 months 3 to 6 months 6 to 12+ months 12 to 36+ months
Expense: $215
* Most insurance will cover this cost, minus your deductible		 $1,400
Most insurance will cover this cost, minus your deductible after prior authorization		 $1,200 $4,000

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