Which Knee Arthritis Injections ACTUALLY Work? Cortisone vs Stem cells vs PRP vs HA
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- Опубліковано 22 бер 2024
- I review the four most common injections for the treatment of knee osteoarthritis. These include corticosteroid or cortisone injections; hyaluronic acid also known as gel shots, HA, or viscosupplementation; stem cell injections including bone marrow aspirate concentrate, stromal vascular fraction (SVF), and umbilical cord stem cells; and platelet rich plasma or PRP injections.
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► ABOUT ME
Jeffrey Peng MD is a nonoperative orthopedist and sports medicine specialist. He focuses on maximizing non-surgical treatments for sports injuries and orthopedic conditions. He specializes in using orthobiologics and ultrasound guided minimally invasive techniques to treat osteoarthritis, tendinopathies, and musculoskeletal disorders.
Dr. Peng is board certified in sports medicine and family medicine. He completed residency with the Stanford family medicine residency program and completed his sports medicine training with the Stanford primary care sports medicine fellowship in San Jose. He is an active faculty member for both programs and is excited about training the next generation of physicians.
Dr. Peng’s sports medicine clinic is located in Campbell, California.
Twitter: @JeffreyPengMD; / jeffreypengmd
Website: www.jeffreypengmd.com/
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I had a cortisone injection and ended up with 10/10 pain more than I originally had. NEVER AGAIN
Keep rubbing organic castor oil
Just a shame that insurance doesn't generally cover PRP treatments.
Im 63 and have stage 3 OA in my left knee. Im getting HA and PRP 2 x a year. My PRP is only 35 ml less than Dr Peng recommends but is spun twice which he does recommend. See Dr Peng’s video on what makes a good PRP procedure. I am also taking turneric, boswellia, and glucosamine chondroitin and tirzepitide for weight loss. Have completed PA. And am rebounding and doing resistance training to strengthen muscles around knee. Recommend subscribing to Dr Peng if you aren’t already.
I hope you have continued success!
1!!!!!😊@@JeffreyPengMD
Dr. Peng,
Thank you very much for such an amazing, thorough and informative presentation on OA injection treatment options.
The more I watch your videos, the more impressed I am with your level and wealth of scientific knowledge, your top notch, unbiased and evidence based presentation skills (making a complex subject easily comprehensible even to a layperson) and above all, a transparent, genuine sincerity and desire in helping and equipping your viewers with current factual medical information.
Keep up the great job.
Much admiration and kudos to you.
I had a landmark-based Monovisc hyaluronic injection about 2 months ago done by the nurse practitioner in my orthopedic surgeon's office, hoping to avoid a total knee replacement in that leg after the "successful " but horrifically traumatic TKR in the other leg. BEWARE! Something went wrong evidently as 6 hours after the Monovisc I was in bed with crippling pain throughout the entire leg and hip. I literally couldn't move. After about 2 days I could hobble around with a walker. Now the knee seems truly fubar, so that an ultrasound guided cortisone injection in the joint was useless. Just a warning to others regarding various injections. I did pay $9000 for stem cell treatment a number of years ago and may have gotten 3 years pain relief out of it before giving up and going for the knee replacement.
I am now going to try prp injections from a reputable MD here in Topeka, Kansas.
Consistent with the research cited in this excellent podcast. Thank you!
Thank you for the excellent explanation of the different procedures.
No problem!
Thanks! This is really helpful! :)
Doctor you're the best.I learned a lot from you.I wonder where your practice is but thank you so much
Im in SA how can i get your injections that can help me KNEE ARTHTIS URIC ACID IM 65YEARS
Bless you doctor for explaining these therapies in details. ❤🙏😇
Glad it was helpful!
Yes, his videos are the best!
Excellent presentation. Looking forward to your next video. Question: why aren't they using these treatments ie HA and PRP on hip arthritis. There is a very big need for additional effective tx besides a hip replacement.
Beautiful explaind.Thank u.
Thanks for a detailed presentation, as always. How about Prolozone therapy, what is it? do you also administer this?
Thank you Dr Peng, I wish more Sports Med Docs would pay attention to detail like you do, it makes a difference , it can be marginal or more , but who doesn't want the best chance at staving off total knee replacement!!!
Thanks for your comment!
The fact that he's a sports medicine doctor is that what makes him good. What makes it good is it he's a real healer. The work he's doing here is tremendous. The amount of time he takes to teach is spectacular. I use all his techniques and agree with his review of all the Articles and have seen all the articles
I 100% see the point in ultrasound-guided injections, and how that could be a factor in the differing recommendations. Ever since the release of more portable US devices, I'm very excited for the future, hearing things such as "Ultrasound probes are the next stethoscopes"!
Hi Dr. Peng, I wish you could treat my knee arthritis, but I live in Northern Virginia. Thanks for explaining these types of injections, I always enjoy how you explain different types of treatments in-depth, so the patient can make the proper choice. I am considering a type of injection but have already ruled out cortisone and am considering Hyaluronic acid, I haven't talked to my orthopedist yet and don't know if he uses the utrasound based technique. I am desperately trying to avoid this intrusive knee replacemen. Too bad insurance doesn't cover PRP, I guess they are waiting for more studies to prove that it is really effective.
Thank you Dr. Penguin for your video. In veterinary medicine we have been a bit ahead of human medicine for once. Some 15 years ago at UC Davis stem cells marked with radionuclide were implanted in dogs’ knees and when check for radioluminiscence the majority had died short after. In my patients routinely I injected stem cells, Hyaluronic Acid and PRP. Needles to say there was a marked improvement, however the number of patients around 50 is too small as being taken as significant.
Hi Dr Peng,
Thanks so much for putting together these videos! Have you seen any research on how combining PRP injections and Shockwave Therapy would impact the outcome for mild osteoarthritis in the knee?
Dr. Peng, I've tried cortisone shots originally In 2022 and 2023 I tried PRP and "Gel" shots. Both of those helped somewhat.
In October of 2023 I had nerve ablation on my arthritic right knee and in January I had the ablation done on my right hip. Both of these procedures significantly reduced pain and discomfort. The ablation is supposed to last between 12 and 24 months. It was covered (mostly) by my insurance. My question is whether or not PRP shots would cause the nerves to grow back sooner that the 18 month average?
Excellent thank you
You are very welcome!
Very well explained. Thank you, Doctor.
At what level of knee arthritis does the PRP treatment works and for how long?
Thank you so much
About 8 years ago, I paid over 3 grand and got 2 units of umbilical/placenta stem cells injected. My right knee has been a lot of pain for 5-6 years My left knee had just started .I only got the stem cells in my right knee.The other one in my left upper arm.. I had several drainings ,then cortisone in my right knee prior to stem cells. Now it's 8 years later, my right knee is better,a bit then my left knee.still better
I have OA, left knee, medial side. It's developed fast (no symptoms prior to 3 years ago). It is pretty much bone on bone. My knee doc gave me cortisone injection. Didn't help. Later, I tried the gel injection (landmark injection), That also didn't help....I realize now my knee is slightly bent now (won't straighten out) so I kind of limp and am uncomfortable walking.... I won't do stem cell. I am terrified of Knee Replacement. I am early 70s.... My OS may be too far along for the PRP.... not sure.....WHAT HELPED ME SO FAR - Collagen UC-II supplements, and just added the Turmeric/Boswella. Prescription Meloxicam for joint pain... Walking slower and watching my step. Orthopedic shoes helps incredibly!- a huge difference having these shoes from orthofeet...
Within the myriad commercial brands of PRP kits available, numerous professionals utilizing various PRP kits assert notable differences in the degree of pain sensation. What could be the underlying cause of this variation? Is it possible that certain companies incorporate local anesthesia into their tubes to mitigate pain levels, despite the recognized compromise in the effectiveness of PRP treatment?
Hi Dr. Peng. I visited the website to schedule a consultation but it only show in-person times, and when I select online it says there are no time available. Is it possible to have online consultation? I live on east coast. Thank you
Is OA stage 2 should start for PRP injection? Or in what stage OA (degenaration) should start injection?
Is it possible to mend a partially torn (30% vertical tear on back horn of medial meniscus) degenerated tear, so that it doesn't have a tear anymore - with any of these injections? Or any other therapy? Is there any known case?
( Im 52, and after 1 year since noticing the issue, practically pain free. But i would love to have a functional (read: not torn) meniscus, so i wouldnt need to avoid half of the phisical exercises for the eest of my life. )
Im not looking to just eliminate symptoms.
Thanks!🙏
Could combinations be given?
Great video Dr Jeffrey. Is there a way to contact you via email for a podcast collaboration? Thanks
What's your opinion on different variants of PRP such as PRF or PRGF+ ?
There is no data to suggest PRF is superior to PRP. This is an active area of investigation. But for now, PRP is the way to go for arthritis
I’m bone on bone both knees. I get Genvisc injections. 1 a week for 5 weeks. Pain is substantially lessened, but both knees are very stiff. If I could get more movement, it would be great.
So why does insurance only cover the injections that show little results?
I recently had stem cell and PRP for a 7 herniated disk injury to the neck which has really help but what I can’t seem to get better from is the Rt side upper & lower trapezius myofascial pain syndrome I have. What other options do you recommend for trigger point injections medicine other than corticosteroids? Which hasn’t help.
I wonder if viscosupplementation has been proven effective for patients who have been diagnosed with avascular necrosis? Zero cartilage left?
It is my understanding that the biggest difficulty for prp injections, is that it cannot get past scar tissue. But that stem cell therapy done well can achieve this. But you don't address this in your distinctions aand recommendations . For example what other side effect do steroid injections have on the body thatn just on the knee Nor do you compare these treatments to the addition of mineral supplements like Boron. Your explanations are really great and I do appreciate them but I do wish you would delve further into some of the deeper issues that clinical trials have not addressed . This whole area is so confusing . For those of us suffering from this difficulty it seems that we have find out the issues for ourselves.
Not sure what you mean by "get past scar tissue" nor is there any evidence that stem cell therapy is superior to PRP. If there is any that I am not aware of, please help me by linking randomized controlled trial evidence.
I'd love to learn more about how Boron can help, do you have any clinical trial evidence of this as well?
If clinical trials have not addressed these issues, where can he get his data from?
Does PRP heal cartilage damage?
My knee OA is in mild (second) stage. I had PRP once. But still has symptoms. Maybe I need to get PRP again? Plz advise me
New studies show that long term use of cortisone can cause infections months after joint replacement
Could you please offer your opinion on Pentosan (PPS)? They are using it in Australia. Thank you.
Interesting. Never heard of this. I only see pilot trials studying its use for arthritis with no large clinical studies. Add this to the ever growing list of *potential* treatments for arthritis that need more data.
Thank you for a very detailed presentation. How about Prolozone, what is it? and do you also administer this?
I have had 4 HA injections all but last one was great which was a different brand. I said to doctor I don't want cortisone it breaks downs cartilege he said I don't have any cartilege!
I got PRP injections and ended up with a life-threatening blood clot in my lower leg. Worse, since the injections my knee pain has significantly increased and I have to use a Walker.
So I'm just wondering if anybody did any studies on a combination of say h a and PRP
Cortisone is so dangerous. I need two knees and by the time I left the hospital from my shot and by the time I got home I was totally gone in my one knee. A 25 minute ride and nothing
Wait so gel injections should be injected using ultra sound?? What the heck I just had one and be just injected it into my knee.
Same.
Can we start creating clothes with stem cell regeneration? It will be like a huge stem cell patch.
Bullshit , my right knee was shot before my left knee, got umbilical placental stem cells in 2018 .Now 2024 my right knee hurts much less then my left
I dont think you realize that Medicare wont pay for hardly of these treatments except one shot a year of Cortisone.
I did not post twice wth
I heard from more than one person that those injections are only temporary, at best. Lose weight and get on some supplements that protect your joints.
Has anyone experienced a new treatment for osteoarthritis called A2m are alpha 2 macrogloblin? Supposedly it inhibits the proteases that degenerate the cartilage therefore slowing the progression of the disease?
About 8 years ago, I paid over 3 grand and got 2 units of umbilical/placenta stem cells injected. My right knee has been a lot of pain for 5-6 years My left knee had just started .I only got the stem cells in my right knee.The other one in my left upper arm.. I had several drainings ,then cortisone in my right knee prior to stem cells. Now it's 8 years later, my right knee is better,a bit then my left knee.still better