Synvisc Alternative
September 26, 2011 by Dr. Marc Darrow, M.D.
Filed under Knee Pain
Synisc is a commonly prescribed injection for osteoarthritis of the knee. Recently a new version has been approved by the FDA called Synvisc-One. It is not a drug, but an injection solution processed from rooster combs that seeks to mimic the naturally occurring synovial fluid in the knee. The goal is to help prevent bone on bone complications for approximately six months
Synvisc treatments need to be administered three times, the new Synvisc-One, one time.
Is Synvisc for you?
At our chronic pain speciality clinic in Los Angeles we do not recommend Synvisc. The reason? Synvisc, at best, is a temporary fix to a long-standing problem – Knee deterioration. Even in the best case scenario – the synvisc products are promoted as providing UP TO 6 months pain relief.
If you are going to have injections in the knee, why not consider a treatment that can provide permanent relief?
Osteoarthritis of the knee
Osteoarthritis or “Bone-on-bone” knee problems are the end result of a knee that has broken down and become unstable.
The knee is held together by thick strong bands of connective tissue such as the tendons that hold the supporting muscles to the bone and the ligaments including the ACL (anterior cruciate ligament), that hold the bones together. When these bands become weak and loose (ligament laxity) they cause the knee to become unstable. In this unstable state, the shin and thigh bones come together and begin to wear away at the articular cartilage that covers the bones and the meniscus, the soft pad between the shin and thigh bone.
Over time, the meniscus can get pinched between the bones and an arthroscopy is recommended by some physicians to alleviate the pain by removing the “trapped” tissue. Eventually a knee replacement may be called for.
When we see a patient in this situation we attack the osteoarthritic knee with Prolotherapy. Our goal is not to delay surgery or provide temporarily relief. Our goal is to provide a permanent, non-surgical, non-drug cure to the patient’s pain.
What is Prolotherapy and how does it work?
Prolotherapy is a simple treatment as Dextrose, (sugar in its simplest form) is injected with a mild analgesic such as dentist grade Novocain into the knee area. The injection causes a small controlled inflammation which in itself mimics the body’s natural healing response to injury repair – the creation of collagen. The new collagen repairs the old by attaching itself to the damaged tissue making it denser and stronger and restoring its natural taut state.
Many studies have shown that not only does Prolotherapy strengthen the ligaments and tendons, but more recently that Prolotherapy can regrow articular cartilage and meniscal tissue.
More importantly – theses studies show long-term and often permanent results – far beyond a 6 month expectancy.
If you have knee osteoarthritis and ould like to explore Prolotherapy and/or PRP, finding the right doctor is the first step. Contact Dr. Darrow or call 310-231-7000.
A Non-Surgical Option For Your Knee
June 30, 2011 by Dr. Marc Darrow, M.D.
Filed under Knee Pain
Over the years we have seen many patients with various knee problems and have found Prolotherapy to be a very effective treatment in not only alleviating pain but also in strengthening the knees by making the ligaments, tendons and other soft tissue stronger within the joint.
Prolotherapy is short for “proliferation therapy,” Proliferation, of course, means “rapid production.” What Prolotherapy rapidly produces is collagen and cartilage. Collagen is a naturally occurring protein in the body that is a necessary element for the formation of new connective tissue that holds the skeletal infrastructure together. These include, tendons, ligaments, muscle fascia and joint capsular tissue.
Prolotherapy helps make collagen through a series of injections, not of collagen, but of mild chemical or natural (such as dextrose-sugar) irritants, that stimulates the immune system’s healing mechanism to produce collagen naturally. Making collagen makes for strengthened and restored joints. Restored and strengthened joints makes for permanent pain relief.
Please watch as a Prolotherapy treatment is applied to the knee. If you are interetsed in making an appointment, call us 1.800.734.2210 or contact us via the web – Contact Dr. Darrow
Prolotherapy and Knee Pain Articles
April 12, 2011 by Dr. Marc Darrow, M.D.
Filed under Knee Pain
NEW Knee Pain Forum
When faced with the ACL treatment decision, a patient will usually weigh two options, surgery or no surgery. There are a lot of opinions offered as to which path the patient should take. Every ACL injury is unique to the patient, so this question is best asked of your physician and better yet, a second opinion physician. ACL surgery is an elective surgery and many athletes have chosen not to have it.
Preventing ACL injuries in elite athletes
Diagnosis of knee injuries is, in my opinion, too dependant on many large machines and invasive techniques. Your knee hurts so you visit the orthopedist, here he uses his tools to figure out why your knee hurts. While some of these tools are very impressive indeed, are they accurate?
To understand the theory (and folly) of this seemingly “harmless” procedure, one needs to understand the physiological composition of the joint. Most of the joints in the body are synovial joints, which are flexible and self-lubricating.
Removing tissue from your knee through surgical intervention can only make your knee weaker in the long run and prone to arthritis because removal of tissue decreases the shock absorption capabilities built in to protect the knee.
It is easy to twist a knee, bang a knee, land the wrong way, there is a lot of reasons, arthritis comes up, those are some of the reasons. Also a lot of Chondromalacia patella, that is where the knee bone kind of cracks a little bit against the femur, the thigh bone.
When the doctor says: “I am recommending surgery, ultimately you will probably need a knee replacement due to the damage in there.” There are two choices to make when the doctor says these words to you. One, accept your destiny and continue to live with an unstable and painful knee until the surgeon calls, or find a solution to your pain now.
To someone wearing a knee brace, who regularly tapes ice on their knee and takes prescribed and over-the-counter pain medication, what else could there be but surgery? How about Prolotherapy?
How Do You Tell A Patient Their Knee Brace Won’t Work For Them?
There are many ways to treat a knee injury, surgery, rehabilitation, and less evasive techniques such as acupuncture, trigger point injections, prolotherapy, exercise and specialized training. These therapies and treatments are carried out by a wide range of medical professionals and while many rehabilitation specialists do not agree on which method is best, the one thing that most agree on is that the use of a knee brace to either prevent a knee injury or help support and provide comfort will not work for everyone.
Discussions with callers to our radio program about ACL problems
Knee Replacement Alternative
March 29, 2011 by Dr. Marc Darrow, M.D.
Filed under Knee Pain
Patient’s Story
Medial arthrotomy, Lateral arthrotomy, and Two Arthroscopies – Then Prolotherapy.
Recently we saw a 65 year old male patient with knee problems. The patient lived an active lifestyle playing sports, lifting weights, and traveling, unfortunately this also lead to chronic knee pain.
His past medical history included four procedures on his right knee: medial arthrotomy, lateral arthrotomy, and two arthroscopies. He also had surgery on his left knee to repair a quadriceps rupture.
The pain he felt was constant and made it difficult to walk. On a scale of 1 to 10 with 10 being the worse, the patient said he was a “7.”
After seeing an orthopedist, who recommended knee replacement surgery, he came to our clinic hoping to avoid surgery.
His X-rays showed severe end stage osteoarthritis of the right knee with lateral luxation, complete ablation of the medial joint space and marked narrowing of the lateral joint space. On physical exam, the patient had a noticeable limp, decreased flexion to 100 degrees, and crepitus.
Figure 1. X-ray, weight bearing, upright (knee): Severe osteoarthritis in the medial compartment of right knee
The patient started to get relief after a month of weekly Prolotherapy injections. Around that time, he noticed he was able to kneel down while gardening without pain. He also felt less pain when bending his knees.
After two months of Prolotherapy, he was nearly pain-free and began doing pilates again.
Currently, his knee does not restrict his activities and he is back to traveling and being active. He has no noticeable limp while walking and very little pain. He had a x-ray of his right knee taken in October 2009 which showed an increase in the joint space, especially the medial compartment, as compared to his previous x-ray. On physical examination, he had decreased crepitus and increased range of motion.
Figure 2. X-ray knee (5 months after prolotherapy): Increased medial compartment space
The patient is now able to resume his active lifestyle and travels frequently
without worrying about his knees.
Injury To The Meniscus
March 29, 2011 by Dr. Marc Darrow, M.D.
Filed under Knee Pain, Meniscus
The meniscus or menisci are the thick, strong cartilage-like shock absorbers that cushion and pad the knee between the thigh (femur) and shin (tibia) bones. Shaped like the letter “C,” the meniscus of each knee provides stability in carrying the weight of the body or in gliding through the knee’s many range of motions.
The meniscus can become problematic either through traumatic injury, or age and wear and tear.
Wear and tear can occur in runners, people who have jobs that require a lot of physical activity where stresses to the knees are applied, or in older people where the degeneration of the cartilage causes tearing in the meniscus.
Meniscus injuries in sports are often caused by impact or in sharp cutting or turning when the meniscus can becomes trapped between the femur and the tibia. Typically an injury to the meniscus will occur in combination with ligament injuries, especially the MCL (medial collateral ligament). One of the worst injuries “O’Donahue’s Triad” occurs when the knee is struck from the outside with enough impact to tear the meniscus and rupture the Anterior Cruciate Ligament and medial collateral ligament.
In simplest terms, the meniscus is a cushion that protect the knee from the daily grind and from sports related impacts. When torn, the damaged area is often removed surgically.
Common sense tells us that when we remove padding, there is less cushion. When you take any padding away from the knee, there is more impact, and knee degeneration may be accelerated. This can lead to future surgeries and knee replacement.
Since the meniscus is involved in knee stability, removing part of it will make the knee less stable.
Cortisone Alternatives and Side Effects
March 26, 2011 by Dr. Marc Darrow, M.D.
Filed under Knee Pain
The damage NSAIDs and anti-inflammatory medications do is permanent and extensive. Effective at reducing pain because of their anti-inflammatory action, cortisone and other Corticosteroids can assault the body with an avalanche of counter-productive side effects if used repeatedly.
Even worse, although exercise normally strengthens the body, studies have shown that when cortisone is injected into the knees, and the patient exercises, there is even greater destruction than with cortisone shots alone, with cartilage cell counts reduced by over 20%.
Steroids inhibit the release of growth hormone and rob the body of calcium and vitamin D.
They also interfere with the development of new tissue growth and disrupt the processes that lead to new cell and blood vessel formation.
Corticosteroids inhibit the synthesis of proteins, collagen, and proteoglycans in articular cartilage by inhibiting chondrocyte production, the cells that comprise and produce the articular cartilage.
The net catabolic effect (chemical decomposition) of repeated corticosteroids is inhibition of fibroblast production of collagen, ground substance, and angiogenesis (new blood vessel formation).
The result is weakened synovial joints, supporting structures, articular cartilage, ligaments, and tendons. This weakness increases the pain, and the increased pain leads to more steroid injections.
Prolotherapy Performed On The Knee
March 19, 2011 by Dr. Marc Darrow, M.D.
Filed under Knee Pain
Knee Pain Forum
March 18, 2011 by Dr. Marc Darrow, M.D.
Filed under Knee Pain
A Patient’s Story:
Medial arthrotomy, Lateral arthrotomy, and Two Arthroscopies – Then Prolotherapy.
Recently we saw a 65 year old male patient with knee problems. The patient lived an active lifestyle playing sports, lifting weights, and traveling, unfortunately this also lead to chronic knee pain. His past medical history included four procedures on his right knee: medial arthrotomy, lateral arthrotomy, and two arthroscopies. He also had surgery on his left knee to repair a quadriceps rupture.
Read a patient’s story
Knee Pain Case History
FV is a 48 year old man with a 3 month history of bilateral knee pain.
The patient was initially seen by a rheumatologist, and given a steroid injection which gave him relief of his pain for 6 months. The pain; however, would return, and another steroid injection provided only minimal relief.
Plagued with pain, and searching for answers, the patient went to see an orthopedic surgeon who ordered an MRI, which revealed a right medial meniscus tear.
An Arthroscopy was recommended; however, FV did not wish to pursue a surgical treatment. Patient was therefore given mobic for symptomatic pain relief, and told to await his eventual need for a total knee arthroplasty.
Seeking alternative therapies, the patient came to the Darrow Sports & Wellness Institute, after a referral from a close personal friend and current patient of Dr. Darrow.
Upon his visit to our office, FV reported significant and worsening right knee pain, described as sharp, and worse with bending of the knee.
After examination, FV was thought to be an optimal candidate for treatment with prolotherapy. He underwent his first prolotherapy treatment into his right knee on 4/20/10.
On 4/29/10 patient returned for his second treatment and reported that the only pain he experienced had been one day prior to his visit at the gym, while running.
He reported a 70% improvement after his first treatment.
On 5/17/2010 patient returned for his third treatment of his right knee, and reported complete resolution of his knee pain.
Ligament Instability and Revision Total Knee Arthroplasty
Researchers writing in the medical journal Der Orthopäde examined how loose ligaments played a role in the need for follow up (revision) knee surgery.
Graichen H, Strauch M, Katzhammer T, Zichner L, von Eisenhart-Rothe R. [Ligament instability in total knee arthroplasty - causal analysis.] Orthopade. 2007 Jun 21;
The researchers examined 135 knee revisions and noted that
-In 32.6 % of all cases, ligament instability was the primary reason for revision.
-In another 21.6%, ligament instability was identified as a secondary reason for revision.
They concluded: Ligament instability is a common reason for revision total knee arthroplasty (TKA).
Prolotherapy as an option
Question: I have a knee that a couple doctors told that I should have a knee replacement surgery. It is pretty swollen and sore, I sure would like to avoid the knee surgery.
Dr. Darrow: With this process of Prolotherapy there is a very good chance of building up enough collagen and cartilage so that you can walk around, hopefully pain free after a few series of injections. Surgery is something, it seems to me, that is something that should be the last option.
Golfer’s Knee
Question: I am over 50, play a lot of golf and have been having a problem with my left knee, the pain comes and goes. I am over 50.
Dr. Darrow: This is typical in older golfers because when they were younger, they were taught to keep their feet parallel in their swing and then roll over the heel of their left foot. It’s not taught like that today because that technique puts great stress on the knee and ankle. Today there is more of a theory of opening up the left foot even to 45 or 90 degree angle so that during the follow through there is less stress placed on the left leg.
We use to do something called a “Reverse C,” where we would throw our heads way back, that was popular 20-30 years ago, and what that would do is torque the whole body and golfers would suffer from terrible back problems, terrible knee pain, terrible ankle pain, terrible foot pain.
We teach our patient golfers to open up that knee and prevent those problems. The nice thing about Prolotherapy is that it really helps with knee pain. It takes three four injections and typically we can help that pain.
Workout Knee
Question: I am 52 and have knee pain after working out. What can I do other than surgery?
Dr. Darrow: At 52 the Collagen in the body starts breaking down, actually it starts in our 40′s and even younger but we start to notice it in our 40′s as we start getting wrinkles around our eyes and on our faces.
As we see in the skin on our faces, the collagen in our knees starts to go and as we continue to work out there is obviously a stress on the joint.
Most knee pain that we see is called Chondromalacia patella. Malacia means break down, condro means cartilage, patella means the back of the knee bone, which is called the patella, (and there) is the thickest cartilage in the body. It starts rubbing the wrong way against the tract that it slides in and with repetitive use like running or stair climbing, things of that nature, any sport really, the repetitive use just wears out the back of that knee cap and begins the arthritis process and pain.
It is also made worse when you are sitting in a movie theater or you are in an airplane and stuck in one place for a long period of time. Often times people can have a little meniscus tear, the meniscus is a little cushion inside the knee. Prolotherapy helps grow back all of this tissue.
Before you decide on surgery, explore Prolotherapy, because of all the things Prolotherapy works on, it works fastest in the knees.
Exercise or Surgery for Chronic Patellofemoral Pain Syndrome?
Study says exercise program just as good as arthroscopy.
Researchers writing in the medical journal BMC Medicine examined the efficacy of arthroscopy in patients with chronic chronic patellofemoral pain syndrome. They split 56 patients into two groups. Those receiving knee arthroscopy and an 8-week home exercise program and those treated with the 8-week home exercise program only.
They found that “Both groups showed marked improvement during the follow-up,” but they added, “In this controlled trial involving patients with chronic PFPS, the outcome when arthroscopy was used in addition to a home exercise program was no better than when the home exercise program was used alone.”
Kettunen JA, Harilainen A, Sandelin J, Schlenzka D, Seitsalo S, Hietaniemi K, Malmivaara A, Kujala UM. Knee arthroscopy and exercise versus exercise only for chronic patellofemoral pain syndrome: a randomized controlled trial. BMC Med. 2007 Dec 13;5(1):38
More about Chondromalacia patella
Knee Braces or NSAIDs for Chronic Patellofemoral Pain Syndrome?
Researchers writing in the medical journal American Family Physican say “there is little evidence to support the routine use of knee braces or non-steroidal anti-inflammatory drugs. Surgery should be considered only after failure of a comprehensive rehabilitation program. Educating patients about modification of risk factors is important in preventing recurrence.”
Dixit S, DiFiori JP, Burton M, Mines B. Management of patellofemoral pain syndrome. Am Fam Physician. 2007 Jan 15;75(2):194-202.
Revision Ligamentoplasty of the Anterior Cruciate Ligament
Recent research examined patients who underwent revision ligamentoplasty of the anterior cruciate ligament (ACL) to assess the functional outcome after this type of surgery”
Rollier JC, Besse JL, Lerat JL, Moyen B. [Anterior cruciate ligament revision: analysis and results from a series of 74 cases.] Rev Chir Orthop Reparatrice Appar Mot. 2007 Jun;93(4):344-50.
DISCUSSION: The functional outcome (of revision) is not as good as after first-intention repair, especially if the initial plasty was done with a synthetic ligament and the knee presented meniscal or cartilage damage.
Do You Recommend Knee Braces?
In our practice we stress the following points on the patient when they request a prescription or recommendation for a brace understanding that we very rarely recommend the use of braces.
First, that the brace must never be thought of as a replacement for a medical treatment.
Second, that the patient must not be allowed to feel a sense of security that the brace will allow them, by itself, to return to a normal active life style.
Third, that perhaps with the exception of the Unloader/Osteoarthritis Brace, and only in certain situations, should a brace ever be used for any extended length of time.
Fourth, in our opinion, rehabilitation for medically treated knees must allow for increased movement and circulation to the knee, two important factors that maybe curtailed with improperly fitted or extended wear of a brace.
Knee pain in the 55 year old skier
We recently had a 55 year old female patient come in, she had bilateral knee pain, both her knees were very painful for about a year. She is a very active person, an avid skier who races during the winter season. It was following last season she started having the knee pain.
She first tried to rehabilitate her knees with physical therapy and did not get good results. She had X-rays of the knees which really didn’t show anything, I just wanted to mention that X-rays mostly just show the bones, they are not great at finding soft tissue issues.
She may have needed an MRI had she gone to another doctor, but came to our office first. You have to be very careful if you get an MRI because they don’t necessarily show where the pain is coming from. They give false positives very often, they may show something that looks terrible but is not the generator of the pain.
Secondly, we did not get the MRI because it is very expensive, we wanted to see how the Prolotherapy worked first.
After the second injection she noticed an improvement in both her knees and decreased pain even after climbing step hills.
She had a third Prolotherapy session and she is doing much better. For knees it is usually the third or four visits, sometimes one time depending on the extent.
Do I need to get an MRI of this person to find out what is going on if she feels great? No, we don’t need too. We occasionally do it when someone does not have great results with their treatment.
Injury To The Meniscus
The meniscus or menisci are the thick, strong cartilage-like shock absorbers that cushion and pad the knee between the thigh (femur) and shin (tibia) bones. Shaped like the letter “C,” the meniscus of each knee provides stability in carrying the weight of the body or in gliding through the knee’s many range of motions.
Knee Pain Treatments In Older Adults
Researchers writing in medical journal Rheumatology (Oxford, England) examined the way older adults with knee pain were treated in primary care. What they found was “Interventions recommended as core treatment for knee pain in older adults were underused-in particular, exercise, weight loss and the provision of written information. There appeared to be early reliance on pharmacological treatments with underuse of non-pharmacological interventions in early treatment choices.”
What the researchers noted:
201 adults were interviewed.
These pateints had each been advised:
1. heat and ice (84%)
2. paracetamol (non-opioid analgesic) (71%)
3. compound opioid analgesics (59%)
4. non-selective non-steroidal anti-inflammatory drugs (59%).
“Three core treatments forknee pain(written information, exercise and weight loss) were advised to 16%, 46% and 39% of the participants, respectively.”
“Referral to surgery was commonly initiated before more conservative options had been tried.”
Porcheret M, Jordan K, Jinks C, Croft P; Primary Care Rheumatology Society. Primary care treatment of knee pain–a survey in older adults.Rheumatology (Oxford). 2007 Nov;46(11):1694-700. Epub 2007 Oct 15.
Another Option
A very conservative treatment we specialize in is Prolotherapy because it works on most knee problems with excellent results. Prolotherapy is a simple injection of dextrose and a local anesthetic, like those used in dentistry work. What the dextrose does is start a very small inflammatory response in the body. Inflammation kicks up the immune system, the immune system brings up fibroblasts which are small cells that produce collagen. In other words the collagen metabolism spoken of before is stimulated. A few injections is of course a lot less invasive than surgery, not to speak of the rehabilitation effort following surgery in comparison.
Prolotherapy Rebuilds Cartilage
March 18, 2011 by Dr. Marc Darrow, M.D.
Filed under Knee Pain, Prolotherapy Treatment Information
Removing tissue from your knee through surgical intervention can only make your knee weaker in the long run and prone to arthritis because removal of tissue decreases the shock absorption capabilities built in to protect the knee.
Why remove tissue then? Because some physicians believe that the meniscus, the piece of cartilage between the femur and the tibia, does not have the ability to be repaired, either by regular body repair mechanisms or surgery. So it is shaved, smoothed, or partially removed. Years ago, when a meniscus was injured, the standard protocol was complete removal. Many of these patients were forced to have knee replacement years later because of the severe pain from the meniscus removal.
A recent study, (Reeves KD Hassanein K Randomized prospective double-blind placebo-controlled study of dextrose Prolotherapy for knee osteoarthritis with or without ACL laxity. Alt Ther Hlth Med 2000;6(2):37-46,) showed that Prolotherapy stimulates the growth of articulate cartilage. In a future article we will discuss Prolotherapy treatment in great detail as well.
In this study, people who had knee arthritis, and, who suffered from knee pain for an average of eight years or more, received Prolotherapy treatment over a six month period. Important to note is that 35% of the knees examined for the study had no cartilage remaining in one or more major compartments.
Prolotherapy to the Knee
Before Prolotherapy After Prolotherapy
Bone-On-Bone space between bone
Arthroscopy
March 18, 2011 by Dr. Marc Darrow, M.D.
Filed under Knee Pain, Wrist Pain
To understand the theory (and folly) of this seemingly “harmless” procedure, one needs to understand the physiological composition of the joint. Most of the joints in the body are synovial joints, which are flexible and self-lubricating.
The ends of the bones are covered with a protective substance known as articular cartilage. These thin coatings are separated by a layer of synovial fluid, which further cushions and lubricates them where they meet to form the joint.
Ligaments add support and hold the joints together. Tendons secure the muscles, which provide movement to the body. The whole structure is wrapped in a capsule of tissue known as the synovial membrane, which also secretes the lubricating and somewhat revitalizing synovial fluid.
The knee and the wrist joints also contain pads of fibrous cartilage, known as menisci, which help these overworked joints bear the extra stresses to which they are often subjected.
The articular cartilage which protects the inner surfaces of the joints is a homogenous substance devoid of nerves, lymphatic vessels or blood cells, made up primarily of water, collagen and specialized proteins (proteoglycans). Its structure is fairly simple; it contains a small percentage of cells known as chondrocytes, which are solely responsible for the maintenance and repair of the articular cartilage, via their ability to synthesis collagen and proteoglycans.
The high water content of the articular cartilage, coupled with the innate compressibility of the proteoglycans, give it the slick, cushioning properties so essential to maintaining healthy, pain free joints, minimizing friction and stress between the bones.
All the available evidence seems to indicate that chondrocytes are fully capable of regenerating articular cartilage throughout the course of a lifetime, which would account for the healthy cell counts even in very old people. However, since they are not fed by blood vessels, they are wholly dependent on nutrient delivery from the synovial fluid; this lack of blood supply puts a damper on their proliferative capabilities.
It is the movement of the joints that loads nutrients into, and waste out of, the cartilage. Despite their limited metabolic resources, chondrocytes can still churn out large quantities of collagen and proteoglycans.
The invasive tools of arthroscopic surgery are used to excise injured ligaments, cartilage and meniscus (which leads to a further depletion of the articular cartilage because the meniscus supplies nutrients to it)—either through shaving or slicing with a high-powered electrical instrument. The immediate result is a temporary respite from whatever pain existed before the procedure— followed by more or less permanent weakness and instability in the joint.
Unfortunately, such “collateral damage” seems more acceptable to the industrialized medical establishment than less invasive (and less profit-oriented) therapies like trigger point injections and Prolotherapy. It would be somewhat comforting to know that such intensely destructive procedures are falling from favor, if it weren’t for the fact that other, less obvious, but equally damaging techniques are still widespread.
Discussions from our Radio Show:
KNEE REPLACEMENT
CALLER: I have a knee that a couple doctors told that I should have a knee replacement surge. IT is pretty swollen and sore, I sure would like to avoid the knee surgery.
Dr. Darrow: With this process of Prolotherapy there is a very good chance of building up enough collagen and cartilage so that you can walk around, hopefully pain free after a few series of injections.
It’s an amazing thing. You know any doctor that you go to will tell you that knee replacement is the way to go, and it seems silly to me to jump into a surgery when there is something else that can be done. Surgery is something, it seems to me, should be the last option, and it is very rare for someone to come to our clinic and then have to go onto surgery.
