Has anyone had a PRP injection in a joint for severe arthritis/pain? I currently have severe osteoarthritis (bone on bone) with significant pain in my right knee which completely limits my mobility and ability to exercise. I tried steroid injections, gel injections and low dose radiation therapy to no avail. I currently take a cocktail of pain meds - tramadol, ibuprofen, acetaminophen - several times a day but this just takes the edge off - the pain never completely goes away. I have oxycodone waiting in the wings. For exercise I use the stationary bike at least 5 X a week (usually more).
I would like to avoid knee replacement surgery if possible as I have read the horror stories of people hospitalized for an injury or surgery that have underlying PD.
Any information would be appreciated.
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Canddy
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I did try injections of platelet enriched plasma for my lumbar facet joints. It did not do any harm but I cannot say it did anything helpful either.
I have researched the effect of various supplements upon osteoarthritis, and there are several that studies have shown to be helpful: curcumin, boswellia, and alpha lipoic acid. I published the details here: tinyurl.com/53fvb4cz
I used PRP for the last ten years of my veterinary practice. It was very good treatment for stifle (knee) arthritis. It requires no special equipment. Torn ACL surgery was 6-8k ten years ago. PRP was $50. Disc disease can respond to PRP but Ozone injections into the disc seemed to work much batter.
My BMI is 22.6, I am 65 and I have hypertension, inflammatory/osteoarthritis, and of course Parkinson's Disease. I take lisinopril, hydroxychloroquine and C/L 500 mg spread in three doses throughout the day. I also have dyskinesia and recently added Gocovri to my regimen.
Okay. First off, boron will do nothing to help you really and I don't know what doctor recommended that. Possibly it was someone with no real knowledge but a lot of opinions for others, since the risk is on others it's easy to do that to people..
Second, you have a chronic, severe and deteriorating situation that is not going to be helped by pain support alone and the platelet-rich blood product is only going to be a palliative at best and a very expensive repeating one at that... it's a temporary assist. And if you have seen some of the commercials showing someone getting arthroscopic surgery in order to scare you into their neighborhood "medical clinic for neuropathy" etc., you are asking for trouble there too, One step above snake oil sales.
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Using pain management medication that is NSAIDs, IE over the counter is going to become problematic because you are going to need them more and more. The problem will be: with aspirin, you will acetylate all of your platelets and expose you to chronic bleeding perhaps all over your body. With the others you're going to put your kidneys and liver at risk. Now if you go to the prescribed products, many of them are opiates and you're going to gradually become addicted as they gradually become ineffective, requiring you to be using more and more and more and therefore you will become an addicted junkie.. plus you will have the heavily degraded joints and you will have those bone spurs which you probably already have since it's part of the osteoarthritis. You are in either stage late three or fully stage 4 of osteoarthritis, at the very least since it is bone on bone your level of impairment is rated "severe." This is going to get worse as you work your way into older age..
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And on top of that you have your pd and the multiple medications load to balance, some of which are psychotropic. And once you start into opiates the PD medications situation may become more complicated or a challenge as well, maybe, opiates in dopamine products are kind of potentially issue prone mix). .
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All this tells me that you should see a doctor, an MD who is an arthroscopic professional for a full workup and full set of recommendations. I think also you're going to have to convince people in a couple other medical specialties, including consultation with your neurologist or whoever is managing your PD situation, and an anesthesiologist, to work with each other, so you are going to want your PD doctor and your GP doctor and your new consultant arthroscopic surgery expert to work with each other as a team, or else you're going to have to fire people on rehire others until you can get folks who will work with each other. Yes it's trouble for someone with PD, but it's also reasonable to think that without the replacement you're might eventually have even more trouble. Maybe..
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This suggests that you may need a multi-specialty clinic, or at least a consult with a multi-specialty clinic put it that way, where they are used to working with each other as a team and cooperating with each other rather than hindering each other or defeating each other.
My guess is you're going to have to seriously think about that replacement sooner or later, long-term is worth a guess, I'm just guessing here, you're going to suffer and become more chronically ill the longer you wait on getting a knee replacement. And you are at risk to become more and more impaired in many ways as your ability to do exercise decreases..
So your outlook is not great without that knee replacement. Maybe you will be fine. It seems to me that if you were being realistic, in my own sometimes admittedly rather blunt way, you really do not have an option. The only luck is that your weight is not extremely obese.
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Now it is still possible to find a good hospital if you do your homework. Likewise it may be possible to have an advocate, if you happen to have a friend or family who's willing to sort of go along and make it a two on one situation like a tag team as you go through all this if you decide to. Otherwise you probably should think of yourself as your own self-advocate role and get a hat to put that on your head so that you know when you were playing that role, because it's important to have that role there and represented even if it's just you by yourself. But do some homework and start doing your homework. Maybe take a few months to get a good done proper job of that homework. When you find a to a good clinic, many of them are associated with good hospitals that are kind of within their family arm reach.. such as Mayo, Cleveland Clinic, some of the hospitals in New york, the Harvard-Boston Brigham Women's, and several other major centers...but even locally this sort of thing is really rather common and you can get good services just about everywhere, I provided you do some homework and are careful to do that homework before you pick a place. Long distance clinics often have a concierge service which will help you find a location and a provider for your rehab that's local, reasonable motels (when we go to Mayo we stay at a local religious hotel which is cut rate, pay them their room and maybe give a donation cheaper regular hotel, the Mayo Concierge Service put us on to the place.). And a good rehab nearby that hospital if you do your homework. Or rehab near you that is good if you do your homework. management so your doctor should be aware of that. Ask your doctors and nurses for who is good and who is not good, what hospitals are good and what hospitals are not good... One trick I have is I ask those people who would you send your loved ones to and who would you not send your loved ones to? I did that with my dentist when getting oral surgery as an example, and he gave me someone who actually was seeing his minor child in a couple weeks. Most people I know who have had knee replacement are very very happy. Very happy. This includes several family members including one who has had both knees done, and several neighbors and friends. Didn't matter the age, we're talking people in 40s all the way up to people in their 90s. I have heard more often than not "Why didn't I do this sooner?"
Now of course these are just one person's best guesses, and they are worth exactly what you paid for them.
Thank you for your very detailed response. Knee replcement surgery is not cmpletely off the table. I have an appointment with an orthopod next week during which time I will discuss all options including surgery.
I did PRP for my tennis elbow. $700!( I have low platelet and white blood cell count.) So the result? Its been 3 months and I have to say- my tennis elbow is the same as before.
BUT I will say that I just did my 2nd visit for "Class 4 laser therapy "on my tennis elbow- and it helped ease the pain after the very 1st session! am thrilled! Painless, noninvasive; so now my son will be going to laser therapy for his chronic pain, as well as my son-in-law, for his shoulder pain ( he is a bodybuilder). Its not covered by insurance- its $85/visit, was about 15 mins long, and the therapist said to go 2x/week for 4 weeks. I AM THRILLED!
hi Canddy, I had my left knee replaced in 2019 and it was one of the worst experiances of my life. A couple of days into recovery I started to feel severe sciatica and eventually it took 3 epidural shots to calm it down. Also, because of the Parkinson's I also developed Panic attack syndrome that I thought was a an interaction between my Parkinson's drugs and my pain meds so I stopped taking my prescription pain meds and just took ibuprofen for my recovery pain which didn't help much. I told my surgeon, my primary care doctor, and my neurologist about the situation and none of them diagnosed panic attack until about 6 weeks later I was a wreck and had my wife take me to a local hospital emergency room where they immediately diagnosed that I was having Panic attacks. I am still on a low dose of sertraline to keep it under control. Don't get me wrong, many people have knee replacements with no problems but I won't have it done to my right knee which is bone on bone. I'm fortunate that it doesn't hurt a lot so I walk, hike, ride my stationary bike, cross country ski and snowshoe along with specific Parkinson exercises every day. I wear a knee wrap on it most of the time but when I hike or ski/snowshoe I wear an un-loader brace. I will add a link from Amazon for the one I just got that works great.
Last summer I aggravated my SI joint and had shock wave therapy along with PRP on it. The pain doctor would do the shock wave which was not too painful, and mark the spots where I had the most pain, then, under x-ray and ultrasound guidance, they injected me in the most painful spots of my SI joint. I ended up having 5 shockwave therapies and 2 PRP sessions and so far so good, I am pain free in my SI joint. Unfortunately, in the US the insurance companies don't pay for it so it cost me about $3,000.
Please don't let my story discourage you from getting done what you need but just be advised that major surgeries can affect Parkies differently than those without Parkinson's disease.
Normally I would not recommend surgery for PWP, but there is such a high success rate with knee replacement that I think it may be worth considering. There are members here who have had it done with no problems. If your pain is debilitating and it’s past the point where exercise can help it may be your best option. I agree with Marion that you need to coordinate with your doctors/team. The good thing is that it doesn’t require a long hospital stay. I think it is generally one to two days and they get you up and moving as soon as possible. I would also recommend that you have someone who can bring you your meds regardless of the rules, so that you are able to be in the best possible shape to deal with the trauma of surgery.
Thank you for this Juliegrace - my pain is debilitating (walking is a problem). I will discuss all options with the orthopod next week. And I already told my husband that if I do choose surgery, he has to bring me my Parkinson's medication while I am hospitalized.
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