Cartilage regeneration

[HeronNS]

Thought this might interest some who follow this community:

med.stanford.edu/news/all-n...

[HeronNS]

So far, from what I've read, stem cell therapy is very hit or miss. This technique sounds less scary to me.

[PMRCanada in reply to HeronNS]

Great article! I investigated stem cell therapy in Michigan but the cost was prohibitive and outcomes were not guaranteed. Some folks who have had success swear by it.

The process and quality of cartilage that is generated via the process outlined in the article seems much more “natural” per se. Just not sure how long before it will be used and commonplace. The only part that scares me is the ‘micro fracture’ aspect....my knees are already in bad shape due to OA and a multitude of meniscal and ACL tears.

Thanks for sharing!

[HeronNS in reply to PMRCanada]

My knee on the leg which had a tibial plateau fracture in 2014 and a recent hard fall (nothing broken) isn't bothering me. It's the other knee which has rendered me a semi-cripple for several months. I think this is telling me something, just not sure exactly what!

And x-ray says the "good" knee has worse arthritis.

[HeronNS in reply to PMRCanada]

Stem cell therapy was discussed a while ago on the Patient forum and the results seemed to be either miraculous or a disappointment at best. I guess if the alternative was a joint replacement it would be worth considering, but as far as I know it's still an unapproved experimental treatment.

[HeronNS]

My physiotherapist has been using ultrasound (I asked her to stop that as I think my aging flesh wasn't responding well) low level light therapy (which I've been getting since late 2015 at various times for PMR stiffness and pred withdrawal, as well as my arthritic neck) which is supposed to stimulate healing. We are also discussing whether I should get a brace. You know things are bad when your physiotherapist tells you to stop walking! I now have a cute little under the desk cycle and have worked up to using that for about an hour a day in several sessions.

[HeronNS]

Yikes!

[PainInTheDeltoids]

Hi HeronNS,

I had an acute injury to my knee cartilage two years ago, and had microdrilling (rather than microfracture) of the injury site to get stem cells from the bone marrow inside, without the highfalutin' hormone treatment. Needless to say it didn't work for me. However being on steroids for PMR has made a world of difference to my knee pains.

There is a silver lining somewhere!!

[Jan_Noack in reply to PainInTheDeltoids]

steroids cured my knees. My left was worse and I had been offered and was considering a knee replacement since 2006...just never got around to it as my Mum's had not been a success and I could still hobble. It was mainly downhill anyway or walking the dogs when they pulled...

The pred stopped all the inflammation on the knees and knee pain. I would get a pad of something besides my knees..large beside my left knee. That disappeared. It came back around that dreaded 7.5mg mark so I ended up staying there for a LONG time. I went to the physio and he told me it was lucky I hadn't got the knee replaced as the problem was inflammation to the knee itself. He told me to take Nurofen for 3 or 4 days (which I did reluctantly) and then go up to 8mg for a while and it went away..the gradually reduce again..staying at 7.5mg for a long time as every time I reduced it came back. Now no more knee pain and they work fine.

[PMRpro Ambassador in reply to Jan_Noack]

I had knee pain - especially going downhill - and a rheumy claimed it was OA. After I got pred it improved - and 13 years later there was no sign of osteoarthritis and my knees are fine

[Jan_Noack in reply to PMRpro]

very similar. It seemed to take me about 3.5 years to fully improve...knees are fine now. Had played up and did show some minor damage in joints from probably 2005 ish? (so 15 years ago?) . This is about the time minor PMR -like symptoms would have been appearing so it all fits together. Xrays did show some OA-like wear and tear I think? (I'd have to dig them out and I'm too tired). I assume any damage is still there just now asymptomatic (which is all I care about!).

[HeronNS in reply to Jan_Noack]

I have x-ray confirmed widespread osteoarthritis. It's true when I started pred for PMR all my aches and pains went away, including those associated with OA, but as my dose lowered the OA came back. I don't take anything for it, except glucosamine. Nsaids interfere with cartilage regeneration and it's likely all the pred I've taken over 5.5 years has also done so. I have managed very well but I think activity changes associated with lockdown in March and April caused my leg muscles to become weaker, and now I'm in the state I am now. My hope is I'll get back to where I was before lockdown, but expectations are lower as I may already have bone-on-bone deterioration in one knee.

[Jan_Noack in reply to HeronNS]

I found glucosamine never helped my knees.. just upped my blood sugar I think .I t was back around 2005-7?

[HeronNS in reply to Jan_Noack]

Interesting comment about the blood sugar, but I looked it up and found: "Even though glucosamine is technically a type of sugar, it doesn't appear to affect blood sugar levels or insulin sensitivity. Some early research had suggested that glucosamine might worsen insulin resistance, which can contribute to increases in blood sugar in people with type 2 diabetes. But later studies refuted these findings." On Mayo Clinic site.

I used to think it wasn't helping but a friend told me her husband took it, and he took twice as much as me. So I doubled my daily dose from 1000 mg to 2000 and after a while, not very long but not instantly, did start to notice it was helping. I've been taking it for perhaps thirty years, although I read one should not take it continuously forever. Not sure why. I did stop when I was at my worst with undiagnosed PMR because I thought it had stopped helping; at the time I thought it was OA getting worse, not realizing it was another condition altogether. I take a powder-filled capsule, not a hard tablet or caplet, and with a meal, which I think avoids the digestive problems some people complain about. I also find that Vitamin B6 seems to help, although I take it as part of a complete B coomplex supplement, not wanting to overdose on any one component of B.

[Jan_Noack in reply to HeronNS]

Thanks Heron. I must admit I never tried larger doses. I also like the P5P form of B6 but only 10mg , and definitely not more than 15mg. B6 used to cause migraines if 25mg or over!.. but yes really helped in small doses, and I forget what it did now! sigh. I guess I've been told I was prediabetic back 3 and 4 decades ago. Glucosamine never caused diabetes in me but i thought it may have been increasing my blood sugar and then, long ago, read it did..so I stopped it. I used to monitor my blood sugar and it never went into diabetes level but I think it did go up a little and back down when I stopped it...but honestly I can't remember. I just thought the research at the time fitted with what I was seeing. I'm glad it's working for you.

[nickm001]

long road from mice to man :). Will we be still alive when this new treatment becomes commercially available?

[HeronNS in reply to nickm001]

Live in hope. At least there's a good chance people in the future will be able to avoid suffering such damage.

[karegodd]

Thank you for sharing this article. As a retired physiotherapist of 37 years I find this article hopeful. May not be in my lifetime but helpful for future people suffering from arthritic changes in their joints from whatever reason. I have seen the evolution of treatment in my orthopedic career. Interventions were always made with the knowledge they had at the time. If they can get to a point where they can avoid invasive joint replacement that would be amazing. For my osteoarthritis joints and PMR, low impact activities and pacing are what has to happen. By the way I love the little pedal bike where you sit on a chair.

[HeronNS in reply to karegodd]

Because I have so much trouble walking these days I now have one of those bikes! Am in the process of getting a brace for the bad knee so hopefully I will be able to walk more. I need to get outdoors more often and for longer.

[karegodd in reply to HeronNS]

Prednisone has been the silver lining for my arthritic joints and walking. My joints liked Tai Chi but the classes stopped due to covid. Not as motivated to do on my own. Pole walking may help you get back to walking as tolerated when able. Good luck with the plugging along. I live by the phrase “if you never quit, you never fail”.

[HeronNS in reply to karegodd]

Actually, using my walking poles has enabled me to get out a bit - I would not have been able to go anywhere at all without them.