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 A Patient’s Story
Medial arthrotomy,
Lateral arthrotomy, and Two Arthroscopies – Then Prolotherapy.
Marc Darrow, M.D.,J.D.
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
orthopedic, 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.
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