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.