 Prolotherapy,
a non-surgical alternative for torn meniscus
Ross Hauser, M.D.
Recently we saw a retired school
teacher. She twisted her knee getting out of a car. She had an
MRI which showed a meniscus tear. Surgery was recommended with
the impression that it would be repaired and that she would
regain full pain-free function of her knee. What did her
surgery report show? As with nearly all of these “meniscus
repair” reports that we see, most show that the meniscus was
indeed not repaired, but removed.
Excerpt from the Surgery
Report:
Pre-op Diagnosis: torn lateral meniscus, left knee.
Post-op Diagnosis: torn lateral meniscus, left knee,
grade III and IV chondromalacia left medial facet, left patella.
Anesthesia: general
Procedure done: …Left knee arthroscopy, debridement of
chondromalacia with ensuing partial lateral meniscectomy and
chondroplasty…
Findings: severe grade 4 chondromalacia of the medial
compartment. Mild patellofemoral changes were seen.
As you can see from the above
report, part of this patient's meniscus was removed, not
repaired.
Not only did the surgeon perform a chondroplasty on the other
side of the knee which involves “reshaping the joint surface,”
which basically means the removal of cartilage tissue. Simply
put the definition of chondroplasty is a surgical technique
where the joint surface is cut, scraped, lasered or burred away
in the hope that the healthy joint surface will heal
over the defect. Are you willing to let someone give you
general anesthesia for something that you hope will
work? We are all for hope and one of our mottos here is “hope
practiced here.” However, we don’t usually tell our patients “We
hope this will work.” We tell our patients that in 90% of cases
such as yours we have been able to resolve the problem. There
are no guarantees in medicine, but the chances for recovery are
excellent with Prolotherapy.
Knee surgery such as
arthroscopy can worsen the pain: The main point in
this example is that the patient came to us post arthroscopy
complaining of much more pain and swelling in her knee
after this arthroscopy! She went in with lateral knee
pain and ended up with lateral and medial knee pain! We
suspect some of her medial knee pain was due to the fact that
the chondroplasty was not successful and somehow in a negative
way altered her chondromalacia! Remember chondromalacia means
cartilage deterioration beneath the knee cap. The best treatment
for this is Prolotherapy. We do not know of any study that
shows long term help for chondromalacia by arthroscopy! We have
documented before and after Prolotherapy x-rays that
Prolotherapy does indeed improve cartilage. This is not this
patient's knee, but another patient's knees - see below:
Should meniscus tears be
removed? You might be thinking to yourself, “Shouldn’t
a meniscus tear be removed?” We feel that the answer to this
question is an emphatic "no!" A person with a torn meniscus
should see an experienced Prolotherapy doctor such as Dr. Hauser
and receive comprehensive Prolotherapy to stimulate the tear to
repair. Yes, you need to alter your activity/exercise regime
while it heals, (ie tennis is probably not a good idea while the
meniscus tear is healing from Prolotherapy), but there are
plenty of exercises you can do while getting Prolotherapy, and
we discuss these at length with our patients. Prolotherapy works
extremely well for meniscus tears. In a study we published in
the Journal of Prolotherapy, 27 of 28 patients with pain from
meniscus injuries and tears were satisfied with the results with
Prolotherapy. Only one patient needed surgery! (1). At Caring
Medical, we also offer more aggressive forms of Prolotherapy
such as PRP (platelet rich plasma) or stem cell therapy (bone
marrow Prolotherapy) to treat these types of injuries.
What to do if you have a
torn meniscus or chondromalacia? Do you or a loved one
have a meniscal tear or chondromalacia? It is our opinion that
the best option is to choose Prolotherapy, not arthroscopy!
Arthroscopy accelerates the road to arthritis. Prolotherapy, by
stimulating the repair of the injured tissue,
has a much better chance at providing a long term solution to
your knee pain. Arthroscopic removal of tissue decreases the
knee’s chances for long term health. By removing tissue such as
the meniscus or cartilage you are in essence “aging” the knee at
an accelerated rate. Aging the knee by 15-20 years with one
procedure, (which can, certainly happen if a lot of the
cartilage or meniscus is removed), just gets the person closer
to a knee replacement. If you don’t want a knee replacement
then consider Prolotherapy instead of arthroscopy!
If you have gotten an arthroscopy,
like and still have the symptoms or you experience worsening of
your symptoms, most likely you will need some Prolotherapy. Our
patient received eight Prolotherapy treatments and is now
entirely well. If we would have seen her before the arthroscopic
removal of her meniscus and cartilage, she would have most
likely required only half as many treatments.
Reference: 1.
The case for utilizing Prolotherapy as first-line treatment for
meniscal pathology: A retrospective study shows Prolotherapy
effective in the treatment of MRI-documented meniscal tears and
degeneration. Journal of Prolotherapy. 2010;(2)3:416-437.
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