If you are experiencing knee pain even when moving the leg slightly, or get up from a sitting position or walk for a small distance without having any pain, then you should be worried. You are among those who have arthritis of the knee joint.
Arthritis is of more than 100 types. And knee osteoarthritis is the commonest among them. In osteoarthritis of the knee joint, the articular cartilage starts wearing. Articular cartilage is a stiff, rubbery tissue that is very smooth and covers the ends of the femur, tibia, and patella. This articular cartilage helps in the smooth gliding of the bones over each other.
With degeneration of cartilage, smooth movements of the bones reduce gradually. At one point in time, the cartilage completely wears out and the bones start rubbing against each other. This causes severe pain. There is stiffness in the movement of the knee joint. Performing even a small movement creates severe pain which is so debilitating that patients start to avoid those works.
The commonest forms of arthritis are rheumatoid arthritis, osteoarthritis, and gout; and osteoarthritis is the most prevalent among them.
Adverse effects of medications
Opioids, antidepressants, or anti-epileptics relieve severe or debilitating pain.
These medications provide only symptomatic relief but do not help in cure. NSAIDs use over the long term causes severe adverse events like gastrointestinal bleeding, liver damage, etc. While with antidepressants the patients are drowsy and opioids can become habitual.
However, the newer modality of treatment using regenerative medicine has proved its safety and efficacy in the treatment of early osteoarthritis. It has given new hope to patients with early osteoarthritis.
Evidence-based medicine has shown that it can relieve pain, safeguard the function of the knee joint, and can even regenerate the cartilage.
Autologous Adipose-Derived Stromal Vascular Fraction
Adipose-derived Stromal Vascular Fraction (Ad-SVF) contains a heterogeneous mix of adipose stromal cells, progenitor cells, pericytes, T-regulatory cells, endothelial progenitor cells, anti-inflammatory M2 macrophages, extracellular matrix, and many other cells types.
The articular joint space received the injection of these cells. The differentiating abilities of these cells help in the formation/repair of the tissue to which they attach with.
This ability helps the formation of cartilage and tissue repair inside the joint.
The process is done in these basic steps – lipoaspiration of adipose tissue, tissue dissociation using sonication, centrifugation, and filtration which takes around 40 minutes.
The stromal vascular fraction is very safe in comparison to other treatment modalities:
- Firstly, it is autologous, which means, the cells obtained are of the patient’s own.
- Secondly, the processing and administration of the injection are done in the same single surgical sitting
- There are no age limitations for this treatment
- Preferred in the early grade of osteoarthritis
- BMI of the patient is not a limiting factor
- Done under local anesthesia
- Patients can start walking from the same day
- No limitations even in patients with other comorbidities like hypertension, diabetes mellitus, etc. and can be recommended even in patients with major heart surgery
The patient can feel the effect (reduction in pain) within the first week of the treatment and by 3-4 weeks, the patient can get back to their normal activities.
There is clinical evidence that reported the growth of cartilage over time. Thus, it provides long-term benefits and in many cases gives freedom from further intervention.
But if there is severe deterioration of knee cartilage (late-stage osteoarthritis), the only option available is to go for surgical intervention.
This therapy is not recommended if the patient is pregnant, or having any blood disorders, or is too lean to obtain sufficient adipose tissue, or having any ongoing infection, or having gout or pseudogout, or is having any chronic terminal disease like cancer.
Tags: early osteoarthritis, regenerative medicine
