Has your physician said you’re not a candidate for knee surgery? If so, what can you do now? And what happens to those referred to as “red knees” or patients who are not candidates for surgery? Fortunately, there are alternatives for the red knee and non-surgical candidates.
The high prevalence of joint injury and the healing ability of joint tissue poses a significant challenge for the orthopedic medical community. Even when the patient is young and healthy, injury puts the patient on the road to degenerative arthritis. But in older patients with ligament instability, arthritis, or systemic disease, the challenge is much more significant, and the options for joint repair are significantly limited. This population of patients is often categorized as “red knees.”
The “red knee” patient is typically left with few treatment options, which may only provide temporary inflammation and pain relief, leaving few options for long-term repair for the “red knee” patients.
The knee injuries of young, healthy patients planning surgery may be referred to as “green knees” because of the patient’s age and health. Patients with “green knees” are commonly included in clinical trials because they have the highest probability of success. But even in these patients, the standard surgical options and arthroscopic repair fall short.
Those with “red knees” are patients with more severe cartilage pathologies and those with co-morbidities that exclude them from the more common surgical procedures. Often, these “red knee” patients are only given palliative treatments such as cortisone, NSAIDs, and hyaluronic acid injections. These treatments are not reparative but only provide possible relief for a few months. These “red knee” patients are often neglected and are typically only given a recommendation for eventual joint replacement.
Regenerative Orthopedics provides a non-surgical answer for both the green and red knee populations. Dextrose Prolotherapy injections may be sufficient for younger patients to repair a knee injury. PRP may also be recommended for certain knee injuries, like meniscus tears. And then, when injuries or degeneration are more severe, Stem Cells may be recommended. All of these procedures are non-surgical, in-office procedures.
Age is the main reason patients are categorized as “red knees, ” excluding them from clinical trials. However, regarding Regenerative Orthopedics, age does not prevent patients from receiving or benefiting from treatments. Many of our patients are older, and they have had successful repair of their knees and/or other joints. Another common exclusion due to “red knees” is the presence of arthritis. But “red knee” patients with arthritis can still benefit from these regenerative therapies.
Ligament instability is another criterion for categorizing a “red knee” patient. Fortunately, Regenerative Orthopedics is the treatment of choice to repair ligament instability. Once an injury occurs, early treatment with regenerative therapies would be beneficial before the joint becomes arthritic.
In previous articles, we discussed the joint instability process that occurs when joint tissues, such as ligaments and tendons, are injured. Basically, these structures weaken and “lax” after injury. Ligament and tendon laxity allow abnormal joint movement. It’s similar to a cabinet hinge that has some screws loose. When the screws and hinge are loose, the cabinet becomes wobbly. When a joint becomes “wobbly,” the joint moves abnormally. With abnormal joint motion, the joint structures begin to degenerate.
Research studies say this: “Although loss of articular cartilage plays a pivotal role in osteoarthritis, the condition is often preceded by joint instability due to soft tissue lesions, such as ligament injury. Prolotherapy studies using dextrose, platelet-rich plasma, and bone marrow have reported success in treating chondromalacia patella and osteoarthritis. Randomized controlled studies have shown the effectiveness of dextrose prolotherapy in treating osteoarthritic knees. Additionally, in a study on knee and hip osteoarthritis, Hauser and Woldin reported the results of a combined dextrose prolotherapy and bone marrow prolotherapy treatment regimen in patients with radiographic osteoarthritis and observed pain relief, improved joint function, and enhanced quality of life.” (1)
Regenerative Orthopedics, like Prolotherapy, PRP, and Stem Cells, stabilize, strengthen, and repair the joint. These are the best treatments for joint instability, as they repair the injured and lax ligaments and tendons. Plus, they are regenerative and can help repair joints, even in cases of arthritis.
Regenerative Orthopedics offers hope for the “red knee” population and an alternative to knee replacement.
Don’t hesitate to call us at 310-453-1234 and find out if you are a candidate.
(1) Hauser, Ross A., et al. “Ligamentous Knee Joint Instability: Association with chronic conditions of the knee and treatment with Prolotherapy.” The Open Pain Journal 16 (2023).
