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Knee injuries.
Treatment with stem cells.
Knee injuries can leave permanent sequelae in people who suffer them, whether post therapy and post orpertorios, many patients come to Novastem after a long time of suffering these affectations, through our stem cell treatments we have achieved many success stories that lead the patient to improve their quality of life.
Anatomical and functional description of the knees
The knee joint is a biaxial and condylar joint, formed by two joints:
Anatomically, several components can be roughly distinguished within the joint:
Bony component. The distal extremity of the femur (femoral condyles and intercondylar notch), the patella with its posterior aspect and the tibial plateau where the menisci are inserted.
Meniscal component. Two menisci (fibrocartilage), the external meniscus is O-shaped and the internal meniscus is C-shaped.
Capsuloligamentous component. On the one hand, the joint capsule, lax, which globally covers both joints and which confers certain stability to the knee when it is in full extension (it relaxes with the flexion of the knee) and, on the other hand, the ligaments and patellar flaps:
- Lateral ligaments. The lateral or lateral external ligament (LLE) and the medial or lateral internal ligament (LLI) provide stability in the lateral plane. They limit the movement of external rotation of the knee.
- Cruciate ligaments. The anterior cruciate ligament (ACL) inserts on the anterior portion of the tibial plateau, in front of the tibial spines and runs backward and outward to the axial aspect of the external femoral condyle. The posterior cruciate ligament (PCL) inserts on the posterior portion of the tibial plateau, behind the tibial spines and runs forward and inward to the internal femoral condyle.
- Patellar flaps. One external and one internal that go from the external and internal border of the patella as a belt, to the external and internal femoral condyles, respectively.
- Musculotendinous component. Numerous muscle bundles are involved in both knee stability and joint mobility (Table 1). They are responsible for much of the pathology of the knee.
Serous bursae. They usually do not communicate with the joint and are the seat of important and frequent knee pathology. They allow the sliding of structures that facilitate knee movements. They stand out:
- Pouch between the semimembranosus and the internal gemellus, which does communicate with the joint and can give rise to the well-known Baker's cyst.
- Subquadricipital bag that also communicates with the joint, easy access, so it can be useful for arthrocentesis and infiltration of the knee. - Pre-patellar bursa, in front of the internal aspect of the patella. - Infratellar bags, the deep one behind the patellar tendon and the superficial one, in front of the patellar tendon and subcutaneous.
- Goose foot bursa. Finally, the vasculonervous component should not be forgotten. It should be noted that the most important elements are the common sciatic nerve, which bifurcates into its terminal branches, and the popliteal vein and artery.
Finally, the vasculonervous component should not be forgotten. It should be noted that the most important elements are the common sciatic nerve, which bifurcates into its terminal branches, and the popliteal vein and artery.
Symptoms of knee injuries
The location and intensity of knee pain can vary depending on the cause of the problem. Signs and symptoms that sometimes accompany knee pain are:
- Swelling and stiffness
- Redness and warmth to the touch
- Weakness or instability
- Popping or cracking sounds
- Inability to fully straighten the knee
Possible Causes of Knee Injuries
Knee pain may be due to injuries, mechanical problems, and some types of arthritis, among other problems.
Injuries. A knee injury can affect any of the ligaments, tendons, or fluid-filled sacs (synovial sacs) that surround the knee joint, as well as the bones, cartilage, and ligaments that make up the joint itself. Some of the most common knee injuries include the following:
Anterior cruciate ligament injury. The injury of the anterior cruciate ligament is the tear of that ligament, which is one of the four ligaments that connect the tibia with the femur. Anterior cruciate ligament injury is particularly common in people who play basketball, soccer or other sports that require sudden changes in direction.
Patellar dislocation. This occurs when the triangular bone that covers the front of the knee (patella) slips out of place, usually to the outside of the knee. In some cases, the kneecap may remain dislocated, and the dislocation can be seen.
Hip or foot pain. If you have hip or foot pain, you can modify your gait to feel less pain in the joint. However, altering the way you walk can cause more stress on the knee joint and knee pain.
Types of arthritis
There are more than 100 different types of arthritis. The varieties that most commonly affect the knee are as follows:
Osteoarthritis. Sometimes called degenerative osteoarthritis, this is the most common type of arthritis. It is a wear-and-tear condition that occurs when the cartilage in the knee deteriorates with use and age.
Rheumatoid arthritis. The most debilitating type of arthritis is rheumatoid arthritis, an autoimmune condition that can affect virtually any joint in the body, including the knees. Although rheumatoid arthritis is a chronic disease, it often varies in intensity and can even come and go.
Gout. This type of arthritis occurs when uric acid crystals build up in the joint. Although gout usually affects the big toe, it can also appear in the knee.
Pseudogout. Pseudogout, a condition often confused with gout, is due to the formation of calcium-containing crystals in the synovial fluid. The knees are the joints most commonly affected by pseudogout.
Septic arthritis. Sometimes the knee joint can become infected, resulting in swelling, pain and redness. Septic arthritis often occurs with fever, and there is usually no trauma before the onset of pain. Septic arthritis can quickly cause general damage to the knee cartilage. If you have knee pain with any of the symptoms of septic arthritis, contact your doctor immediately.
Other problems
Patellofemoral pain syndrome is a general term that refers to pain arising between the kneecap and the femur below it. It is common in athletes, in young adults, especially those whose kneecap is not properly held in its groove, and in older adults, who usually have the condition as a result of arthritis in the kneecap.
Risk Factors
There are several factors that can increase the risk of suffering knee problems, among them:
Overweight. Being overweight or obese increases the strain on knee joints, even during common activities such as walking or going up and down stairs. It also increases the risk of osteoarthritis by accelerating the breakdown of joint cartilage.
Lack of flexibility or muscle strength. Lack of strength and flexibility can increase the risk of knee injuries. Strong muscles help stabilize and protect joints, and muscle flexibility can help achieve full range of motion.
Certain sports and occupations. Some sports put more stress on the knees than others. Downhill skiing, with the stiff ski boots and potential falls, the jumping and twisting of basketball, and the repeated impact absorbed by the knees when running or jogging increase the risk of knee injuries. Jobs that require repeated stress on the knees, such as construction or farming, can also increase risk.
Previous injury. Having had a previous knee injury makes it more likely that you will reinjure your knee.
Complications
Not all knee pain is serious. But some knee injuries and diseases, such as osteoarthritis, can lead to more pain, joint damage and disability if left untreated. And having a knee injury – even a minor one – makes you more likely to suffer similar injuries in the future.
Prevention
While it’s not always possible to prevent knee pain, the following suggestions can help prevent injury and joint deterioration:
Maintain an appropriate weight, with no extra pounds. Maintain a healthy weight; it’s one of the best things you can do for your knees. Every extra pound puts extra stress on your joints and increases the risk of injury and osteoarthritis.
Stay in shape for sports. To prepare your muscles for the demands of sports, take time for conditioning.
Practice to perfection. Make sure you use the best technique and correct movement patterns in your sport or activity. Classes with a professional can be helpful.
Gain strength, maintain flexibility. Muscle weakness is the leading cause of knee injuries. You’ll benefit from strengthening your quadriceps and hamstrings, the muscles in the front and back of your thighs that help support your knees. Training to improve balance and stability helps the muscles around your knees work together more effectively.
And because tight muscles can also promote injury, it’s important to stretch them well. Try to incorporate flexibility exercises into your workout.
Exercise smart. If you have osteoarthritis, chronic knee pain or recurring injuries, you may need to change the way you exercise. You could swim, do aqua aerobics or another low-impact activity at least a few days a week. Sometimes limiting high-impact activities is enough to relieve pain.
If you still have not solved the after-effects after suffering a knee injury, Novastem can help you, schedule a consultation with one of our specialists.
Treatment
Treatments vary according to the exact cause of the knee pain.
Medications
Your doctor may prescribe some medications to relieve pain and to treat conditions that cause knee pain, such as rheumatoid arthritis or gout.
Therapy
Strengthening the muscles around your knee will make your knee more stable. Your doctor may recommend physical therapy or different types of strengthening exercises depending on the specific condition that is causing your pain.
If you are physically active or play sports, you may need exercises to correct movement patterns that may be affecting your knees and to establish good technique during sport or activity. In addition, exercises to improve flexibility and balance are important.
Orthotics, which sometimes have a wedge on one side of the heel, can help reduce pressure on the side of the knee most affected by osteoarthritis. For certain conditions, different types of knee braces may be used to help protect and stabilize the knee joint.
Injections
In some cases, your doctor may suggest injecting medications or other substances directly into the joint. Examples include:
Corticosteroids. Injecting a corticosteroid medication into your knee can help reduce the symptoms of an arthritis flare-up and relieve pain for a few months. However, these injections are not effective in all cases.
Hyaluronic acid. Hyaluronic acid, a thick fluid similar to that which naturally lubricates joints, can be injected into the knee to improve mobility and relieve pain. While studies have yielded varying results about the effectiveness of this treatment, the relief provided by one injection or a series of injections can last up to six months.
Platelet-rich plasma (PRP). Platelet-rich plasma contains a concentration of many growth factors that reduce inflammation and promote healing. Some studies have shown that platelet-rich plasma may benefit certain people with osteoarthritis, but more studies are needed.
Surgery
If you have an injury that may require surgery, it is usually not necessary to have surgery right away. Before making a decision, consider the advantages and disadvantages of both non-surgical rehabilitation and surgical reconstruction, keeping in mind what is most important to you. If you choose surgery, options include:
Arthroscopic surgery. Depending on the injury, your doctor may be able to examine and repair joint damage with a fiber-optic camera and long, thin tools inserted through small incisions around the knee. Arthroscopy may be used to remove loose bodies from the knee joint, to remove or repair damaged cartilage (especially if it is blocking the knee), and to reconstruct torn ligaments.
Partial knee replacement surgery. In this procedure, the surgeon replaces only the most damaged part of the knee with metal and plastic parts. The surgery can usually be performed through small incisions, so you are likely to heal faster than with surgery to replace the entire knee.
Total knee replacement. In this procedure, the surgeon cuts the damaged bone and cartilage from the femur, tibia and patella, and replaces them with an artificial joint made of metal alloy, premium plastics and polymers.
Osteotomy. This procedure involves removing bone from the femur or tibia to better align the knee and relieve pain caused by arthritis. This surgery may help you delay or avoid total knee replacement surgery.
If you still do not solve the sequelae after suffering an injury to your knees, Novastem can help you, schedule a consultation with one of our specialists.
Benefits of Using Stem Cell Treatment for Knee Injuries
Stem cells promote self-healing of the knee joint cartilage. In osteoarthrosis of the knee, a gradual change in the immune system occurs, the cartilage is damaged, the bone structure is remodeled and chronic inflammation of the synovium develops.
Mesenchymal stem cells have been shown to regulate the immune system response, inhibit inflammation, stimulate blood vessel growth, repair tissue and stimulate cartilage self-regeneration.
Stem cells and Platelet Rich Plasma (PRP) are easily harvested from the patient to be treated, ensuring that there will be no rejection.
A stem cell transplant therapy can benefit patients with knee injuries in several ways: improving range of motion, reducing swelling and stiffness, and possibly delaying or eliminating the need for surgery. We want patients to be able to continue the activities they enjoy so much.
How do we do it at Novastem?
Over the years, numerous attempts have been made to discover medical and non-medical treatment options for this condition. In some cases, medical treatments have led to increased survival and improved quality of life, and options for non-medical therapeutics have emerged.
Novastem’s goal with our treatments is to reverse the lack of functionality, eliminating pain and allowing you to enjoy 100% of daily activities and life again.
In Novastem we have the strictest protocols of acceptance to treat a patient laboratory studies are performed before each therapy, we use for joint injuries injection of mesenchymal stem cells derived from bone marrow with platelet-rich plasma or PRP, the treatment is guided by ultrasound and / or fluoroscopy of a single day with or without anesthesia for direct application in the area to be treated.
If you still do not solve the sequelae after suffering an injury to your knees, Novastem can help you, schedule a consultation with one of our specialists.