Knee Pain
Mike Murphy
Mike is a 66 year old male who first presented to Darrow Sports and Wellness Institute 5/06/09. Mike lived an active lifestyle playing sports, lifting weights, and traveling which ultimately led to chronic knee pain. His past medical history included four procedures on his right knee: medial arthrotomy, lateral arthrotomy, and two arthroscopies. He also underwent surgery on his left knee to repair a quadriceps rupture.
Mike had constant pain rated 7 out of 10 which made it difficult to walk. Mike first went to see an orthopedist who recommended a total knee replacement surgery. Mike came to Darrow Sports and Wellness Institute hoping to avoid surgery.
An X-ray on 5/5/09 showed severe 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, Mike had a noticeable limp and decreased knee flexion measured at 100 degrees out of 135 degrees with crepitus during active range of motion.
Upon reviewing his options Mike decided to try prolotherapy instead of a total knee replacement. After just four days from his first injection he noted a 10% reduction in pain. One month after weekly injections with prolotherapy and Mike was able to kneel down while gardening without pain. After 2 months of prolotherapy Mike was nearly pain-free and began doing pilates again. Mike had another Xray taken on 10/09/09 which showed an increase in the joint space, especially the medial compartment, as compared to his previous x-ray. He also had an increase in keen flexion from 100 degrees to 115 degrees.
Figure 2. X-ray knee (5 months after prolotherapy): Increased medial compartment space
Mike is thankful prolotherapy worked for him and he avoided surgery. He is now able to resume his active lifestyle and travels frequently without worrying about his knees. Although he is pain-free he continues to be a patient at Darrow Sports and Wellness Institute and comes in for injections to continue to re-grow tissue. There is no limit to the amount of prolotherapy injections one can receive over time. Mike recently went to see an orthopedist who told him his knee is not degenerating and this time he did not recommend a total knee replacement. Another prolotherapy success!
Nathalia Adrian
Nathalia Adrian is a 68 year old female who presented to our clinic with right knee pain after she took a fall in February 2009. After the fall, she had pain with walking. Physical therapy for a month provided little relief.
Nathalia Adrian came to our clinic in a lot of pain. She rated the pain as 8 out of 10. Her x-ray on the right knee showed degenerative change. We started her on prolotherapy with dextrose (50%) and lidocaine (50%). After her second set of injections she began to feel 80% better and her pain was reduced to 3 out of 10. She continued to receive weekly prolotherapy injections and eventually became 95% better after her 5th injection. She no longer has discomfort while walking and has returned to her regular exercise routine.
Armida Corry
Armida Corry is a 67 year old female who presented to our clinic with right knee pain. The pain started a year ago and severely limited her activities. She could no longer go on walks with her husband and remained in her house due to the pain in her knee. The pain escalated to the point where she had pain at rest. Earlier in the year, she had an operation on the same knee to repair a torn meniscus. The surgery did not provide any relief for her pain.
Her most recent x-ray showed degenerative changes in both femoral tibial compartments with spurring and narrowing of the medial compartment. On examination, her right knee was positive for crepitus without laxity, erythema, or an effusion. She had tenderness at her tibial tuberosity.
After a weekly Prolotherapy injections for a month, she starting noticing improvements in her pain and mobility. She continued receiving treatment and became increasingly better with each injection. Armida is almost pain free now and is able to go on longer walks with her husband. She does not feel her knee limits her activities anymore.
Doug Kruschke
Doug Kruschke, a 68 year old management consultant came to our clinic with right knee pain he had been experiencing for the past 8 months. He noticed the pain while speed walking. The pain was sharp and he felt it was mostly on the inside part of his right knee. Doug went to go see an orthopedist shortly after the injury. He received a cortisone shot from the orthopedic surgeon which brought temporary relief. A few weeks later, his knee was injected with Euflexxa (a form of hyaluronic acid). After receiving a second injection with Euflexxa, he felt relief.
Doug Kruschke’s MRI showed a small tear of his medial meniscus with a 9mm cartilage defect of his medial femoral condyle, chondromalacia of the patella, moderate joint effusion, cartilaginous thinning of the lateral femoral condyle, and edema superficial and deep to the medial collateral ligament. On physical examination, his right knee was mildly tender on the medial aspect with no laxity, effusion, erythema or warmth. He had FROM in bilateral knees. Patellar DTR was 2+.
We treated Doug with prolotherapy. Using a Dextrose/Lidocaine (50/50) injection, we injected 6cc into the right knee and an additional 3cc into the medial meniscus. He got little relief from the 1st injection but received a 50% improvement after the 2nd injection. The pain was lessened and he felt he improvements in his ROM. Also he was able to walk around with less discomfort and more stability. The tenderness on the medial aspect of his right knee was no longer there.
Mike Murphy.
Mike Murphy is a 65 year old male who came to our clinic in May 2009. Mike lived an active lifestyle playing sports, lifting weights, and traveling. This led 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. The pain was 7 out of 10. After seeing an orthopedist, 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, MM 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
Dennis Reitz
Dennis Reitz started having right knee pain about a year ago. He remembers injuring it during a ski trip when he fell directly on his right leg while wearing ski boots. Since October, he has been having pain while getting up from a chair and pain with workouts. He felt his knee was locking up and most movements provided discomfort. The pain had become constant.
In our clinic, his physical examination showed pain with right knee extension and deep flexion. The impression from his MRI was a large complex tear of the posterior horn and body of the medial meniscus, quadriceps tendinosis, defect of the medial femoral condyle articular cartilage, and a joint effusion.
After starting Dennis on prolotherapy, he noticed improved after the first injection. He was walking around easier and the pain was intermittent. He was able to walk longer distances without discomfort. After his fourth treatment, he felt 70% better overall. He had no pain walking down stairs and he was able to start working out in the gym. He is now to the point where he has no pain after riding the stationary bike or working out at the gym.
Gerald Holland
Gerald Holland is a 71 year old male who first presented to Darrow Sports and Wellness Institute on 2/3/2011 with complaints of right knee pain. Gerald does a lot of farming and gardening and would only notice the pain while kneeling down on his right knee. He rated his pain a 7 out of 10. He also had complaints of right rib pain for 3 years from no known injury which bothered him while bending forward. Gerald also rated his rib pain a 7 out of 10. Gerald had seen chiropractors for treatment of his rib pain with no relief.
X-Rays of the lateral view of the knee showed patello-femoral joint space narrowing and chondromalacia.
After his first injection Gerald was amazed that the ribs that had bothered him for 3 years were finally not as painful. The pain decreased from 7 out of 10 to 2 out of 10. After his 3rd injection he was able to kneel on the floor during housework almost pain-free reporting a reduction in pain from 7 out of 10 to 1 out of 10. Gerald also had some injections in his left knee just for a “tune up”. He is pleased with the outcome he has had with prolotherapy thus far and continues to be a patient at Darrow Sports and Wellness Institute.