I had 3rd-degree arthritis in my knee that I developed after 4 surgeries due to a football(soccer) injury.
4 years ago I could only walk with crouches due to pain.
Last month I competed in 2 half-marathons.
I was able to get much much better by doing a lot of PRP (platelet-rich plasma) injections over past years and a single SVF (stromal vascular fraction) injection 1.5 years ago.
My MRI shows that cartilage has grown back significantly (not fully, but I no longer have a gaping hole in it).
I have a friend I am advocating for who has degenerative arthritis in their ankles in their early 30s and are on their way to being wheelchair bound. Are there any resources you could recommend that would enable me to improve their outcome? Your comment is very helpful already, I appreciate it.
Just like in programming, the boring but true answer is "it depends", because every situation is different.
A generic advice that I learned is that muscle-strengthening exercises help A LOT. Basically muscles form a protective corset around your knee and reduce the stress on your joints by a lot.
Also, arthritis often happens due to low blood flow, so as painful as it may be, you have to keep moving, try not to sit too much.
Another generic piece of advice is controlling your weight, this is just simple math, the less you weigh, the less stress your knee receives.
What also worked for me was hyaluronic acid injections, when I was in a lot of pain and it was hard to work on my muscles, hyaluronic acid helped to reduce this pain by being a good lubricant. Probably I am going overboard with it now, but I keep having injections every 3 months just to be safe. It can be of different concentration and volume. If you inject something with a smaller % you have to do it multiple times in a row with 5-7 days between, if you inject something with a higher % then a single injection is okay.
The PRP / SVF part you already read about.
I am also a 31 yo, so while I am young my body is better at regeneration, I don't think elderly people get the same effect from these.
I did 3 sessions x 5 PRP injections with 6 months between sessions. The effect is by no means immediate.
It's certainly a hard road, but better than a wheelchair.
Yes building supporting/stabilizing muscles can do wonders, but as with everything key is to start way before you actually have problems and pain - that's a phase when body is already struggling and failing to fix things long term and degradation happens. Look at your direct ancestors for clues.
Adequate stress on joints from right exercises executed in good form are part of this. Beginners almost never got this right and overdo things, investing into professional help in the beginning is very good idea.
Same with weight - when people react to degrading health due to say being obese, one is beyond point of return in many things comprising overall quality of life and health. Like getting your act together after first heart attack, way too late.
If in pain, generally don't exercise through it, body is saying something ain't right so rather address it. Try things like swimming which put very little stress on the knees yet can work whole body efficiently. You really want to have all parts of body developed well, otherwise you will be always chasing some degradation like whack-a-mole without ever winning.
In case this is useful - I had end stage arthritis in one of my ankles and ended up getting a bipolar ankle allograft in San Diego at Scripps. I barely think about it nowadays except that sometimes after a long hike or strenuous workout it will feel a bit stuff. Considering I could barely walk before it was a night and day difference.
You essentially get a completely new joint surface from a donor and have to be in crutches for 3 months but it was 100% worth it for me. I refused to do fusion and avoided any doctor that said nothing could be done.
I read in a previous post of yours that you did 50!! PRP injections. I was also advised to get PRP injections by a doc, he said a lot of top athletes suffer from cartilage damage, and they do these injections to prolong their careers. But then I was held back because it seemed they had a business from doing these PRP shots, I didn't trust them. They were also pretty expensive, around 500 euros/shot, and you needed to do several. But 50? that seems a lot, and a lot of times you had your blood drawn. In the Netherlands where I live, the doc didn't even mention PRPs, he jumped straight to a microfracture surgery. It felt like the guy was looking for someone to practice surgery on, hate these doctors.
Of those 50 injections around 15 were PRP and the rest were hyaluronic acid injections.
I was doing them back in Russia and a PRP injection there would cost around $80.
I keep doing hyaluronic acid injections every 3 months just to be safe, whatever I am doing it seems to be working, so I continue doing them. Right now I live in Georgia they cost around $105 here ($90 for the syringe, $15 for the doctor).
SVF seemed to have a much stronger effect than PRP, it's hard to quantify, but I would say a single SVF felt close to all the PRPs I did before.
I was recently talking to a colleague of mine from Canada who needs to get shoulder surgery but there's no end in sight for the waiting.
I think it's worth it considering getting a paid surgery in a "2nd world" country, like Kazakhstan, Turkey, Russia (pre-war, feels uneasy going there now) and etc.
Things there cost 10 times less and most surgeries, where hospitals don't need very advanced equipment, are probably done on the same level as "1st world" countries.
When I was 18 I went for a long run with a heavy backpack and developed extreme tendonitis on the sides of my knees. I could barely walk without excruciating pain. After three weeks of this suffering I got one round of PRP injections and was able to walk a week later. I made a full recovery within the month. Insane. There was no way it would have healed so fast without the injections based on the pain trajectory from the prior weeks.
Yes, in PRP they take your blood, extract platelet-rich plasma from it and inject it into your joint.
With SVF they make you a small liposuction (around 80 ml if I am not mistaken, local anesthesia),
then also extract cells from it that are similar in function to stem cells and inject them into your knee.
PRP is very noninvasive.
SVF is more invasive, mostly the liposuction part, but I'd say it's still walk-in the part if you compare it with something like arthroscopic surgery.
Managed to finish in the top 10% after 6 months of preparation.
There was no pain during them, but once you cool down you feel all the beating you received.
I mean, I am still not 100% healthy, I get some swelling after exercise, and I don't think I can compete with anyone doing it seriously, I just can't get the same volume of exercise a healthy person can. Like, I can only run 10-16km every 2 days, because I need to give my knee time to recover, while a healthy person can run it every day.
But hell, just some time ago I was looking with jealousy at people running at all.
Switzerland produces a lot of surgical implants so something like this would impact that industry but like everything you need to move forward and find better ways to heal people even if it affects your bottom line.
>Most EU countries have a healthcare model like Switzerland where you have mandatory private insurance.
No they don't. Most EU healthcare systems are socialized and publicly run by the state, with the option of paying private for better/faster services on non-life-threatening issues where the public system is overcrowded, or for things not covered by the state insurance.
The likes of Switzerland and a few others like the Netherlands where health insurance is fully private like in the US, are the exception. But AFAIK in CH/NL the state will still subsidize your healthcare anyway if you're below the poverty line and too broke to afford the private plans.
It might be, but this exchange rate is no evidence for that statement. The CHF/USD exchange rate is literally at one of it's highest points since 1985.
Isn't a silverback gorilla actually strong? The dollar is quite week in comparison against the CHF than what it used to be. In 1985 1 CHF got you just 38 cents.
4 years ago I could only walk with crouches due to pain.
Last month I competed in 2 half-marathons.
I was able to get much much better by doing a lot of PRP (platelet-rich plasma) injections over past years and a single SVF (stromal vascular fraction) injection 1.5 years ago.
My MRI shows that cartilage has grown back significantly (not fully, but I no longer have a gaping hole in it).