Heal Your Knees with Prolotherapy
Noel Peterson, N.D.
Drs.Yoo-Sin Park and Si-Woong Lim had kept careful notes for several years as their patients’ knees responded to Prolotherapy. Their older patients had less pain and found it easier to climb stairs, walk the golf course, and ride their bikes, while many of their younger patients recovered from knee trauma and surgeries as if they had never been injured. The doctors began to think of how to design an experiment that would demonstrate to their skeptical colleagues that cartilage regeneration was the cause of their patient’s improvement. They assembled a team of researchers at the Institute of Biomedical Science of Hanyang University, College of Medicine and at the Department of Physical Medicine, Inje University, School of Medicine in Seoul, South Korea.
They knew that laxity of knee ligaments increases the wear-and-tear on joints, causing cartilage to wear out prematurely. They decided to surgically cause osteoarthritis and loss of cartilage by transecting the anterior cruciate ligaments (ACL) in the left knees of 24 New Zealand White rabbits. ACL transection destabilizes the knee, much like weakened and lax ligaments do as we age and after sports injuries.
Half of the rabbits were given injections of a nutritive Prolotherapy solution into the left knee at week 6, 8, 10, 13 and 16 after surgery, while the other half were given placebo injections of normal saline (NS) at the same interval. The animals were sacrificed at 19 weeks and the knees were examined by pathological sampling and staining and by electron scanning microscopy for pathological and arthritic changes. What they discovered was remarkable!
Since ACL transection is expected to cause osteoarthritis of the knee, it was no surprise that all of the animals given placebo injections showed advanced arthritic changes. The knees had severe cartilage loss and erosion, loss of chondrocytes, calcification of cartilage, and severe degenerative changes in the medial tibial plateau.
By contrast, the knees in the Prolotherapy treated group looked as if no surgery had been performed. Prolotherapy injections had prevented the erosion of cartilage, and had conferred protective effects against the OA-like degenerative changes in the articular cartilage.
Prolotherapy works in several mechanisms to repair knees. Cartilage has virtually no blood supply of it’s own. Therefore, cartilage cells are almost entirely dependent on the nutrients provided by the synovial fluid. The authors note that Prolotherapy injections are nutritive to chondrocytes and induce proliferation of chondrocytes, osteocytes and fibroblasts. They yield osmotic changes that induce the release of local tissue growth factors and cause the production of precursors for extracellular matrix macromolecules in articular chondrocytes. Prolo injections also enhance protein synthesis and amino acid transport into cartilage cells.
In contrast, conventional treatments have many well-known drawbacks. Steroid injections cause softening and loss of cartilage, weaken fibro-osseous tissues that stabilize the joint, cause immune suppression, are painful and produce “dry knee syndrome”. Ibuprofen and other NSAIDS show no long-term benefit in osteoarthritis. In fact, they inhibit the formation of new collagen matrix, thereby inhibiting tissue repair. Hyaluronic acid only improves short-term viscoelasticity of the synovial fluids and may actually interrupt cartilage synthesis. Surgery is expensive, requires extensive rehabilitation and has been demonstrated to provide no benefit when compared to placebo surgery.
The authors concluded that Prolotherapy injections are “relatively inexpensive, are less painful, less invasive, safer and have long-term benefits when compared to conventional treatment of knee osteoarthritis.”
Arthritis Research & Therapy, Volume 9:1, 26 January 2007