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Knee Problems – History

Tue, 09/08/2009 – 23:23 — BruceLerner

My awareness of issues with my knees came in March of 1998 a couple of days before my 1st Dan Test (Tae Kwon Do). I thought I hyper-extended my left knee while performing an overhead kick. I iced, wrapped and completed my requirements for 1st Dan. My knee was never the same. I trained for another 18-24 months becoming less able to perform and eventually retreated to running and bicycling. 

in the Fall of 2001 I started to play pick-up soccer on Thursdays. During the fall season I experienced knee pain and had an MRI in November. Evidently there were signs of minor degeneration and possibly a tear neither of which led to suggestions for treatment. For the next couple of years I continued activities with knee braces and ibuprofen.In the fall of 2003 I was no longer able to keep up with soccer and in December, following a set of x-rays, was informed that I had “a little arthritis” and was prescribed Naproxin. 

Over the previous few years I had been forming a bunion which by now was becoming painful. I realized that my gait had been thrown off and thought that the bunion might be the cause and this led me to a Bunionectomy in February of 2004. At this point I’d like to interject a bit of hindsight. Bone tends to grow in response to various pressures. These pressures in the foot are often caused by bio-mechanical abnormalities. One cause is flat-footedness which I do have. The combination of flat feet, bunions and knee problems should have raised an alarm to evaluate the overall bio-mechanics but this is hindsight. I have no doubt that addressing the flat feet with orthotics rather than having the bunionectomy would have provided more years out of my knees (but less income to the surgeon). The bunionectomy was painful, had me on crutches for 6 weeks and within 5 years the bunion had returned (as the underlying problem hadn’t been addressed).

Following the recovery for my foot, my knees continued to bother me. In March of 2006 new x-rays with a new orthopedic surgeon resulted in a diagnosis of “medial compartment degenerative changes of a moderately severe degree……but not actual bone on bone contact.” The progression and prescription for my knees were explained as follows:

  1. braces, ice, over the counter inflammation/pain control
  2. prescription pain control
  3. Hyaluronan injections
  4. Knee replacement

I began searching for other options.
In August 2006 I began seeing a rheumatologist. I was introduced to this particular doctor at a work sponsored lunchtime presentation. He appeared to be aware of issues associated with OA and as I was looking for someone not inclined to operate. I signed up. The treatment was primarily for pain management. I was prescribed Celebrex which I took for a few months before deciding that I wasn’t interested in just taking drugs. I downgraded to naproxen taken as needed. 

I began to see articles about work being done with platelet rich plasma and stem cells for damaged tendons and cartilage, but mostly animal studies on small populations. I found that the rheumatologist really had no knowledge or interest in this area study and stopped seeing him in the spring of 2008.

In September 2008 I heard an interview on Tech Nation]( with an Australian doctor succeeding with culturing and growing cartilage cells and then reintroducing them to the damaged area in race horses. I began looking in earnest for human trials. I found a few articles about work being done in Tehran and fewer about work in Asia. In spring 2009 I started seeing papers about the application of platelet rich plasma (PRP) in humans for generalized healing and over the summer found articles by Dr. Nathan Wei]( of Frederick, MD, about the application of stem cells and PRP. 

In August 2009, I hooked an evaluation appointment onto a trip to visit friends and family in Maryland and found that I had enough remaining cartilage to be a candidate for the stem cell procedure. I had the procedure on September 18th, 2009