Knee Pain Overview

As we have seen above, knee pain is an incredibly widespread condition, which can affect anyone, at any stage of life. However, understanding the causes and consequences of knee pain isn’t always straightforward. 

The knee is the largest, most complex, and most injured joint in the body. This joint connects the bones of the lower leg (the tibia [shinbone] and the fibula) to the upper leg (the femur or thigh bone). At the front of the joint is located the kneecap or patella. 

These bones are connected to one another by four main ligaments (the anterior cruciate ligament, the posterior cruciate ligament, the medial collateral ligament, and the lateral collateral ligament). They are also connected to the surrounding muscles by tendons. 

The joint structure is kept lubricated and protected from shock and friction damage by hyaline cartilage and the synovial membrane (a fluid-filled sac). Other cartilaginous structures of the knee include the meniscus. 

These components work together to stabilize the body and redistribute forces and shock during your daily activities, thus enabling a wide range of movements, including bending, jumping, sitting, or simply walking. 

Given the complexity of the knee joint, it isn’t always easy to determine what’s causing pain. However, some main risk factors and contributors include the following:

  • Degenerative diseases. Degenerative diseases cause the progressive deterioration of one or more components of the knee. One of the common forms of degenerative diseases of the knee is osteoarthritis (OA). 

    OA occurs when the cartilage that protects the joint begins to break down, leading to further inflammation, pain, and, ultimately, impaired knee function. Today, OA is a leading cause of knee pain and disability in people aged 50 and over.

  • Knee overuse and excessive stress. Excessive stress on the knee can derive from performing regular, forceful movements, such as twisting or jumping. These movements can speed up age-related degeneration of the knee components.

    Being obese or overweight can also put undue stress on the knee, thus increasing the risk of pain and degenerative diseases like OA.

  • Direct trauma. New injuries – such as a direct blow to the knee – can cause damage to one or more of the components of the knee (e.g. ligament tears or fractures), which can cause pain. Old injuries, especially if not properly treated, may also compromise the mechanics of the knee. 

    Over time, this can put areas of the joint under undue stress and cause damage to components that should normally be unaffected during movement.

  • Genetics and knee mechanics. Having a medical history of knee conditions, dealing with deformed knee bones or joints, or suffering from autoimmune diseases (such as rheumatoid arthritis) can lead to knee pain.

Improper posture, lifestyle habits, and daily activities can also take a toll on your knee health in the long term.

Symptoms of Knee Pain

To understand the symptoms and nature of knee pain, it is firstly important to look at the differences between chronic and acute pain. 

  • Acute knee pain. Acute pain is a biological response objectifying itself as a bodily sensation, triggered by an identifiable disease or injury. It enables the body to protect itself from further damage by activating the flight-or-fight response and causing you to feel discomfort. 

    The condition is self-limited, begins suddenly after an injury, and does not usually last beyond six months. Acute pain is often caused by health events like fractures, burns, or direct blows to the knee. Once the problem is treated, the pain disappears without causing long-lasting damage.

  • Chronic knee pain. Chronic knee pain is more complex to diagnose and cure. Your knee pain is regarded as chronic when it lasts longer than six months or after you’ve fully recovered from an injury. 

    The root cause of all chronic pain conditions is systemic inflammation, which can arise from lifestyle, psychological, and environmental factors, as well as health events and diseases. This condition causes your nervous system to persistently send pain signals, even without injury.

 

The symptoms of knee pain conditions can vary, depending on what’s causing them. For example, if you have a torn anterior cruciate ligament, you may struggle with load bearing. On the other hand, if you have knee OA, your symptoms will involve “popping” and “grinding” sounds, reduced range of motion, and deformities such as bone spurs.

The most common symptoms you’ll experience include:

  • Painful sensations, localized in and around the knee area. Over time, the pain can spread through the upper leg, lower leg, and foot.
  • Pain that intensifies during physical activity or after prolonged periods of rest (e.g. in the morning, after you wake up).
  • Swelling and stiffness. The inflammatory response can cause the build-up of fluids around the site of injury, which can cause your knee to swell – a symptom that further aggravates stiffness and reduced range of movement. 
  • Inability to bear weight on the knee affected. This can occur in the event of severe cartilage (meniscus) or ligament tears. 
  • Reduced range of motion, due to components of the knee no longer working harmoniously.
  • Impaired knee mechanics and deformities such as bone spurs. Bony growth occurs when the body attempts to repair the damage caused by conditions such as osteoarthritis, thus creating new bone tissue.
  • Crepitus, or clicking, grinding, and popping noises. This is a symptom common in people with arthritis or osteoarthritis and derives from altered knee mechanics. 

Conventional Treatment Options

If your knee pain is acute in nature, treating its cause is the most straightforward path to regaining your knee health. For example, if you’ve fractured your kneecap, your doctor will help you restore your knee health by recommending immobilization and rehabilitation therapies. 

However, if you suffer from a chronic knee pain condition, it is important to find a line of treatment that will do more than just ease your symptoms. Today, many people with OA live with the condition for 30 years or longer

Medications such as NSAIDs, opioids, or corticosteroids may ease the pain in the short term but won’t be effective in restoring your knee health or inhibiting the disease progression. To make things worse, taking medications for months or years at a time can cause severe side effects.

Below, we’ll explore some of the most commonly prescribed treatments for knee pain. We’ll also look at how they work and the risks they bring.

 

Corticosteroid Injections

Corticosteroids emulate the work of cortisol, a hormone in your body that modulates inflammation and pain. They are usually injected into the affected area – the knee, in the case of knee pain conditions. 

Once administered, crystals in the corticosteroid slowly emit pain-relieving substances, which, unlike other treatment options, provide lasting relief. 

Nonetheless, despite being commonly used for different types of pain conditions, corticosteroids aren’t always the best or safest treatment. According to new research, prolonged use of corticosteroids may disrupt adrenal glands (the glands responsible for producing cortisol) and lead to a severe condition known as adrenal insufficiency. 

What’s more, these chemicals can, over time, contribute to further degeneration of cartilage.

 

NSAIDs 

NSAIDs – or non-steroidal anti-inflammatory drugs – are among the most commonly prescribed medications for knee pain conditions. They work by inhibiting the COX enzyme, which regulates inflammation-causing prostaglandins. By reducing prostaglandin production, NSAIDs can temporarily alleviate pain. 

One of the greatest advantages of NSAIDs is the fact that these drugs are immediately available as over-the-counter alternatives, and they are often highly affordable. Nonetheless, these drugs come with risks such as stomach ulcers, kidney problems, addiction risk, heart attack, and stroke when used in the long term. 

 

Arthroscopy

Surgical interventions for knee pain should only be considered as a last resort, due to the risks, side effects, and significant rehabilitation periods they involve. However, depending on what’s causing your knee pain, there is more than one surgical option that may help you regain your knee function. 

Arthroscopy is one of the least invasive alternatives. This surgery involves performing two small incisions around the knee area. The surgeon will then insert a thin viewing instrument – called an arthroscope – through the incisions. 

This instrument will provide the surgeon with visuals of the inside of the knee, which can be used to diagnose the cause of pain and guide minor surgical interventions. Depending on the cause of your knee pain, the arthroscope can be used to remove inflamed or damaged tissue, alleviate pressure on ligaments and nerves, and rid the knee of debris. 

Although arthroscopy is less invasive than other methods, it’s not entirely free of risk. These risks include adverse reactions to anesthesia, infection, and ineffective outcomes.

 

Ligament Reconstruction Surgery 

One of the most common causes of acute knee pain is ligament tears, usually affecting the anterior cruciate ligament. Ligament reconstruction surgery works by removing the damaged parts of the ligament and replacing the connective tissue with a graft. The graft can be collected by other tendons in your own body or sourced from a deceased donor. 

Synthetic grafts made of Teflon may also be used. Once in place, the graft is then fastened with screws or pins. 

This surgery is highly invasive and involves several months of recovery and rehabilitation. The main risks of this intervention include infection, the need for revision surgery, graft failure, nerve damage, and the possibility that your body will reject the graft. 

 

Knee Replacement Surgery 

Knee replacement surgery, also known as arthroplasty, is a procedure that involves replacing a damaged or worn-out knee with an artificial joint. Typically, it’s performed to relieve knee pain linked to various forms of arthritis. 

In this surgery, the surgeon removes damaged or diseased parts of your knee joint and replaces them with prosthetic parts made from metals, plastic, or ceramics.

There are two main types of arthroplasty: total and partial knee replacement surgery. Total knee replacement (TKR) involves replacing all three components of the knee. On the other hand, in partial knee replacement (PKR), only one aspect of your knee is replaced.

Although this form of surgery is recommended for severe forms of arthritis and osteoarthritis, it comes with significant risks, including infection, blood clots, stroke, nerve damage, and complications resulting from anesthesia.

What Is Platelet-Rich Plasma, Or PRP? 

Platelet-rich plasma, commonly known as PRP, is a type of regenerative treatment using the patient’s own blood. Samples of the blood, once harvested, are concentrated to supply higher counts of platelets than what is usually observed in baseline values (i.e. in “normal” blood). 

Naturally, these platelets are a type of blood cell that serves a crucial role in our body: they promote healing actions such as coagulation (blood clotting) and wound healing. But what makes platelets so special is the fact that they are extraordinarily rich in growth factors.

Growth factors are proteins located within platelets, in “packets” known as alpha granules. These proteins are responsible for stimulating a wide range of cellular processes, including proliferation and, in the case of stem cells, differentiation. 

In other words, they cause stem cells around the area of injury (and stem cells from across the body) to multiply and transform into specialized cells. These specialized cells have the role of repairing and regenerating damaged musculoskeletal tissue – such as ligaments, tendons, bones, and cartilage. 

Given the high concentrations of platelets, PRP is extremely rich in growth factors. This, in turn, makes PRP injections a simple, safe, and effective way of stimulating the body’s self-healing capabilities.

 

PRP For Knee Pain 

As seen above, platelet-rich plasma has the remarkable ability to enhance your body’s inherent healing capabilities. Because of this, it has become a prominent regenerative treatment option used in the treatment of a wide range of conditions, including joint instability, arthritis, muscle strains, and ligament and tendon tears.

There are currently over 30 randomized trials demonstrating the ability of PRP to stimulate the healing abilities of stem cells in and around the site of injury. Given these properties, as well as the lack of side effects, PRP is now considered a superior treatment option compared to corticosteroid injections, NSAIDs, and opioids. 

In the case of knee pain, PRP has been seen to help in a range of conditions. 

  • Osteoarthritis. PRP has been seen to be a valid treatment alternative, effectively reducing pain and improving quality of life and functional scores, even six months after the treatment. (2022)
  • Meniscus injuries. Studies show that PRP can aid in the treatment of meniscal injuries, such as tears. These injections can lead to significant functional improvements, reduce pain, and speed up recovery. (2022)
  • Post-operative recovery. Besides treating conditions of the knee, PRP can also speed up recovery after surgical interventions such as ACL reconstruction surgery. It does so by reducing postoperative pain and improving knee function in the short and medium terms. (2022)

A 2020 study comparing corticosteroid (CS) injections to PRP in the treatment of knee pain conditions confirms that PRP produces significantly greater improvements at a one-year follow-up compared to CS.

Why Are Orthagenex PRP Injections Superior?

A glance at the studies above will tell you that PRP is quickly emerging as a superior alternative to treatment options such as corticosteroids or NSAIDs in the management of knee pain. Beyond this, PRP can also stimulate the body’s ability to heal naturally, thus reducing the need for medications and helping to build long-term musculoskeletal health. 

However, when it comes to determining how effective PRP injections are, a major role is played by the concentrations of platelets in the solution. That’s where Orthagenex’s high-dose PRP sets itself apart from the injections offered by standard orthopedic clinics across the US. 

There are four main aspects that make the protocol pioneered by Orthagenex the gold standard for PRP injections:

  • The use of imaging guidance to improve needle placement accuracy
  • The use of extensive laboratory settings to optimize the concentration of platelets and remove unfavorable components
  • Injectable PRP solutions that are entirely customized to the needs of each patient
  • Doctors who are trained in interventional orthopedics

In the sections below, we’ll explore these aspects in more detail. 

Interventional Orthopedics

Orthagenex has been instrumental in paving the way for a new field of medicine, known as interventional orthopedics. This discipline rests on three core principles:

  • Utilizing injections, such as platelet-rich plasma (PRP), to stimulate tissue regeneration and boost the body’s natural healing abilities
  • Using imaging technology to enhance the placement of the needle (and, in turn, of the PRP solution) in the area in need
  • A commitment to the ongoing improvement of treatment solutions and delivery methods

 

Image-Guidance To Place PRP Solutions

Most clinics across the US offering PRP treatments today perform injections “blindly,” relying on tactile sensations rather than vision. This can significantly increase the risk of missing the target location of the injection. Even when some form of imaging guidance is used, practitioners often lack the necessary training to interpret results. 

At Orthagenex, we commit to never leaving anything to chance when it comes to restoring your knee health. That’s why we leverage two of the most advanced imaging guidance techniques available: 

  • Ultrasound guidance. This technique allows for real-time tracking of the needle’s position through ultrasound waves as it penetrates the skin.
  • Fluoroscopy. This technique provides real-time, multi-angle X-ray visuals of the needle’s placement as it travels toward the injury site.

At Orthagenex, these imaging guidance techniques are used as a standard as part of our high-dose PRP protocol. Each of our medical staff members is also trained in interventional orthopedics, thus fully prepared to accurately interpret results. 

 

Lab-Processed For Higher Concentrations of Platelets

In addition to the accuracy of needle placement, two crucial elements determine the effectiveness of PRP treatments. These are the concentrations of platelets and the purity of the solution.

Nonetheless, most clinics offering PRP treatments in the US rely on standard centrifuge machines to create their injections. These machines are highly inefficient in optimizing the concentrations of platelets in the injectable solution. They are also incapable of adequately removing unfavorable substances or customizing the injectate to the patient’s needs.

These centrifuges work by spinning the blood sample to separate red and white blood cells from the platelet-rich plasma. The blood sample is usually processed immediately after collection, and it is re-injected shortly after being centrifuged. 

Given how inefficient these protocols are in treating musculoskeletal conditions, Orthagenex has implemented an innovative, more targeted solution. In our high-dose PRP protocol, we take advantage of extensive laboratory environments, which allow our specialists to refine each injectable solution, maximize the concentrations of platelets, and remove unfavorable components. The solution is also entirely customized to the patient’s unique needs before re-injection.

Here’s an overview of the differences between the Orthagenex protocol and the techniques used by most other clinics across the country:

Other clinics Orthagenex
Tools used to create PRP Bedside standard centrifuges Specialized laboratories and cutting-edge equipment
Protocol to perform PRP PRP is immediately injected after being centrifuged The blood sample is concentrated, purified, and customized before injection. 
Resultant concentration of platelets in PRP Maximum 2-4 times higher than “normal blood” values  10-30 times higher than “normal blood” values

 

Amber PRP vs. Red PRP

Platelet-rich plasma (PRP) is available in two variants: red and amber PRP. 

  • Red PRP or leukocyte-rich PRP, appears red due to an abundance of red and white blood cells along with platelets. 
  • Amber PRP or leukocyte-poor PRP, has a distinct amber color because it contains fewer white and red blood cells.

According to studies by Orthagenex, the presence of white and red blood cells can negatively affect the outcomes of PRP treatment. Not only do they contribute to inflammation, but they also have an inhibiting effect on the same cells PRP is attempting to stimulate.

At Orthagenex, the purer, more efficient amber PRP is used as the injectate of choice.

 

Next-Generation Platelet Lysate 

Just like platelet-rich plasma, platelet lysate (PL) helps repair damaged tissue by optimizing platelet and growth factor concentrations. However, PL differs in several ways that might make it a more suitable choice for certain cases. 

One of the key benefits of PL is its excellent anti-inflammatory properties. Additionally, platelet lysate injections release the growth factors immediately and en masse to the injury site, resulting in a quicker healing process.

The chart below offers an overview of the two therapies offered at Orthagenex. 

PRP PL
Releases platelets and growth factors over time to the site of the injury Growth factors are released immediately and en masse
May cause some degree of inflammation It is anti-inflammatory
May not be as suitable for treating sensitive areas It can be used around sensitive areas (e.g. near nerves and the spinal cord)

Here at Orthagenex, we are not just keeping up with the latest advancements in PL treatments – we’re pioneering them. Many clinics in the US are still introducing this treatment to their offer. 

However, we are already advancing through the third and fourth-generation PL injections. Meanwhile, we keep our focus on continuous improvement: we are already at work to deliver superior, even more efficient PL injectables to our patients. 

 

PRP Customized To Each Patient’s Need

Above, we’ve explored how the high-dose PRP protocol offered at Orthagenex is made superior by the optimized concentrations of platelets, the purity of our injectable solutions, and by the use of imaging guidance. But there’s another aspect that we’ve not yet explored: the customization of our injectable solutions around the unique needs of each patient

We can do so in two ways: 

  • By using the extensive cellular laboratory facilities located within our clinics
  • By providing auxiliary treatment options to our patients, such as bone marrow concentrate (BCM)

Let’s look at these aspects below. 

 

Lab-Processed PRP Solutions

At Orthagenex, we strive to set new, higher industry standards. Because of this, we looked beyond using simple centrifuge machines and tapped into the potential of advanced cellular lab settings instead. In these modern laboratories, our highly-trained team employs the latest technology to craft customized injections for superior health results.

At our clinics, you’ll never find standard, off-the-shelf injections. Instead, each blood sample is carefully processed to optimize the concentrations of platelets, achieve greater purity, and target the unique health needs of each patient. 

 

Bone Marrow Concentrate Can Be Used 

Knee pain can have a unique and profound impact on your life – we understand this. That’s why we never recommend a “one-size-fits-all” treatment journey to our patients. Instead, we provide auxiliary therapies that allow for the full customization of our treatment plans. 

One of these therapies is bone marrow concentrate (BMC). Working alongside PRP, BMC is another regenerative therapy that aims to boost the levels of restorative repair cells in the areas of the body affected by injury or degeneration – the knee, in this case. 

BMC procedures work by extracting small samples of stem-cell-rich bone marrow. Through cutting-edge processing techniques, the sample is concentrated, purified, and re-injected into the site of injury. Here the newly supplied stem cells will work to support the body’s ability to heal naturally.

 

Doctors Specializing In Interventional Orthopedics

At Orthagenex, the secret to our superior PRP therapies lies in the hands of our skilled medical staff. Our team is composed of world-class musculoskeletal specialists, committed to their craft. 

Each one is board-certified and fellowship-trained, providing a level of expertise that exceeds typical standards. Furthermore, our physicians sit amongst the elite 1% of orthopedic doctors in America being trained in both interventional orthopedics and imaging guidance

This statistic illustrates how Orthagenex has been able to successfully assist more orthopedic patients than any other regenerative medicine clinic nationwide.

 

Core Competencies

  • Imaging guidance 
  • Lab-processed solutions for higher concentrations of platelets
  • Formulations customized to each patient’s needs
  • The use of the purer amber LP-PRP injections
  • The availability of auxiliary regenerative therapies, such as BMC
  • The use of SANS 

SANS – Orthagenex’s method of evaluation for systemic inflammation and chronic pain conditions. 

Most chronic pain conditions derive from systemic inflammation. Systemic inflammation can have a wide range of causes, including environmental influences, psychological factors, lifestyle habits, and health events. In turn, determining the root cause of chronic pain becomes a major challenge – a challenge that often hinders treatment. 

This is where the role of SANS becomes important. SANS stands for Stability, Articulation, Neuromuscular functionality, and Symmetry. By examining these elements relevant to chronic pain cases, our medical experts can more precisely diagnose the severity, nature, location, and triggers of chronic pain and inflammation. These insights then pave the way for designing well-informed, more efficient treatment strategies.

Here’s how it works:

Orthagenex – Your Alternative to Knee Pain Surgery

Knee pain can have a dramatic impact on a person’s ability to live fully and independently. At Orthagenex, we are fully aware of it – and we are also aware that taking medications daily or living in fear of needing surgery can have an even more profound effect on your mental and physical well-being. 

That’s why we are here to champion a superior, non-invasive, and non-drug treatment alternative: high-dose PRP. Our proprietary protocol can help support your body’s ability to heal naturally and assist you in building long-lasting knee health. 

 

Stop being brought to your knees by pain and inflammation. Discover the Orthagenex approach.