Two Knees: A Story

It's been a good day for stem cell procedures. I had the pleasure of seeing a 68 year old patient 8 weeks out from his RIGHT knee stem cell procedure. He reported 30% improvement. 30% you might say, that's not very good. However, I told him from the start that his candidacy was poor (this means <30% chance of good improvement). His poor candidacy was due to very severe osteoarthritis with loose bodies in the joint. We had agreed in advance that 20% improvement of pain relief and increased functional status would represent a good outcome. Furthermore, I then turned my attention to his LEFT knee, which had been replaced 6 months prior. His LEFT knee (total knee arthroscopy=TKA) was grossly swollen. He told me that his LEFT knee continues to give him quite a bit of pain and discomfort, 6 months after surgery. All in all, a good day with a good outcome and alternative for a patient for whom TKA was not successful. A study out of France, using the patient as their own control, found similar results: Use of BMC in Treating TKA-eligible Elderly Patients P. Hernigou, MD (presented at 2017 ASIPP)

• Patients 80 y/o or older, eligible for bilateral TKA were treated with percutaneous BMC in one knee and TKA in the other (n=40) Treatment consisted of BMC injections into the tibial plateau and femoral condyle subchondral compartments KSS scores reached an average of 80.3 by 1-yr for BMC patients and 78.3 in the TKA knees One BMC-treated patient has gone on to have a TKA at 6-yrs Two TKA knees were revised