Monday, September 26, 2016

Natural versus Pharmaceutical Treatment for Knee Osteoarthritis

Many physicians and patients, alike, are searching for new and emerging treatments for chronic pain. One of the most debilitating areas of chronic pain can be due to knee arthritis.  Knee arthritis affects one's ability to maneuver throughout society without pain.  Depending on the degree of pain the patient is in, it will affect their ability to maintain function, exercise, and thus affect other areas of health as well.

Due to the fact that we do not know the exact cause of arthritis, it makes it difficult to treat.  We do know that with osteoarthritis, people have degeneration of their protective layers of cartilage in their joints.  Though we do not know how this happens (and just assume that it is predominately due to wear and tear over time), pharmaceutical companies have come up with ways to try to emulate the job of cartilage in the joints.  Of of those medications is called hyaluronic acid (HA).  It has been used for many years.  It works to provide increased joint lubrication, and thus decrease the friction between two bones that may be rubbing together, thereby decreasing pain.  HA is one of the most common treatments for osteoarthritis of the knee. However, it's effects only tend to last about 6 months, and multiple injections are required.

Platelet-rich plasma (PRP) is made from the patient's own blood.  It has healing properties and can be used in a variety of conditions.  It actually serves to stimulated the body's natural ability to regenerate tissues.  It is the hope of physicians presently using PRP and other regenerative forms of medicine, that they can recreate the body's natural ability to heal and grow, without the use of pharmaceuticals.

In the article that I researched, I was able to compare the use of HA, PRP and HA in combination with PRP for knee osteoarthritis.  I regularly perform PRP injections in my clinic.  PRP injections are not covered by insurance, and I wanted to make sure that the added cost of the injection, to the patient, was the best medical treatment I could offer them.  I was actually surprised to find out how effective all 3 treatments are!



Even though the HA treatment group ended up with a Treatment Grade of "D", a 37.5% improvement in physical ability a year after treatment is a good number.  However, it is pretty notable that both PRP groups still had a significantly better score than the HA group alone.

Through Treatment Scores, we can compare different treatments for a variety of diseases in a more organized manner.  In this way, we can place values on treatments.

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