If You’re Resolved to Have Surgery or Medical Treatments, Here Are Options to Consider

I’m not a big fan of surgery for chronic knee pain, to put it mildly. Some procedures absolutely make me shudder (“lateral release,” e.g.). Others I imagine could be useful, in certain circumstances.

If I were desperate enough to seek a medical intervention, I’d favor something as natural as possible. That means a procedure that encourages my own body to turbocharge the healing process.

With that in mind, here are treatments worth looking at (Note: that’s not an endorsement of any of these, and anyone with knowledge of, or experience with, any of the following, please add your thoughts below). Also, important caveat: These procedures are more for problems with tendons and ligaments than cartilage, as far as I can tell.

(1) Prolotherapy

I was first introduced to this on Doug Kelsey’s (now defunct) blog, The View. As many of you know, I have tremendous respect for Kelsey, whose thinking about chronic knee pain greatly influenced me during my recovery.

Kelsey’s genius on matters of physical therapy probably derives in part, unfortunately, from his own misfortune -- he has a number of ailments, including a knee problem of his own. Anyway, he underwent prolotherapy.

My understanding is that the treatment involves a series of shots that cause an inflammatory response in the body’s tissues that spurs healing. It is painful, apparently! (Inflammation often is.)

(2) Injections of platelet-rich plasma

Scientific American took a look at this treatment almost three years ago (not the freshest information, but a decent place to start). A small vial of your blood is spun in a centrifuge to separate out the platelet-rich plasma, which is then injected into the injured tissue.

The theory behind why this should work: The injured areas, such as tendons, have a poor blood supply, so healing sometimes becomes difficult. The concentrated platelets in the plasma bolster the nutrients and growth factors at the site, aiding healing.

Notice the word “theory.” “PRP” has its skeptics. Still, the doctor in the Scientific American article said that, of his patients who have undergone it, maybe 60 percent have gotten better.

(3) Whatever Kobe Bryant had done

Bryant, of course, is the NBA superstar who plays for the Los Angeles Lakers. His right knee, under the kneecap, is missing so much cartilage that it’s practically bone on bone, he has said. He flew to Germany for treatments that apparently worked wonders, leading other athletes to make the pilgrimage to the same doctor, hoping for similar results.

What’s the procedure? Apparently it’s a more vampiric undertaking than PRP (“as much blood as they took the first day, I didn’t think I’d have any left,” said this patient). Again, the blood is centrifuged, but heated first, because the objective is to capture anti-inflammatory proteins, rather than platelets. The resulting orange serum is then injected into the ailing joint.

So there you have it. Three novel treatments worth a look (if you’re resolved to have some kind of treatment anyway). Anyone familiar with any of them, feel free to share your thoughts below.