How are cartilage problems in the knee treated?
It can be treated with 2 main methods according to the duration of the problem, the age of the patient, and the severity of the cartilage problem in the knee. These are surgical and non-surgical methods.
What are non-surgical methods?
1. Physiotherapy: It is performed by medical doctors and physiotherapists who have special training in this subject.
2. Oral medications or injections into the knee: Products such as shark cartilage, hyaluronic acid, chondroitin sulfate preparations reduce the frequency and severity of complaints although their medical benefit is not proven. Here we can refer to the placebo effect. In other words, the patient psychologically believes the treatment given and thinks that he/she will recover.
3. Losing weight: People who are overweight are 20 percent more likely to have a cartilage problem. This is because when the cartilage load-bearing capacity exceeds a certain limit, this tissue calcifies faster, wears off more quickly and degenerates easily. Therefore, the weight loss also reduces the weight on the knee. For example , when 6 kg of weight is lost, the knee load reduces 48 kg… Each excess weight is reflected in the cartilage when certain movements are carried out. This is a scientifically proven fact.
4. Exercise: Especially swimming, tai chi from Far East sports, muscle strengthening like pilates, movements that stretch the body and are not tiresome are useful for cartilage health.
5. PRP: It is a platelet-enriched plasma method.
6. Stem cell therapies
What is performed in PRP?
A certain amount of blood is drawn from the patient. The cells that provide the blood coagulation are separated.
How many sessions are performed?
PRP can be performed 1 session. Sometimes it can be performed 3 times with a week-off. The sessions vary depending on the case and the application of the phycisian. The blood is taken once and the remaining injection is frozen after the procedure. If more than one sessions will be carried out to the patient, the frozen injection is used. This concentrated blood is then given back to the body of the person. The advantage is that nothing is given to the patient from the outside as exogenic. If it is prepared with correct methods, there is no allergic or reactive effect.
Many substances are found in the plasma rich in clotting cells. They are able to suppress inflammation. For example, the reaction that occurs when a sand is entered in the eyes is watering. Similarly, the PRP allows the suppression of the inflammation created by the cartilage pieces in the knee. Let’s compare the hyaluronic acid or cortisone applications with PRP. There are no scientifically proven differences between these three methods particularly for the patients with damaged cartilages who have advanced calcification.
What affects the success of PRP?
The PRP needs to be prepared correctly. It is also important for the success of the procedure to be performed with an image guidance during injection. In a procedure performed under ultrasound imaging, it can be ensured that PRP is properly injected into the joint. In the case of operations without imaging, there is a risk that the substance is given outside the joint by 50 percent.
There is currently no scientific evidence for the benefits of PRP. However, sports injuries, the cartilage problems behind the knee cap especially in young women, it has pain relief features and reduces the inflammation. PRP has no features of cartilage repairing, relieving cartilage problems and providing a permanent treatment. However, it has a feature that is interfering with the symptoms of the disease.