This document discusses treatment options for knee arthritis, including traditional methods like medications and surgery as well as regenerative techniques using platelet rich plasma (PRP). It notes that 10 million Americans have knee arthritis and $30 billion is spent yearly on knee replacements. Traditional methods are criticized for their side effects, while PRP is presented as a natural alternative that stimulates the body's healing processes, reduces inflammation, strengthens cartilage, and can avoid or delay more invasive options like surgery. PRP is described as an autologous treatment that has advantages over medications in stimulating normal healing pathways without inherent negative effects.

1. Knee Arthritis -
Treatment and Joint Preservation
with PRP
Regenerative Medicine
and
Joint Preservation Center
of
Santa Rosa
Raymond Severt, M.D.
1144 Sonoma Avenue, Suite 121
Santa Rosa, California, 90025
(707) 978-4322
Heal Naturally

2. Knee Arthritis is a BIG
Problem
10 million in US have knee arthritis
$30 billion spend yearly on knee replacements
Should we keep treating it with the
“traditional” methods?
Or should we treat it in a way that can use the
body’s own healing ability without all the
typical side-effects?

3. Regenerative Medicine
Offers groundbreaking
techniques to treat and
control arthritis
Avoid more invasive
treatment options

4. Normal Knee
Knee is a critical joint
Commonly damaged
Commonly develops arthritis
Cartilage is smooth and
strong/resilient
Ligaments maintain stability
Meniscus provides cushioning
Good viscosity of fluid

5. Knee Arthritis
Cartilage wears out often to
bone
Inflammation develops in
joint
Reduced
lubrication/cushioning -
hyaluronic acid
Knee deforms and
becomes unstable
Knee becomes painful,
swollen, and stiff

6. “Traditional” Treatment
What is typically offered to
patients
Rest, Ice, Braces
Physical Therapy
Medications
NSAID
Corticosteroid Injections
Surgery

7. Is There Something Wrong With
These “Traditional” Treatment
Methods?
Rest, Ice, Braces - NO
Physical Therapy - NO
Medications - YES
Corticosteroid Injection -
YES
Surgery - YES

8. Rest, Icing, Bracing
Certainly helpful
No negative effects
Comforting
Reduces pain
Patient can do these on
their own at their own
discretion

9. Physical Therapy
Certainly helpful
Strengthens
Mobility
Home Exercise Program
Prevents further injury
Often invaluable for
prevention and to help in
recovery

10. Medications- NSAIDs
Prescription and OTC
Have MANY side effect
Ulcers
Bleeding
Heart Attack
Stroke
Kidney
Liver
One of highest causes of hospitalization and death in
elderly
Expensive
Many pulled off market because of safety issues (Vioxx,
Bextra)

11. Corticosteroid Injections
Depo-Medrol, Kenalog, Celestone
Do reduce inflammation - but for a very limited
timeframe
COMPLICATIONS - not trivial!
“flare reaction”
soft tissue damage - ligaments, tendons
cartilage deterioration - decreased cartilage cell
viability - softens cartilage
osteoporosis - softens bone
skin atrophy - depigmentation
These complications produce effects that are
completely contrary to what the patient needs
and wants!

12. Medications - Oral and
Injectables
Produce effects in the body
that are completely
“unnatural”
Produce effects that are
damaging
Block normal inflammatory
cascades
Block healing mechanisms
Block biological pathways
that are necessary for proper
healing of damaged tissue

13. Surgery
May be needed in some
situations - with proper
indications!
Significant risks
Invasive
Once done is “irreversible”
Long recovery
Complications

14. Surgery - Cost
Knee Replacement $40K
- out of pocket cost -
several $100’s or
$1,000’s
Is surgery done too
often?
Knee arthroscopy -
indications, findings,
results?
Repeat/Revision Surgery

15. What About
Platelet Rich
Plasma
Treatment - PRP
A natural way to
stimulate the body to
heal damaged tissue

16. How Does PRP Work For
Arthritis?
Stimulates body's natural healing
process
Balances inflammation/anti-
inflammatory cascades
Reduces inflammation and pain
Stimulates chondrocytes to
strengthen cartilage
Increased hyaluronic acid
secretion and superficial zone
protein
Inhibits and reverses osteoarthritis
pathogenesis pathways
(interleukin, aggrecan, nuclear
factor B)

17. PRP Stops and Reverses
the Arthritic ProcessStrengthens cartilage -
increases cartilage cell
viability
Improves protective viscosity
of joint fluid
Reverses osteoarthritic
pathways
MRI and functional studies
have shown that PRP halts
the progressive thinning of
cartilage and improves
function.Halpern, et al., Clin J Sport Med, 2013

18. PRP Advantages
Autologous
Natural
Safe
Stimulates/activates the
normal healing pathways that
the body already has
Does not have the inherent
negative effects seen with
medications (oral or
injectable)
Can avoid or delay surgery

19. PRP Advantages
Completely outpatient
setting
Can initiate
rehabilitation quickly
Long lasting results
Can be safely repeated
if needed

20. PRP for Knee Arthritis
Not all PRP’s are alike
Intra-articular PRP must be
appropriately prepared
Reduce inflammation, stimulate
chondrocytes, increase hyaluronic acid
production
Proper experience and equipment
needed
Reduce erythrocyte and granulocytes
in preparation
Maintain high platelet and growth
factor levels

21. PRP for Knee Arthritis
A natural way to treat the
symptoms of knee arthritis
and to help preserve the
structure and function of the
knee in its natural state for
an extended period of time.

22. Regenerative Medicine
and
Joint Preservation Center
1144 Sonoma Avenue
Suite 121
Santa Rosa, CA
95405
(707) 978-4322
OrthoRegenSR.com
Maintain. Preserve. Sustain.