Biologics Are the Future for Treatment of Knee Arthritis

By Nancy Kennedy

If you are one of the 60 million American adults who have arthritic knee pain, you may assume that the ordeal of total knee replacement looms in your future.

Maybe, maybe not. The future of arthritic knee treatment now includes innovative alternatives, and that future is happening right now. At Sports Medicine and Joint Replacement Specialists, a promising new treatment called Bone Marrow Aspiration Stem Cells (BMA) is being offered by Derrick J. Fluhme, M.D., a board certified orthopedic surgeon and sports medicine specialist. BMA therapy is available for patients who have joint pain, but are not in need of joint replacement; the treatment uses the body’s own natural healing capacity to repair the tissues in knees that are damaged by osteoarthritis.

“I have been treating knee arthritis for nearly 20 years,” Dr. Fluhme explains. “I realized years ago that we were simply chasing our patient’s symptoms with conservative management such as ice, NSAIDs, bracing, physical therapy, and injections. Injections primarily consisted of corticosteroids which simply masked their discomfort while adding to the deterioration of their cartilage, thus making the arthritis worse. Viscosupplementation was another treatment, a simple lubricant that rarely was effective enough on its own. While total knee replacement remains a very effective way of treating patients with severe bone on bone knee arthritis, nine out of 10 patients that present to me do not yet require surgery. Thus, we were simply chasing symptoms until that patient’s knee cartilage was so worn out that they needed a knee replacement.”

In 2015 Dr. Fluhme began searching for an alternative for those patients stuck in what he calls the “purgatory” of knee pain: enough arthritis to cause pain and bother them, but not enough to warrant total knee replacement. Instead of administering injections that were ineffective, and potentially adding to their problem, he began using biologic-based injections and has had excellent outcomes.

Bone marrow, the soft spongy tissue which is found in the center of the bones, is the dynamic manufacturing site where the human body produces red blood cells, white blood cells and plasma components. Stem cells, the immature form of these cells, are also found in bone marrow. These have the potential to develop into mature cells that form the muscles, blood vessels, cartilage or bones. Certain stem cells drive tissue regeneration and have the capacity to reduce pain and inflammation and repair damaged cells, naturally and biologically.

According to Dr. Fluhme, the biologic injection process involves a safe, minimally invasive procedure performed in his office. Bone marrow is aspirated from the pelvis, with a local numbing medication, yielding a rich supply of cells. The extraction takes about ten minutes, and the cells are injected into the knee right away. The patient can expect to resume normal activity with minimal discomfort. Results may take four to six weeks to take effect, and at that time a booster injection of platelet rich plasma (PRP) will be given.

Bone marrow aspiration offers many benefits to the patient. It uses natural, organic tissue from your own body; it has fewer side effects than steroid injections; it accelerates healing and there is minimal down time involved in the procedure. BMA treatment is not yet covered by health insurance, but Sports Medicine and Joint Replacement Specialists keep costs to a minimum and offer payment plans. Dr. Fluhme encourages patients to seek this treatment from orthopedic surgeons. “People with knee pain deserve to be seen by an experienced joint specialist whose treatment includes surgery. Only an orthopedic surgeon who knows the full spectrum of joint disease and treatment can tell you if you need joint surgery.”

Treatment with bone marrow stem cells is not an alternative to surgery, but to steroid injections, Dr. Fluhme says. “This treatment offers the most prolonged pain relief for those with mild to moderate pain and can delay the need for surgery. It can reduce pain and improve functioning, helping people achieve a higher quality of life: they will be better able to walk, socialize and enjoy activities, all of which improve general health. There is nothing we can offer that is protective or reparative, other than biologic injections.”

To learn more about stem cell therapy, visit Drfluhme.com.
To learn more about Dr. Fluhme’s practice, or to make an appointment, visit Drfluhme.com.
To learn more about Sports Medicine and Joint Replacement Specialists, visit wDrgreghabib.com
To make an appointment for the Mt. Lebanon or Greensburg location, call 412-207-9780.