25 April 2012

A Follow-Up on the Regenexx Stem Cell Procedure for my Knee



In my last post I talked about how I avoided another knee surgery by using an alternative treatment called Regenexx SD. Essentially the procedure extracts stem cells from my hips and injects them into my right knee. This was back in February and since that time, I have had some requests for another update. So this post is to report on my follow-up with Dr. Centeno since having the treatment.

Current Status

A couple of weeks ago I had my first follow-up with Dr. Centeno since I had the Regenexx treatment back in early February. It had been seven weeks since the treatment and everything is going extremely well. I've been doing cycling workouts as well as various core workouts lately to get back into shape for the cycling season (the foam roller is my personal masseuse right now). The day before my appointment, I had just started running two to three times a week. I'm also coaching my youngest daughter's soccer team again which requires running, kicking, etc. So far I'm happy to report that I have no pain during these sports at all. This is great news because it means that the tears in the meniscus are doing very well as a result of the procedure. The only issue I have currently is some stiffness of the muscles around and through the right knee which were preventing me from doing a deep squat on that knee. This is a result of my mental guarding of that knee to protect it. At the urging of Dr. Centeno and my physical therapist, I started squatting deeper and deeper a little at a time to stretch it and get it used to regular full motion. I have already found that this continued stretching and squatting is helping that along nicely, even just in the last couple weeks.

Dr. Centeno also performed the standard Lachman test on my right knee. To even his surprise, it was quite tight and responded very well. As a point of comparison, he also tested my left knee (the one that has never been injured) and it is very loose. It was so loose, in fact, that I could see the dislocation. Again, even he was surprised. So he tried my right knee again and he really tugged on it, but still it wouldn't budge. Because I was also diagnosed with a partial tear to the ACL, this was wonderful news! It means that the procedure has changed the state of the the ACL as well. We were both very happy to see this level of progress. I guess it was wonderful news for my right knee (the one that had the Regenexx treatment), but not so good news for my left knee. After this demonstration, I explained the stiffness in the left knee that has been increasing over the years. I had even been joking that perhaps I should have the Regenexx treatment on my left knee after the right knee is all healed up. So I'm having a MRI on my left knee to see what's going on with it. Depending on what we find, I am seriously considering the Regenexx treatment for my left knee as well. This is a testament to the results that I have experienced from the Regenexx treatment. I'm not sure if I will have it right away or not. I've got come cycling events coming up in June, so I would need to have it done really soon if I'm going to keep up my workouts in preparation for those events.

Continued Physical Therapy + Supplements

Not only am I continuing with some minor physical therapy to loosen my right patella but I am also continuing to take doses of a chondroitin/glucosamine supplement and a hyaluronic acid supplement twice a day. (The Collagen II contains the protein building blocks to support damaged cartilage and the hyaluronic acid lubricates the joints and helps to prevent free radicals from destroying healthy cartilage.) Additionally, last week I began a series of IMS (Intra-Muscular Stimulation) treatments for some muscles in my hamstrings, quads, IT bands and lower back. IMS is essentially deep tissue acupuncture to create micro-damage in key muscles to encourage them to heal themselves. It will take a few more treatments before I see some distinct results, but I'm hoping that this will dovetail well with the core workouts, yoga and cycling that I do.

Regenerative Medicine

I have a friend who sells surgical tools and equipment. One tool he's selling now is a laser that is used to create micro-damage in very specific locations of the human heart. Just like what Dr. Centeno did with my knee, such micro-damage causes red blood cells to respond to heal the area (i.e., encouraging the body to heal itself). This creates an ideal situation for the injection of stem cells to grow new tissue in place of damaged tissue. He told me that they do this procedure for patients who have chronic heart disease and in some cases they can double the heart's ability to pump blood. For some patients, this translates into adding years to their life. So when I mentioned this procedure for my knee to him, he immediately knew what I was describing and told me that regenerative medicine is the new wave. So, in my opinion, the FDA better wake up and embrace the future and stop playing favorites with big pharma. Here's some interesting info on the lawsuit against stem cells from the FDA:


Conclusion


According to my doctor, my verall my progress has been excellent and, at this point, I couldn't be happier that I chose the Regenexx procedure vs. surgery. Now tomorrow I have an MRI on my left knee to begin the possible pursuit of the same regimen of treatment for my left knee. Stay tuned.

49 comments:

  1. Hey Bruce, glad to hear your results. I had an ACL reconstruction with some meniscus repair about 20 years ago. The doc did a good job and I had been able to play soccer, basketball etc for many years afterward at a high performance level. However now my knee does ok ONLY if I stick to walking or very light running. Cutting sports like basketball are out of the question. I played an hour of basketball a couple of days ago and my knee is in great pain, inflamed, clicking and I'm limping mildly. The last time I did this it too 3 weeks to subside. I can give up basketball but I'd like to be able to at least run more.

    So thanks for the update on your experience with Regenexx. It's something I hope could get my knee back to a better condition as I'm normally very athletic.

    Question - What affect do you think the treatment is having to your meniscus tears? Do you think they are healing like they would if they had ample blood supply?

    Question 2- How would you compare your Regenexx knee to your normal knee? Do you think the Regenexx procedure is bringing back the meniscus function? If so to what degree - 50% of a normal knee/meniscus.... 75%, 100%?

    Question 3 - how hard have you tested your knee since the procedure?

    Also what did the MRI say?

    Thanks a ton!
    -Bill

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    1. Bill, Below are my answers to your questions:

      1) Before the Regenexx treatement, once the initial meniscus pain had mostly subsided from the injury, if I tried to run my knee got sore very quickly right around the tear spots and I'd have to stop. Now I am able to play soccer without any pain at all, though I have not played competitively since the injury. This is due to a self-imposed limitation that I described in a previous blog post (but I've been itching to play recently so I'm considering it). I have been cycling, running, cutting, turning, jumping, etc. and I have no pain or stiffness whatsoever in the Regenexx knee. I do experience stiffness in my other knee (the one that has never been injured) which is why I'm considering a treatment for it now.

      2) The Regenexx knee actually feels more stable and the ACL is much tighter than the ACL in the other knee (as my doctor has proven using a Lachmann test). Since the treatment, I can do a deep, full weight-bearing squat on the Regenexx knee without any pain -- I haven't been able to do that in over 25 years now! Four weeks after the Regenexx treatment, I was doing full cycling workouts and I was not holding back at all. Six weeks after treatement, I started running and doing plyometrics workouts (lots of jumping) and did not feel any pain afterwards. Just last week I finished up coaching youth soccer for the spring season where I was doing lots more running, cutting, sprinting, etc. and I have zero pain or discomfort. My Regenexx knee is 100%, no question.

      3) The only thing that I have not done since the Regenexx treatement is play competitive soccer. For the last few years I have played in an indoor co-ed soccer league with my wife as well as on a men's 40+ outdoor league. I would really like to play both of these again but to date I'm not sure that I want to risk even the possibility of another knee injury. I want to remain active for the next 30 years, so I'd rather not play one sport I Iove to be able to play many other sports I love into the future. This is the self-imposed restriction I mentioned above, though I definitely have the yearning to play when I see my friends and my wife playing, it's very difficult to just sit and watch from the sidelines.

      Dr. Centeno has not looked at my recent MRIs yet. That appointment takes place next week, so I will probably create a follow-up blog post after that.

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  2. Bruce thanks a lot. I'm following your blog and will be on the lookout for any updates.

    I'm pretty sure I have some sort of tear that gets aggravated when I stress it. This is the clicking I feel. I would love, love ,love to have this heal so I can be active with it again.

    Any thoughts on the various treatments i.e the "SD" vs the "C" (available in the Caymans) ? Multiplying the cells seem like an obvious advantage however it sounds like you're getting what you need from the SD treatment. Figured I'd ask.

    Again thanks a ton. Not a whole lot of feedback on this new technique so it's very valuable.

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    1. I had questions initially as well so I just scheduled an appointment to be evaluated. Of course, I live very close to the clinic so this was easy for me.

      At any rate, I was told that mostly pro athletes go for the Regenexx C treatment and I don't know anything more than that.

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  3. Hi Bruce, great blog. How’s the healing coming along?

    I’m a Midwest guy (Michigan) working with a physician trained in the Regenexx method. We are seriously considering a procedure similar to yours. I’m 28 and have had two ACL’s surgeries, one meniscus scope and a posterior lateral corner revision over the past 12 years (sports and motorcycles ). At this point I’m developing a pretty uncomfortable case of medial knee AO. We’re speculating that the primary culprit of the AO is the reduced and deteriorating medial meniscus/cartilage surface (I don’t think that’s rocket science).

    So, the theoretical plan is to try and regenerate the medial meniscus and anterior cartilage surface using stem cell therapy. This seems similar to what you have done. Right? However, one thing that strikes me as significantly different from your operation – as you’ve described it -- is that rather than injecting and repairing a meniscus “tear” it seems I’m trying to regenerating the medial meniscus in terms of mass (I’m visualizing it as a partially melted ice cube which we are surrounding with more water and then putting back in the freezer).

    This objective does sound tricky. I’m having a difficult time understanding how the new tissue growth takes shape. How it knows where and how to heal. DNA perhaps, scaffolding, coagulant. Not really sure.

    I’m planning to speak more specifically about this with my doc but am curious if, in your dealing with your doc, you may have discussed this how this feat is accomplished? Were you also working to increase meniscal mass?

    Hope your healing is coming along, wish you all the best.

    Zach

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    1. One day prior to the Regenexx treatment, the areas in your knee that need the tissue regrowth are subject to micro-damage, essentially inserting a needle all around the affected area. As it was explained to me, this procedure causes the red blood cells to flood into the joint and begin the healing process of those areas that were damaged. Then when the stem cells and plasma are injected, they work with the red blood cells to cause tissue regrowth where the micro-damage was performed as well as to any injured areas that are attracting red blood cells.

      My doctor is Chris Centeno, the guy who invented Regenexx. The main goal of the procedure that I had was to heal the meniscal tears. Additionally, we could see a few areas where the cartilage was worn and weakened, so he targeted those areas as well. So far, the results have been very positive for me. So positive, in fact, that just this morning I scheduled two prolotherapy injections and a platlet-rich plasma injection for my left knee later this summer.

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    2. Hello ZACH,

      I have a similar condition (except ACL surgery) in my medial meniscus.

      I am a marathon runner in Miami and just took the Regenexx treatment last week in Colorado.

      I would like to establish contact with you.
      Did you decide to get the treatment?
      thank you,

      Miguel

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  4. Hi Bruce, how you feeling? Still noticing improvement?

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    1. Still running and cycling without any troubles. I'm scheduled to have some prolo injections and a PRP (platlet-rich plasma) injection on my non-Regenexx knee in the july/august/september.

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  5. Hey Bruce,
    I'm so glad I found your blog. I suffered a complex tear in the lateral meniscus of my right knee on April 20th. My first knee injury! I too have heard many stories from friends who have had the surgery and are now worse off. The pain from my tear subsided pretty quickly and after about 2 weeks I was back to doing Crossfit, squatting 250# below parallel, and jumping rope. Still can't run and I don't dare try a box jump, which is how I hurt it, but it's doing okay.
    I have been researching alternatives to surgery and came across prolotherapy, PRP, and stem cell injections. Since my pain level isn't bad I'm thinking I'll wait it out and wait for insurance to jump on the bandwagon.
    It sounds like your experience has been great and you're back to a pretty high level of activity which is awesome!
    How in depth was Regenexx's review of your case befoer they started charging you money?
    Thanks again for posting your experience. It's been a great moral booster.

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    1. Being that this was my third major injury to my right knee in my lifetime, I had already guessed accurately that it was a torn meniscus. So I knew that I had two choices -- surgery or do nothing and live with it. Meniscal injuries do not heal completely on their own. The meniscus is a very low bloodflow tissue which is the root cause of the slow healing. The further I read I found that surgery on this tissue is generally a 50/50 crap shoot. Not something I wanted to gamble with given how much I enjoy rigorous physical activity.

      Anyway, there's not much diagnosis required for this type of injury. Get an MRI and have a competent orthopedic doctor read the results. Once you see the injury yourself on the MRI, there's no question. The only question for me was how this alternative therapy would work on my body. All evidence to date pointed at success and I knew that I could fall back on surgery if necessary, so I made the decision to give it a try. Boy am I glad I did.

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  6. Glad to stumble across your blog ... I am in the same boat. I've had 3 surgeries over 15 years - medial meniscus torn ... basically bone on bone now..

    Did you have the other knee done? Results just as good?

    thanks

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    1. Sorry to hear about your situation, that doesn't sound fun. I did have my other knee treated and the write-up is available here:

      The Regenexx Stem Cell Procedure For My Left Knee

      My knees are definitely improved. As proof, I just return from a five mile run. No knee pain like I used to have previous to the Regenexx treatments.

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  7. Hi Bruce, I have two torn ACLs and am totally shut down at age 47. Can't even ride a bike or walk without pain. Is this covered by insurance? If not, what are the costs for treatment? I have very recent MRIs so I should be able to use those.

    Thanks,

    Andy

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    1. If the ACL is completely torn, then the Regenexx treatment will not help you. The only option for complete tears is surgery to rebuild it.

      Because the treatments are so new, they are not typically covered by health insurance. The cost for my Regenexx SD treatment for the torn meniscus was about $5600. The cost of my Regenexx SCP treatment for general wear and tear with laxity in the ACL was about $2000. These costs were out of pocket.

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  8. Nice to see someone write about this. Personally I've been suspicious of this process. You know when something seems to good to be true it usually is. I was wondering what you're out of pocket expenses where since I'm pretty sure insurance doesn't cover this.

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    1. Take a look at one of my previous posts where I outlined the cost involved with the treatment of meniscus tears:

      The Regenexx Stem Cell Procedure for my Knee

      Health insurance typically does not pay for this treatment because it's new. But given that I've had surgery previously, the Regenexx procedure far less invasive (and therefore less damaging) which made my recovery time dramatically faster and much easier, I would definitely choose this treatment again. In fact, I've already chosen the treatment a second time as I had the treatment on my other knee back in August 2012 to treat a loose ACL and general wear and tear:

      The Regenexx Stem Cell Procedure For My Left Knee

      After experiencing Regenexx for myself now twice, I'm convinced that regenerative medicine is the future of medicine versus surgical procedures as the default treatment. Regenerative medicine is already being used on many other areas of the human body including the human heart and the success stories are really stacking up.

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  9. How much are your supplements per month? I've read on other reviews they are very expensive and not disclosed up front in the price.?

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    1. I have provided links to the recommended supplements below:

      Collagen MD® Collagen II Joint Formula - $34.95 for a one month supply

      Collagen MD® Hyaluronic Acid - $27.95/bottle (3 bottles/month = $83.85)

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  10. Are they required as part of your treatment?

    Thanks.

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    1. Note my use of the word 'recommended'.

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  11. I would greatly appreciate hearing from someone who had a rotator cuff repair. hank@henrymarkholzer.com.

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  12. Wow! Best blog about Regenexx so far! Organized, Factual and to the point. Thank you. I live in Orlando, FL and have a telephone conference scheduled with Dr. Centeno this Wednesday. I hope, to be a good candidate for this procedure. Thanks for sharing Bruce... your blog was an excellent source of information. It is much appreciated. :)

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    1. Thank you, Valentina and good luck!

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  13. Hi Bruce! Thanks for all of this information. I've had two meniscus repair surgeries. I am a runner but also do a very physical form of yoga which requires excellent strength and flexibility in the knee. Can you comment on how your knee has healed and the range of motion that you have now? I'm considering another surgery or this treatment and most concerned with a bit of strength but more importantly an excellent range of motion. Thanks so much.

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    1. Hi William, I have had both knees treated (each with different treatments both from Regenexx) and my range of motion is better than before the treatment. About 25 years ago, I had my right ACL reconstructed and I had not been able to go into a full, deep squat since that time. But after having the Regenexx treatment, I have no problem performing a deep squat with nearly 100% range of motion.

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  14. Bruce,

    How painful was the extraction of the bone marrow? I am not a very good patient, if I am in pain. I am considering this for my low back.

    Thanks,
    HMedina

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    1. The procedure wasn't a big deal on the pain scale, but I did have a local anesthetic. For several days following the bone marrow extraction procedure, it became more sore each day as it healed, but that was it.

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  15. Bruce,

    I don't mean to be rude, but were you compensated in any way by Regenexx or by anyone associated with them.

    Thanks
    Ajay

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    1. Absolutely not. I received neither compensation nor discount for writing about my experiences with Regenexx. It was solely my idea to spend the time to write up everything and post it to my blog.

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  16. If you're not paid or associated with them, what about their logo on this weblog? I would think they have a copyright on their logo. Nike, for example, wouldn't be happy about an unsanctioned use of their logo. Disney moreso.

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    1. I have published these entries on blog with my doctor's permission. He is one of the two guys who invented Regenexx.

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  17. Hey Bruce, i came across your blog as i was curious to the effects of Regenexx as an alternative treatment for knee problems. Did you consider any other stem cell treatment for your knees before deciding on Regenexx?

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    1. I did not consider other stem cell treatments for a couple of reasons:

      1) To my knowledge, there were not that many other stem cell treatments like this in existence yet. As far as I know, Regenexx was one of the first.

      2) The doctors who created Regenexx are about five miles from my home and the testimonies from patients was already very good.

      3) The book Orthopedics 2.0 was written by Chris Centeno who is a pioneer in regenerative medicine and was one of the creators of Regenexx.

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  18. I did my research, and was pretty optimistic, but then I came across some of your videos and noticed that they all have comments hidden and ratings disabled. That made me just a little worried, because I really felt Regenexx should receive positive comments and thumbs ups on videos, rather than have them disabled.

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    1. I'm not sure to what videos you are referring. I have never created any videos about Regenexx.

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  19. Howdy! I have been reading up on Regenexx for a couple years now hoping that I can eventually have the treatment performed. Even though I am nearing 60 and have had "numerous" surgeries to "clean up" my joints (both knees and both shoulders) I have had tremendous results and relief from pain and able to return to high level athletic endeavors. However, over time the arthritis aggravates the issue again and I can no longer do "any" activities. Surgeries (orthoscopic) are no longer viable--except for knee replacements, which I don't want to do!
    I have also had tremendous results from injections, mostly Synvisc, but it's not as long lasting as Regenexx reports. I came across your blog today and just wanted to know your thoughts as a potential candidate. ^_^

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    1. Hi Sheila, all I can say is that I had very good success with Regenexx. I encourage you to read all of my blog posts about Regenexx and they contain all of my experiences. As for your potentially being a candidate for it, I'm not a doctor so I cannot say. I can also suggest reading the literature available on the Regenexx website: http://www.regenexx.com/

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  20. Hi Bruce,
    I am overjoyed to read your blog.

    I am a very active 41 year old mother of 2 that had the misfortune of having a lot of cartilage taken out (after accident) by conventional cartilage operation when I was about 12 years old followed with another arthroscopy 2-3 years later as the knee never settled down.
    Since then I have played nearly 30 years of hockey (still play for representative), I go to a mild crossfit gym twice weekly and trail run around 7km, 2-3 times per week. I do the odd longer run and cycle too. I have always stayed in shape but since a further injury to cartilage and another arthroscopy in Dec 2011 the knee has been often swelling with a dull ache after a serious game of hockey. Since January the trail running and new level of strength and fitness seemed to be helping quite a lot with the knee feeling nearly pain/swelling free for until May. 3 weeks ago I started strengthening that weak knee under physio instructions to get rid of a bit of a limp (while running) and the knee has been swelling after every hockey game and trail run ever since. An xray 2 days ago has highlighted bone on bone and and a high level of osteoathritis in one compartment.

    I am interested to know whether you think a treatment similar to yours could help me. I very much wish to be able to stay / return to trail (hill) running if at all possible and therefore interested to hear what expectations could be after treatment on both my activity level and long term use of the knee.

    I just cant believe what I am reading on this blog....simply thrilled. I have been worried the day I couldn't play hockey anymore for over 20 years

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    1. I am in New Zealand and we play field hockey here

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    2. Hi Carla, I always love hearing from folks our age (I am 42) or older that they want to remain athletically active! Regarding your question, it is my understanding from all of the research I did into Regenexx that it is used quite often for arthritic joints. There are two things you can do for yourself:

      1) Find a doctor near you who practices this treatment and be evaluated
      2) Conduct your own research via the internet. The Regenexx website is *full* of information including Dr. Centeno's book titled Orthopedics 2.0 which is an excellent read.

      Best of luck, Carla!

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  21. Magnificent goods from you, man. I have understand your stuff previous to and you are just extremely great.

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  22. Hi Bruce,
    How severe was your meniscus injury? What kind of meniscus injury did you have? Did you have tears or ruptures only in the white zone or in both the red and white zones for example? Did your post treatment MRI show evidence that such tears actually healed particularly in the white zone?

    My MRI summary states: " Horizontal tear of the body and posterior horn of the medial meniscus with tiny, 2 mm posterior paramedical cyst. Tear extends to the inferior articular surface in the posterior horn and body.

    Any feedback would be greatly appreciated
    Cheers
    James

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    1. As stated in the last post, I experienced two meniscal tears (one medial, one lateral) as well as a possible partial tear of the ACL. My knee injury healed so well that I had treatments on my other knee just to tighten up the ligaments to correct general looseness.

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  23. My question is regarding the specific details of your injury. For example: We're the tears in the red or white zones of the meniscus? And the types of tears were they?Horizontal or flap tear or otherwise? There size? As

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    1. Unfortunately I don't recall if they were in the red zone or white zone and if they were oblique or lateral tears.

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  24. Hello Bruce,
    Can you comment on whether you sense any "degradation" in performance for the knee, now that it looks like you are at least couple years out (for right knee). I have wondered as to the longevity of such procedures.
    Do you need/get periodic PRP treatments (or any types of injections ) to "keep it going"??

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    1. I have not had a need to continue the treatments because I experienced zero degradation. For a couple years after the treatments, I ran and cycling many, many miles on a very regular basis. Unfortunately, seven months ago, I was in a car vs. bicycle accident that left my feet paralyzed (http://bsnyderblog.blogspot.com/2014/05/car-vs-bike-in-boulder-colorado-bruce.html), so I haven't been able to run or ride since then. I'm very hopeful that my body will heal over time and I will be back at. I'm already walking with arm crutches and not experiencing any trouble with my knees.

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