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  1. #1
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    Platelet Rich Plasma (PRP) Injection?

    Hi, recently diagnosed with Chondromalacia in my left knee, Dr. suggested I try a Platelet Rich Plasma (PRP) injection, wondering if anyone has had experience with Chondromalacia or PRP?

    Appreciate any information you can provide.

    Thanks,
    ifcjti

  2. #2
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    Quote Originally Posted by ifcjti View Post
    Hi, recently diagnosed with Chondromalacia in my left knee, Dr. suggested I try a Platelet Rich Plasma (PRP) injection, wondering if anyone has had experience with Chondromalacia or PRP?
    I've had PRP treatments twice - once for my knee and once for my elbow. In the case of the knee, I had a lot of other treatments done at the same time, so I can't conclusively say PRP was responsible for the improvement. In the case of the elbow, however, I can vouch for the PRP treatment.

    I have also had many cortisone injections. PRP doesn't give you the quick relief that cortisone often provides, but it gives a steady improvement over a few weeks. Despite the cost, I will likely opt for PRP over cortisone in the future.

  3. #3
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    I think that it was back in 1978 that Bicycling Magazine published an article on chondromalacia. One of their suggestions was to run lower gears and higher RPMs. Since I had trashed my knees as a distance runner in high school from '72-76 (fall XC, winter and spring track) I took it to heart and changed out my crankset so as to run a 38/48 chainring setup. Nearly forty years later my knees still thank me.
    Life is short... enjoy the ride.

  4. #4
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    I had one cortisone shot in my knee, it was great for 10 days then wore off. Been doing PT exercise to strengthen my hip and leg muscles. I'll probably wait until after the 1st of the year to give PRP a try once I reload my health care spending account. For now since it's been colder and the days shorter i'priding the trainer 2-3 times a week and taking it easy. I have an appointment if 3 weeks with a cycling medical practice that will look at my MRI and X-rays, how my bike is presently set up and make suggestions for any changes to my current set up and further exercise. It's really a drag knowing there is no real cure for this condition, already had a THR, so I know this feeling in my knee is not a good thing.
    Thanks for your replies.

  5. #5
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    I had one done when I had my shoulder operated on it worked great and really sped the healing up.

  6. #6
    dcb
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    I've seen a lot of good results with PRP injections in athletes I've known and worked with. It's not a magic bullet and isn't always effective, but it's worth a shot.........pun intended.

  7. #7
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    I had PRP after an Achilles tear. It healed but took forever and I was in a boot for 8 weeks or so. I have know idea if it would have healed at the same rate without the PRP but I wanted the best chance possible at a good outcome.

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    Thanks for your replies about your experiences with PRP. The one difference for my situation I believe is that I have arthritis in my knee, so its not really something that will heel, I'm hoping to find someone who has had PRP injections their knee for a similar arthritic condition and if it helped. Thanks!

  9. #9
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    Chondromalacia is the damage to specific cartledge in your knee that is caused by physiomechanical reason. (For instance improper knee cap tracking in the groove.) So identifying the cause will often allow you options to correct the cause. Without success in that area you are always going to have it.

    Strategic exercise is best for arthritis. So if biking is the exercise that's right for that than we are usually talking proper fit and personalized gearing and cadence that you knee likes best. Time pedaling is important too. (I assume the arthritis in your knee is in the anterior compartment? I know it could be elsewhere but that's my guess.)

    The treatment you describe couldn't hurt, (other than your pocketbook), and MAYBE it can help.

    Best of luck to you.

  10. #10
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    Quote Originally Posted by ifcjti View Post
    Thanks for your replies about your experiences with PRP. The one difference for my situation I believe is that I have arthritis in my knee, so its not really something that will heel, I'm hoping to find someone who has had PRP injections their knee for a similar arthritic condition and if it helped. Thanks!
    My Dad fits the scenario you are talking about to a T. I'd say to the extreme because he's really stubborn and has a high pain tolerance so let it go for years and years to the point he could barely walk before he gave in and did something about it.

    He says the injections work really great and that they last about 6 months. He does ride a bike but not the type of riding someone posting on a cycling site probably does. He rides very slow and casual on a upright hybrid and says the injections work well enough to do that no problem. (he had to really suffer to do it sans injections)

    His doctor says what he really needs is a knee replacement but he says he's content to continue dealing with it wirh the injections.

  11. #11
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    Globalguy, thanks for your input. Difficult to determine what caused the cartilage to wear. Been cycling for 45+ years, guess it's gradual deterioration of the cartridge and genetics. Was a runner for 30+ years before my hip went and had a THR 6 years ago. I've been comfortable on my bike set up and have made minor adjustments over the years, but knees have never bothered me till now. Going to a cycling medical practice next week to be evaluated by a phisiatrist and a PT, hope to get some answers then. Been doing PT for 5 weeks to build leg and hip muscles, seems to help, but still soreness. Rode 20 miles hard this past Saturday, overall felt pretty good and didn't hurt the next day. I'll continue to do PT and see what the cycling Dr. has to say.
    Yhanks,
    ifcjti

    Quote Originally Posted by GlobalGuy View Post
    Chondromalacia is the damage to specific cartledge in your knee that is caused by physiomechanical reason. (For instance improper knee cap tracking in the groove.) So identifying the cause will often allow you options to correct the cause. Without success in that area you are always going to have it.

    Strategic exercise is best for arthritis. So if biking is the exercise that's right for that than we are usually talking proper fit and personalized gearing and cadence that you knee likes best. Time pedaling is important too. (I assume the arthritis in your knee is in the anterior compartment? I know it could be elsewhere but that's my guess.)

    The treatment you describe couldn't hurt, (other than your pocketbook), and MAYBE it can help.

    Best of luck to you.

  12. #12
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    I took a very quick look at the research literature. Very quick.

    I did not see any large scale double blind studies. What I did see were a few small N studies. Some were basically case studies (2 or 3 patients), some had a couple dozen.

    It seems to help some people. There is little downside to trying it, combined with PT. However, I would say that given the type of research published, and not published, this might be one of those treatments that has mild to no benefits for the population as a whole, but huge benefits for some people in the population.

    I would certainly give it a shot (heh), if I had the condition and saw little improvement from PT alone.
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  13. #13
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    Good timing for this thread! I'm going in Wednesday 12/6 for a PRP injection for my left knee. Going with Dr. Roh at Stanford. I'll subscribe to this thread and post my thoughts and experiences as it goes.

  14. #14
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    Quote Originally Posted by surfinguru View Post
    Good timing for this thread! I'm going in Wednesday 12/6 for a PRP injection for my left knee. Going with Dr. Roh at Stanford. I'll subscribe to this thread and post my thoughts and experiences as it goes.
    Hi surfinguru, thanks for your post! Do you have a diagnosis for what's wrong with your knee? Mine is Chondromalacia in my left knee, the cartridge is thin in the bottom and rubs the bone causing pain mostly when I bend my knee towards 90 degree. Cycling is not to bad, although I do feel it on the top outer side. Been trying to not take any ibuprofen, although it helps quite a bit when I do. Taking Turmeric and Omega 3 and Glucosamine/Chondroitin liquid, but not really sure how much they help. Been doing PT now for about 6 weeks, it definitely helps, but still have daily discomfort.
    Good luck with your PRP injection. How many do you ultimately think you will have? if you don't mind my asking, what is the cost? Here in MA it's $1200 for an injection, not covered by Blue Cross. Best of luck with your knee, hope you get some relief!
    ifcjti

  15. #15
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    Quote Originally Posted by ifcjti View Post
    Hi surfinguru, thanks for your post! Do you have a diagnosis for what's wrong with your knee? Mine is Chondromalacia in my left knee, the cartridge is thin in the bottom and rubs the bone causing pain mostly when I bend my knee towards 90 degree. Cycling is not to bad, although I do feel it on the top outer side. Been trying to not take any ibuprofen, although it helps quite a bit when I do. Taking Turmeric and Omega 3 and Glucosamine/Chondroitin liquid, but not really sure how much they help. Been doing PT now for about 6 weeks, it definitely helps, but still have daily discomfort.
    Good luck with your PRP injection. How many do you ultimately think you will have? if you don't mind my asking, what is the cost? Here in MA it's $1200 for an injection, not covered by Blue Cross. Best of luck with your knee, hope you get some relief!
    ifcjti
    Can't recall the terminology at the moment, but I had my knee scoped in May. Synovectomy, ACL clean up from really old injury, removal of three cysts and some clean up on my patellar tendon. I still have daily swelling in the patellar tenor which is what we're targeting.

    I managed to get about 1100 miles in after the surgery and I was able to get my power numbers back to within 20 points of where I was before the surgery. Problem was I just can't do really long rides.

    The follow up MRI in October came back clean. Doc did a really good job and there's nothing left for him to repair, thus the referral.

    Cost is going to be $1425.00 for one round of treatment. (Yeah, ouch!)

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    Quote Originally Posted by surfinguru View Post
    Can't recall the terminology at the moment, but I had my knee scoped in May. Synovectomy, ACL clean up from really old injury, removal of three cysts and some clean up on my patellar tendon. I still have daily swelling in the patellar tenor which is what we're targeting.

    I managed to get about 1100 miles in after the surgery and I was able to get my power numbers back to within 20 points of where I was before the surgery. Problem was I just can't do really long rides.

    The follow up MRI in October came back clean. Doc did a really good job and there's nothing left for him to repair, thus the referral.

    Cost is going to be $1425.00 for one round of treatment. (Yeah, ouch!)
    Surfinguru, best of luck with your treatment! Although we have different issues going on in our knees, I'll be very anxious to hear how your PRP therapy goes, I hope it's an overwhelming success.
    Keep us posted.
    Best,
    ifcjti

  17. #17
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    I had right (1/15) and left (8/15) total knee replacements. My right knee is fine, my left knee has been troublesome since September of 2016. Quad tendonitis and inflamed scar tissue among other issues. My yearly mileage has been down by 1/3 this year because of these ongoing issues and my speed is also off. My ortho surgeon recommends easier riding and limited weight training. Another ortho doc I am seeing for a torn bicep tendon suggested that PRP injections might improve my knee. My Ortho doc is skeptical, but I think he is just being conservative. Ii there is a remote chance the PRP injection will reduce/resolve the tendonitis and inflammation issue with my left knee, I am all in as long as the Ortho docs agree on the potential risks and benefits. It is a serious consideration for me since my riding is definitely affected by these ongoing and hard to resolve issues (yup being doing physical therapy stuff for months....)

  18. #18
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    Had an appointment with a Dr. and PT at a cycling medical practice yesterday to look at my knee again, as well as my feet, hips, cycling specific orthotics, cycling shoes, position on the bike while cycling including knee tracking. Wonderful experience, Very interesting observations. Among the tweaks discussed, due to my THR going to shorter cranks, from 172.5 to 165, larger shoes to account for my long arch relative to my foot length (from a 42.5 to a 43.5 or 44), continued PT to strengthen legs and hips. The Dr. also discussed Bone Marrow Aspirate Concentrate Injection (from Stem Cells) together with PRP. This is apparently the next thing. I'm going to look into it further, very interesting! For now I'll continue with PT and make some bike/shoe adjustments.

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