Are There Any Safe Alternatives to Knee Replacement Surgery

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  • āđ€āļœāļĒāđāļžāļĢāđˆāđ€āļĄāļ·āđˆāļ­ 18 āļĄāļī.āļĒ. 2024
  • Are there alternatives to knee replacement surgery?
    Many individuals suffering from knee pain wonder if there are alternative solutions to alleviate their discomfort. Fortunately, there are various options available for knee pain relief and management without immediately resorting to knee replacement surgery.
    These alternatives encompass low-impact exercises tailored to strengthen the knee, weight loss to reduce stress on the joint, physical therapy to improve mobility, joint supplements to support cartilage health, and knee pain injections for targeted relief.
    However, it's crucial to thoroughly consider the effectiveness and suitability of each alternative. While non-surgical methods can provide temporary relief, they may not address the underlying cause of the knee pain. If you're seeking a long-term solution to restore mobility and experience lasting relief from chronic knee pain, surgical intervention can be a viable option.
    We specialize in a comprehensive range of services including sports medicine, orthopedics, open MRI, physical therapy, and athletic training. Our team of experts can guide you through the entire process and help you make an informed decision about knee pain treatment.
    In this video, we delve into the topic of alternatives to knee replacement surgery, providing valuable insights into various non-surgical approaches for knee pain relief and management.
    Links to mentioned:
    V Slim - victorysportsmedicine.com/ser...
    Glucosamine and chondroitin sulfate - victorysportsmedicine.com/?s=...
    Hyaluronic acid - victorysportsmedicine.com/?s=...
    Cortisone - victorysportsmedicine.com/?s=...
    PRP, Platelet Rich Plasma - victorysportsmedicine.com/prp...
    Bone Marrow Cells. - victorysportsmedicine.com/bon...
    Chapters:
    00:00 Intro
    00:34 5 alternatives to knee replacement surgery
    00:39 Number 1
    02:26 Number 2
    03:58 Number 3
    06:55 Number 4
    12:36 Number 5
    22:26 End
    Disclaimer:
    The content provided in this video is solely for informational purposes and is not intended to be construed as specific medical advice for any particular individual viewing this content. It is essential to consult a healthcare professional for personalized guidance regarding any specific medical condition. We explicitly disclaim any responsibility and shall not be held liable for any damages, losses, injuries, or liabilities arising from your reliance on the information provided on this channel.
    *****
    ðŸ‘Ļ‍⚕ïļ About Dr. Marc P. Pietropaoli 'Dr. P':
    Dr. Marc P. Pietropaoli also known as 'Dr. P,' is licensed in the states of New York, Alabama, Florida, Vermont, Maine, Connecticut, Pennsylvania, and Kansas. If you have any medical concerns or questions, don't hesitate to reach out.
    Connect with us now!
    Facebook - / victorysportsmedicineo...
    Instagram - / victorysportsmedicine
    Linkedin - / marc-pietropaoli-b246473
    TH-cam - / @victorysportsmed
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    Website: victorysportsmedicine.com/ and www.victorysurgeon.com/
    Call us at 315-685-7544 or email us: info@victorysportsmedicine.com
    #KneeReplacementSurgeryAlternatives #KneeReplacement

āļ„āļ§āļēāļĄāļ„āļīāļ”āđ€āļŦāđ‡āļ™ • 59

  • @vickysmith7644
    @vickysmith7644 4 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™ +8

    The bad thing about physical therapy that I went to after knee replacement was they had to many people at one time and don’t have time for you and don’t watch you and they only have me minimal exercise and now I am suffering because they didn’t get me ready for my very physical job. I suffer every day with swelling fluid collect and I can’t do my job .

    • @VictorySportsMed
      @VictorySportsMed  4 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™ +2

      Vicky, thank you for your comment. SORRY to hear that your knee is still in pain and swelling. make sure you let your surgeon know that if they already do not. Yes, unfortunately, with “traditional” physical therapy, it is more of an “Assembly line” type of operation, however, this is not the fault of the physical therapist, it is the fault of the insurance companies. Having said that, at our office, we either utilize a 1/2 hour or a one hour one on one session. where are you located?

  • @boardhead911
    @boardhead911 6 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™ +4

    Thank you for your very thorough explanation of the different types of methods that may improve one's knee osteoarthritis condition . One should only have a knee replacement as a last resort.

    • @VictorySportsMed
      @VictorySportsMed  5 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™

      You're very welcome!

  • @dhansubba4876
    @dhansubba4876 3 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™ +1

    Very nice. Honest. Straight forward. Educative. Thanks.
    ⭐⭐⭐⭐⭐

    • @VictorySportsMed
      @VictorySportsMed  3 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™

      Much appreciated. Thank YOU for commenting. Please feel free to forward to friends and family. The more we can educate people about these things, the more they can be empowered to take control of their own health!

  • @steveprevesk6627
    @steveprevesk6627 2 āļ§āļąāļ™āļ—āļĩāđˆāļœāđˆāļēāļ™āļĄāļē

    Prolotherapy helps me and I have bone on bone but it's expensive - about $150 per injection. The doctor gives me a shot full of peptides then puts nitrous oxide in. It lasts a couple weeks but a couple weeks without the pain is worth it. I know I need a partial shortly

    • @VictorySportsMed
      @VictorySportsMed  āļ§āļąāļ™āļ—āļĩāđˆāļœāđˆāļēāļ™āļĄāļē

      Thank you for your comment and for sharing your experiences. We stopped doing à la carte injection only treatments during COVID when hospitals shut down and we were unable to perform knee replacements anymore. We had been performing à la carte single PRP injections since 2008, Bone Marrow Cell injections since 2017, MLS laser since 2017 and V-Fit total body metabolic fitness (the most important piece of the puzzle for long term joint pain management and relief in our experience) since 2009. Each one of those absolutely works to help patients like you we found over the years, HOWEVER, when COVID hit and we could no longer perform knee replacements, we had a group of patients who were desperate for pain relief, and increased function. they asked if there was anything we could do, and we decided to put all of those components together into one program (there are also several other components that we utilize at times, but those four are the heart and backbone of most of our programs for patients suffering from what you suffer from) and, as we suspected, “The Whole Was Greater Than The Sum Of Its Parts”! In other words, those individual “à la carte” components worked SYNERGISTICALLY , much more effectively than utilizing them as individual parts. Hence was born our trademarked “Knee Repair, NOT Knee Replacement TM” brand/systems/programs. Yes, these individual parts were not covered by insurance still, even though, during the unique situation of the COVID pandemic, we tried to get the insurance companies to make exceptions since we could not perform knee replacements on these unfortunate patients. Unfortunately, none of the insurance companies made exceptions, and these were not covered. We found that during the first year of us utilizing these Knee Repair, NOT Knee Replacement TM programs, 91% of patients reached their goals. We like to treat patient’s goals, and not necessarily their “diagnosis“. Every patient has unique goals as you know. We have, and continue to be amazed by the power of our own body, “with a little assistance from us”, to calm, soothe, and heal itself. It shouldn’t really be a surprise, however, because if our body did not heal ourselves, we would fall apart in no time. So, why not utilize the power of the own body to help restart the healing process and heal itself? This is a very exciting time and we are just on the tip of the spear so to speak with regenerative medicine. We found that even using the à la carte individual treatments described above, by themselves, they lasted a lot longer than just two weeks. So, if you add up what you were spending in time and money just to get a couple of weeks relief, it starts to become abundantly clear that yes, patients have to pay thousands of dollars sometimes, but there are much better programs out there for longer lasting relief. Many people spend thousands of dollars on their pets, but refused to invest any of their money in their own health. It is not just money either, there is no magic or magic shot, there has to be an investment of time and mental fortitude. We like to say we only choose patients who are “ALL IN”. In other words, not every person qualifies for our Knee Repair, NOT Knee Replacement TM programs. There are many other possible components to our Knee Repair, NOT Knee Replacement TM programs as they have evolved since 2020. We also now track our results in a national databank registry called Databiologics and have found that tracking our results scientifically and comparing to the rest of the country, these treatments definitely work in general, and, we feel, because we utilize programs and not an à la carte philosophy, that it is not surprising that our results have consistently been better than the national average utilizing orthobiologics. We will do a post on that soon. Thank you, again, for your comment and we wish you luck in the future!
      PS: on a separate note, it is our understanding that injections of peptides are not FDA approved, and since there is no FDA indication for these, technically, those cannot be performed in United States. That does not mean that we feel that peptides can and do have potential positive implications, it is just that we are not allowed to perform them as injections in the United States at this time. oral peptides are considered “supplements“, but that is also something that needs more clarification.

  • @umagupta63
    @umagupta63 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™

    Thank you
    Very informative

    • @VictorySportsMed
      @VictorySportsMed  āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™

      You are welcome!

  • @cezdizon1229
    @cezdizon1229 4 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™ +1

    Nicr explanation thanks for sharing

    • @VictorySportsMed
      @VictorySportsMed  4 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™

      Thank YOU for your comment and following us!

  • @rehanatharani229
    @rehanatharani229 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™ +1

    Very nicely and clearly explained

    • @VictorySportsMed
      @VictorySportsMed  āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™

      Thank you!

  • @lauranglover521
    @lauranglover521 4 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™ +1

    This was an excellent review, thank you! I'm hoping insurance will cover the biologic (stem cell injection), as all the other methods have failed, and I'm not wanting a TKR.

    • @VictorySportsMed
      @VictorySportsMed  4 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™ +4

      Thank you very much for your comment! It is highly unlikely that insurance will cover this anytime soon, not because there aren’t a lot of excellent level one and level two studies, but more because it is you, healing yourself. All we are doing is concentrating something that comes from you and injecting it back into the place that needs help. so, you are the “factory“ or “manufacturing plant“, and drug manufactures and insurance companies don’t stand to make anything off of you healing yourself. Just my theory and two cents. Thank you!

    • @lauranglover521
      @lauranglover521 4 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™ +2

      @@VictorySportsMed You're spot on! Our industry has been so captured, it's ridiculous!

  • @tomsakin3059
    @tomsakin3059 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™

    Thanks

    • @VictorySportsMed
      @VictorySportsMed  āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™

      You are welcome!

  • @sjc4836
    @sjc4836 4 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™ +1

    Today I too PRP injection in my knee
    After 1 hr it started painting.. still painting.. 5 hrs passed..knee healing going on well😊

    • @VictorySportsMed
      @VictorySportsMed  4 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™

      Glad you are doing well already 👍

    • @amishmuscle2536
      @amishmuscle2536 14 āļ§āļąāļ™āļ—āļĩāđˆāļœāđˆāļēāļ™āļĄāļē

      That’s awesome! I do it every 6 months mixed with MonoVisc and it’s been a miracle. Going 7 years strong at every 6 months.

  • @wacki_cjk
    @wacki_cjk 6 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™ +1

    YOU ARE THE MAN DR. P MUCH LOVE ðŸĨ·ðŸ–Ī

    • @VictorySportsMed
      @VictorySportsMed  5 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™ +1

      And to you my friend, when is your next fight?

    • @wacki_cjk
      @wacki_cjk 5 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™

      @@VictorySportsMed I compete in NAGA in January!! Jiu jitsu tournament. I will aim to fight in the summer !

  • @amishmuscle2536
    @amishmuscle2536 14 āļ§āļąāļ™āļ—āļĩāđˆāļœāđˆāļēāļ™āļĄāļē

    Misha shock absorber is what I’m looking into in 2 days with Dr Frush in Novi Michigan. I do PRP/Hyrolonic Acid hybrid injections every 6 months and it’s saved my life. But I’m looking into the MISHA system as well

    • @VictorySportsMed
      @VictorySportsMed  14 āļ§āļąāļ™āļ—āļĩāđˆāļœāđˆāļēāļ™āļĄāļē +1

      That is a surgical option out there.

    • @amishmuscle2536
      @amishmuscle2536 14 āļ§āļąāļ™āļ—āļĩāđˆāļœāđˆāļēāļ™āļĄāļē

      @@VictorySportsMedyes. It’s amazing. Also I’m on a clinical trial list for another product in 2025 â€Ķ

    • @VictorySportsMed
      @VictorySportsMed  14 āļ§āļąāļ™āļ—āļĩāđˆāļœāđˆāļēāļ™āļĄāļē

      @@amishmuscle2536 it still is mechanical and an implant, so those are things to consider and be wary about. Thx!

  • @eddydizon7174
    @eddydizon7174 4 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™

    very informative i hope i can avail it here in philippines

    • @VictorySportsMed
      @VictorySportsMed  4 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™

      Thank you very much for your comment!

    • @simon15708
      @simon15708 4 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™

      Mancao pain management

  • @MsTamikaMichelle
    @MsTamikaMichelle 3 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™

    Would the bone marrow injections be helpful for someone who’s lost all or almost all cartilage in their knee?

    • @VictorySportsMed
      @VictorySportsMed  3 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™

      As you know, we cannot give medical advice in this type of format. However, we do always encourage people, if they do want that, to call our office and/or set up a telemedicine appointment. Otherwise, Iin general, we do find that the vast majority of patients who undergo bone marrow aspirate/bone marrow concentrate into their knees, experience a significant amount of relief. There is certainly no guarantee, just like there is no guarantee with surgery. However, in our practice, we don’t usually do “just” an injection, we usually do a full, multifaceted, individualized, personalized program after we determine what the patient’s goals are, and then we try to meet and exceed those goals with a personalized program and not just “an injection“. I hope that helps! Thank you for your question!

  • @rehanatharani229
    @rehanatharani229 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™

    âĪ

  • @lauranglover521
    @lauranglover521 4 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™ +1

    PRP does not work as well in knees as in other joints, and the pain is off-the-charts...(ie. up there with birthing a child...I know, as I've done both).

    • @VictorySportsMed
      @VictorySportsMed  4 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™ +3

      Thank you for your comment. There are at least 37 studies in the literature that show that PRP can be extremely effective in patients who have arthritis. remember, not all PRP is equal. Not all practitioners understand dose, concentration, single or double spin, leukocyte rich, or leukocyte poor, how many cc of blood to draw, etc., etc. Make sure that you choose a provider who can answer all of those questions, and many more like we can. Also, it is exceedingly rare to have severe pain from a PRP injection in the knee for osteoarthritis, so that is a bit odd as well. We have done thousands of knee injections over the years and it is very rare for any type of knee injection to cause “severe pain“. Having said that, anything is certainly possible. Thank you again for your comments.

    • @lauranglover521
      @lauranglover521 4 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™ +1

      @@VictorySportsMed just had a cuople who said it didn't work well in knees, but I could try it. I was desperate, so I did. Didn't work. PRP is successful in other joints, just not as successful in knees, likely secondary to the vascularization. (When he injected, he stated, "I'm sorry, this is gonna hurt like hell!"...and it certainly did! I generally have a very high pain tolerance.

    • @VictorySportsMed
      @VictorySportsMed  4 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™ +1

      @@lauranglover521 that has not been our experience. IN GENERAL PRP works well in knees, and the pain is usually not “off the charts”. We feel bone marrow cells combined with PRP tends to work better anyway. However, again, everyone is different. Also we rarely do an isolated PRP injection anyway. We use an individualized, personalized multi-pronged program which works better than “Ala carte” Thank you for your response!

  • @vikkicolbert6612
    @vikkicolbert6612 3 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™

    I have been getting cortisone injections roughly twice a year for the last 3 years. I'd like to try the gel injections, however if they do not work for me how long would I need to wait before getting the cortisone injections again?

    • @VictorySportsMed
      @VictorySportsMed  3 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™

      While we cannot give specific advice to people in this format, I have other posts that give our thoughts and philosophies about Cortisone and hyaluronic acid injections. There have been several studies that show the many negative effects of multiple cortisone injections, especially on the articular cartilage, in particular the knee. There were two studies relatively recently that showed that patients who underwent Cortisone injections in their knee, developed arthritis faster than patients who did not undergo Cortisone injections. PRP injections have been shown in several studies to outlast Cortisone and hyaluronic acid injections as well as equivalent to or better than standard physical therapy, and even arthroscopy in certain circumstances. They are also safer than Cortisone injections. Technically the use of PRP for knee arthritis is an “off label“ use, but there are currently approximately 37 studies that show positive affects of PRP when utilized in patients who have knee arthritis.

    • @vikkicolbert6612
      @vikkicolbert6612 3 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™

      Thank you so much for the guidance 🙂

    • @barblue3
      @barblue3 20 āļ§āļąāļ™āļ—āļĩāđˆāļœāđˆāļēāļ™āļĄāļē

      At some point the cortisone shots won’t work. That’s what happened to me. Then I started having a combination of cortisone and hyaluronic acid. They don’t work anymore. My knee is bone on bone and the doctor told me that I need to get a knee replacement which I’m terrified to do. I’m in pain everyday as soon as I start walking or cleaning my house. My knee is constantly swollen. Injections stopped working. I’m trying to lose weight.

  • @bhagyalakshmips2330
    @bhagyalakshmips2330 5 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™ +3

    How much cost of injection and where is available please

    • @VictorySportsMed
      @VictorySportsMed  5 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™ +1

      Costs vary patient to patient and diagnosis to diagnosis and especially based on what the patient’s goals are. Please call 315-707-8891 or e-mail info@victorysportsmedicine.com for further details. Thx!

  • @reggievillarama6367
    @reggievillarama6367 24 āļ§āļąāļ™āļ—āļĩāđˆāļœāđˆāļēāļ™āļĄāļē

    If you’re anemic, can PRP be use in your knee?

    • @VictorySportsMed
      @VictorySportsMed  24 āļ§āļąāļ™āļ—āļĩāđˆāļœāđˆāļēāļ™āļĄāļē

      It depends on why and how bad, etc. the patient is anemic (low red blood cells/low hemoglobin/low hematocrit), but in general, low or dysfunctional platelets would be worse. So if not “too” anemic (and if not anemic due to blood cancer, etcâ€Ķ), with normal numbers of functional platelets PRP could still be done. As always, consult your own health care providers as every patient is unique. Thank you for your question!

  • @kamallyons2035
    @kamallyons2035 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™ +1

    Excellent info Doctor I am seeing a doctor tomorrow and you have helped me to make a decision. I don’t agree with surgery unless it is life threateningâĪ

    • @VictorySportsMed
      @VictorySportsMed  āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™

      Thank you and good luck on your journey.

    • @sabinayesmin1575
      @sabinayesmin1575 20 āļ§āļąāļ™āļ—āļĩāđˆāļœāđˆāļēāļ™āļĄāļē

      Yes

  • @manjula9851
    @manjula9851 21 āļ§āļąāļ™āļ—āļĩāđˆāļœāđˆāļēāļ™āļĄāļē

    What about ozone therapy??

    • @VictorySportsMed
      @VictorySportsMed  21 āļ§āļąāļ™āļ—āļĩāđˆāļœāđˆāļēāļ™āļĄāļē

      We have not utilized it as of yet and do not have any experience with using it at this time.
      www.medicalnewstoday.com/articles/320759

    • @amishmuscle2536
      @amishmuscle2536 14 āļ§āļąāļ™āļ—āļĩāđˆāļœāđˆāļēāļ™āļĄāļē

      I have done Ozone therapy with stem cell and PRP on one of my hips and the Ozone works more as a pain relief for a couple days to a week or so than tends to wear off. But it’s pretty cool.

    • @VictorySportsMed
      @VictorySportsMed  14 āļ§āļąāļ™āļ—āļĩāđˆāļœāđˆāļēāļ™āļĄāļē

      @@amishmuscle2536 interesting, thank you for your comments and input!

  • @AMYBIERHAUS
    @AMYBIERHAUS 4 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™

    What are your thoughts on Turmeric and Curcumin as a supplement for knee pain?

    • @VictorySportsMed
      @VictorySportsMed  4 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™ +2

      They are known as anti inflammatory supplements and some people love them. They are usually not earth shattering. Always ask your primary care provider prior to going on any type of supplement or medication. Thank you!

    • @pitchkapizda8355
      @pitchkapizda8355 3 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™ +1

      Doesn’t work

    • @VictorySportsMed
      @VictorySportsMed  3 āļŦāļĨāļēāļĒāđ€āļ”āļ·āļ­āļ™āļāđˆāļ­āļ™

      @@pitchkapizda8355 thank you for your input