I had half the meniscus in my right knee removed 8 years ago and have had bone-on-bone pain ever since. In addition, because my other knee had to take the load, it became arthritic. Two weeks after PRP injections I'm feeling pretty good -- and a little better every day. After so many years of a painful, sedentary life, I'm looking forward to recovering my old level of fitness. My spine is a train wreck, and I need to work on that next, bit it's a great relief to be able to walk again.
Hi Kath, I'm just curious, how do you know you are "bone on bone". Have you lost all the cartilage on your bones or had an x-ray? I'm curious because I have some knee pain.
@@kqh123 After 2 hip replacements, the pain was unmistakable, but yes, I did have x-rays to confirm the state of my knees. It's been more than a month, now, since my PRP injections, and the results are different with each knee. The left is almost perfect, but the injured knee still grinds and snaps, is pretty painful at times. Good luck! I hope you get the relief you need.
I had it done today, and I shit you not...once the panic of having that needle inside my knee was over...so was the pain. PRP resolved my meniscus issue and a shoulder tear I had over 3 years ago, and I work loading trucks and train jiu-jitsu almost every day.
After 50 years as an expert black diamond diehard skier, I had an anterior menicus tear, confirmed by MRI, over 2 years ago (at age 63) from alpine skiing. Chronic irritating pain that would not heal. Not bad enough for surgery and xrays were excellent showing very healthy knees. As an avid cyclist (30 miles, 4x weekly) I have been cycling last 2 summers (now 65) but not seeing any improvements so I had a PRP injection. Dr. Peng knows his stuff. I found a Dr. who injects high concentration PRP with an Angel centrifuge. After 3 weeks I have noticed significant relief. Waiting for the 3 and 6 month mark to see if it completely heals. Keep in mind I could not get out of the saddle and sprint with my meniscus tear without significant pain on hill climbs. I'm hoping that will change during the upcoming cyling season. At $900 an injection 💉 I have high faith it will be successful with just 1 injection. My brother has bone on bone and he convinced me about its effects to alleviate pain. I'm now a believer.
This is interesting. I'm 60 and in fairly good athletic shape but now 7 months suffered a complex medial meniscus tear that refuses to heal (over running). No loss of motion for the most part but lots of pain and irritation which is especially troublesome at night as the leg doesn't like to be fully extended for a period of time. Like you, xrays show a healthy knee. Living like this long term is not acceptable so considering a knee scope but I wonder if a PRP injection is worth a try? Would pay $900 to try once. Wonder if QC Kintics a good place to get this done?
@@garypond3451 You are experiencing "exactly" what I did right down to not being able to fully extend the leg at night while sleeping. It wasn't agonizing but very "annoying" on a daily basis. DO NOT have your knee "scoped". Dr. Peng explains this in detail. My brother had his scoped and regrets it now (age 61). It will only make the situation worse and create arthritis as you age. I have heard of QC Kinitics. The are an outfit similiar to "Regenex", who actually pionered PRP injections. This is what I have come to expect from "QC Kinetix". In my opinion, this is an "aggressive sales" outfit that runs clinics staffed by mid-levels (Not a doctor). They have a lot of overhead Not that you need a doctor to do these injections, BUT, a medical center that uses high quality "Angel centrifuge" (www.arthrex.com/orthobiologics/arthrex-angel-system). My brother and I found a Doctor at UBMD in Buffalo that studied under Regenex and spins the blood sample in the same room as you are being treated in. You can witness and see the sample never leave the room and be processed (15 mins) right before you very eyes! I have looked into Regenex 20 years ago but they were very, very expensive at the time. They insist on doing multiple treatments. Ask questions, get pricing $$, ask to see their equipment. There are too many shysters (nurses, chiropracters, etc) out there trying to get into this business using cheap, inferior equipement. Believe me I've been to them. MY hope is that the healthcare providers will see the benefits from PRP and at least pay for half the cost in the very near future.
@@newts1964 I'm about 75% better after 1 year. Slight minor pain with some burning sensation if I walk 3.5 to 4 miles with some steep 12% grades. 😂😂 I have cycled up hills at 8-10% grades and had to climb getting out of the saddle. Climbed 1500 ft of vertical over 1 mile! I definitely would not have done that 1 year ago. I would never of done this without the PRP injection (now age 66). I may consider getting 1 more injection at $1000 (inflation) to seal the deal. Keep in mind the doctor who did the injection with an "Angel" centrifuge did not believe it would work, yet he definitely took my $$$$. My total bill, if I get a 2nd injection would end up costing $1900 with no surgery. What's your health worth?
PRP is expensive because it's an out of pocket expense. Yet, any surgery is paid partially or totally. Still expensive. The repair of knees or any joint is within our grasp. Studies are clear. It's the cost that isn't within any financial control.
@@JeffreyPengMD What are your thoughts about PRP treatment to avoid surgery for specifically a bucket handle meniscus tear. I appreciate any feedback and experiences you may have w this.
Great video Dr Peng. Thanks a lot for sharing. Here is our protocol for surgical meniscal augmentation with PRGF: 1. Meniscectomy: When a partial or sub-total meniscectomy is performed, activated liquid is infiltrated into the meniscal wall in an extra-articular manner using a 21G needle and a 3ml syringe. In the case of posterior horn of the external meniscus, infiltration is performed from within to avoid vascular/nerve damage. The reason for its use is that, in contrast to other tissues such as muscle or tendon, the meniscus is extremely dense and requires high pressure to ensure the diffusion of Endoret. This part of the meniscus should be kept whenever possible in order to maintain, and not to alter joint stability. Furthermore, it is the area where the cells and blood vessels are to be found. This allows at least a partial repair and healing process to be induced. The knee is then infiltrated intra-articularly with 8 ml of activated liquid. 2. When meniscal suture is indicated in order to preserve knee structure, and thereby stabilize and protect its cartilage, as far as possible, once the suture has been performed, the meniscal wall and the suture zone are infiltrated with activated liquid. Once the arthroscopy is complete, the joint is infiltrated.
@@omstygomsty Hi! I don't delete comments. Unfortunately I'm not sure what you're referring to. I do see you commented in another video which I just didn't have time to respond to yet!
Hi! I don't delete comments. Unfortunately I'm not sure what you're referring to. I do see you commented in another video which I just didn't have time to respond to yet!
Fantastic video, Doc - I was recently diagnosed via ultrasound with an acute partial meniscus tear and have an MRI scheduled in 2 days to determine the severity. That said, I am 50, roughly 60lbs overweight, and have been lifting heavy weights since I was 14 so I expect there to be some evidence of degeneration but am wondering about 2 things regardless of the results of the MRI: 1) Is stem cell therapy an option for meniscus tears? 2) Do artificial meniscus exist - either manmade or a transplant from a cadaver? Or perhaps repurposing cartilage from another part of my body? I haven’t asked my doctor these questions yet but was so impressed with your video that I thought I’d run them by you as you seem to think straight and talk straight! Thank you in advance for your time and thoughts - stay healthy and be well!
I am so grateful for your videos. I have learned so much and feel prepared when I speak to my doctor. I am getting a meniscus repair and a knee microfracture under the at the same time in June. The surgeon assured me he wouldn’t be cutting any meniscus out. My question is this: Is ok to augment the microfracture portion of the surgery with a PRP injection? And at what point should I get the PRP injection? Response very much appreciated!
Hi, I (27, active male) got a bucket handle tear repair on the medial menicus last Sept. Here in Germany the surgeon recommended 3 PCR injections (15mL each), here they cost 130eur/injection. The surgeon encouraged me to do, but possibly kinda bias, since in their clinic they perform it. He got them after a knee surgery he had. My physio told me that PRP could help the healing process, saying that we do not know if it is funsamental, but for sure could help within the mix surgery+physio to heal properly. Hence with athat mindset I did it, already did the 2nd today. Hopefully it will help, I wamt to go back to strength training and fight training 🙏🏻
Think of PRP as super glue, it will help bind small tears in the meniscus but not large tears, it will also help your cartilage as well and your tendons in your knee, so it is beneficial for many things except large tears which need stiches
Hello Dr Peng. Should PRP be injected immediately after meniscus repair or after longer post op period? I love and appreciate your informative and clear videos. Thank you for doing what you do 🙏🏻
I’m in the middle of PRP injections along with laser therapy. I have a MMPRT and the orthopedist said arthroscopic surgery wouldn’t work due to extensive arthritis and I would need a replacement in the future. In the meantime, just anti-inflammatory meds. 2 weeks in I’m almost off using my cane but not quite and with very little pain. Now on to 2 more injections 3 weeks apart. So far, I’m impressed with going this route and hopefully won’t need knee replacement surgery.
@@Suppressive I’ve had a bit of a setback as of today. Woke up with swelling and not able to fully straighten my leg when standing. Still I’m able to walk up stairs rather than one at a time. May have gotten carried away with trying to strengthen last night which may have caused this but I’ve definitely seen improvement. They say the recovery time after I’ve finished the PRP could be 3-6 months. Trying to stay positive. I still believe in it. Just gonna take time. Thank you for asking.
@@dianad7759 I hope you feel better soon. It's great that you're listening to your body and recognizing when you may have overdone it. I feel it's an important part of the recovery process; discovering what works and what doesn't work for you. Keep up the great work and don't lose hope. Glad to hear things have been improving overall.
Hey Dr Pang. I have had PRP in both knees with great success. One knee my surgeon advised to have a knee replacement. I also have had a great exercise physiologist. I’m 74 & Australian. Wish you were here!!! Question. Can PRP added intravenously assist with other issues like lung and heart problems? Great videos and they helped me make the decision to have PRP.
Hi Jeffrey, I had my ACL reconstruction and lateral meniscus repair one month ago my doctor is suggesting me to take a prp for faster recovery, what would be your suggestion, It would be really helpful for me doctor if you could reply my comment, Thankyou.
Thank you for your video, I had a lot of questions about this, after watching the video it's more clear. It would be similar for monocytes infiltration treatment??? KR, Karina
I had 2 meniscus tears in my knee, got arth. Surgery 6 years ago. It started getting painful again in Feb. I’m now getting PRP injections in both knees, my third injections this morning. So far, I’m pretty pleased overall. I jsut wish insurance would get PRP. On a firxed income, it’s quite a dent, but I’m trying to avoid a replacement at my age of 71.
@@servantofthecreator The first surgery repaired the meniscus. The arthritis is what made the knee painful after the second surgery for arthritis and injections helped relieve that pain
What about an older person who's x-ray shows no arthritis, but, MRI shows a complex medial meniscus tear that was caused by an injury to the knee? The video didn't answer that question.
HELP !!! I have a large calcified loose body (CLB) embedded in Hoffman's fat of my patella. The CLB is doing great damage to my femoral Cartledge and it urgently needs to be arthroscopically removed. The surgeons are refusing to schedule me to remove the large calcified object from my knee unless I give them leave to trim my meniscus) I am seeking a doctor who will simply remove large calcified object and leave my meniscus alone I have scheduled a surgery for 2/14/24 .I have until then to find a doctor who will simply remove large calcified object and leave my meniscus alone . I am in Fayetteville NC
Thanks Dr Peng, Great video. I am a 60+ male patient with a meniscus root tear. Currently going through intensity physio therapy. Should I go for surgery and would a PRP injection help my situation?
PRP can help treat underlying osteoarthritis which is often the cause of degenerative meniscus tears. You may find this helpful: th-cam.com/video/hmSsJgpg03k/w-d-xo.html
Had my meniscus removed, or almost all of it, 40 years ago. It was a severe tear, and the recommended procedure from a long time ago, just as Dr. Peng discussed at about 5:00. That's not my issue today. Having quite a bit of pain there now, and the benefit of steroid shots has really diminished to almost nothing. Gel was no help. There is no meniscus repair for me- mine is gone. Is PRP a good option for me now?
Hello dr. Peng. I watched your video with interest. I would be very grateful if you could comment on my case, in relation to what you said in the video. 1. I am a 52 year old female, with a vertical medial meniscus tear. I went to the doctors with a fresh tear but they never considered me for a repair surgery. I now see from your last mentioned study that the failure rate is "only" 22%. in my case they said it is "not done because there's no chance of healing". Some said that the chance of this injury healing in a young person is 80% when repaired, and only 20% in a person my age, if repair would be attempted. 2 surgeons i saw said i need the partial meniscectomy because the tear produces damage on the cartilage, so cutting it presents the "minor evil". whereas 2 other surgeons said they would not cut, because of bad long term prognosis ( more cushioning is still better than less cushioning). QUESTION: From what you say, it looks like this is not true. --> can you please comment? 2. i am now (after cancelling partial meniscectomy twice, they would cut away 30%) deciding which way to go. I am leaning towards a combination of hyperbaric chamber and PRP. --> QUESTION: do you have any opinion/knowledge on the hyperbaric chamber? (i found an article where a young athlete had this combination instead of surgery and healed in 6 weeks: 3 PRPs, one every 2 weeks and the accompanying hyperbaric chamber) 3. I read that the joints can be regenerated well into old age, with a combination of workout, lifestyel, diet and supplements. I have read the procedures for regeneration. --> QUESTION: in this case i dont know if it would make more sense to do the partial meniscectomy, to get rid of the crack, then attempt regeneration? (this data comes from someone who was left with almost no meniscus after the partial surgery, and now is running half-marathons regularly. Best regards! 🙏
I had repair of meniscus of right knee but after 3 years it started hurting again. Had one time steroid shot but pain came back after 3 months. So I went back to the doctor and he was suggesting hyaluronic acid but I told him that I want the PRP even if the insurance doesn't cover it. More than a year now and the pain is less now
Thanks for your comment. Unfortunately I cannot give medical advice over the internet. Please seek the advice of your trusted health care provider. Best of luck!
Hi doctor. Thank you for all the information. I have a couple of questions. If the ACL was totally rupture, the only option is surgery?? What are the chances that the new ligament ruptures again?
In general, yes, ACL ruptures need surgery. There is some data to suggest not all ACL tears need surgery, but this needs to be individualized and discussed with a surgeon. Re-tear rates are not common, but can happen (unfortunately).
مساء الخير انا شاب عمري 18 عام اعاني من تنكس في الغضاريف الهلاليه في الركبتين مع العلم اني لا اعاني من مرض مناعي ولا اي اصابه و وزني مثالي {لا اعاني من زيادة الوزن } برأيك ما سبب تأكل الغضاريف الهلاليه في الركبتين
Dr Peng is there a good Dr you would recommend in NY that shares your views? I live in the suburbs of NYC and my daughter just had an issue with her MCL folloed by what looks to be meniscus (waiting to get an MRI to confirm) and I know a good number of drs immediately sugget cutting out meniscus instead of repairing. Just getting ready for that talk.
i have a torn Meniscus and am experiencing considerable pain and occasional painful locking. My problem is that i have an over seas trip coming up which would have to be cancelled should. i get treatment. My question is, will it make it worse to wait a couple months before treatment?
Hi, I was wondering if it would be possible to combine PRP and stem cell injection for a meniscus tear. For example, I could have the stem cell treatment in the first week and then the PRP in the second week, followed by stem cell again in the third week? I'd be really grateful if you could let me know whether this is an option. Thanks in advance.
WRT efficacy of the PRP injection - what about post op and pre injection, I was given a NSAID after meniscus surgery,(same procedure still on operating table) and right before the injection of PRP. My blood draw was Prior to the NSAIDs, so the shot was given at the end of the operation , so my NSAID clean PRP injection blood was then injected into my knee and the Tramodol was given IV. the NSAID application was NOT supposed to happen...the team just dropped the ball. there was lots of briefing to the Surgeon Dr. Anesthesiologist and the nurse . they just dropped the ball on the NSAID administration. What does this do or might do to the efficacy of the PRP shot?
I just had my first of 3 PRP, (torn meniscus) my doctor told me not to take any NSAID, only Acetaminophen , he told me that NSAIDS lower the efficacy of the PRP, how much, I don't know
Dr. Peng should the PRP be placed directly into the meniscus itself or should it just be injected into the knee cavity. I ask this as I have had over a dozen PRP injections into my knee cavity to help with the meniscus but with very little help. However I just had my meniscus injected directly with PRP and A2M in both my Medial and lateral meniscus with ultra sound guidance. I am hoping this will be a game changer for me.
Can your PRP strategy work and help? I have a medial side complex meniscus tear of the body that extends into the root ligament? I had a partial knee replacement to lateral side of left knee 5/1/2019 and now just injured the medial side of knee. Hoping for possible solutions to avoid a total knee replacement now. Thank you for review and if possible are you seeing new patients? Robert
5:27 “It turns out that a torn meniscus is still functional when it comes to shock absorption” Reference please (my orthopedic surgeon told me the exact opposite)
If I had a meniscus repair surgery that did not fully repair my tear, is getting the PRP shot a good idea now? I’m 21 years old and an athlete and it’s been 6 months since my surgery and my knee is still not able to allow me to play sports. Thanks for your time
I got some of my meniscus removed and after i had hell of a pain and couldnt play sports and run for almost 2 years until i found PRF, PRF works and is much much better than prp
Hi Jrswisher, I had my ACL reconstruction and lateral meniscus repair one month ago my doctor is suggesting me to take a prp for faster recovery, what would be your suggestion, It would be really helpful for me doctor if you could reply my comment, Thankyou.
If I have tendinosis throughout most of the tendons in the palm side of my hand/wrist will the PRP need to be injected into each individual tendon or can it spread throughout all the tendons in that area? Curious because seems like it'd would be quite expensive to get each tendon injected individually. TY!
Unfortunately you'd need to have them injected individually. PRP only works where it is placed. It's not like corticosteroids which I describe similar to throwing a grenade. PRP works more like throwing a dart.
@@JeffreyPengMD could you get multiple in one day, lets say one in pinky finger tendon in palm and one in ring finger tendon in palm or is that too close to do both in 1 day? Also is it possible to split one injection and do 2 spots or is that never done. ty again really appreciate it
@@JeffreyPengMD also was wondering is it possible that golfers elbow symptoms can be affecting the wrist/palm pain as well? I have golfers elbow but the pain is minor, 70-80% of my pain is in my wrist/palm
@@JeffreyPengMD Fair enough Doc, but in cases (like mine) where the ligaments and muscles are strong, but the rupture remains, it seems PT risks causing more pain than helping. I have no pain until I "make the wrong move" -- then a pop and an ouch. However, I agree, strengthening your muscles/ligaments never hurts.
Thanks for your comment. Unfortunately I cannot give medical advice over the internet. Please seek the advice of your trusted health care provider. Best of luck!
What should I do if I have a small tear in the white zone? Your answer would be greatly appreciated. About a year ago, I received a tear and six months later, I did an MRI which revealed the tear. I was advised to strengthen my knee by going to the gym, and for a while, I didn't experience any pain. However, when I climbed a hill, my knee cap hurt really badly and I had to rest for one or two months. Afterward, I started experiencing pain again where the tear was. I still have my MRI results from a year ago and was informed at that time that the tear was minimal.
Doctor very unbiased ..educative details !!!Thanks A lot !!!🎉🎉❤❤❤❤
I had half the meniscus in my right knee removed 8 years ago and have had bone-on-bone pain ever since. In addition, because my other knee had to take the load, it became arthritic. Two weeks after PRP injections I'm feeling pretty good -- and a little better every day. After so many years of a painful, sedentary life, I'm looking forward to recovering my old level of fitness. My spine is a train wreck, and I need to work on that next, bit it's a great relief to be able to walk again.
Hi Kath,
I'm just curious, how do you know you are "bone on bone". Have you lost all the cartilage on your bones or had an x-ray? I'm curious because I have some knee pain.
@@kqh123 After 2 hip replacements, the pain was unmistakable, but yes, I did have x-rays to confirm the state of my knees. It's been more than a month, now, since my PRP injections, and the results are different with each knee. The left is almost perfect, but the injured knee still grinds and snaps, is pretty painful at times. Good luck! I hope you get the relief you need.
@@kqh123 After 2 hip replacements I was familiar with the pain, but I had x-rays, too.
I had it done today, and I shit you not...once the panic of having that needle inside my knee was over...so was the pain. PRP resolved my meniscus issue and a shoulder tear I had over 3 years ago, and I work loading trucks and train jiu-jitsu almost every day.
After 50 years as an expert black diamond diehard skier, I had an anterior menicus tear, confirmed by MRI, over 2 years ago (at age 63) from alpine skiing. Chronic irritating pain that would not heal. Not bad enough for surgery and xrays were excellent showing very healthy knees. As an avid cyclist (30 miles, 4x weekly) I have been cycling last 2 summers (now 65) but not seeing any improvements so I had a PRP injection. Dr. Peng knows his stuff. I found a Dr. who injects high concentration PRP with an Angel centrifuge. After 3 weeks I have noticed significant relief. Waiting for the 3 and 6 month mark to see if it completely heals. Keep in mind I could not get out of the saddle and sprint with my meniscus tear without significant pain on hill climbs. I'm hoping that will change during the upcoming cyling season. At $900 an injection 💉 I have high faith it will be successful with just 1 injection. My brother has bone on bone and he convinced me about its effects to alleviate pain. I'm now a believer.
This is interesting. I'm 60 and in fairly good athletic shape but now 7 months suffered a complex medial meniscus tear that refuses to heal (over running). No loss of motion for the most part but lots of pain and irritation which is especially troublesome at night as the leg doesn't like to be fully extended for a period of time. Like you, xrays show a healthy knee. Living like this long term is not acceptable so considering a knee scope but I wonder if a PRP injection is worth a try? Would pay $900 to try once. Wonder if QC Kintics a good place to get this done?
@@garypond3451 You are experiencing "exactly" what I did right down to not being able to fully extend the leg at night while sleeping. It wasn't agonizing but very "annoying" on a daily basis. DO NOT have your knee "scoped". Dr. Peng explains this in detail. My brother had his scoped and regrets it now (age 61). It will only make the situation worse and create arthritis as you age. I have heard of QC Kinitics. The are an outfit similiar to "Regenex", who actually pionered PRP injections. This is what I have come to expect from "QC Kinetix". In my opinion, this is an "aggressive sales" outfit that runs clinics staffed by mid-levels (Not a doctor). They have a lot of overhead Not that you need a doctor to do these injections, BUT, a medical center that uses high quality "Angel centrifuge" (www.arthrex.com/orthobiologics/arthrex-angel-system). My brother and I found a Doctor at UBMD in Buffalo that studied under Regenex and spins the blood sample in the same room as you are being treated in. You can witness and see the sample never leave the room and be processed (15 mins) right before you very eyes! I have looked into Regenex 20 years ago but they were very, very expensive at the time. They insist on doing multiple treatments. Ask questions, get pricing $$, ask to see their equipment. There are too many shysters (nurses, chiropracters, etc) out there trying to get into this business using cheap, inferior equipement. Believe me I've been to them. MY hope is that the healthcare providers will see the benefits from PRP and at least pay for half the cost in the very near future.
@@garypond3451you should try shockwave it works pretty good as well
How are you now
@@newts1964 I'm about 75% better after 1 year. Slight minor pain with some burning sensation if I walk 3.5 to 4 miles with some steep 12% grades. 😂😂 I have cycled up hills at 8-10% grades and had to climb getting out of the saddle. Climbed 1500 ft of vertical over 1 mile! I definitely would not have done that 1 year ago. I would never of done this without the PRP injection (now age 66). I may consider getting 1 more injection at $1000 (inflation) to seal the deal. Keep in mind the doctor who did the injection with an "Angel" centrifuge did not believe it would work, yet he definitely took my $$$$. My total bill, if I get a 2nd injection would end up costing $1900 with no surgery. What's your health worth?
PRP is expensive because it's an out of pocket expense. Yet, any surgery is paid partially or totally. Still expensive. The repair of knees or any joint is within our grasp. Studies are clear. It's the cost that isn't within any financial control.
I am very grateful to you for these beautiful lectures and wonderful comparisons
You're welcome! Thanks for commenting
@@JeffreyPengMD What are your thoughts about PRP treatment to avoid surgery for specifically a bucket handle meniscus tear. I appreciate any feedback and experiences you may have w this.
Great video Dr Peng. Thanks a lot for sharing.
Here is our protocol for surgical meniscal augmentation with PRGF:
1. Meniscectomy: When a partial or sub-total meniscectomy is performed, activated liquid is infiltrated into the meniscal wall in an extra-articular manner using a 21G needle and a 3ml syringe. In the case of posterior horn of the external meniscus, infiltration is performed from within to avoid vascular/nerve damage. The reason for its use is that, in contrast to other tissues such as muscle or tendon, the meniscus is extremely dense and requires high pressure to ensure the diffusion of Endoret. This part of the meniscus should be kept whenever possible in order to maintain, and not to alter joint stability. Furthermore, it is the area where the cells and blood vessels are to be found. This allows at least a partial repair and healing process to be induced. The knee is then infiltrated intra-articularly with 8 ml of activated liquid.
2. When meniscal suture is indicated in order to preserve knee structure, and thereby stabilize and protect its cartilage, as far as possible, once the suture has been performed, the meniscal wall and the suture zone are infiltrated with activated liquid. Once the arthroscopy is complete, the joint is infiltrated.
Great protocol! Thanks for sharing.
Hey there,
Did you delete my comment? Can you kindly explain why ?
@@JeffreyPengMD Hey there, did you delete my comment on this video yesterday? If so, can you kindly explain why?
@@omstygomsty Hi! I don't delete comments. Unfortunately I'm not sure what you're referring to. I do see you commented in another video which I just didn't have time to respond to yet!
Hi! I don't delete comments. Unfortunately I'm not sure what you're referring to. I do see you commented in another video which I just didn't have time to respond to yet!
Fantastic video, Doc - I was recently diagnosed via ultrasound with an acute partial meniscus tear and have an MRI scheduled in 2 days to determine the severity. That said, I am 50, roughly 60lbs overweight, and have been lifting heavy weights since I was 14 so I expect there to be some evidence of degeneration but am wondering about 2 things regardless of the results of the MRI:
1) Is stem cell therapy an option for meniscus tears?
2) Do artificial meniscus exist - either manmade or a transplant from a cadaver? Or perhaps repurposing cartilage from another part of my body?
I haven’t asked my doctor these questions yet but was so impressed with your video that I thought I’d run them by you as you seem to think straight and talk straight!
Thank you in advance for your time and thoughts - stay healthy and be well!
I am so grateful for your videos. I have learned so much and feel prepared when I speak to my doctor.
I am getting a meniscus repair and a knee microfracture under the at the same time in June. The surgeon assured me he wouldn’t be cutting any meniscus out.
My question is this: Is ok to augment the microfracture portion of the surgery with a PRP injection? And at what point should I get the PRP injection?
Response very much appreciated!
Hi, I (27, active male) got a bucket handle tear repair on the medial menicus last Sept. Here in Germany the surgeon recommended 3 PCR injections (15mL each), here they cost 130eur/injection.
The surgeon encouraged me to do, but possibly kinda bias, since in their clinic they perform it. He got them after a knee surgery he had. My physio told me that PRP could help the healing process, saying that we do not know if it is funsamental, but for sure could help within the mix surgery+physio to heal properly. Hence with athat mindset I did it, already did the 2nd today. Hopefully it will help, I wamt to go back to strength training and fight training 🙏🏻
Think of PRP as super glue, it will help bind small tears in the meniscus but not large tears, it will also help your cartilage as well and your tendons in your knee, so it is beneficial for many things except large tears which need stiches
PRP is useless for everything. PRP stands for profit rich placebo!
You haven’t highlighted how expensive these injections are.
@@ianwallace16 they’re like $550 but it depends where you live it can be a little more expensive
@@ianwallace16: In Toronto, one PRP injection was $1500 six months ago.
The intended outcome was not successful.
Is there evidence for this that it heals small meniscus tears?
Hello Dr Peng. Should PRP be injected immediately after meniscus repair or after longer post op period? I love and appreciate your informative and clear videos. Thank you for doing what you do 🙏🏻
Doctor Peng, what do you think about combing PRP with oral BPC-157, ipamorelin or MK-677 for meniscus tear? Thanks for this informative video!
I’m in the middle of PRP injections along with laser therapy. I have a MMPRT and the orthopedist said arthroscopic surgery wouldn’t work due to extensive arthritis and I would need a replacement in the future. In the meantime, just anti-inflammatory meds. 2 weeks in I’m almost off using my cane but not quite and with very little pain. Now on to 2 more injections 3 weeks apart. So far, I’m impressed with going this route and hopefully won’t need knee replacement surgery.
How are you feeling now?
@@Suppressive I’ve had a bit of a setback as of today. Woke up with swelling and not able to fully straighten my leg when standing. Still I’m able to walk up stairs rather than one at a time. May have gotten carried away with trying to strengthen last night which may have caused this but I’ve definitely seen improvement. They say the recovery time after I’ve finished the PRP could be 3-6 months. Trying to stay positive. I still believe in it. Just gonna take time. Thank you for asking.
@@dianad7759 I hope you feel better soon. It's great that you're listening to your body and recognizing when you may have overdone it. I feel it's an important part of the recovery process; discovering what works and what doesn't work for you. Keep up the great work and don't lose hope. Glad to hear things have been improving overall.
Appreciate your videos. Just wanted your thoughts on PT and PRP. Should PT be done before, concurrently, or after PRP? I am an active 73 yo male.
Hey Dr Pang. I have had PRP in both knees with great success. One knee my surgeon advised to have a knee replacement.
I also have had a great exercise physiologist. I’m 74 & Australian. Wish you were here!!!
Question. Can PRP added intravenously assist with other issues like lung and heart problems? Great videos and they helped me make the decision to have PRP.
Great valuable information thank you so much
19% is good from my perspective of being in pain!
Hi Jeffrey,
I had my ACL reconstruction and lateral meniscus repair one month ago my doctor is suggesting me to take a prp for faster recovery, what would be your suggestion,
It would be really helpful for me doctor if you could reply my comment,
Thankyou.
Thank you for your video, I had a lot of questions about this, after watching the video it's more clear. It would be similar for monocytes infiltration treatment??? KR, Karina
Is there any study of people who took prp injection for their meniscus tear and it healed???
I had 2 meniscus tears in my knee, got arth. Surgery 6 years ago. It started getting painful again in Feb. I’m now getting PRP injections in both knees, my third injections this morning. So far, I’m pretty pleased overall. I jsut wish insurance would get PRP. On a firxed income, it’s quite a dent, but I’m trying to avoid a replacement at my age of 71.
Did prp heal the meniscus?
@@servantofthecreator The first surgery repaired the meniscus. The arthritis is what made the knee painful after the second surgery for arthritis and injections helped relieve that pain
@@lindaelston4728 how long did it relieve it
@@servantofthecreator The right knee is still doing okay, hardly any pain right now.
I have free edge fraying at the anterior horn and body of the medial meniscus. What treatment would you recommend?
I'm 31, i took 1st injection today for knee. I'm hoping for best
Hallo how was you and how was your pain after take PRP injection please reply me please 🙏
@@medicinenews4351 i got 2 injections in last 20 days. My pain has reduced nearly 40%.
will PRP stop the future locking?
Excellent
Thanks!
What about an older person who's x-ray shows no arthritis, but, MRI shows a complex medial meniscus tear that was caused by an injury to the knee? The video didn't answer that question.
HELP !!! I have a large calcified loose body (CLB) embedded in Hoffman's fat of my patella. The CLB is doing great damage to my femoral Cartledge and it urgently needs to be arthroscopically removed.
The surgeons are refusing to schedule me to remove the large calcified object from my knee unless I give them leave to trim my meniscus)
I am seeking a doctor who will simply remove large calcified object and leave my meniscus alone
I have scheduled a surgery for 2/14/24 .I have until then to find a doctor who will simply remove large calcified object and leave my meniscus alone . I am in Fayetteville NC
Medial meniscus tear 3rd grade can repaired by PRP injection?
Had 60% of mine cut out, surgeon didn't even mention repair. Probably doesn't know how. Gave me grade 4 OA a year later. Choose your surgeon carefully
Thanks Dr Peng, Great video. I am a 60+ male patient with a meniscus root tear. Currently going through intensity physio therapy. Should I go for surgery and would a PRP injection help my situation?
Best to discuss with your health care provider, good luck
I have a posterior horn, meniscus radial tear. Would prp help me? Without surgery?
PRP can help treat underlying osteoarthritis which is often the cause of degenerative meniscus tears. You may find this helpful: th-cam.com/video/hmSsJgpg03k/w-d-xo.html
Had my meniscus removed, or almost all of it, 40 years ago. It was a severe tear, and the recommended procedure from a long time ago, just as Dr. Peng discussed at about 5:00. That's not my issue today.
Having quite a bit of pain there now, and the benefit of steroid shots has really diminished to almost nothing. Gel was no help. There is no meniscus repair for me- mine is gone. Is PRP a good option for me now?
Hello dr. Peng. I watched your video with interest.
I would be very grateful if you could comment on my case, in relation to what you said in the video.
1. I am a 52 year old female, with a vertical medial meniscus tear. I went to the doctors with a fresh tear but they never considered me for a repair surgery. I now see from your last mentioned study that the failure rate is "only" 22%. in my case they said it is "not done because there's no chance of healing". Some said that the chance of this injury healing in a young person is 80% when repaired, and only 20% in a person my age, if repair would be attempted.
2 surgeons i saw said i need the partial meniscectomy because the tear produces damage on the cartilage, so cutting it presents the "minor evil". whereas 2 other surgeons said they would not cut, because of bad long term prognosis ( more cushioning is still better than less cushioning).
QUESTION: From what you say, it looks like this is not true. --> can you please comment?
2. i am now (after cancelling partial meniscectomy twice, they would cut away 30%) deciding which way to go. I am leaning towards a combination of hyperbaric chamber and PRP. -->
QUESTION: do you have any opinion/knowledge on the hyperbaric chamber?
(i found an article where a young athlete had this combination instead of surgery and healed in 6 weeks: 3 PRPs, one every 2 weeks and the accompanying hyperbaric chamber)
3. I read that the joints can be regenerated well into old age, with a combination of workout, lifestyel, diet and supplements. I have read the procedures for regeneration. -->
QUESTION: in this case i dont know if it would make more sense to do the partial meniscectomy, to get rid of the crack, then attempt regeneration?
(this data comes from someone who was left with almost no meniscus after the partial surgery, and now is running half-marathons regularly.
Best regards! 🙏
How much is an one shot PRP injection for one knee with mild arthritis? Thanks
I just had one. It was $400 but probably varies by geographical area and practice.
@@rollingrock4759 thanks, I’ve got a $840 estimate for both knees. Unfortunately, insurance won’t cover.
It really depends on where you go! Be sure to ask about platelet counts and concentration!!
In India AP state kadapa just ₹6000 only one shot
@@kesavaramana5384 hai where it is can you guide me
I had repair of meniscus of right knee but after 3 years it started hurting again. Had one time steroid shot but pain came back after 3 months. So I went back to the doctor and he was suggesting hyaluronic acid but I told him that I want the PRP even if the insurance doesn't cover it. More than a year now and the pain is less now
What if I had a partial meniscectomy already what do you recommend?
Exercise therapy! th-cam.com/video/aMMHfFjwAmM/w-d-xo.html
Does anyone have any experience with a bucket handle tear and avoiding surgery with PRP. I would appreciate any feedback.
So, can I do stem cell therapy after a bucket handle meniscus tear?
Thanks for your comment. Unfortunately I cannot give medical advice over the internet. Please seek the advice of your trusted health care provider. Best of luck!
Hi doctor. Thank you for all the information. I have a couple of questions. If the ACL was totally rupture, the only option is surgery?? What are the chances that the new ligament ruptures again?
In general, yes, ACL ruptures need surgery. There is some data to suggest not all ACL tears need surgery, but this needs to be individualized and discussed with a surgeon. Re-tear rates are not common, but can happen (unfortunately).
مساء الخير انا شاب عمري 18 عام اعاني من تنكس في الغضاريف الهلاليه في الركبتين مع العلم اني لا اعاني من مرض مناعي ولا اي اصابه و وزني مثالي {لا اعاني من زيادة الوزن } برأيك ما سبب تأكل الغضاريف الهلاليه في الركبتين
Hi doctor!
What about PRF? Why no one recommend this injection for meniscus tear
PRF got me back to playing sports after 2 years of meniscus and cartilage damage, PRF works👏
Dr Peng is there a good Dr you would recommend in NY that shares your views? I live in the suburbs of NYC and my daughter just had an issue with her MCL folloed by what looks to be meniscus (waiting to get an MRI to confirm) and I know a good number of drs immediately sugget cutting out meniscus instead of repairing. Just getting ready for that talk.
i have a torn Meniscus and am experiencing considerable pain and occasional painful locking. My problem is that i have an over seas trip coming up which would have to be cancelled should. i get treatment. My question is, will it make it worse to wait a couple months before treatment?
Hi, I was wondering if it would be possible to combine PRP and stem cell injection for a meniscus tear. For example, I could have the stem cell treatment in the first week and then the PRP in the second week, followed by stem cell again in the third week? I'd be really grateful if you could let me know whether this is an option. Thanks in advance.
they do mix both at the same time here in Switzerland in Malaysia i saw same option.
Thanks for the info.🙏🏻
WRT efficacy of the PRP injection - what about post op and pre injection, I was given a NSAID after meniscus surgery,(same procedure still on operating table) and right before the injection of PRP. My blood draw was Prior to the NSAIDs, so the shot was given at the end of the operation , so my NSAID clean PRP injection blood was then injected into my knee and the Tramodol was given IV. the NSAID application was NOT supposed to happen...the team just dropped the ball. there was lots of briefing to the Surgeon Dr. Anesthesiologist and the nurse . they just dropped the ball on the NSAID administration. What does this do or might do to the efficacy of the PRP shot?
I just had my first of 3 PRP, (torn meniscus) my doctor told me not to take any NSAID, only Acetaminophen , he told me that NSAIDS lower the efficacy of the PRP, how much, I don't know
Dr. Peng should the PRP be placed directly into the meniscus itself or should it just be injected into the knee cavity. I ask this as I have had over a dozen PRP injections into my knee cavity to help with the meniscus but with very little help. However I just had my meniscus injected directly with PRP and A2M in both my Medial and lateral meniscus with ultra sound guidance. I am hoping this will be a game changer for me.
Please keep us updated!
What do you think about mixing PRP with ozone and then doing the injection??
Not a lot of research on this.
Can your PRP strategy work and help? I have a medial side complex meniscus tear of the body that extends into the root ligament? I had a partial knee replacement to lateral side of left knee 5/1/2019 and now just injured the medial side of knee. Hoping for possible solutions to avoid a total knee replacement now. Thank you for review and if possible are you seeing new patients? Robert
PRP can 100% help a degenerative knee. Yes, our clinic takes new patients, but only in California
5:27 “It turns out that a torn meniscus is still functional when it comes to shock absorption” Reference please (my orthopedic surgeon told me the exact opposite)
is prp able regenerate the partially remove menicus after partial meniscectomy
Nope
If I had a meniscus repair surgery that did not fully repair my tear, is getting the PRP shot a good idea now? I’m 21 years old and an athlete and it’s been 6 months since my surgery and my knee is still not able to allow me to play sports. Thanks for your time
PRP is an option but one that you'll want to discuss with your health care provider.
Did u try it? Or what did u end up doin? I too just had a repair and it seems like it didn’t work. Lmk?
I got some of my meniscus removed and after i had hell of a pain and couldnt play sports and run for almost 2 years until i found PRF, PRF works and is much much better than prp
Hi Jrswisher,
I had my ACL reconstruction and lateral meniscus repair one month ago my doctor is suggesting me to take a prp for faster recovery, what would be your suggestion,
It would be really helpful for me doctor if you could reply my comment,
Thankyou.
I have a lateral meniscus tear. Rather deal with it, then remove any part of it.
Hi Dr Peng is it possible to have PRP injections on both knees at the same ?
Yes, absolutely!
If I have tendinosis throughout most of the tendons in the palm side of my hand/wrist will the PRP need to be injected into each individual tendon or can it spread throughout all the tendons in that area? Curious because seems like it'd would be quite expensive to get each tendon injected individually. TY!
Unfortunately you'd need to have them injected individually. PRP only works where it is placed. It's not like corticosteroids which I describe similar to throwing a grenade. PRP works more like throwing a dart.
@@JeffreyPengMD could you get multiple in one day, lets say one in pinky finger tendon in palm and one in ring finger tendon in palm or is that too close to do both in 1 day? Also is it possible to split one injection and do 2 spots or is that never done. ty again really appreciate it
@@JeffreyPengMD also was wondering is it possible that golfers elbow symptoms can be affecting the wrist/palm pain as well? I have golfers elbow but the pain is minor, 70-80% of my pain is in my wrist/palm
How does physio help with Meniscus rupture? PRP by itself wont fix a reputure as well ...
PT helps strengthen the muscles around the knee to offload and take the pressure off the meniscus. th-cam.com/video/inuf3AsTu1Q/w-d-xo.html
@@JeffreyPengMD Fair enough Doc, but in cases (like mine) where the ligaments and muscles are strong, but the rupture remains, it seems PT risks causing more pain than helping. I have no pain until I "make the wrong move" -- then a pop and an ouch. However, I agree, strengthening your muscles/ligaments never hurts.
Miniscus tear grade 2 injury can heal by PRP injection
Thanks for your comment. Unfortunately I cannot give medical advice over the internet. Please seek the advice of your trusted health care provider. Best of luck!
What should I do if I have a small tear in the white zone? Your answer would be greatly appreciated.
About a year ago, I received a tear and six months later, I did an MRI which revealed the tear. I was advised to strengthen my knee by going to the gym, and for a while, I didn't experience any pain. However, when I climbed a hill, my knee cap hurt really badly and I had to rest for one or two months. Afterward, I started experiencing pain again where the tear was.
I still have my MRI results from a year ago and was informed at that time that the tear was minimal.