I had your exact situation. Only months away from a fusion or an artificial joint. In fact I was worse. I had dead bone from years of lack of cartilage. You only have cartilage defects? Your in good shape. Really it is sad your doctor doesn't know any other solution. I HIGHLY suggest moving away from him and going another route. When you do life changing medical procedures, you always get another alternative to look at.

What I eventually did in my situation was Prolotherapy. This was just what the ligaments needed to realign and stabilize the joint in order for the healing to truly take place within the joint surface itself.

Prolotherapy has been around for over 60 years so it is not new. Just make sure and find a doc who truly does it for a living not as a sideline. Also, research this procedure. There is lots of info. and is also known as "Regenerative Injection Therapy". I suggest this because if you go to your current doctor, they either have not heard of it or can't recommend it (not won't but can't).

Another thing to motivate you: you can go about your normal life while doing this procedure. No surgery and no "off your feet for weeks or months". Hell, people go and do their normal sport activity the day they get the procedure done. Granted you will take a bit of time for YOU to start running perfectly but hopefully you get my point.

Let's go further. in combination with ligaments repair, which probably allowed the cartilage damage, now you need to repair the cartilage. This is where either intra articular (in the joint) HGH shots or "Platelet Rich Plasma" shots should be used. I did both. Depending upon the condition of the joint, it can be anywhere from 2 to over 10 shots. I had my ankle done and 7 injections of HGH and 2 of PRP later, I have close to all my cartilage gap back from a condition of 0 gap...actually dead bone.

Dr. Dunn in FL did my first series of shots for HGH but I finished up with a Prolotherapist in AZ for both ligament and intra-articular shots. Dr. Dunn is a world leader in cartilage but he knows cartilage rebuilding only. This is why I took the role with my joints of "Complete Joint Regeneration" (ligaments included)as compared to just cartilage rebuilding.

I have new ankle joints and will never worry about future issues again. Fusion brings on further problems and artificial joints wear out. This is my cartilage and so will last the rest of my life.

Please feel free to respond. this can be a lot to take in.

Ben

Ben,
Very interesting. My doc is big into cartilage regeneration and repair, but he seems to change his song every time I see him. He talked about doing cartilage grafts before, and now he doesn't. What he did this time was called microfracture - to get stem cells to come out of the marrow, and then injected OP-1, a protein substance that is supposed to make the stem cells grow new cartilage or at least fibrous tissue to cover the defect areas. But, the way my ankle grinds now I don't think anything protective is growing in there. My doc does not want to do the fusion. He has injected the ankle several times with synvisc, but it seemed to have no effect either. This last time he injected steroids. That didn't help either. It took down the swelling but had no effect on the pain. You talked about the platelet rich plasma and i saw brochures for that in his office, but he never mentioned it as an alternative or an injection only process. I think he uses it in surgery, but I don't really know. It is hard to find docs up here in Alaska that are doing the newer procedures but this guy seems to be one of them. One thing I am sure of is that my insurance will not pay for PRP injections. My insurance sucks. And I am not rolling in money at the moment either. gah. As for the ligaments, he did repair those in the surgery I had in December. My body seems to think cartilage is something to eat though, and is destroying it in all my joints. I have lost one knee to this already and had to get a total knee replacement. My spine is a mess and needs work too but I'm not going there yet. Both ankles are going, and the other knee. I really fear this is going to disable me before long. I will look into prolotherapy as you suggest. Thanks for the info.

Vanyel

Ah, now you are getting into more details.

First thing: find out why you have these multiple joint issues. If you don't know that, you can't keep this from getting worse in other joints. For me, I found I had Hemochromatosis (high iron) and commonly causes arthritis. I have since deironed and am now working through my joints to recover them but my ankles were by far the worst off. Please get to the root of the problem. Any past blood tests you can refer to?

Regarding your insurance, everything I have mentioned is NOT covered by insurance. You just have to accept it and move forward. My guess is recovering your ankle should cost you $3-$5K in injections and prolotherapy (if you also do the prolo) over the coming year. If it is worth it, do it.

Microfracture is not real cartilage and requires surgery. I HIGHLY suggest just going the simple route and doing HGH injections directly into the joint. Do the research and show your doctor. Lead your doctor as this procedure is becoming more common and is easily done. No surgeries should be needed. Both Synvisc and the steroid shot you got do nothing to rebuild cartilage. Why not inject something into the joint that will rebuild the cartilage? Nothing else makes sense.

PRP can be used many different ways. Your doctor has to be open to it. They are YOUR platelets. You need to decide where they are injected. Again research, get very comfortable with intra-articular HGH and PRP and then direct your doctor...nicely. If they are unwilling, go to another who is.

Good luck and glad to help.
Ben

Ben,
We have tried to figure out the root of the joint problems and have come up empty. They have tested me for all sorts of auto immune inflammatory diseases and come up negative. They say it is just osteoarthritis, but it seems very aggressive and I can't help but think there is more to it than that. The damn rheumatologist up here strung me along for 3 years 'treating' me for inflammatory arthritis before she up and decided I didn't have it after all and just told me to go see a pain doctor. I could have spit. I was so angry and so frustrated and am now so disillusioned with doctors I don't even want to go anymore. I took myself to an integrative medicine guy and he is the only one that seems to have any interest in trying to figure things out. He found out that I have no adrenal function and we've been trying to get that under control. He doesn't have an answer for the joint problems though - he comes up with ideas and we test them out, but so far have not found the root cause. It is extremely frustrating. I think I am getting muscle wasting now too and wonder if there is some neurological or neuromuscular problem. I don't know, but we keep working on it.
The microfracture has already been done. I had the surgery in December and am still trying to recover from it. At this point, the doc and I seem to think it failed to work as the pain has not subsided at all and the joint still grinds horribly. He did stabilize the joint with some ligament repair while he was in there. I know synvisc and steroids do nothing to repair cartilage - that is why we went on to the surgery. I will have to ask him about PRP though. I saw brochures for it in his office last time I was there, so I'm sure he's open to it. I'll have to see what he thinks about it.
Meanwhile, the other ankle is now hurting as well and I am getting quite fearful that I won't be able to keep walking well enough to keep working before long. I am getting desperate. I have issues in my neck as well that are getting worse - alot of tingling down the arms and they say a lot of narrowing of the spinal canal and nerve roots. I'm just falling apart. And then there is the knee I already had replaced - its now grinding again and hurting and is only 2 years old. The other knee is not far behind either. Its a damn mess.
Thanks for your advice. I have done some looking at the prolotherapy stuff online and will definitely talk to my doc and see what he thinks. Oh, and as for the hemachromatosis - I have been tested for that stuff too, and do not have it. I'm glad they were able to find an answer for you. Keep on healing!

Vanyel

yes have bad ankles.
Havent had any opertaions on it yet.
I had a joint injection and that worked for, had no pain for weeks.
Also had a nerve block for ankle and that worked as well.

Dang ankles. Mine are really bad tonight, especially the one he operated on. I have had it injected 3 times now, twice with synvisc and once with steroids. No help from any of them. THe steroids made the swelling go down a tad, but no help with the pain. He has not mentioned nerve blocks. How do they do that? How long does that last?