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Have osteoarthritis of knee joints. Will bone marrow stem cell injection help to cure knee pain?

DOCTOR OF THE MONTH - Feb 2014
Feb 2014
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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 2004
Answered : 5931 Questions
Question
My father is 92 yrs old. Suffers from osteo arthritis of knee joints. Left knee is slightly bent and is affected more. Pains only when he stands up. No pain while lying down or sitting. After sitting for a while, getting up is problematic. Does not take any pain killer but about 8 months ago he was given synvasc 2 injection in his left knee. It gave him some 20% relief for about3/4 months. Takes medicines for prostrat, BP, sugar depression andsleep. Can walk very slowly with a stick for about 5 mins. but if some one is holding his hand, he can walk slowly for about 30 mins maxm.
What best can be done for him??
Will bone marrow stem cell injection help him???
XXXXXXX
Posted Sun, 17 Feb 2013 in Bones, Muscles and Joints
 
 
Answered by Dr. Saurabh Gupta 2 hours later
Hello XXXXXXX
Thanks for posting your query.

I can understand your concern and from description it seems that your father having severe degree of osteoarthritis left knee.

Your father have a stiff, painful knee that makes him difficult to perform even the simplest of activities and other treatments are no longer working.

Option of knee replacement surgery seems to be best for him.The ultimate goal of having this surgery is pain relief and improved knee function.

Bone marrow stem cell therapy is in a development phase.The safety of stem cell therapy is still to be fully determined.

I hope this answers your query. I will be available for further guidance if you needed.

Wishing him good health...

Regards.
Dr Saurabh Gupta.
Orthopaedic Surgeon.
Above answer was peer-reviewed by
 
Follow-up: Have osteoarthritis of knee joints. Will bone marrow stem cell injection help to cure knee pain? 14 hours later
AT this age of 92/93 years, can he negotiate the post operative trauma/rehabilitation ordeals?? Any alternative??
We are in Delhi. Where and what kind of knee replacement is possible for him??
What is the likely cost of knee replacement and rehabilitation for him???

XXXXXXX
 
 
Answered by Dr. Saurabh Gupta 7 hours later
Hello,
Thanks for posting your query again.

These surgeries are most often done in patients between the ages of 55 to 80, but they can be performed in patients in their 80s and 90s.There is no age limit to have a joint replacement surgery.

Overall health including the medical conditions your father may have will determine if he is likely to safely tolerate anesthesia, surgery, and recovery.

If he is too morbid for surgical procedure, alternative is conservative one with good physical therapy, pain medication, modification in lifestyle, Intraarticular hyaluronic acid/cortisone/platelet XXXXXXX plasma.

Hospital you choose should be well-equipped with orthopedic operation theatre, well trained staff familiar with Total knee replacement, having ICU facility.

Likely cost is around 1.5-2 lac in private setup.

Hope this will help you.

Regards.
Dr Saurabh Gupta.
Orthopaedic Surgeon.
Above answer was peer-reviewed by
 
Follow-up: Have osteoarthritis of knee joints. Will bone marrow stem cell injection help to cure knee pain? 17 hours later
The cost indicated as 1.5 to 2.0 lacs in a private set up is probably of one full knee replacement. Am I correct? Pl. confirm.

At this age of 92 yrs. what in your experience is generally most suitable??
--a regular knee replacement?
--Unicondylar knee replacement?
--micro fracture surgery?
Kindly indicate the cost of Unicondylar and micro fracture surgeries also.

What is roughly the estimated cost of the alternative COSERVATIVE treatment suggested by you, namely intraarticular hyaluronic acid/plated XXXXXXX plasma/ cortisone with good physical therapy, pain medication and modification in life style??
XXXXXXX
 
 
Answered by Dr. Saurabh Gupta 8 hours later
Hi,

You are correct. The cost is of one full knee replacement.

In my experience even at this age a regular knee replacement is suitable.
*Unicondylar knee replacement done, if only one compartment of knee is involved.
*Micro fracture surgery is performed by arthroscopy, after the joint is cleaned of calcified cartilage.The procedure is less effective in treating older patients, overweight patients, or a cartilage lesion larger than 2.5 cm. Further on, chances are high that after only 1 or 2 years of the surgery symptoms start to return as the fibrocartilage wears away, forcing the patient to reengage in articular cartilage repair.

Cost of Unicondylar- approx 1-1.25 lac
Cost of micro fracture surgery- approx 50 thousand

Roughly estimated cost of these conservative management 10-15 thousand.

Hope this information helps you.

Good luck -- I hope things go well.

Regards.
Dr Saurabh Gupta.
Orthopaedic Surgeon.
Above answer was peer-reviewed by
 
Follow-up: Have osteoarthritis of knee joints. Will bone marrow stem cell injection help to cure knee pain? 2 hours later
Last question.
Which is the best equipped centre for knee surgery in Delhi ncr, and who you think would be best suitable doctor for my father????

XXXXXXX
 
 
Answered by Dr. Saurabh Gupta 40 minutes later
Hi,

There are many well equipied private centre for knee surgery in Delhi NCR. Few of them are- Fortis, Apollo, Medanta. These centres having good team of orthopaedic surgeons doing knee surgeries.

I hope this helps you.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.

Take care,
Regards.
Above answer was peer-reviewed by
 
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