I've had debilitating knee pain for over 20 years when a horse fell on my knee. This also aggravated a previous injury from about 10 years before that when, ironically, another horse fell on the same knee. I was too young for doctors to be comfortable replacing my knee, and I didn't want that anyway. I had a total of four HA injections. I had an allergic reaction to the first and the second to fourth were just completely useless. A local doctor was advertising experimantal PRP and stim cell therapy. He was very honest with me and they have about at 75% success rate and no clear reason why some people do not respond to the therapy. My first treatment was with donated placental stim cells and PRP, which ran around $3k, not covered by insurance. It also included a follow-up PRP to give the stim cells an extra boost. The results were almost immediate. Working a few weeks, I was able to walk without my cane for the first time in a long time. I had a second round of stim cells harvested directly from my own bone marrow and PRP. This has kept me going for almost ten years now. Yes, I have pain, but not unbearable pain. If more insurances would cover this treatment rather than immediately going to joint replacement, they would save $100k per patient and avoid unnecessary and irreversible surgery.
I agree! I have two arthritic knees plus a football injury did not help. Now at 67, I get around pretty well but it’s getting more painful. So I am nosing around to see what insurance will cover.
Thanks for your sharing and happy to hear that the stem cell and PRP treatments help you to avoid surgery. I am also trying all possible treatments (PRP, HA injection, acupuncture, physiotherapy, taking supplements, etc) to avoid surgery. I dare not go for stem cell treatment as it costs more than 10 thousand in my country.
@@whitewolf6730 re-insurance (the backers of companies like blue cross) as well as insurance companies for work comp and PI cases are often covering the cost of a new biologic that is more effective than stem cells, etc.
i think the choice should be based on the type of injury. i have grade 1 chondromalacia and did 3 prp injections with zero response. i will get hyaluronic acid injection which friends with the same injury said it worked wonders lasting little over a year. not necessarily fixing the problem but reducing pain. i stopped soccer for 7 years so the HA injection should allow me to train without pain and my solution is strengthening my legs along with dropping 44 lbs that i gained over the years. i know a professional soccer player who is currently playing with grade 4 chondromalacia however his quads is extremely developed. i will update you under this comment later.
@@thedeeptissuedoc288 i had it last month. only 30% improvement which is great for my case. i always thought it should eliminate/mask the pain 100% but it didn't. will i get another one? no. why? because insurance doesn't cover it and it is expensive for a 30% improvement. i will concentrate on strengthen my leg muscles from now on.
@@thedeeptissuedoc288 prp did not work. hyaluronic acid injection fluctuate between 30% and 80% meaning one week is good and the other is not. from today i will concentrate on reducing my weight and train my legs. i might consider another hyaluronic injection and planning to get stem cells in mexico. if you think i am doing too much i cannot afford my knee to be 90% even because i want to return to sport as full time
Have used PRP in horses with great success along with stem cell procedures to treat specific injuries. Use hyaluronic acid and polysulfated glycoaminoglycan injections mainly as a prophylactic in working sport horses--usually on a monthly basis after a series of initial injections to ensure joint fluid and cartilage are kept in healthy condition. There a saying in the equine world that horses are arthritis. Can't ever get rid of it, but can manage it and extend the working life of a horse. Dr. Peng's video is one most clear and concise explanations I've ever heard for human patients.
I am a 67 year old competitive runner. Knee pain slowed my training for nearly 2 years. I recently received an HA injection and now have been running pain free for almost 2 months.
Wow, I can't believe I found this just when I was visiting doctors who might use these injections. It's hard to find them! This is amazing information. Thank you so much!
People, I hate to say this, and know no two cases are alike, but knee replacement surgery got to be my only option. I got Synvisc injections in both knees, two years ago that were extremely painful even when deadened with lidocaine and they didn’t do a thing. A little over a year ago, I got cortisone and it just put a bandaid on it. I looked at my x-rays the month before I got my surgery on my right knee and it was 100% bone on bone in the medial and middle compartment. Only the lateral part had cartilage, but still the entire knee had a lot of scar tissue. I’m seven weeks postop now. my knee is still stiff, a little swollen, and physical therapy is a pain in the butt, having to bend and straighten it, but I don’t regret it.
You are fortunate to have a good outcome. I had knee replacement surgery in Feb. No one can believe I had the surgery----my balance is off, I get dizzy when I walk for too long, I can't climb stairs, I can't do much housework and absolutely no outside work in the yard because I fall. In fact, I've fallen 18 times since the surgery. I still have pain in the knee, and it's stiff and swollen all the time. I have not slept in my bed since the surgery----the pain is too much to handle. I sleep in the recliner. Believe me, had someone told me that I would be suffering and in so much pain post surgery, I would have never gone through with the surgery. I'm glad the surgery was successful for you----it's not for some of us.
At 50 yo I was told that knee was my only chance before I was presented PRP option by another doctor. 53 yo after only one PRP injection, pain was drastically reduced and knee replacement is delayed. PRP or stem cells will take place first. In the meantime I modified my diet with a minimal sugar policy.
I’m currently age 43 with osteoarthritis in both knees due to being a professional athlete. I first tried a series of HA injections(1 per week for 3 weeks) and had amazing results. By week 4 I was pain free. This lasted for 8 months. My doctor convinced me to try PRP next, pretty much for all the reasons listed in this video. Unfortunately after 6 weeks, I only felt about half the symptom relief from PRP as I did with HA.
Your experience gives me so much hope. I recently completed my three injections, with the final one being administered four days ago. My insurance covered Euflexxa. I eagerly anticipate the day when I will be able to walk again. Unfortunately, I suffered a fall on ice that resulted in damage to my patella. I am praying that these injections will restore my mobility and allow me to reclaim my life.
I had the series of HA injections. The insurance company paid for the drug but not the injections. I'm out $1700 for something that will not do anything for a joint with bad OA. I am 2.5 years post TKA done with the MAKO robotic system and I can't tell most days I have an artificial knee. I'm sure this has worked for others but if your knee shows real issues after an MRI evaluation then think hard before you do HA. I do have a neighbor that had the PRP injections and they gave him a great amount of relief. The question that is yet to be answered is the longevity of the relief. We'll see.
Come to India. India’s government hospital do knee replacement free of cost. Ur country have good Heath facilities but very costly. Normal people can’t afford a knee replacement surgery. But in India a road side baggers can also afford a knee replacement surgery bcz our government provide us free of cost medical facilities. Proud to India 🇮🇳 thanks
So, here’s one major issue that will tip the scales for many: HA is covered by Medicare and most private insurers, while PRP is not. That’s one reason my orthopedist is going with HA for my right knee to see how that works, and if that doesn’t help much we’ll try PRP in 6-12 months.
I am in the process of doing this. I have replaced both hips, but want to avoid knee replacement. My knees are stiff with occasional pain. I have lost near 70 pounds with 20 to 30 more to go. It didn’t help my hip joints, I had to replace them. Im hoping it will help my knee discomfort.
I’m allergic to steroids so after synovectomy and therapy I still have pain and issues w knee. My orthopedist offered hyaularonic acid injection to try and I love I. I get 1 injection every 6-10months depending how I feel. I suffer from muscle spasms and seizures that affect any injured body part the worst so my poor knee gets a nasty workout weekly. This shot greatly reduces my knee pain and stiffness and I don’t react to it. I would say try it or consider it as an alternative option if you react to meds like I do. May everybody on here get well.❤
THANK YOU....❤. I am 32 and have suffered from excruciating knee pain since age 18. I had knee scopes and a partial synovectomy which made the pain and ADLs 10x worse. I've tried cortisone, HA, and PRP injections, I've been in PT for 18 months. This info is the most concise, research based, empowering info I've found. BLESS YOU 🙏
Just a warning; I had a HA injection and suffered a fairly severe reaction to it. The doctors believe that I actually reacted to the avian ova medium in which the HA was made. High dose steroids eventually calmed everything down, but not for a few days. I went to sleep a few hours after the injection and everyone in the house was told to "Leave Dad alone". Nobody knew about the reaction I was having for three days. If you get the injection have someone check up on you regularly.
I used to get HA injections, but had to stop when I lost my good insurance. Stopping didn’t seem to make any difference, what has made a difference is cycling on a regular basis. I’m also not overweight.
Im a referee for football and basketball. I have traumatic OA from and injury back when playing basketball in high school. Have gained a lot of weight because the last two years after running, I hurt for days after. Sometimes, I took off work because of the pain. I started HA injections this season. Best decision Ive made. My pain has reduced like 90 percent.
I wish I'd seen these very helpful recommendations you have so kindly posted here before I ever went to get my hyalauronic injections. Would you please tell us what to do or say when the doctor does not use the crucial factor of ultra sound guidance? My doctor did NOT use any ultrasound guidance whatsoever nor did he mention it to me ever as an option. 1st appt the injection did not hurt at all. Relief was fairly good. 2nd appt one week later with same doctor: He attempted sev. x to inject my knee again, then again, but it hurt tremendously as he streuggled 3x to inject me. It hurt enormously.I was in the most excruciating pain for more than 12 days and he denied making more than 1 attempt to inject me. It was a horrifically painful experience. He said rather casually "Maybe I hit a blood vessel since it hurt you so much.".
How do stem cell injections compare to PRP for Knee joint pain on medium flexion following torn meniscus and synovitis? Thanks for your informative videos
Doc, Have you considered comparing both of your recommended methods of injection therapy with a natural foods diet? Cost-wise, it costs no more to eat a healthy natural foods diet that it does to eat poorly. Isn't eating poorly the cause of most of our osteoarthritis? Next month I will be 78 and have had many injections of corticosteroids in my knees. They worked for a good while then stopped. Then I got HA injections 4 years ago and they worked after some delay, for a good while. But actually I started a natural foods diet, specifically keto, about 5 years ago. It worked for many other things pretty quickly, but after about 1 year from my HA shots, I noticed I did not need more of them. I play tennis 4 times a week and for the last couple years without a knee brace. I eat all the eggs and bacon I want, but no sugar, no fast foods or packaged junk foods.
Doc QUICK question, Post 2x meniscectomy of Rt knee, to HELP PREVENT inevitable Osteo Arth. which should I lean toward PRP or HA injections (no other issues withstanding , $ , NSAIDS , no other meds etc) Thanks you have been big help and I have really learned a lot from you so far WRT PRP.
Dr, thanks for the info, I have learned a lot from the videos. Channel subscribed, stay awesome and keep up your good works. I decided to try all possible means (steroid injection, PRP injection, HA injection, physiotherapy, Chinese acupuncture, taking supplements, etc) with the goal to avoid surgery, reduce pain and reduce intake of painkillers. I had knee injury after several falls (Chondromalacia patella, ligament tear, mild knee effusion, inner upper knee thigh musle injury with myositis oddificans). I just did my HA injection, followed by 3 PRP injection two weeks apart for each injection. There was pain and inflammation after PRP injection in about 2 weeks. Although the doctor here in my country did not use ultrasound, after first injection, pain was at the greatest level. Pain after second injection was less than first injection, pain after third injection was less than second injection. Thankfully, the pain has reduced. But, i am not sure how long will the pain reduction last? Hopefully the pain is gone forever and for good.
Thanks Dr. Peng. You really explain the what and why of these injections clearly. I've had many HA shots in both knees and also had allergic reactions after several times. My Dr. switched to gel 1 which was ok but administration was always hit or miss, especially when he started letting the assistant do the administration. Eventually, I gave up on him and the treatments. My condition has probably advanced at this point where replacement is the best choice.
What kind of allergic reactions did you get? I'm very allergic and scared to get the HA shots because of this. I get anaphylaxis...my throat swells up and I get shortness of breath. Very scary.
So I discussed a treatment regimen that included a treatment called A2M, Stem Cell and PRP over the course of 3-4 months. Thoughts on the treatments individually and as a regimen? For clarification each treatment would be provided separately.
I had a couple of rounds hyaluronic injections some years ago and they were effective. However, after the third round, I had severe local allergic reaction, and my doctor said I can not use it ever again.
Got the HA injection today, (6-28-2024) Three cc lidocaine and 6cc synvisc one. I forgot to ask the Dr, how long till I can play golf again? A week? Two weeks?
Awesome video - thank you! I have read that there is some evidence demonstrating PRPs regenerative ability. In your experience is this true? As such, could it be possible that PRP could in fact “heal” vice just providing pain relief? Thank you
Might be better but then why doesn't insurance cover it? I think its ridiculous to have to pay $500 for every single shot. Not everyone just has that kind of money laying around! So maybe the government and insurance should step up and do the right thing for those of us who struggle day to day just to pay normal bills let alone medical costs like this! Its really not fair so I will stay with Hyaluronic acid or steroid injections because at least they are covered by my insurance cost!! Might not be as good to you or doctor's sadly but it's better than nothing or having to substitute food for the price of a single shot!! Seriously medical is ridiculous!!! And yet we are the richest country meaning we can do better!!
Have horrible arthritis. Hips already replaced and shoulders and knees a complete mess. Tried both HA and PRP and believe neither are long term answers to relieve constant pain.
Your videos have been invaluable in helping me find a Clinic here on the east coast to do my injections and get the pure PRP and high platelet count that will give me the greatest chance for a good outcome. I am trying to decide which of my supplements should I discontinue because they may cause a lesser quality of platelet. Inflammation and knee pain from arthritis and gout are the issues and when I discontinue the meds and supplements I am concerned if I will be able to endure the 8 to 10 weeks without NSAIDS. I have found Chondroitin, Glucosamine, HA, MSM, and Serrapeptase to be helpful and wanted to see if you may have any info as to there effect on the Platelets in my body before and after my injections. Thanks for any help and for sharing your knowledge. I understand you have to be cautious with recommendations as a Physician, but I am just looking for your help, not a way to hold you responsible.
How about HA with DMSO massage of the knee and leg instead of injections? This can be done daily if necessary without any side effects other than lower pain and inflammation and with continued exercise and knee tension therapies?
Dr Pang. Thank you for your information. For cost consideration...Is the combination of HA n PRP injections done on the same time ? In that case, Am I only paying for one procedure charges ? If separate two days, i have to pay two times procedure charges. Please clarify. Thank you !
Do either of these treatments help with osteochondral defects? Damaged it doing sprints and also tore the meniscus. I have no swelling but light pain when walking and lock out at full extension.
@@JeffreyPengMD Thank you for the feedback. I am seeing a doc now and unfortunately my insurance Blue Cross Blue Shield does not cover either. I plan on paying for PRP out of pocket to see how i make out. Thanks again for the video and feed back
I have severe pain in one knee and have had HA injections twice and it didn't help either time, I was told by a surgeon that I do not need a knee replacement, which I'm not convinced is true. I did look into PRP and was told by the doctor that due to the amount of arthriis that the chances of it helping was about 50/50. He said the better option for me was PRP with stem cell and that raises the chances to about 75%, but the cost goes from $2200 to $6200. Any thoughts?
Late to comment. Hope someone will respond. If you were to do both, which one do you do first and how much time between injections? Hyaluronic acid lubricates and PRP heals. Maybe first lubricate to reduce any inflammation and then PRP? Maybe a month apart? Thoughts appreciated.
Before my TKR, I tried HA injections when I found steroids did nothing for me. For me HA was only mildly effective. It took a full month to really feel any improvement, and wore off in a few months. I have OA in my hands, and may investigate PRP. Are there any studies on PRP for other joints?
Hi Dr. I started with meniscus tear & got healed with physio treatment. No pain but I was quite slow to get up from seated position & had to stand for awhile, I can walk. I went for 3 HA injections (within 3 weeks) & a PRP after a week rest. I’ve no kneee pain but still having the same problem. Having stiffness & soreness. Pl advise what actions I should take. I hope to avoid TKR.
Why don't to tell how provider bill for Ultrasound "guided" injection however there is no needle pictured in the image? If you patient, ask them to show you the joint and needle in same picture.
100%. Some docs put the ultrasound on the knee, take a picture, and then do a landmark injection. This is NOT an ultrasound guided injection. It is most DEFINITELY fraud.
Had HA yesterday in both knees.won't know result for several week. Even with UHC medicare Advantage plan I paid $670.00 copay! Plan PRP at some point likely. Wish I'd known how much HA copay was cuz out of pocket for PRP here is $850.00-- sheesh!
Hello Dr. Jeffrey I watched your video, very good and informative. I want to do a PRP treatment but there where I live the Doctor don't have a Ultrasound system. So I would have to do it with out. What can happen or what is the problem when doing it with out the Ultrasound system?
Why was my 1st HA 7 years ago they did not explain. It was a three series , so I was given the full injection. It was very painful I couldn’t walk for a week… The second knee I did ask question on being given three series ,as I did some research went with the three series injections of HA that my left knee leg blew up huge entire leg had to go do a DVT test in case of a clog. Why did that happen painful after procedures on injections both injections different times I was in severe pain arriving home the first weeks. Can people be allergic to that? HA?? It was never explain to me. I’m afraid to have them done. Again if it was a bad reaction Was use on me , was ( SYNVISC ONE Hylan G-F 20?). That’s why I’m asking because I am in pain. has anyone experienced any of this type of pain or rejection of this HA medication..??? or procedure been painful. You can’t walk after having a procedure done. ??
Hi Dr Peng. I have wear and tear arthritis in both knees ( I have already one total knee replacement). My other knee is now very problematic. Near bone on bone, not total bone on bone. But the knee is constantly buckling, swollen, red and painful. I also have bad rheumatoid arthritis. I am on DMARD medications. My orthopedic surgeon says it is my RA that is making my knee so unstable and he recommends another replacement. He says that RA cannot attack titanium. But he is willing to do cortisone or gel to prolong period before I decide I cannot take it and get another replacement. My question, for someone with RA and regular arthritis, which is most helpful: Prp, gel?
There are exactly zero randomized controlled trials (that I know of) using exosomes for the treatment of knee osteoarthritis. Ultimately they may work really well, or they may be no better than PRP (which is what current data for BMAC/MFAT stem cells show). I prefer to stick with treatments that have a robust database of clinical trials.
why don't you talk about Thumb arthritits and prp. I can not find any videos on that. I have stage 3 arthritis in my thumb and I want to know if this injection will help as I am bone on bone. Do you have any videos on this?
PRP will work for Polio Effected Leg also(PPRP)? I am having RA also from 7 years. In 3 days of time OA symptoms developed restrticing me to walk, stand and sit. Please advice the best. TIA.
At least in the U.S. you are looking at $700 a shot for PRP. I would go for that now if that was the case in Canada. Instead, the cost here is $1700 for a shot with no guarantee that it will work. Please explain to me why, taking my blood, centrifuging it for the platelets, and spending 10 min with me to ultrasound guide the shot has a cost of $1700 ?????? Is somebody enriching themselves at the expense of only people who have a lot of cash ??
I've had debilitating knee pain for over 20 years when a horse fell on my knee. This also aggravated a previous injury from about 10 years before that when, ironically, another horse fell on the same knee. I was too young for doctors to be comfortable replacing my knee, and I didn't want that anyway. I had a total of four HA injections. I had an allergic reaction to the first and the second to fourth were just completely useless. A local doctor was advertising experimantal PRP and stim cell therapy. He was very honest with me and they have about at 75% success rate and no clear reason why some people do not respond to the therapy. My first treatment was with donated placental stim cells and PRP, which ran around $3k, not covered by insurance. It also included a follow-up PRP to give the stim cells an extra boost. The results were almost immediate. Working a few weeks, I was able to walk without my cane for the first time in a long time. I had a second round of stim cells harvested directly from my own bone marrow and PRP. This has kept me going for almost ten years now. Yes, I have pain, but not unbearable pain. If more insurances would cover this treatment rather than immediately going to joint replacement, they would save $100k per patient and avoid unnecessary and irreversible surgery.
I agree! I have two arthritic knees plus a football injury did not help. Now at 67, I get around pretty well but it’s getting more painful. So I am nosing around to see what insurance will cover.
Thanks for your sharing and happy to hear that the stem cell and PRP treatments help you to avoid surgery. I am also trying all possible treatments (PRP, HA injection, acupuncture, physiotherapy, taking supplements, etc) to avoid surgery. I dare not go for stem cell treatment as it costs more than 10 thousand in my country.
@morrigan908 , wow, that is interesting to know that PRP is the way to go!👍
@@whitewolf6730 re-insurance (the backers of companies like blue cross) as well as insurance companies for work comp and PI cases are often covering the cost of a new biologic that is more effective than stem cells, etc.
Fake
i think the choice should be based on the type of injury. i have grade 1 chondromalacia and did 3 prp injections with zero response. i will get hyaluronic acid injection which friends with the same injury said it worked wonders lasting little over a year. not necessarily fixing the problem but reducing pain. i stopped soccer for 7 years so the HA injection should allow me to train without pain and my solution is strengthening my legs along with dropping 44 lbs that i gained over the years. i know a professional soccer player who is currently playing with grade 4 chondromalacia however his quads is extremely developed. i will update you under this comment later.
HA is needed every 6 months ... just FYI.
Update, please, please!!!
@@thedeeptissuedoc288 i had it last month. only 30% improvement which is great for my case. i always thought it should eliminate/mask the pain 100% but it didn't. will i get another one? no. why? because insurance doesn't cover it and it is expensive for a 30% improvement. i will concentrate on strengthen my leg muscles from now on.
Hi,
Can you share your progress with PRP , i just took the injection .
@@thedeeptissuedoc288 prp did not work. hyaluronic acid injection fluctuate between 30% and 80% meaning one week is good and the other is not. from today i will concentrate on reducing my weight and train my legs. i might consider another hyaluronic injection and planning to get stem cells in mexico. if you think i am doing too much i cannot afford my knee to be 90% even because i want to return to sport as full time
Have used PRP in horses with great success along with stem cell procedures to treat specific injuries. Use hyaluronic acid and polysulfated glycoaminoglycan injections mainly as a prophylactic in working sport horses--usually on a monthly basis after a series of initial injections to ensure joint fluid and cartilage are kept in healthy condition. There a saying in the equine world that horses are arthritis. Can't ever get rid of it, but can manage it and extend the working life of a horse. Dr. Peng's video is one most clear and concise explanations I've ever heard for human patients.
I am a 67 year old competitive runner. Knee pain slowed my training for nearly 2 years. I recently received an HA injection and now have been running pain free for almost 2 months.
Wow, I can't believe I found this just when I was visiting doctors who might use these injections. It's hard to find them! This is amazing information. Thank you so much!
People, I hate to say this, and know no two cases are alike, but knee replacement surgery got to be my only option. I got Synvisc injections in both knees, two years ago that were extremely painful even when deadened with lidocaine and they didn’t do a thing. A little over a year ago, I got cortisone and it just put a bandaid on it. I looked at my x-rays the month before I got my surgery on my right knee and it was 100% bone on bone in the medial and middle compartment. Only the lateral part had cartilage, but still the entire knee had a lot of scar tissue. I’m seven weeks postop now. my knee is still stiff, a little swollen, and physical therapy is a pain in the butt, having to bend and straighten it, but I don’t regret it.
Good luck!
You are fortunate to have a good outcome. I had knee replacement surgery in Feb. No one can believe I had the surgery----my balance is off, I get dizzy when I
walk for too long, I can't climb stairs, I can't do much housework and absolutely no outside work in the yard because I fall. In fact, I've fallen 18 times since the surgery. I still have pain in the knee, and it's stiff and swollen all the time. I have not slept in my bed since the surgery----the pain is too much to handle. I sleep in the recliner. Believe me, had someone told me that I would be suffering and in so much pain post surgery, I would have never gone through with the surgery. I'm glad the surgery was successful for you----it's not for some of us.
Dr Jeffrey you are great. Your PRP and HA injection was nicely explained which was easy to understand. Thank you very much.
At 50 yo I was told that knee was my only chance before I was presented PRP option by another doctor. 53 yo after only one PRP injection, pain was drastically reduced and knee replacement is delayed. PRP or stem cells will take place first. In the meantime I modified my diet with a minimal sugar policy.
I tried everything. Nothing was working long-term. My doctor convinced me to do a Total Knee Replacement. It was the best decision I have made.
Not for me, but all I hear is everyone is different.
I’m currently age 43 with osteoarthritis in both knees due to being a professional athlete. I first tried a series of HA injections(1 per week for 3 weeks) and had amazing results. By week 4 I was pain free. This lasted for 8 months. My doctor convinced me to try PRP next, pretty much for all the reasons listed in this video. Unfortunately after 6 weeks, I only felt about half the symptom relief from PRP as I did with HA.
Your experience gives me so much hope. I recently completed my three injections, with the final one being administered four days ago. My insurance covered Euflexxa. I eagerly anticipate the day when I will be able to walk again. Unfortunately, I suffered a fall on ice that resulted in damage to my patella. I am praying that these injections will restore my mobility and allow me to reclaim my life.
PRP did not work for me and that was so disappointing but the HA is currently helping a fair bit.
Thank you for excellent information about knee arthritis you are perfect the way you describe the cause and the treatment for arthritis
I had the series of HA injections. The insurance company paid for the drug but not the injections. I'm out $1700 for something that will not do anything for a joint with bad OA. I am 2.5 years post TKA done with the MAKO robotic system and I can't tell most days I have an artificial knee. I'm sure this has worked for others but if your knee shows real issues after an MRI evaluation then think hard before you do HA. I do have a neighbor that had the PRP injections and they gave him a great amount of relief. The question that is yet to be answered is the longevity of the relief. We'll see.
Come to India. India’s government hospital do knee replacement free of cost. Ur country have good Heath facilities but very costly. Normal people can’t afford a knee replacement surgery. But in India a road side baggers can also afford a knee replacement surgery bcz our government provide us free of cost medical facilities. Proud to India 🇮🇳 thanks
So, here’s one major issue that will tip the scales for many: HA is covered by Medicare and most private insurers, while PRP is not. That’s one reason my orthopedist is going with HA for my right knee to see how that works, and if that doesn’t help much we’ll try PRP in 6-12 months.
VA won't don't it as it isn't FDA approved for this. That is their loophole
One thing I would encourage you to add is the huge importance of losing body fat is easing any knee pain.
You're right! ruclips.net/video/jWnNS5I5Zv8/видео.html
I am in the process of doing this. I have replaced both hips, but want to avoid knee replacement. My knees are stiff with occasional pain. I have lost near 70 pounds with 20 to 30 more to go. It didn’t help my hip joints, I had to replace them. Im hoping it will help my knee discomfort.
But not always. My BMI has always been in low normal
I’m allergic to steroids so after synovectomy and therapy I still have pain and issues w knee. My orthopedist offered hyaularonic acid injection to try and I love I. I get 1 injection every 6-10months depending how I feel. I suffer from muscle spasms and seizures that affect any injured body part the worst so my poor knee gets a nasty workout weekly. This shot greatly reduces my knee pain and stiffness and I don’t react to it. I would say try it or consider it as an alternative option if you react to meds like I do. May everybody on here get well.❤
Great!
THANK YOU....❤. I am 32 and have suffered from excruciating knee pain since age 18. I had knee scopes and a partial synovectomy which made the pain and ADLs 10x worse. I've tried cortisone, HA, and PRP injections, I've been in PT for 18 months. This info is the most concise, research based, empowering info I've found. BLESS YOU 🙏
So much cheaper in UK, around £100 an injection
Just a warning; I had a HA injection and suffered a fairly severe reaction to it. The doctors believe that I actually reacted to the avian ova medium in which the HA was made. High dose steroids eventually calmed everything down, but not for a few days. I went to sleep a few hours after the injection and everyone in the house was told to "Leave Dad alone". Nobody knew about the reaction I was having for three days. If you get the injection have someone check up on you regularly.
I used to get HA injections, but had to stop when I lost my good insurance. Stopping didn’t seem to make any difference, what has made a difference is cycling on a regular basis. I’m also not overweight.
both need to be used at the same time… especially if there is bone on bone contact. The prp will also help the hyaluronic gel last longer!
Im a referee for football and basketball. I have traumatic OA from and injury back when playing basketball in high school. Have gained a lot of weight because the last two years after running, I hurt for days after. Sometimes, I took off work because of the pain. I started HA injections this season. Best decision Ive made. My pain has reduced like 90 percent.
You can also take hyaluronic acid orally everyday to help with all your joints. Just make sure you are buying supplements from a highly rate company.
Thanks for the advice
I had 2 PRP which help for a year. The only problem is the cost.
try malaysia...cost if 800 ringgit per injection....just sharing.....try e.a clinic in penang if you happen to tour in south east asia....
How much?
Very informative Doc. I am awaiting your video on Boswellia.
Very soon!
I wish I'd seen these very helpful recommendations you have so kindly posted here before I ever went to get my hyalauronic injections.
Would you please tell us what to do or say when the doctor does not use the crucial factor of ultra sound guidance?
My doctor did NOT use any ultrasound guidance whatsoever nor did he mention it to me ever as an option.
1st appt the injection did not hurt at all. Relief was fairly good.
2nd appt one week later with same doctor: He attempted sev. x to inject my knee again, then again, but it hurt tremendously as he streuggled 3x to inject me. It hurt enormously.I was in the most excruciating pain for more than 12 days and he denied making more than 1 attempt to inject me. It was a horrifically painful experience. He said rather casually "Maybe I hit a blood vessel since it hurt you so much.".
My Symvisc-one injection lasted about a year. I just had my second injection and so far it OK.
Update, please!!! 😊
@@thedeeptissuedoc288 My knee is still pain free.
How do stem cell injections compare to PRP for Knee joint pain on medium flexion following torn meniscus and synovitis? Thanks for your informative videos
Thank you immensely Dr. Peng for the information I have learned from your video.
Doc, Have you considered comparing both of your recommended methods of injection therapy with a natural foods diet? Cost-wise, it costs no more to eat a healthy natural foods diet that it does to eat poorly. Isn't eating poorly the cause of most of our osteoarthritis? Next month I will be 78 and have had many injections of corticosteroids in my knees. They worked for a good while then stopped. Then I got HA injections 4 years ago and they worked after some delay, for a good while. But actually I started a natural foods diet, specifically keto, about 5 years ago. It worked for many other things pretty quickly, but after about 1 year from my HA shots, I noticed I did not need more of them. I play tennis 4 times a week and for the last couple years without a knee brace. I eat all the eggs and bacon I want, but no sugar, no fast foods or packaged junk foods.
Doc QUICK question, Post 2x meniscectomy of Rt knee, to HELP PREVENT inevitable Osteo Arth. which should I lean toward PRP or HA injections (no other issues withstanding , $ , NSAIDS , no other meds etc) Thanks you have been big help and I have really learned a lot from you so far WRT PRP.
Doctors need to push for FDA approval. Both procedures are good.but, now, they are Uber expensive since neither is covered by insurance
I think PRP would greatly depend on age and other factors
Dr, thanks for the info, I have learned a lot from the videos. Channel subscribed, stay awesome and keep up your good works. I decided to try all possible means (steroid injection, PRP injection, HA injection, physiotherapy, Chinese acupuncture, taking supplements, etc) with the goal to avoid surgery, reduce pain and reduce intake of painkillers. I had knee injury after several
falls (Chondromalacia patella, ligament tear, mild knee effusion, inner upper knee thigh musle injury with myositis oddificans). I just did my HA injection, followed by 3 PRP injection two weeks apart for each injection. There was pain and inflammation after PRP injection in about 2 weeks. Although the doctor here in my country did not use ultrasound, after first injection, pain was at the greatest level. Pain after second injection was less than first injection, pain after third injection was less than second injection. Thankfully, the pain has reduced. But, i am not sure how long will the pain reduction last? Hopefully the pain is gone forever and for good.
Update, please!!! 😊
HA for arthritis or to prevent it; PRP for light injury -- stem cells over all.
Thank you. Very informative and helpful video.
Thanks Dr. Peng. You really explain the what and why of these injections clearly. I've had many HA shots in both knees and also had allergic reactions after several times. My Dr. switched to gel 1 which was ok but administration was always hit or miss, especially when he started letting the assistant do the administration. Eventually, I gave up on him and the treatments. My condition has probably advanced at this point where replacement is the best choice.
What kind of allergic reactions did you get? I'm very allergic and scared to get the HA shots because of this. I get anaphylaxis...my throat swells up and I get shortness of breath. Very scary.
Great. I got the answer of many of my questions. Thanks a lot Dr Jeffery Peng.
Excellent!
So I discussed a treatment regimen that included a treatment called A2M, Stem Cell and PRP over the course of 3-4 months. Thoughts on the treatments individually and as a regimen? For clarification each treatment would be provided separately.
I had a couple of rounds hyaluronic injections some years ago and they were effective.
However, after the third round, I had severe local allergic reaction, and my doctor said I can not use it ever again.
HA and physical therapy worked for me. No more running though.
Glad to hear!
Got the HA injection today, (6-28-2024) Three cc lidocaine and 6cc synvisc one. I forgot to ask the Dr, how long till I can play golf again? A week? Two weeks?
Very informative, many thanks
I've been pain free for 2.5 years on hyaluronic acid injections. I'll stay with what insurance pays for.
Great information, thanks for sharing 👍
Awesome video - thank you! I have read that there is some evidence demonstrating PRPs regenerative ability. In your experience is this true? As such, could it be possible that PRP could in fact “heal” vice just providing pain relief? Thank you
Thanks. I learnt the difference between PRP and halyuronic injections. The ultrasound is a good tip.
Thx for commenting
@JeffreyPengMD can you compare/contrast the difference between leukocyte rich and leukocyte poor PRP?
Might be better but then why doesn't insurance cover it? I think its ridiculous to have to pay $500 for every single shot. Not everyone just has that kind of money laying around! So maybe the government and insurance should step up and do the right thing for those of us who struggle day to day just to pay normal bills let alone medical costs like this! Its really not fair so I will stay with Hyaluronic acid or steroid injections because at least they are covered by my insurance cost!! Might not be as good to you or doctor's sadly but it's better than nothing or having to substitute food for the price of a single shot!! Seriously medical is ridiculous!!! And yet we are the richest country meaning we can do better!!
❤❤❤ HBO on
Have horrible arthritis. Hips already replaced and shoulders and knees a complete mess. Tried both HA and PRP and believe neither are long term answers to relieve constant pain.
If they are so much better, why are they not covered by insurance to lower healthcare costs?
Big pharma can't make your own plasma.
Very well explained
Your videos have been invaluable in helping me find a Clinic here on the east coast to do my injections and get the pure PRP and high platelet count that will give me the greatest chance for a good outcome. I am trying to decide which of my supplements should I discontinue because they may cause a lesser quality of platelet. Inflammation and knee pain from arthritis and gout are the issues and when I discontinue the meds and supplements I am concerned if I will be able to endure the 8 to 10 weeks without NSAIDS. I have found Chondroitin, Glucosamine, HA, MSM, and Serrapeptase to be helpful and wanted to see if you may have any info as to there effect on the Platelets in my body before and after my injections. Thanks for any help and for sharing your knowledge. I understand you have to be cautious with recommendations as a Physician, but I am just looking for your help, not a way to hold you responsible.
How about HA with DMSO massage of the knee and leg instead of injections? This can be done daily if necessary without any side effects other than lower pain and inflammation and with continued exercise and knee tension therapies?
Sorry, I haven't heard too much of DMSO massages before.
add camfor menthol and Tumeric oil other essential oils may help - this is a perfect therapy Go for it!!!
Well explained, thanks
Dr Pang. Thank you for your information. For cost consideration...Is the combination of HA n PRP injections done on the same time ? In that case, Am I only paying for one procedure charges ? If separate two days, i have to pay two times procedure charges. Please clarify. Thank you !
Do either of these treatments help with osteochondral defects? Damaged it doing sprints and also tore the meniscus. I have no swelling but light pain when walking and lock out at full extension.
PRP and HA can both be used to treat osteochondral defects. Best to discuss with your health care providers about your individual situation
@@JeffreyPengMD Thank you for the feedback. I am seeing a doc now and unfortunately my insurance Blue Cross Blue Shield does not cover either. I plan on paying for PRP out of pocket to see how i make out. Thanks again for the video and feed back
I have severe pain in one knee and have had HA injections twice and it didn't help either time, I was told by a surgeon that I do not need a knee replacement, which I'm not convinced is true. I did look into PRP and was told by the doctor that due to the amount of arthriis that the chances of it helping was about 50/50. He said the better option for me was PRP with stem cell and that raises the chances to about 75%, but the cost goes from $2200 to $6200. Any thoughts?
Very informative!
arthroscopy with stem cell implants worked for me
Where did u get stem cells done??
Thank you.❤❤❤
Late to comment. Hope someone will respond. If you were to do both, which one do you do first and how much time between injections? Hyaluronic acid lubricates and PRP heals. Maybe first lubricate to reduce any inflammation and then PRP? Maybe a month apart? Thoughts appreciated.
Before my TKR, I tried HA injections when I found steroids did nothing for me. For me HA was only mildly effective. It took a full month to really feel any improvement, and wore off in a few months. I have OA in my hands, and may investigate PRP. Are there any studies on PRP for other joints?
Hi Dr.
I started with meniscus tear & got healed with physio treatment. No pain but I was quite slow to get up from seated position & had to stand for awhile, I can walk. I went for 3 HA injections (within 3 weeks) & a PRP after a week rest.
I’ve no kneee pain but still having the same problem. Having stiffness & soreness. Pl advise what actions I should take. I hope to avoid TKR.
What do you think of hydra gel (Arthrosamid) it’s getting good reviews
Why don't to tell how provider bill for Ultrasound "guided" injection however there is no needle pictured in the image? If you patient, ask them to show you the joint and needle in same picture.
100%. Some docs put the ultrasound on the knee, take a picture, and then do a landmark injection. This is NOT an ultrasound guided injection. It is most DEFINITELY fraud.
Good information & presentation. Well done & thank you. 👍💯🎯
Had HA yesterday in both knees.won't know result for several week. Even with UHC medicare Advantage plan I paid $670.00 copay! Plan PRP at some point likely. Wish I'd known how much HA copay was cuz out of pocket for PRP here is $850.00-- sheesh!
Have you ever tested red light therapy for arthritis in hips?
Hello Dr. Jeffrey
I watched your video, very good and informative.
I want to do a PRP treatment but there where I live the Doctor don't have a Ultrasound system.
So I would have to do it with out. What can happen or what is the problem when doing it with out the Ultrasound system?
What about HA and or combo of prp with prp for knee ligaments? Any effect at all?
Can't they do both? (A hybrid mix)?
Is bone on bone the same thing as osteoarthritis ?
What about combining PRP, HA, and stem cells?
Is Baker cyst does she " steal " and the drag ( PRP and HA intraarticular injection ) and what to do in that case ? Thank you .
What are your thoughts about the new HA injection as 1 injection???
Probably just as good as series of 3
@@JeffreyPengMD Thank you. Hubby just received it a few weeks ago.
Why was my 1st HA 7 years ago they did not explain. It was a three series , so I was given the full injection. It was very painful I couldn’t walk for a week…
The second knee I did ask question on being given three series ,as I did some research went with the three series injections of HA that my left knee leg blew up huge entire leg had to go do a DVT test in case of a clog. Why did that happen painful after procedures on injections both injections different times I was in severe pain arriving home the first weeks.
Can people be allergic to that? HA?? It was never explain to me. I’m afraid to have them done. Again if it was a bad reaction Was use on me , was ( SYNVISC ONE Hylan G-F 20?). That’s why I’m asking because I am in pain. has anyone experienced any of this type of pain or rejection of this HA medication..??? or procedure been painful. You can’t walk after having a procedure done. ??
how about autologous protein solution vs PRP
Hi Dr Peng. I have wear and tear arthritis in both knees ( I have already one total knee replacement). My other knee is now very problematic. Near bone on bone, not total bone on bone. But the knee is constantly buckling, swollen, red and painful. I also have bad rheumatoid arthritis. I am on DMARD medications. My orthopedic surgeon says it is my RA that is making my knee so unstable and he recommends another replacement. He says that RA cannot attack titanium. But he is willing to do cortisone or gel to prolong period before I decide I cannot take it and get another replacement. My question, for someone with RA and regular arthritis, which is most helpful: Prp, gel?
Prp+ gel is benefit to my RA. You may try
What about workers comp is that covered
Great vids. Have you looked into Exosomes injections with PRP? I'd love to hear your pov.
There are exactly zero randomized controlled trials (that I know of) using exosomes for the treatment of knee osteoarthritis. Ultimately they may work really well, or they may be no better than PRP (which is what current data for BMAC/MFAT stem cells show). I prefer to stick with treatments that have a robust database of clinical trials.
I have MCTD, Lupus including Scleraderma, which procedure is preferred
why don't you talk about Thumb arthritits and prp. I can not find any videos on that. I have stage 3 arthritis in my thumb and I want to know if this injection will help as I am bone on bone. Do you have any videos on this?
thank you sir your vedeos very informative
Thanks for commenting!
Thank you!
You're welcome!
I saw 8 to 12 weeks after a PRP injection to be better... Same for HA?
What about PRP drilled into the knee? Does the drilling have better effect?
Appriciate Dr,
Is Supartz the same as Hyaluronic Acid and if not, is one better than the other? Thanks.
PRP will work for Polio Effected Leg also(PPRP)? I am having RA also from 7 years. In 3 days of time OA symptoms developed restrticing me to walk, stand and sit. Please advice the best. TIA.
Can you get prp on NHS?
No
When PRP ( OA gr 2-3 ? ) and when HA ( OA gr 4 ? )
What about a meniscus tear? Which one is best for that?
Do either help someone with no meniscus, And has bone on bone wear?
Can you recommend anyone in Brisbane, Australia? Thank you!
How big were the PRP studies?
1512 patients from all the studies combined
Is Arthritis always finished u have complete treatment
PRP is much better for me
What’s the difference between PRP and APS injections?
How does one find a dr who does ultrasound guided HA injections without calling every dr in your area?
Can i get HA in my neck for spine arthritis?
At least in the U.S. you are looking at $700 a shot for PRP. I would go for that now if that was the case in Canada. Instead, the cost here is $1700 for a shot with no guarantee that it will work. Please explain to me why, taking my blood, centrifuging it for the platelets, and spending 10 min with me to ultrasound guide the shot has a cost of $1700 ?????? Is somebody enriching themselves at the expense of only people who have a lot of cash ??
Dr Peng, Amado Ong here…may I ask would you recommend PRP if a patient is taking lozartan as maintenance?
I have a minus split surgery in 2016. Is prp still the better choice?