I had a landmark-based Monovisc hyaluronic injection about 2 months ago done by the nurse practitioner in my orthopedic surgeon's office, hoping to avoid a total knee replacement in that leg after the "successful " but horrifically traumatic TKR in the other leg. BEWARE! Something went wrong evidently as 6 hours after the Monovisc I was in bed with crippling pain throughout the entire leg and hip. I literally couldn't move. After about 2 days I could hobble around with a walker. Now the knee seems truly fubar, so that an ultrasound guided cortisone injection in the joint was useless. Just a warning to others regarding various injections. I did pay $9000 for stem cell treatment a number of years ago and may have gotten 3 years pain relief out of it before giving up and going for the knee replacement. I am now going to try prp injections from a reputable MD here in Topeka, Kansas. Consistent with the research cited in this excellent podcast. Thank you!
@krefcenz9 ай бұрын
Im 63 and have stage 3 OA in my left knee. Im getting HA and PRP 2 x a year. My PRP is only 35 ml less than Dr Peng recommends but is spun twice which he does recommend. See Dr Peng’s video on what makes a good PRP procedure. I am also taking turneric, boswellia, and glucosamine chondroitin and tirzepitide for weight loss. Have completed PA. And am rebounding and doing resistance training to strengthen muscles around knee. Recommend subscribing to Dr Peng if you aren’t already.
@JeffreyPengMD9 ай бұрын
I hope you have continued success!
@YvonneEccleston8 ай бұрын
1!!!!!😊@@JeffreyPengMD
@ybd33268 ай бұрын
Dr. Peng, Thank you very much for such an amazing, thorough and informative presentation on OA injection treatment options. The more I watch your videos, the more impressed I am with your level and wealth of scientific knowledge, your top notch, unbiased and evidence based presentation skills (making a complex subject easily comprehensible even to a layperson) and above all, a transparent, genuine sincerity and desire in helping and equipping your viewers with current factual medical information. Keep up the great job. Much admiration and kudos to you.
@marianneiwanski64844 ай бұрын
I had hyaluronic acid injections for knee osteoarthritis, first the left, then about two years later, the right. At the time of the injections the doctor (also a sports medicine doc) said that the therapies could be done again in a year if needed. Well, 10 years later and I’m just now starting to feel some mild discomfort in my right knee. The left is still ok. And even the right is ok as long as I’m careful with it. I’m scheduled to see the same doc this week for evaluation. It may or may not indicate that another treatment is or will be needed. But I’m so pleased with the results of the first treatments that if it’s needed, I’ll gladly go with it.
@4coopdawgАй бұрын
My knees are bad and I think I’m going to try the acid injection if I can find a dr that does it in DFW.
@FullOfHabits8 ай бұрын
I 100% see the point in ultrasound-guided injections, and how that could be a factor in the differing recommendations. Ever since the release of more portable US devices, I'm very excited for the future, hearing things such as "Ultrasound probes are the next stethoscopes"!
@petedog95818 ай бұрын
So why does insurance only cover the injections that show little results?
@sbluhrs1069 ай бұрын
Just a shame that insurance doesn't generally cover PRP treatments.
@jamescostello6529Ай бұрын
Most don't cover hyaluronic injection either. Mine paid for the injectable but not the charges to inject. Also it did nothing for me. I had that knee replaced 4 years ago this coming February. My Ortho used the Mako robotic system and I am better than before. Other knee is being done in May.
@ClintG-rh6kh3 ай бұрын
Had stem cell injections about 6-7 years ago 7k for both...as a UPS driver the discomfort was starting to return by the end of the work week. Had Synvisc one HA injections 2 weeks ago. Beginning to feel relief. Doctor said it would be 2-3 weeks before noticable improvement. I like that it is covered by my insurance and that I can have this done every 6-8 months.
@marigincinco93159 ай бұрын
Thanks for a detailed presentation, as always. How about Prolozone therapy, what is it? do you also administer this?
@863099 ай бұрын
Thank you Dr Peng, I wish more Sports Med Docs would pay attention to detail like you do, it makes a difference , it can be marginal or more , but who doesn't want the best chance at staving off total knee replacement!!!
@JeffreyPengMD9 ай бұрын
Thanks for your comment!
@juanblanch87059 ай бұрын
The fact that he's a sports medicine doctor is that what makes him good. What makes it good is it he's a real healer. The work he's doing here is tremendous. The amount of time he takes to teach is spectacular. I use all his techniques and agree with his review of all the Articles and have seen all the articles
@patrickpatchinsr.77056 ай бұрын
Thank you Dr. Peng your videos are extremely informative. I have right knee bone on bone condition and have now had my second prp injection there. The first injection gave me about a year and a half of pain relief( about 60 percent). And now I have had a second injection about one month ago which has given me about the same amount of relief. I was told by an ortho. doctor pre PRP injection that my only option was a total right knee replacement. But after viewing your videos on PRP I decided to give these injections a try and I am so glad I did. Again, thank you Dr. Peng.
@chipster94229 ай бұрын
Excellent presentation. Looking forward to your next video. Question: why aren't they using these treatments ie HA and PRP on hip arthritis. There is a very big need for additional effective tx besides a hip replacement.
@lauraconzatti5830Ай бұрын
I have had Duralane for the last 4 years and it has helped my osteo considerably. I am 63 and now going for a Knee replacement as it is time.
@DJ-lq5fd3 ай бұрын
Jeff - As a Harvard trained triple boarded physician (pain management, ICU medicine, and anesthesiology) I want to congratulate you on a fabulous video presentation, balanced and backed by real science. I'm very pleased that you highlighted the importance of U/S guided injections. My only tiny objection is that perhaps it gives the impression that only sports medicine docs use U/S guidance; certainly anesthesia trained pain management docs, PMR docs, etc., also use U/S guidance, and that not all sports medicine docs do! But great presentation. I'm also curious what your thoughts are on how long after an acute-on-chronic meniscal tear you would proceed with a PRP injection?
@consciousnessrenaissance78049 ай бұрын
Bless you doctor for explaining these therapies in details. ❤🙏😇
@JeffreyPengMD9 ай бұрын
Glad it was helpful!
@bar84199 ай бұрын
Yes, his videos are the best!
@Chacarruna8 ай бұрын
Thank you Dr. Penguin for your video. In veterinary medicine we have been a bit ahead of human medicine for once. Some 15 years ago at UC Davis stem cells marked with radionuclide were implanted in dogs’ knees and when check for radioluminiscence the majority had died short after. In my patients routinely I injected stem cells, Hyaluronic Acid and PRP. Needles to say there was a marked improvement, however the number of patients around 50 is too small as being taken as significant.
@anthonymuttillo88149 ай бұрын
Thank you for the excellent explanation of the different procedures.
@JeffreyPengMD9 ай бұрын
No problem!
@albertvasquez-d3s9 ай бұрын
Doctor you're the best.I learned a lot from you.I wonder where your practice is but thank you so much
@bongekilesibiya87368 ай бұрын
Im in SA how can i get your injections that can help me KNEE ARTHTIS URIC ACID IM 65YEARS
@opaulamorgan42658 ай бұрын
Hi Dr. Peng, I wish you could treat my knee arthritis, but I live in Northern Virginia. Thanks for explaining these types of injections, I always enjoy how you explain different types of treatments in-depth, so the patient can make the proper choice. I am considering a type of injection but have already ruled out cortisone and am considering Hyaluronic acid, I haven't talked to my orthopedist yet and don't know if he uses the utrasound based technique. I am desperately trying to avoid this intrusive knee replacemen. Too bad insurance doesn't cover PRP, I guess they are waiting for more studies to prove that it is really effective.
@rajnikantvyas25507 ай бұрын
Very well explained. Thank you, Doctor. At what level of knee arthritis does the PRP treatment works and for how long? Thank you so much
@richardnathan69128 ай бұрын
Hi Dr Peng, Thanks so much for putting together these videos! Have you seen any research on how combining PRP injections and Shockwave Therapy would impact the outcome for mild osteoarthritis in the knee?
@northernassassin6056Ай бұрын
I got a Cingal injection (80% hyaluronic 20% cortisone) 8 days ago and so far my knee feels much better. It's my first knee injection so I have nothing to compare it to.
@Spicymeatball18527 күн бұрын
I received gel injection just by touch on my knee area . Duralane injection knee was stiff for at least 3 months afterwards. Had to keep stretching my knee out and currently seeing a chiropractor for care .. seems to have worked between chiropractor, stretching and high potency C B D cream ..
@susananderson96198 ай бұрын
About 8 years ago, I paid over 3 grand and got 2 units of umbilical/placenta stem cells injected. My right knee has been a lot of pain for 5-6 years My left knee had just started .I only got the stem cells in my right knee.The other one in my left upper arm.. I had several drainings ,then cortisone in my right knee prior to stem cells. Now it's 8 years later, my right knee is better,a bit then my left knee.still better
@billger5710Ай бұрын
very helpful...my orthopedist said HA not supported by research as well as PRP....I'll just have to pay for it
@bar84199 ай бұрын
I have OA, left knee, medial side. It's developed fast (no symptoms prior to 3 years ago). It is pretty much bone on bone. My knee doc gave me cortisone injection. Didn't help. Later, I tried the gel injection (landmark injection), That also didn't help....I realize now my knee is slightly bent now (won't straighten out) so I kind of limp and am uncomfortable walking.... I won't do stem cell. I am terrified of Knee Replacement. I am early 70s.... My OS may be too far along for the PRP.... not sure.....WHAT HELPED ME SO FAR - Collagen UC-II supplements, and just added the Turmeric/Boswella. Prescription Meloxicam for joint pain... Walking slower and watching my step. Orthopedic shoes helps incredibly!- a huge difference having these shoes from orthofeet...
@andybencsics52259 ай бұрын
Dr. Peng, I've tried cortisone shots originally In 2022 and 2023 I tried PRP and "Gel" shots. Both of those helped somewhat. In October of 2023 I had nerve ablation on my arthritic right knee and in January I had the ablation done on my right hip. Both of these procedures significantly reduced pain and discomfort. The ablation is supposed to last between 12 and 24 months. It was covered (mostly) by my insurance. My question is whether or not PRP shots would cause the nerves to grow back sooner that the 18 month average?
@bethschreck45992 ай бұрын
very interesting! thank you. Last spring, I pulled a tendon or ligament in my groin. Seemed also to affect my knee. I ended up having to use a can. Finally Oct 15 after a very long & painful summer, I had an injection using ultrasound into the joint which appeared to be inflamed. It felt like a miracle. I walked out of the clinic like a normal human being without pain for the first time since last spring! I am thankful for all of you in this field!. I am a bit achy today, but know every day gets better and am so happy to walk normally again!
@ddiaz88324 күн бұрын
Thank you you are always so informative
@gbass732813 күн бұрын
Good videos and expertise.....I got my injections (one each knee ) 2 months ago and they are working just ok. I have also just started hyaluronic acid topical cream applications as my home remedy. Your thoughts on if this will help supplement the injections? I am doing 2 applications a day for a week, one week off and another week of 2 a day. I just finished the first week.
@liamdevoy68046 ай бұрын
Excellent , unbiased information, having OA in both knees and multiple scope. I found the deep dives of the options very helpful. I think there will be one or two more relief modes the peptides TB500 and BPC 157
@reetsoz25928 ай бұрын
I had a cortisone injection and ended up with 10/10 pain more than I originally had. NEVER AGAIN
@fionaestherfortuin41858 ай бұрын
Keep rubbing organic castor oil
@carlanajohnson80847 ай бұрын
Yes that's what I do cause nothing helps but castor oil. Be blessed.@@fionaestherfortuin4185
@carlanajohnson80847 ай бұрын
I received one and it did absolutely nothing for me.
@rangerdoc10295 ай бұрын
Same here
@sharong88413 ай бұрын
Same thing happened to me!!!!!!
@avgonyma18 ай бұрын
Is it possible to mend a partially torn (30% vertical tear on back horn of medial meniscus) degenerated tear, so that it doesn't have a tear anymore - with any of these injections? Or any other therapy? Is there any known case? ( Im 52, and after 1 year since noticing the issue, practically pain free. But i would love to have a functional (read: not torn) meniscus, so i wouldnt need to avoid half of the phisical exercises for the eest of my life. ) Im not looking to just eliminate symptoms. Thanks!🙏
@yourbud1235 ай бұрын
Please answer this question your the best Dr. Peng
@dawnmackey4182Ай бұрын
Thank you so much for the great video. I have bone on bone both knees, steroid injections work well for them but I'm afraid of the long term effects. Will the other therapies you mentioned work? I would like to avoid surgery as long as I can. Thank you.
@dangeroreilly20287 ай бұрын
Had cartiledge removed due to sports injury when I was college age. Now I'm 65. Cortisone worked very well for me a few years ago, but got less and less lasting as time went on. Now it lasts only a month or so, and my doc says that's too frequent. The gel was completely ineffective for me, so I am nearing the total replacement.
@tomellicott57096 ай бұрын
Another WELL DONE video
@georginapaul96722 ай бұрын
THANK YOU from South Africa.
@TheOutlier-c6o9 ай бұрын
Could combinations be given?
@yourbud1235 ай бұрын
Finally someone qualifed for their job its sad how you got to the doc for knee pain and they instantly want yo go with surgery instead of giving you supplements first and time to heal im taking boswellia glucosamine chondrotin hyluronic acid and fish oils daily also vitamin c , D and zinc seems to be helping so far only been a few days but without Dr. Peng i would feel so much worse thanks for atleast giving me some hope 😊
@carlanajohnson80847 ай бұрын
Hello Dr. Peng what can I do for fluid on my knee.
@ardenherman4176Ай бұрын
I had a cortisone shot 6momths ago. . So far so good.
@carolvineyard18967 ай бұрын
I’m bone on bone both knees. I get Genvisc injections. 1 a week for 5 weeks. Pain is substantially lessened, but both knees are very stiff. If I could get more movement, it would be great.
@lisbethsalander17232 ай бұрын
How are the injections working out? I just had one shot, still struggling.
@paulavisagie88742 ай бұрын
Thank you from Namibia.
@nizarnimri30849 ай бұрын
Within the myriad commercial brands of PRP kits available, numerous professionals utilizing various PRP kits assert notable differences in the degree of pain sensation. What could be the underlying cause of this variation? Is it possible that certain companies incorporate local anesthesia into their tubes to mitigate pain levels, despite the recognized compromise in the effectiveness of PRP treatment?
@RamaChandra-ld9wf9 ай бұрын
Beautiful explaind.Thank u.
@freesk89 ай бұрын
Thanks! This is really helpful! :)
@SN-ho2qs9 ай бұрын
New studies show that long term use of cortisone can cause infections months after joint replacement
@OriginaldueАй бұрын
My Dr wants to do stem cell therapy and says just prp isn’t enough for long term pain relief from a torn meniscus and associated arthritis
@antonjuhimenko63208 ай бұрын
Hi Dr. Peng. I visited the website to schedule a consultation but it only show in-person times, and when I select online it says there are no time available. Is it possible to have online consultation? I live on east coast. Thank you
@thanosfisherman9 ай бұрын
What's your opinion on different variants of PRP such as PRF or PRGF+ ?
@JeffreyPengMD9 ай бұрын
There is no data to suggest PRF is superior to PRP. This is an active area of investigation. But for now, PRP is the way to go for arthritis
@ExtremeRecluseАй бұрын
My ortho doctor drained fluid from my knee and injected cortisone. I told him 6-7 years ago a had a baseball size bone my on the left medial proximal fibula. he looked at me with a blank stare and continued the injection. Shortly after the bone mass reduced to normal, I immediately had multiple joint inflammation and stiffness staring in the hips and knees. I do not have arthritis. All of the autoimmune and arthritis labs were negative. He still referred me to rheumatology. I do have severe synovitis of the left knee. But, I do not have arthritis. I researched the significance of bone masses associated with joint pain, swelling and stiffness. every time a came up with chondrosarcoma. In my case, it is synovial sarcoma. I mentioned this to the ortho doctor and he chuckled. What an idiot. I continually told him about my symptoms like the baseball sized bone mass. I am helpless with this fool. And how much does he get paid? The knee draining and cortisone were very effective but it is extremely effective on all malignant joint cancers.
@Passion50929 ай бұрын
Could you please offer your opinion on Pentosan (PPS)? They are using it in Australia. Thank you.
@JeffreyPengMD9 ай бұрын
Interesting. Never heard of this. I only see pilot trials studying its use for arthritis with no large clinical studies. Add this to the ever growing list of *potential* treatments for arthritis that need more data.
@marigincinco93159 ай бұрын
Thank you for a very detailed presentation. How about Prolozone, what is it? and do you also administer this?
@deeptisharma8704Ай бұрын
Please tell me if PRP is advised for Grade 4 knee arthrities..my age is 30 years..pls reply
@alwayslearning9575 ай бұрын
Does PRP work regardless of the patient's age? i red a study that shows it doesn't work for older patients.
@georginapaul96723 ай бұрын
THANK YOU! GREAT INFO. LOOKING FWD TO YR FOLLOW UP VIDEO. Greetings from Cape Town. S.A.
@dr.davidsadisgursky7 ай бұрын
Can you help me understand how you figured the differences with PRP on terms of comparison with cortisona?
@KK-jo9yb9 ай бұрын
Has anyone experienced a new treatment for osteoarthritis called A2m are alpha 2 macrogloblin? Supposedly it inhibits the proteases that degenerate the cartilage therefore slowing the progression of the disease?
@Getoworkstopspying5 ай бұрын
I hope PRP works with those with “bone on bond” osteoporosis?
@racquelbutler61399 ай бұрын
I wonder if viscosupplementation has been proven effective for patients who have been diagnosed with avascular necrosis? Zero cartilage left?
@tailoredsuits5 ай бұрын
@ Jeff. We called your office to schedule consult and PRP for one knee possible two knees depending on your exam. Was told we can’t do both same day or next day. We would be traveling to see you and would want to do consult and PRP injections close to same time. Is this a possibility ? I was told it might be two weeks after consult, which wouldn’t make seeing you a possibility. Can we do PRP same day or within a day or two of consult?
@grandmothersukhrealta36119 ай бұрын
I got PRP injections and ended up with a life-threatening blood clot in my lower leg. Worse, since the injections my knee pain has significantly increased and I have to use a Walker.
@PeterEssex-j9fАй бұрын
I would like to have this in pill form ❤
@DC-uo2ci8 ай бұрын
So I'm just wondering if anybody did any studies on a combination of say h a and PRP
@deborahann55527 ай бұрын
Wait so gel injections should be injected using ultra sound?? What the heck I just had one and be just injected it into my knee.
@anotherpenny19427 ай бұрын
Same.
@jka245299 ай бұрын
Is OA stage 2 should start for PRP injection? Or in what stage OA (degenaration) should start injection?
@apaulatauiliili70256 ай бұрын
Well the orthopedic had be giving me cortisone injections not the HA injection I wonder why not, Is it insurance reasons..
@Optimizedforlife8 ай бұрын
I recently had stem cell and PRP for a 7 herniated disk injury to the neck which has really help but what I can’t seem to get better from is the Rt side upper & lower trapezius myofascial pain syndrome I have. What other options do you recommend for trigger point injections medicine other than corticosteroids? Which hasn’t help.
@Getoworkstopspying5 ай бұрын
You are a blessing ❤🙏
@123hrojas1239 ай бұрын
Excellent thank you
@JeffreyPengMD9 ай бұрын
You are very welcome!
@javhaad80218 ай бұрын
My knee OA is in mild (second) stage. I had PRP once. But still has symptoms. Maybe I need to get PRP again? Plz advise me
@diannefitzmaurice98139 ай бұрын
It is my understanding that the biggest difficulty for prp injections, is that it cannot get past scar tissue. But that stem cell therapy done well can achieve this. But you don't address this in your distinctions aand recommendations . For example what other side effect do steroid injections have on the body thatn just on the knee Nor do you compare these treatments to the addition of mineral supplements like Boron. Your explanations are really great and I do appreciate them but I do wish you would delve further into some of the deeper issues that clinical trials have not addressed . This whole area is so confusing . For those of us suffering from this difficulty it seems that we have find out the issues for ourselves.
@JeffreyPengMD9 ай бұрын
Not sure what you mean by "get past scar tissue" nor is there any evidence that stem cell therapy is superior to PRP. If there is any that I am not aware of, please help me by linking randomized controlled trial evidence. I'd love to learn more about how Boron can help, do you have any clinical trial evidence of this as well?
@chipster94229 ай бұрын
If clinical trials have not addressed these issues, where can he get his data from?
@presley8813 ай бұрын
I had cortisone shots in both knees and it stopped the pain,but, I started working again like my knees were good. I'm paying for it now. After the shots wore off,the pain was nearly double because I did more damage to my knees because there was no pain and I went full bore working. I don't recommend cortisone shots.
@sherrilynn40008 ай бұрын
Cortisone is so dangerous. I need two knees and by the time I left the hospital from my shot and by the time I got home I was totally gone in my one knee. A 25 minute ride and nothing
@dr.davidsadisgursky7 ай бұрын
Excellent explanation. However, on the other hand, I did not understand the contradiction in presenting studies that compare with cortisone, considering that in other videos you deem this comparison inadequate since the long-term side effects of corticosteroid injections are unquestionable. In other words, mesenchymal cells demonstrate non-inferiority, which translates to superiority in effectiveness with fewer adverse effects.
@susananderson96198 ай бұрын
Bullshit , my right knee was shot before my left knee, got umbilical placental stem cells in 2018 .Now 2024 my right knee hurts much less then my left
@marktarascio47667 ай бұрын
I dont think you realize that Medicare wont pay for hardly of these treatments except one shot a year of Cortisone.
@Leo-Boss9998 ай бұрын
Can we start creating clothes with stem cell regeneration? It will be like a huge stem cell patch.
@ajaiasai8 ай бұрын
Does PRP heal cartilage damage?
@susananderson96198 ай бұрын
I did not post twice wth
@Keep-on-ok8 ай бұрын
I heard from more than one person that those injections are only temporary, at best. Lose weight and get on some supplements that protect your joints.
@samuelcargin62827 ай бұрын
I have had 4 HA injections all but last one was great which was a different brand. I said to doctor I don't want cortisone it breaks downs cartilege he said I don't have any cartilege!
@karenmyers67277 ай бұрын
I wondered if there was a difference in brands of gel injections. What brand worked for you? I would love it if the doctor could please comment on this topic. How different are different brands of gel? Besides how they are administered, what should we be asking for in the gel product itself? Any recommendations please?
@lizjones7220Ай бұрын
Not in USA FyI
@anniepurse28316 ай бұрын
I really enjoy listening to you but the background music is very irritating. Sorry.
@sillystuff6247Ай бұрын
can't listen because of annoying background music.
@susananderson96198 ай бұрын
About 8 years ago, I paid over 3 grand and got 2 units of umbilical/placenta stem cells injected. My right knee has been a lot of pain for 5-6 years My left knee had just started .I only got the stem cells in my right knee.The other one in my left upper arm.. I had several drainings ,then cortisone in my right knee prior to stem cells. Now it's 8 years later, my right knee is better,a bit then my left knee.still better