Knee pain may occur as a result of injury to a number of different structures throughout the knee
and may be caused by anything from athletic injury and degeneration to aging and “wear and tear”. All of the tissues in the body, including the knee, are designed to repair themselves after injury. Unfortunately, however, the meniscus, cartilage, ligaments, and tendons that comprise each of the joints have a limited blood supply and often do not heal fully.
MRI scans and X-Rays can help to diagnose these injuries but often miss many of the causes
of joint pain. Quite frequently there are additional hidden injuries to the ligaments, tendons, and the joint capsule that are missed by MRI. Surgery is often directed to the abnormalities that MRI scans indicate, such as a tear of the meniscus, but many of the painful structures that are hidden to
MRI Scans are also hidden to the surgeon’s arthroscope.
A number of studies have looked at this challenge in the past 10-15 years using “sham” (fake)
surgery compared to the standard arthroscopic surgery for knee meniscus tears. Half of the
patients are prepared for surgery, and the arthroscopy incisions are made but no surgery is
performed. The other half receive the intended “real” surgery. The outcomes of multiple
studies have been very consistent, showing that the patients who receive the “real” surgery do
no better (and in many cases, do worse) than those that are treated with the “fake” surgery.
Statistically it appears that, in general, knee arthroscopy for meniscus tears does not improve
knee pain for many patients.
Fortunately, other non-surgical techniques have been proven to improve knee pain of all types,
including meniscus tears, compared to placebo treatments and physical therapy alone. Studies
have shown healing of meniscus tears and markedly improved pain and function after a series
of injections using a technique called “Prolotherapy”.
Prolotherapy involves injecting growth factors and other natural substances that promote growth
factor release into the knee joint and the structures that hold the knee together (ligaments) and
that operate the knee (tendons). A study from Argentina published this year showed consistent
hyaline cartilage growth inside the joint after a series of 6 dextrose (sugar) prolotherapy
injections into the knee. The doctors used arthroscopy before and after the series of injections
to photograph and to take samples of the newly grown cartilage. The majority of the patients in
the study no longer desired knee replacement surgery because their knee pain was much
The most likely reason that Prolotherapy works so well compared to surgery is that many of the
hidden causes of knee pain are treated in the same visit, and the treatment is repeated until the
vast majority of the painful, injured tissue is regenerated and strengthened back to normal or
even better than normal. Surgery often requires 3-6 months of recovery time, while Prolotherapy
typically produces only moderate soreness for several days, with no restrictions in activity. The
risks and the cost of Prolotherapy are also much less than surgery.
Learn more about Prolotherapy, Platelet-Rich Plasma, and Stem Cell treatments at