Osteoarthritis is a chronic and debilitating joint disease. It occurs through a sequence of events that has, at its core, a loss of joint cartilage.This affects other joint structures, and eventually will lead to joint space narrowing and bony overgrowth, progressing until joint movement becomes noticeably restricted.
What occurs before the cartilage loss? Osteoarthritis almost always begins with ligament weakness or injury. Joints are composed of two bones covered with articular cartilage. Healthy ligaments hold the bones together and, along with the cartilage, enable the bones to glide evenly over one another. When the ligaments are weak, the bones will glide over one another in an uneven manner, causing one area of bone to bear additional weight on the articular cartilage.
Articular cartilage has no blood supply, and therefore, tends to heal slowly and imperfectly. Cartilage also lacks a neural network and does not elicit pain itself. The pain in osteoarthritis occurs from the pressure on the subchondral bone after the loss of cartilage tissue and from the stress on the tendons and ligaments of the joint. 
Treatments for Osteoarthritis
There are many medications and procedures that temporarily relieve or mask the pain of arthritis. Non-steroidal anti-inflammatory drugs (NSAIDs), for instance, can accelerate the degeneration of the joints because they inhibit the normal tissue repair process.1 (See Figure 1.) Exercise, physical therapy, and lifestyle modification may provide symptom relief or surrounding muscle improvements, but they do nothing to regenerate the joint itself. There are, however, treatments available that stimulate the regenerative processes in the joint to facilitate the restoration of degenerated cartilage. One regenerative technique that has shown success is Stem Cell Prolotherapy. This is a natural injection treatment option that supplies the affected joint with chondrogenic (cartilage forming) stem cells and growth factors from a person’s own bone marrow and/or fat cells. Stem cells are in abundance in these tissues and have the ability to become various types of cells. Ongoing research and clinical evidence shows that injecting these cells into the degenerated joint supports chondrogenesis (the process by which cartilage is developed). (See Figure 2.)
Caring Medical Regenerative Medicine Clinics has performed several studies from its own patient population who have pain and/or osteoarthritis and opted for Prolotherapy and Stem Cell Prolotherapy instead of joint surgery. One study of seven patients with hip, knee or ankle osteoarthritis and another cohort comprised of 24 patients who had been clinically diagnosed with radiographic osteoarthritis. 2,3 The treatments comprised of dextrose Prolotherapy in and around the involved joint as well as stem cell/bone marrow aspirate injections in and around the arthritic joints.
Dextrose Prolotherapy itself is a technique that is used to aid the body in healing by prompting it to create new collagen. Numerous studies have shown the effectiveness of dextrose Prolotherapy in treating osteoarthritis, as well as ligament and tendon injuries.4-7 Prolotherapy offers benefits in terms of pain relief, regenerative properties, and cartilage repair for people affected by musculoskeletal disorders. Dextrose Prolotherapy involves the injection of a hypersmolar dextrose solution into an injury site to elicit localized inflammation, which is the first step in healing the damaged area. The dextrose solution acts as a proliferant via the induction of local healing cascades. With the addition of the cellular solutions, the goal is to improve treatment outcomes in patients with advanced osteoarthritic conditions, including those evidenced by X-ray. (See X-rays.)
Prolotherapy provides a safe and effective regenerative treatment option for osteoarthritis, one that has demonstrated the potential to slow down the progression of osteoarthritis and one that promotes the regeneration of articular cartilage… essentially a new paradigm in the treatment of osteoarthritis.
Prolotherapy
Specialists:
Ross A. Hauser, MD.
Danielle R. Steilen. MMS, PA-C
Timothy L. Speciale, DO
239-303-4546
www.CaringMedical.com
References:
1. Hauser R. The acceleration of articular cartilage degeneration in osteoarthritis by Nonsteroidal anti-inflammatory drugs. Journal of Prolotherapy.
2. Hauser R, Amos Orlofsky. Regenerative injection therapy with whole bone marrow aspirate for degenerative joint disease: a case series, Clin Med
Insights Arthritis Musculoskeletal Disord. 2013:6:65-72.
3. Hauser R, Wolden B. Treating Osteoarthritic Joints Using Dextrose Prolotherapy and Direct Bone Marrow Aspirate Injection Therapy. 2014; (7):
ISSN: 1876-5394. http://benthamopen.com/FULLTEXT/TOARTHJ-7-1.
4. Reeves KD, Hassanein K. Randomized prospective double-blind placebo-controlled study of dextrose prolotherapy for knee osteoarthritis with or
without ACL laxity. Alt Ther Health Med. 2000; 6(2):68–80.
5. Reeves KD, Hassanein K. Randomized, prospective, placebo-controlled double-blind study of dextrose prolotherapy for osteoarthritic thumb and
finger (DIP, PIP, and trapeziometacarpal) joints: evidence of clinical efficacy. J Altern Complement Med. 2000; 6(4):311–20.
6. Dagenais S, Yelland MJ, Del Mar C, Schoene ML. Prolotherapy injections for chronic low-back pain. Cochrane Database Syst Rev. Apr 18, 2007; (2):
CD004059.
7. Rabago D, Zgierska A, Fortney L, et al. Hypertonic dextrose injections (prolotherapy) for knee osteoarthritis: results of a single-arm uncontrolled
study with 1-year follow-up. J Altern Complement Med. 2012;18(4): 408–14.