If you’re an avid player of pickleball but have found yourself serving up more plates of pasta than you have been that yellow wiffle ball, pay attention to the following.
In my practice, I see a lot of pickleball players with knee pain. There are three tissues typically responsible for their issues:
Ligament Strain – Ligaments connect a bone to another bone.
Meniscus Tear – The meniscus is the flexible cartilage within the knee.
Articular Cartilage Injury, i.e. Arthritis – This is the cap of cartilage on the end of the bone.
Conventionally, these types of injuries lead down a common path. NSAID medications to help pain, physical therapy to attempt to improve mechanics/strength, to not stress the injured tissues as much. When that fails, surgery is often the next step.
The exciting news, if you’ve tried some of the above and/or are not excited about the prospect of surgery, is that in January 2024, leading scientists in orthopedic research published an article that was pretty mind-blowing. In short… More pasta = less pain from knee arthritis.
The research was performed by an Italian group of researchers, with Italian patients, who eat plenty of pasta! And as you know, some of that pasta undoubtedly turns into something else within those patients—fat.
Here’s the actual article title: “Autologous micro fragmented adipose tissue treatment of knee osteoarthritis demonstrates effectiveness in 68% of patients at 4-year follow-up”.
Now, a fraction of that fat, not just in Italians, but in me and you as well, is useful for deriving healing stem cells and other growth factors. What scientists refer to as the “healing niche”.
In this study, patients had failed common interventions including: Physical therapy, NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen or Naprosyn and Cortisone injections.
The patients underwent a diagnostic arthroscopy, i.e. a knee scope surgery, so that the extent of cartilage damage from the osteoarthritis could be directly visualized and characterized.
They then received a single injection of mFAT, or micronized fat (adipose) tissue taken from their own “fat storage depots” at the flank or abdomen.
In my practice, I have been using this same type of treatment for more than 5 years as a component of our comprehensive full cellular treatments whereby we 1.) Draw your blood to get another fraction of cells, platelets. 2.) Extract a small fraction of fat from your side to micro fragment as they did in this study. 3.) Extract a small amount of bone marrow from your pelvic bone where we can get actual stem cells.
Let’s break down why this treatment does what it does:
Platelets contain powerful healing growth factors.
Adipose (fat) tissue also contains healing growth factors and other proteins, as well as a fraction of stem cells.
Bone marrow contains a rich supply of stem cells in the body.
When these cells are injected into an arthritic joint, in this study, the knee and the cells trigger a powerful healing cascade that turns down the “inflammatory chemistry” that makes an arthritic knee hurt.
This slows the downward degeneration that we know is typical of knee osteoarthritis, while stimulating some “micro-healing” of the damaged tissue, cartilage, meniscus and ligaments at the surface level.
The endpoint, as shown in this study, is that there can be a significant pain reduction and functional improvement that is sustained in many subjects for years. Patients that are more than four years out are still reporting pain relief and functional improvement with this version of treatment.
Look, if a drug performed this well, i.e. a single dose lasted four years with 68 percent reported success in those patients, it would be a trillion-dollar drug.
This is the power in these treatments. This is also why the pharmaceutical industry is in an arms-race to find a way to bottle it up, scale it up and sell it back to you through your insurance company! Perhaps that’s three to five years out, maybe sooner.
Until then… time is your most valuable resource because time is tissue. The longer one waits, the lesser the chance of these treatments helping. And the longer you are off the courts, course, or hiking trails wondering if your knee may ever get better.
Early intervention is key in cases of “knee going bad”, that many let smolder for years. For many cases, these treatments can return people to high-demand activities such as pickleball in two to three months.
In time, these procedures may prevent the need for more invasive knee athroscopy or replacement surgery.
If you’ve been sidelined with some form of “pickleballer’s knee”, which is often a combination of ligament and/or meniscus tears, with or without a dollop of knee arthritis, these treatments may be something for you to consider.
Tucson Rep. Juan Ciscomani's brother-in-law calls his border politics hypocritical
