Board-certified Dr. Helen Powell-Stoddart provides viscosupplementation and regenerative knee treatments for knee arthritis as an alternative to knee surgery for patients in Huntsville/Madison, Alabama and throughout the state.

Viscosupplementation and Regenerative Procedures for Knee Arthritis

Viscosupplementation and regenerative procedures are innovative and revolutionary non-surgical procedures for people suffering from knee pain due to osteoarthritis. Viscosupplementation utilizes a gel-like substance to restore shock absorption capacity to the arthritic knee to improve pain and function.

Regenerative knee procedures such as stem cell recruitment therapy are non-surgical injection-based procedures for people suffering from knee pain due to osteoarthritis, and other injuries of the knee. These procedures utilize a concentrated combination of repair cells and antiinflammatory cells that are used to promote your body’s own natural ability to repair itself subsequently relieving pain and improving function.
People suffering from knee arthritis have traditionally been offered treatments such as acetaminophen, anti-inflammatory medications, corticosteroid injections, weight loss, bracing, physical therapy and finally total joint replacement therapy (using artificial material such as metal or plastic to repair the joint). These interventions may or may not provide relief or avoid disability. Surgery is associated with many risk factors including that of anesthesia, infection and bleeding and often requires months to rehabilitate the knee after these invasive interventions.

Viscosupplementation and regenerative procedures are designed to help reduce pain and improve function with precise highly specific image-guided non-invasive, nonsurgical procedures.

Common Symptoms of Knee Arthritis
Difficulty negotiating stairs
Crepitus (loud sounds in the joint)
Loss of joint motion
Joint deformity

This Could Be Your Alternative to Invasive Knee Surgery

The available surgical interventions for knee arthritis typically involves arthroscopic procedures to “clean out” the joint or remove the meniscus all the way to total knee replacements. This may or may not provide relief to the painful knee patient.

Knee replacement surgery is an invasive and traumatic intervention that comes with several risks including chronic pain, loosening of the joint material requiring another surgical repair, along with the possibility of infection and bleeding. In addition, these surgeries require several months of painful rehabilitation therapy to regain strength, flexibility and mobility. Once the surgery is complete and the metal or plastic is in the joint, the clock begins to tick counting down the time to “replace the replacement” usually in about 10-20 years.

The Pain 2 Wellness Knee Restoration Program is proud to have witnessed exciting results on very difficult cases including those who have been recommended to have total knee replacements. We have helped patients avoid or delay total knee replacements and go back to activities that they love with little to no pain at all.

Your Pain 2 Wellness Knee Restoration provider will determine if you are or are not, a candidate for these procedures and will be happy to recommend an Orthopedic Surgeon if we determine that you are not a candidate for this revolutionary program. For more information, call for your private consultation at 256-325-5700.

Frequently asked questions

What is Osteoarthritis?
According to the Centers for Disease Control (CDC), Osteoarthritis (OA) is the most common form of arthritis and is the single most common cause of disability in older adults. It affects millions of people worldwide. In the US alone, there are some 54.4 million Americans with some form of arthritis. The numbers are expected to rise to an estimated 78 million US adults greater than 18 years old with doctor diagnosed arthritis by 2040. Though osteoarthritis can develop secondary to trauma in the teens, the most vulnerable group involves about 50% of people aged 65 years and older.

Between bones, there is a protective cartilage that acts as a shock absorber much like the rubber soles of shoes. When this protective joint cartilage becomes damaged and the natural cushion is destroyed, it will cause the corresponding bony attachments to wear down over time. Because OA is a progressive joint disorder characterized by the deterioration of cartilage and damage to the bone, it is often referred to as degenerative joint disease or “wear and tear” arthritis.

Deterioration of the joint leads to severe pain and disability. OA can affect any joint in the body including the hands, hips, shoulders, neck, back, ankles and knees. It is associated with thickening and overgrowth of the attached bone and lead to severe pain, stiffness, swelling, loss of range of motion and can even progress to deformed joints.

At this point, there is a significant drop in the level of activity as the joint pain increases. Simple activities can cause pain. Even sitting for short periods of time can cause severe stiffness.

One of the most common sites of this debilitating disease is in the knees. Individuals with knee arthritis develop a gradual increase in pain that may increase with walking, kneeling, climbing stairs or going from a sitting to standing position. The knees can become inflamed with swelling from bone spurs or extra joint fluid that may increase with activity. It becomes difficult to feel confident in walking due to knee buckling and locking when spurs develop. The knees become loud and creaky (crepitus) and loses its normal range of motion.

How is osteoarthritis diagnosed?
Medical evaluation of the joint involves obtaining x-rays of the knees and symptom determination.

What are my treatment options for knee osteoarthritis?
Conservative treatment options may include antiinflammatories, weight management, bracing, topical creams, canes, and injections.

Surgical options may include arthroscopic knee surgery to repair or remove the meniscus or total knee replacements using artificial material to mimic the native joint.

The Pain 2 Wellness Healthcare Knee Restoration Program offers innovative, revolutionary and effective alternative treatment solutions to manage pain and improve activities. Click here to learn more.

What is Viscosupplementation?

Viscosupplementation is a nonsurgical treatment option for knee OA. In this procedure, a gel-like fluid called hyaluronic acid is slowly injected into the knee joint. This fluid acts as a lubricant for the knee that serves as a shock absorber for the joint similar to the rubber on shoes.

People with arthritis of the knees have difficulty with loading the joint as in daily walking, climbing or sitting due to a lowerthan-normal concentration of the native hyaluronic acid in the knee. The goal of using this gel-like substance in the arthritic joint is to improve pain and facilitate movement of the joint.

Am I a candidate for viscosupplementation?
If you have arthritis in the knee, it is important to come in to be evaluated for this condition. Viscosupplementation may be right for you. Even if a total knee replacement has been recommended to you, this procedure may be able to delay or even eliminate the need for knee surgery. For more information, call for your private consultation at 256-325-5700.

What if I have swelling in the knee?
If there is swelling in the knee, the excess fluid is removed prior to the injection of the procedures including steroid injections, viscosupplementation or regenerative procedures. Removing the fluid allows the steroid, viscosupplementation or stem cell material to be more effective in the joint. Usually, the aspiration and the injection are done using one needle injected into the joint.

What is regenerative stem cell recruitment therapy?
Wharton’s jelly is a gelatinous material derived from human umbilical cord tissue used to reduce inflammation, modulate the immune system and produce factors that may contribute to the regeneration of many tissues in the body. In the Pain 2 Wellness Knee Restoration Program, this tissue is used for knee pain due to arthritis and other tissue injuries. For your risk-free consultation, please call 256-325-5700.

Regenerative stem cell recruitment therapy uses the highest quality tissue allografts (taken from another person of the same species) derived from tissues that are acquired from healthy, living, consented donors who are thoroughly screened for communicable diseases. Mothers must meet the eligibility requirements or the tissue is discarded or not used.

The tissues are “minimally manipulated” to meet strict codes of governing agents and can be used for arthritic joints.

Frequently asked questions about stem cell recruitment therapy

What do you use for stem cell procedures?
The Pain 2 Wellness Knee Restoration Program uses Wharton’s jelly for tissue repair.

Why do you use Wharton’s jelly?
Wharton’s jelly has the highest concentration of Mesenchymal stem cells, growth factors, hyaluronic acid (found in the joint), anti-inflammatory cytokines, collagen (found in the joint), and growth factors. These substances are effective at decreasing inflammation and assisting the native tissue to regenerate.

What are the benefits of Wharton’s jelly?
The cartilage in the natural knee joint serves as a shock absorber or cushioning agent for the joint. Wharton’s jelly may provide cushioning, support and lubrication in the joint for pain control and the improvement in function. Wharton’s jelly has a high concentration of hyaluronic acid, growth factors and (anti-inflammatory) cytokines which are important for joint health.

How long will it take to see improvement in pain and function with the use of Wharton’s jelly?
There is no guarantee of how fast you will see results. Some patients will receive immediate pain relief and improvement in function, while others may require 4-6 weeks to see results.

Do you have special protocols for stem cell injections?
Our staff is highly trained in the use of stem cell injections and the guidance used for these tissue transplants so that the tissue is put in the intended space for the best results. Secure your private consultation by calling 256-325-4700.

Why can’t I use my own bone marrow for the stem cell transplants?
Research by the International Journal of Molecular Sciences has shown that while young, vibrant umbilical cord stem cells can duplicate themselves every 22-28 hours, for up to 65 generations or more, 50+ year old bone marrow aspirate and adipose derived stem cells duplicate at a much slower rate of 3 to 5 days for an average of only 11 to 15 generations. This means (that) the effect of younger cells will last longer.

Also of note is that older cells experience aging at a much faster rate than young, vibrant umbilical cord cells and aging cells produce less quantities and less effective growth factors, proteins, and cytokines. In addition, young cells, such as those found in Wharton’s jelly, have a stimulative effect on the patient’s older cells causing an increased ability to stimulate the native tissue for repair regeneration.

What are side effects of stem cells?
No long-term side effects have been reported regarding Wharton’s jelly, however, any side effects will result from the injection site soreness. There is a risk for infection and bleeding, but these complications are extremely rare.

Do stem cells cause cancer or stimulate cancer cells?
No, many studies have shown the long-term safety of stem cells. Stem cells do not cause cancer cells to grow.

How soon will I need to schedule my stem cell injection?
For best results, it is advisable to proceed with treatment as soon as possible. We require a lead time of 2 days to order the cells and have them delivered to our office for your treatment. Secure your private consultation by calling 256-325-4700.

How are the cells delivered from the lab?
The cells are delivered via Federal Express on dry ice (-125ºC) packaged in individual frozen vials in a styrofoam container which is inside an outer cardboard box. It arrives in less than 24 hours.

Can you split the contents of the vial and use it on different patients?
Regulation does not allow us to split product and use it between individuals. The vials are single use and can ONLY be used on a SINGLE PATIENT. However the contents of the vial can be split and used at multiple sites for the SAME PATIENT.

Do you use aborted fetuses?
Absolutely not! The use of aborted fetuses in practice is unethical. We use umbilical cord blood from healthy and consented live births.

Are the cells safe for use?
The umbilical cord is processed in the hospital according to the rules and regulations of the American Association of Tissue Banks (AATB).

Approximately 4 weeks prior to a scheduled caesarean section, the mother’s OB/GYN asks her if she would like to keep and store her unborn child’s umbilical cord for future use. If the mother declines, she is asked if she would like to donate the umbilical cord. If she agrees, she undergoes a review of her medical history, social history, and a blood test. If she is deemed an acceptable donor according to prevailing rules of the AATB, then, at the time of her caesarean section, a trained technician will clamp the umbilical cord, take it to a sterile room, and remove the contents of the umbilical cord and place it into a blood bag.

The bag of umbilical cord blood is then delivered to the lab for processing. Once at the lab, a sample of the umbilical cord blood is sent to a 3rd party independent FDA registered lab for testing according to United States Pharmacopoeia rule 71 (U.S.P. 71), which is a test for all known communicable diseases. While that test is taking place, the tissue is processed from the cord and all red blood cells are removed. A sample of the harvested tissue is then sent to a different 3rd party independent FDA registered lab for sterility testing and for the absence of HLA-DR markers.

Only after both lab reports come back as “clean” and the tissue has passed the regulatory requirements, are the processed tissues available for distribution.

Will I have to miss work or my normal activities?
This is a highly specific procedure. Our goal is to have a successful tranplantation of the tissue to the site of injury.

Though there is no downtime, in order to protect the healing process, we ask our patients to refrain from heavy (activity) for a period of about 3 weeks. At that time, we can begin physical therapy to maximize the success of the transplanted tissue. Secure your private consultation by calling 256-325-4700.

Are there any other treatments to enhance the success of the stem cell transplant?
Yes. At the Pain 2 Wellness Knee Restoration Center, we offer cold laser therapy to enhance the success of the transplanted tissue. Cold laser is a specialized form of light therapy that may enhance stem cell transplantation therapy, by increasing circulation to the affected site, while also promoting pain control and tissue repair. Cold laser therapy is offered at half price with stem cell therapy.

How much is cold laser therapy with stem cell therapy?
Cold laser therapy uses low level light therapy that may enhance the stem cell treatment. It entails 10-12 sessions during the first 3-4 weeks to further promote tissue repair. The fee is normally $600 for the knee treatment, but is offered at a 50% discount with stem cell therapy. Secure your private consultation by calling 256-325-4700.

Will I need physical therapy after my stem cell transplant?
Not all clinics include physical therapy or cold laser therapy in their stem cell treatment protocols, but we do. We have found that patients who have physical therapy following this specialized treatment have better outcomes and improve function much more rapidly. We will write a physical therapy prescription for you and it will generally be covered by your insurance.

How many times will I require stem cell recruitment therapy?
For many patients with osteoarthritis of the knee joint, we anticipate needing only one treatment in a patient’s lifetime, one and done theory. However, if there are new traumas to the joint following treatment, it may require a booster injection.

How much does stem cell recruitment therapy cost?
The cost of stem cell recruitment therapy is determined by the size of the treatment area and the amount of damage to the joint. Most patients are treated for thousands less than the cost of knee surgery and ranges from $5,000- $5,500. If two joints are involved, the cost decreases with the second joint to a range of $7,000-$7,500.

Does insurance cover stem cell therapy?
Unfortunately, no insurance payers cover cell therapy as they are not yet FDA approved, which makes our process and the stem cell product even more economical and desirable.

There is some talk of coverage for Medicare and it is presently being evaluated for possible coverage. We are still waiting for the final word. Currently, the only FDA approved therapy is umbilical cord stem cells for a very specific cancer. Currently we follow FDA guidelines and regulations set forth by the American Association of Tissue Banks (AATB) regarding our handling and delivery of stem cells to patients.

Am I a candidate for stem cell recruitment therapy?
In order to determine if you are a candidate for stem cell recruitment therapy, we must first have a thorough evaluation including radiographic studies to determine the amount and extent of tissue damage. If the damage is too severe, we may recommend surgical intervention first and then stem cell treatment after surgery. The best way to determine your candidacy is to have a risk-free consultation by calling 256-325-5700

What are side effects of steroid injections?
Steroids have side effects that may or may not happen. It may cause blood pressure elevations, elevated blood sugar levels,allergic reactions, post-injection flare of pain, weight gain, increased appetite, and difficulty sleeping. This list is not exhaustive.

You may notice a local reaction such as warmth, pain, and slight swelling immediately after the injection. The symptoms generally do not last long. An ice pack to the site will help decrease the swelling.

Infection and bleeding are possible complications, but these are very rare with this procedure.

What are the side effects of viscosupplementation injections?
You may notice a local reaction such as warmth, pain and slight swelling immediately after the shot injection. The symptoms generally do not last long. An ice pack to the site with help decrease the swelling.

A local allergic reaction to the lubricant my occur of there are allergies to chicken, egg or egg products. Please notify the doctor if there are any known allergies to these substances.

Infection and bleeding are possible complications, but these are very rare with this procedure. For more information, call for your private consultation at 256-325-5700.

Post procedure instructions
Depending on the product used, there will be 1 injection per week over 1-5 weeks. It may take several weeks to notice improvement. However, some patients report improvement that will last for several months. The improvement time varies, but it is expected to last 6 months. If the injections are found to be effective, it may be repeated after 6 months.

For the first 48 hours after the injection, avoid excessive activity such as jogging or heavy lifting. You will be provided with a written post procedure guide/manual for your
convenience. For more information, call for your private consultation at 256-325-5700.

Is viscosupplementation covered by insurance?
Osteoarthritis must be established through radiographic studies such as xray. Once determined, Medicare will provide 80% coverage as long as the treatment is medically necessary. A secondary insurance or private pay will cover the remaining 20%. Medical necessity involves having tried and failed conservative managment including (anti-inflammatory) therapy, exercise, bracing and weight loss. Private insurances will ususally cover the treatment as well, but will require preauthorization. For more information, call for your private consultation at 256-325-5700.

I am interested in the Pain 2 Wellness Knee Restoration Program. What do I do next?
The Pain 2 Wellness Knee Restoration Program is an exciting, innovative way to improve pain, function and perhaps to delay or eliminate the need for total knee replacements.

Find out if this treatment is right for you by calling our office for your private consultation to meet your individual needs at 256-325-5700.