Knee Pain Specialist

What causes chronic knee pain?

Chronic knee pain can be from simple wear and tear or from tendon, ligament, or meniscus injuries. Trauma and injury accelerate joint degeneration. As the cartilage wears down, the knee loses cushioning and bone spurs begin to form. Sometimes the knee will feel warm, and many complain that the pain is worse with cold weather, and at night. Occasionally, patients have already had knee surgery, or even knee replacement surgery, and continue to have knee pain. This does not mean that the surgery was not performed right -- there is published evidence and research that 25% of knee surgery patients continue to have pain after surgery. Do not worry -- you do have more options!

I was told I need knee surgery or a knee replacement, but I don’t want major surgery. Do I have a choice?

While some patients really do not have other options but major knee surgery, most patients still have other options. Acute knee trauma, and even osteoarthritis, can often be successfully treated with minimally-invasive regenerative medicine and stem cell options. For those who have already had knee surgery, but still have pain, FDA-approved radio-frequency ablation is another excellent option and can be performed on any knee, even if you have had a knee replacement!

The radiofrequency ablation procedure is performed under very light sedation, and there is essentially no recovery or downtime. Four special needles are inserted around the knee in very specific locations and connected to an advanced FDA-approved radio-frequency generator. The needles then emit a radio-frequency signal to eliminate the nerve signals causing pain in your knee and are then removed. The knee pain is no longer generated, and the results typically last between 6 months and 2 years.

Dr. Enayati and Dr. Gruver often combine radiofrequency ablation with regenerative medicine and stem cells treatments. This allows for immediate pain relief so that the patient can participate in more active physical therapy and knee muscle rebalancing, while the regenerative therapy helps the damaged knee cartilage regenerate on a cellular level over the course of the next 3-4 months.

Is there evidence behind using stem cell injections and radiofrequency ablation therapy to treat knee pain?

Absolutely. New studies on this subject are coming out all the time and the results are exciting. Below are a few examples of studies recently published in reputable medical journals.

Analgesic Effect and Functional Improvement Caused by Radiofrequency Treatment of Genicular Nerves in Patients With Advanced Osteoarthritis of the Knee Until 1 Year Following Treatment 
Regional Anesthesia & Pain Medicine 
January/February 2017 - Volume 42 - Issue 1, pages 62–68

In patients with symptomatic knee Osteoarthritis, PRP injections results in significant clinical improvements….

Efficacy of Intra-articular Platelet-Rich Plasma Injections in Knee Osteoarthritis: A Systematic Review 
Arthroscopy, The Journal of Arthroscopic and Related Surgery 
March 2016, Volume 32, Issue 3, pages 495-595

[PRP] is safe and provides quantifiable benefits for pain relief and functional improvement with regard to knee Osteoarthritis….

Intra-articular Autologous Conditioned Plasma Injections Provide Safe and Efficacious Treatment for Knee Osteoarthritis
An FDA-Sanctioned, Randomized, Double-blind, Placebo-controlled Clinical Trial 
The American Journal of Sports Medicine 
Volume 44, Issue 4, 2016

PRP injections have been found in the majority of recent clinical studies to be helpful for pain and function….
Role of PRP in the Treatment of Knee Osteoarthritis 
Current Physical Medicine and Rehabilitation Reports; (2016) 4: 138.
doi:10.1007/s40141-016-0119-4

Amniotic membranes have many promising applications in sports medicine. They are a source of pluripotent cells, highly organized collagen, antifibrotic and anti-inflammatory cytokines, immunomodulators, and matrix proteins. These properties may make it beneficial when applied as tissue engineering scaffolds, improving tissue organization in healing, and treatment of the arthritic joint….

Human Amniotic Membrane–Derived Products in Sports Medicine Basic Science, Early Results, and Potential Clinical Applications 
The American Journal of Sports Medicine 
Volume 44, Issue 9, 2016

Human amniotic suspension allografts (ASA) have anti-inflammatory and chondro-regenerative potential and thus represent a promising treatment strategy….

Cryopreserved Amniotic Suspension for the Treatment of Knee Osteoarthritis 
The Journal of Knee Surgery 
2016; 29(06): pages 443-450

The literature seems to support orthobiologics in the treatment of knee osteoarthritis for 1 year or longer, depending on the age of the patient and disease severity….
Orthobiologics and Knee Osteoarthritis: A Recent Literature Review, Treatment Algorithm, and Pathophysiology Discussion 
Physical Medicine and Rehabilitation Clinics of North America 
Volume 27, Issue 4, Nov 2016, pages 985–1002