Ich habe heute die Ergebnisse meiner MRT-Untersuchung erhalten. Der Arzt hat mir nicht alles mitgeteilt, was auf seinem Bildschirm stand. Als er den Raum verlassen hatte, habe ich selbst nachgeschaut. Es steht dort, dass die Patella minimal medizinisch verschoben ist und es eine Verdickung und Unregelmäßigkeit des lateralen Patellofemoralbandes gibt, was auf mindestens einen Teilriss hindeutet, und das mediale Band ist um 7 mm locker? Kann mir jemand das bitte erklären, da mir der Arzt nur gesagt hat, dass sie mir Blut mit einer Maschine entnehmen und es dann in mein Knie injizieren wollen und wenn das nicht funktioniert, wird eine Gelenkspiegelung erforderlich sein, um zu sehen, was los ist? Jede Hilfe wäre sehr willkommen.
I'm not a doctor but this is what I think they mean:
Your kneecap is not in quite the right position (are you sure it was "medically" and not "medially"? One of the ligaments (the lateral patellofemoral) that attaches the kneecap to the thigh bone is thickened and does not have the smooth appearance it should have. This suggests it has been torn at some point. I think they mean that the medial collateral ligament is also stretched - that is the ligament that stabilises the knee down the side.
The treatment he is suggesting is probably a technique called Platelet-Rich Plasma therapy. This is an extract from an article about it:
"The process of making P.R.P. is relatively simple. A doctor draws between half an ounce and an ounce of the patient’s blood and spins it in a centrifuge to separate the platelets, the disc-shaped cells best known for their crucial role in clotting, from most of the red and white blood cells. The spinning concentrates the platelets in the plasma, the liquid part of blood. When the process is finished, the number of platelets in the plasma increases by a factor of between two and twenty, depending on the spinning method. The substance is then injected into the site of the injury, whether it’s a ligament, a tendon, or an arthritic joint.
The treatment was first used about thirty years ago by dental surgeons, to repair jaws and other facial bones that often don’t heal well. Researchers knew that these areas have fewer blood vessels than many other parts of the body, and wondered if the healing problem was related to a lack of blood. They found that P.R.P. could improve results in these situations, as well as for wounds that were slow to heal. The side effects were generally minimal—soreness, stiffness, and swelling from the injection—so doctors were willing to try it. In the mid-nineties, veterinarians began using it to treat tendon, ligament, and cartilage injuries in horses; like bone, these tissues tend to have a relatively limited blood supply. About a decade ago, P.R.P. moved back to human orthopedics and sports medicine. Practitioners estimate that P.R.P. is now used by a few hundred doctors around the country, mostly orthopedists and sports-medicine specialists. There are no statistics on how many people have been treated, but Ibrahim and others who use P.R.P. put the number in the tens of thousands, including hundreds of élite athletes like Waddell.
At the same time, P.R.P. remains controversial. One of the leading skeptics is Stephen Weber, an orthopedic surgeon in Sacramento. Six years ago, he became interested in P.R.P. and set up a study to see if it could help patients recover from shoulder surgery more quickly. He operated on the rotator cuffs of sixty people, half of whom received a P.R.P. injection afterward. His study, which was published last year, found that P.R.P. made no difference in patients’ recovery speeds. “We need to be very cautious,” he said. “Just because a Los Angeles Laker gets it doesn’t mean that it works.”
If you use your search engine to search for a section out of it you should be able to get the original. And there are probably a lot of other articles about PRP too - there is a good explanation on the Arthritis-health site for example. It is relatively new and there seem to be mixed opinions. It is said to speed up the healing of soft-tissue injuries in joints. It is also used for osteoarthritis. I couldn't find any studies to read in a quick search - but I think I might want to get some more information about the numbers of cases they have treated and their results. And I think I would get a second opinion. The surgeon from Sacramento (above) is of the opinion it doesn't speed things up - in fact, if they do it and it doesn't work, then it slows recovery down doesn't it because you will have to wait for the other procedure to be done.
The only good medical source I can find is from the British Medical Journal, written in February 2016, so it is pretty up to date. They say in their "important points to take away" bit:
"What you need to know
- Autologous platelet-rich plasma (PRP) is increasingly used to treat musculoskeletal soft tissue injuries, either on its own or as an adjunct to surgery
- Routine use is not recommended as there is insufficient evidence of clinical efficacy; instead, its use should be restricted to research settings
- Ensure patients receiving PRP are aware of the limited evidence of efficacy, so that they can make an informed decision about their care
- Clinicians should be aware of the concentration of PRP, and yield of bioactive proteins, produced by their selected preparation device"
and in the article itself say "As an autologous preparation, PRP has been introduced into clinical practice without being subject to the stringent development required of new drugs." - this means it has not been subjected to clinical trials to show whether it really does do what they say it does. You have only their word for it.
So basically - I wonder if your doctor is adding to his personal clinical study experience? Are you in the USA? Will YOU have to pay for any part of it? And if it fails - who pays for that?
haha ja, es sollte "medial" heißen. Ich gebe dem Wörterbuch die Schuld. Wow, du weißt ja viel. Ich komme aus dem UK. Alles, was er mir gesagt hat, ist, dass es sich um eine Maschine handelt, die mein Blut nimmt und alles Heilende daraus entfernt und es dann in mein Bein injiziert. Er sagte, es wird sehr schmerzhaft sein und wenn das nicht funktioniert, wird es eine Schlüssellochchirurgie geben, um zu sehen, was los ist. Ich hatte zuvor 4 Operationen an diesem Bein, eine davon, um die Schrauben zu entfernen, aber sie fragen mich ständig, wer die Operationen in der Vergangenheit durchgeführt hat. Also fragte ich sie, ob meine Operationen falsch durchgeführt wurden, und alles, was er sagte, war, dass es nicht unbedingt so sei, dass mein Kniescheibe früher links war, aber jetzt ist sie nach rechts bewegt worden, aber ich hatte diese Operationen vor fast 10 Jahren.
