Hoy recibí los resultados de mi resonancia magnética. El médico no me dijo todo lo que aparecía en su pantalla, así que cuando salió de la habitación, eché un vistazo yo mismo. Dice que la rótula está mínimamente desplazada médicamente y que hay engrosamiento e irregularidad del ligamento patelo-femoral lateral, lo que sugiere al menos una rotura parcial, y que el ligamento medial está flojo por 7 mm. ¿Alguien puede explicarme esto, por favor, ya que todo lo que el médico me ha dicho es que quieren extraerme sangre con una máquina y luego inyectarla en mi rodilla y si no funciona, requeriré una cirugía de mínima invasión para ver qué está pasando? Cualquier ayuda sería muy apreciada.
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?
jaja sí, estaba destinado a decir medialmente, culpo al diccionario. ¡Vaya, sabes mucho! Soy del Reino Unido y todo lo que me dijo es que es una máquina que toma mi sangre y extrae todo el poder de curación y luego lo inyecta en mi pierna. Dijo que será muy doloroso y si eso no funciona, será una cirugía de pequeño orificio para ver qué está pasando. Anteriormente tuve 4 operaciones en esta pierna, una fue para retirar los tornillos, pero constantemente me preguntan quién realizó las operaciones en el pasado, así que les pregunté si mis operaciones se hicieron incorrectamente y todo lo que dijo fue que no necesariamente, ya que antes mi rótula estaba a la izquierda, pero ahora se ha movido a la derecha, pero tuve estas operaciones hace casi 10 años.
