Austin OrthoBiologics: State of the Art 2021 Part II - Knee Injury

Dr. Kelly Cunningham and the team at Austin Ortho+Biologics have developed a focused and reproducible strategy for dealing with orthopedic injuries of the knee.

Through years of research, clinical orthopedic practice and evaluation of results, methods of treatment have evolved to deal with various common injuries, in athletes of all ages.

 Regenerative biologic techniques can be used as a stand-alone procedure or in combination with outpatient knee surgery:

    Knee Injury                                         Treatment Recommendation

Meniscus cartilage tear

     Pain                                                             PRP 

                                                                         surgical meniscus repair + PRP (failed PT trial^)

    Pain + “mechanical symptoms”              surgical repair + PRP

         notes:    PT trial  =  an initial course of Physical Therapy, based on patient-specific activity, to attempt to delay/avoid surgery ^

                       “mechanical symptoms”   such as knee catching, locking, repeated swelling              

                        PRP (Platelet-Rich Plasma injection, patient-derived) has demonstrated an ability to relieve pain, improve function & provide growth factors to knee cartilage injury - in contrast to steroid injection, which may limit healing & treatment options

                       Combined with meniscus repair (arthroscopic, outpatient procedure), PRP may improve cartilage healing rates

Articular cartilage injury      

         Pain, loss of function, mech symptoms   

                      “surface” lesion             MACI, Biocartilage “enhanced” microfracture surgery

                       bone involvement          auto/allograft osteochondral OATS surgery    

    notes:   PRP &/or MSC (Cellular "stem cell")  may be used to augment articular cartilage repair

                   requires normal limb alignment/no underlying arthritis

ACL tear

           Partial tear                          brace,  PT trial^          consider PRP/MSC injection

           Complete tear/knee instability                 

                                                   Level I/II athlete:       ACL ligament reconstruction + PRP

                                                   Less active adults*:     PT trial^, sports brace

   notes:   Combined with patient-derived & especially donor-derived ACL grafts, PRP may improve healing rates

                 *Failed conservative care may necessitate surgery

Dr. Cunningham is a board-certified, fellowship-trained orthopedic surgeon with special interest in the treatment of cartilage injuries and degeneration of the shoulder, knee, hip and elbow.

He focuses on non-surgical and surgical care of his patients, using innovative and cutting-edge regenerative sports medicine techniques, including cellular “stem cell” & PRP (“platelet-rich plasma”) therapy.

He has practiced in Austin, Texas, for over 30 years.

austinorthobio.com                                512-410-0767

Author

Dr. Kelly Cunningham Physician