I avoided total knee surgery for 23 years after major joint injury. I modified my activity and figured out how to unload my knees. See www.Drlannysinsoles.com. Then I discovered PCA and its benefit to joint health. I started taking many years ago. Finally after coping for many years I reinjured my right knee and submitted to a total knee replacement.
There is an ancient proverb, “Physician heal thyself”. The following is my story and success at healing myself and avoiding total knee surgery.
In 1996, with a single golf swing out of heavy rough I torn both medial meniscus and sheared of the cartilage of both medial femoral condyles. Both massively swollen knees underwent arthroscopic surgery to remove hundreds or cartilage fragment while confirming the major loss of cartilage covering the thigh bone. The prognosis was bad. I was already a candidate for total knee surgery.
I started to look into ways to preserve what cartilage remained, minimize progression, have less pain, stay active and avoid a total knee replacement. Why?
Under publicized is that 25% of patients having a total knee operation are not satisfied with the results. The risk of infection is reported as much as 2%. That percentage is low, but the event is tragic. Underreported is that the 5-year mortality of an infected total joint is worse than cancer of the breast or prostate; 25%. Wow! If the patient lives they have years of pain, loss of life style, multiple courses of antibiotics, repeated operations the final reconstructive results are compromised at best, if they live.
My case, like most knee arthritic cases was initially on the inner side of the knee, not the entire knee joint to which it later will spread.
Wedged Insoles: It is known that pressure forces on an arthritic joint lead to onset and or progression of the condition. Therefore, I set out to study how to reduce the forces across the inner knee joint of my knee. A study at independent contract laboratory in La Jolla, California was performed on four patients who had already had a total knee in place, but all with load sensors for scientific study.
It was learned that a wedged insole would unload the inner aspect of those with the sensor total knees. https://drlannysinsoles.com/independent-testing/
Wedged insoles have been controversial, but because the appliance was applied but without identifying if the potential user was biomechanically qualified to benefit. I discovered a simple test to learn if the patient would benefit from wedged insoles. https://drlannysinsoles.com/wedged-insoles-for-the-arthritic-knee/
I started wearing such wedges and found them an immediate benefit in reduction of pain. Because of my interest in golf and having credentials as instructor on PGA Tour, I got these insoles USGA approved as legal for tournament golf. I have offered them for sale to others at a nominal charge. www.drlannysinsoles.com
An Arthritis Pill? Joint swelling and inflammation accompany arthritis as the joint deteriorates and sheds of fragments of cartilage. I have a long interest in cartilage healing, pre-dating my injury. I have published on the treatment of such not thinking at the time, I would be a patient.
About 15 years ago I was saw an article in the local Lansing, Michigan newspaper reporting Michigan State scientists discovered that that dyes that make cherries red, when applied to rodent pancreatic islet cells caused increase insulin expression. I reasoned that these dyes might cause other cells or tissues to produce an insulin like hormone; IGF-1. IGF-1 is long known in the scientific community to heal cartilage, but no clinical application has emerged.
I returned to the La Jolla laboratory and demonstrated that these dyes called cyanidin-3-glycoside when applied to human joint lining explants in the laboratory resulted in increased IGF-1 production. I was granted US patents concerning such.
8, 263,069 September 11, 2012. This patent showed that the dyes of plants (anthocyanins and anthocyanins) the precursor of the metabolite protocatechuic acid turned on the gene for growth hormone IGF-1 in human synovium.
9,486,468: November 8, 2016. This patent secured the intra articular injection route not previously included in the granted patent claims.
However, it was learned that the bioactive reagent was not cyanidin-3-glucoside, but the primary metabolite of such; protocatechuic acid (PCA). PCA is a food supplement and classified as a nutraceutical. A patent application was made for such and remains under review.
After further study and research, I secured capsules for my use to decrease the inflammation associated with arthritis. They were successful, so I made them available to others. Presently they are commercially available at https://drjsnatural.com/Total-Wellness-PCA.
Time Marches On: It now was 2021 and I had no pain or swelling for daily activities. I could walk more than a mile with no problem, but not often. I could stand on PGA Tour, teaching for 8-10 hours without a problem, given occasional chance to sit down. I golfed in a car, hit practice balls and no problem.
Cosmetically my knees became more bowed but I was not anticipating a beauty contest. I have minimal loss of extension but retained full flexion.
However, stair climbing and decent remain a major problem. I also lose my balance walking on rocky or uneven surfaces. Muscular control or responsiveness is not there. I keep forgetting I am 90 years old. Finally decided it was in my best interests to have a total knee on the worst right knee. I am still coping with the other side and active hitting golf balls and majoring in coping with old age.
Lanny L. Johnson, M.D.
