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Facing the challenge of bone-on-bone osteoarthritis in joints like the shoulder can be daunting, especially when surgery seems like the only option. In this blog, we delve into various treatments beyond the traditional path of cortisone shots and joint replacement. Join us as we explore the potential of regenerative injections, such as stem cells and exosomes, in offering relief and delaying invasive procedures. Dr. David Guyer, a renowned orthopedic surgeon and regenerative medicine expert, shares insights from his video series, addressing the pros and cons of these innovative approaches. Whether you’re newly diagnosed or seeking alternatives, this discussion sheds light on options that could help you manage pain and improve function despite severe arthritis.

Cortisone Shots: A Temporary Relief

Cortisone injections have long been used in the management of arthritis-related pain. They work by reducing inflammation, providing temporary relief to aching joints, but they come with a set of concerns. For individuals at the bone-on-bone stage, frequent cortisone shots may accelerate the damage to the joint, potentially hastening the need for replacement surgery.

Repeated cortisone injections, particularly in the shoulder, could pose additional risks by potentially weakening the rotator cuff tendons. This could complicate future surgical procedures and extend recovery times. Thus, while cortisone can provide short-term pain relief, its long-term impact can sometimes outweigh immediate benefits.

Visco-Supplementation: Limited by Severity

Another option sometimes considered is visco-supplementation. This involves injecting hyaluronic acid into the joint to improve lubrication and provide some level of cushioning. While it can be effective in earlier stages of arthritis, when it reaches a bone-on-bone state, visco-supplementation tends to offer limited relief due to the lack of existing cartilage to work with.

Regenerative Injections: Stem Cells and Exosomes

Regenerative treatments, though experimental and still under extensive evaluation, offer a different approach. These involve using stem cells or exosomes to target joint damage with the hope of encouraging healing and reducing inflammation. While they might not regenerate cartilage to the level of a younger, healthier joint, they can potentially provide pain relief and enhance mobility to some extent.

• Stem Cells: These have the capability to differentiate into various cell types, which includes cells found in cartilage. The idea is that they may help in halting the progression of osteoarthritis or delay the need for replacement surgery.
• Exosomes: These are derived from stem cells and can carry proteins and genetic material to cells, potentially offering more targeted anti-inflammatory benefits.

However, it’s essential to note that, while promising, these treatments are considered experimental by the FDA, and comprehensive long-term studies are still needed to fully understand their efficacy and safety.

Balancing Expectations

For those with bone-on-bone osteoarthritis, understanding what regenerative treatments can realistically offer is crucial. They are unlikely to fully restore a joint to its pre-arthritis condition but might provide a bridge that delays surgery, improves function, and lessens pain.

Patients considering these therapies should engage in thorough discussions with their orthopedic surgeons, weighing the potential benefits and risks uniquely applicable to their condition. It’s also vital to remember that, as these treatments advance, decisions should be based on the most current research and clinical evidence available.

Exploring Non-Surgical Paths

Apart from injections, exploring lifestyle changes and other non-surgical interventions can also play a role in managing symptoms:

• Physical Therapy: Tailored exercises can help maintain joint function and reduce pain.
• Diet and Weight Management: Maintaining a healthy weight reduces stress on joints, which can help in alleviating symptoms.
• Medication: Over-the-counter pain relievers can offer temporary relief without the complications of shots.

Navigating the Choices

Ultimately, the choice of treatment is a personal one, influenced by the severity of symptoms, the impact on daily life, and individual health goals. Keeping abreast of emerging treatments and maintaining open communication with healthcare providers ensures that choices made are fully informed and aligned with what is personally most important.

Staying engaged with resources like Dr. David Guyer’s information can help individuals make better-informed decisions, potentially enriching their lives with less pain and more activity despite the challenges of bone-on-bone osteoarthritis.

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