What Are The Most Common Types Of Knee Injuries?

Fractures, dislocations, sprains, strains, and tears are the most commonly reported knee injuries. The patella is the most likely knee structure to be broken or dislocated. Tears affect the ligaments that connect bones and muscles and cartilage that cushions joint bones.

When Is It Appropriate To Seek Medical Attention For Knee Pain?

When acute knee pain occurs, use RICE (rest, ice, compression, and elevation) to attempt to resolve the issue. Ibuprofen and other over-the-counter medications reduce inflammation and pain. If symptoms do not improve within 24 hours, schedule an appointment with a physician. Redness, tenderness, and extreme warmth that does resolve with RICE are also valid reasons to visit a doctor.

Seek medical attention immediately if there is an extensive swelling, significant pain, or symptoms present with a fever. Injuries that cause an audible popping sound or make it impossible for the limb to bear weight merit a visit to emergency services.

What Should Patients Expect During A Physical Examination Of The Knee?

After gathering a thorough medical history, doctors discuss the symptoms patients are experiencing. Then, the doctor visually examines the affected joint. Gentle palpitations of the bones, muscles, and ligaments help medical professionals assess joint stability and pinpoint possible areas of damage. Range of motion exercises may also be used as an evaluation tool.

Imaging technology, like x-rays, CAT scans, and MRIs are essential tools that help physicians confirm a diagnosis or aid in developing a treatment plan. Blood tests maybe prescribed to uncover possible underlying conditions, such as gout or certain arthritic conditions.

What Are Some Common Causes Of Knee Pain?

Acute knee pain is most commonly caused by overuse and improper load-bearing technique. Impact injuries suffered during sports or accidents are other sources of sudden and intense pain around the knee.

A variety of musculoskeletal conditions can cause chronic knee pain. Arthritis, bursitis, poor posture while standing or walking and issues with the iliotibial (IT) band weaken muscles and cause misaligned bone structures. Malalignment causes friction and irritation which, over time, contributes to an increased inflammatory response and chronic pain.

How Is Knee Pain Treated?

Doctors use a variety of techniques to resolve knee pain. Prescription pain medications alleviate pain symptoms and allow the patient to rest comfortably while the body heals from injury. For chronic conditions, injections of cortisone, hyaluronic acid, or platelet-rich plasmas (PRP) may be prescribed for longer-term relief.

Physical therapy sessions strengthen the muscles that support the limb to increase physical ability and correct alignment issues. Assistive devices like arch supports, braces, walkers, and canes reduce joint pressure from everyday activities caused by arthritic conditions.

How Will I Know If I Need Knee Surgery?

In some cases, surgery is necessary to repair damaged joint structures. Torn cartilage, cysts, and fractures often need surgical intervention to facilitate healing. Doctors may suggest surgery when physical and prescription drug therapies fail to grant relief from chronic issues.

What Are The Different Types Of Knee Surgery?

Arthroscopic surgery allows physicians to enter the joint cavity through a small incision to remove loose bodies, remove damaged tissues, and reconstruct ligaments. Using a small camera and microscopic tools, doctors can navigate the joint without the need for a prolonged hospital stay. Meniscus repairs, transplants, ligament repair, and cartilage repair are common arthroscopic procedures.

Meniscus surgery is one of the most common orthopedic surgeries performed. Meniscus tears are very common, although not all meniscus tears need surgery. Some meniscus tears require removing the damaged tissue (meniscectomy), although new technology and surgical allow many meniscus tears being able to be surgically repaired. In some cases, a meniscal transplant can be performed to replace a meniscus that is damaged beyond repair.

ACL (anterior cruciate ligament) reconstruction is frequently need to fully restore function after an ACL tear. The ACL is crucial to maintain adequate knee stability. The ACL has very limited healing potential, and most ACL tears require “reconstruction,” using a new ligament or tendon to replace the injured ACL. In a small subset of patients, the patient’s own ACL can be repaired. Restoring knee stability with ACL surgery protects the knee from further cartilage and meniscus damage and allows patients to return to unrestricted activities.

What Is Knee Replacement Surgery?

Extensive damage may require a partial or total replacement of the knee joint called arthroplasty. The goal of knee replacement surgery is to remove damaged tissues and replace them with synthetic structures. Metal and plastic parts are used to cap boney joints and provide stability during motion. Partial replacements concentrate only on compromised tissues. In a full replacement, all parts of the knee joint are substituted for synthetic structures.

Who Needs Knee Replacement Surgery?

A partial or total knee replacement may be needed when less invasive therapy options are not effective. Severe loss of mobility, chronic and uncontrolled inflammation, and pain that interferes with sleeping and daily duties may indicate the need for surgical intervention. Consult an orthopedic surgeon for a personal assessment.

What Are The Alternatives To Knee Replacement?

The use of assistive devices like knee braces and walking canes mitigates knee pain and make it possible to perform many daily activities without the need for surgical intervention. A regular exercise routine increases blood flow to affected areas and encourages the body’s natural healing processes. Using a combination of physical therapy and pain medications or opting for less invasive arthroscopic procedures can delay the need for a knee replacement.

An alternative to knee replacement that is becoming more popular with patients is the cartilage regeneration procedure. This treatment for the knee utilizes your body’s stem cells to regrow lost cartilage by combining a surgical approach with in-office injections.

Injuries of the Anterior Cruciate Ligament (ACL)

Download the ACL Patient Kit Today.

There are three letters embedded in the mind of all doctors - ACL. Injuries of the anterior cruciate ligament (ACL) in the knee are common, particularly among athletes. Learn more about the ACL, the type of injuries it may sustain, who is most at risk, and more in this comprehensive patient kit.

In this kit, we will provide you with the following resources :

Fact Sheet (includes statistics regarding ACL injuries and patients)
Infographic
Video

 

ACL Patient Kit

Bone and Joint Clinic ACL Repair
  • Joseph E. Broyles, M.D.

    Dr. Joseph Broyles MDDr. Broyles has been treating patients with knee cartilage loss with a procedure called Biologic Augmented Microdrilling (BAM) since 2011. BAM is a biologic treatment for regenerating cartilage, and it is applicable to patients with bone-on-bone and large area cartilage loss. As a leader in the cartilage regeneration field, Dr. Broyles started The Cartilage Regeneration Center at the Bone and Joint Clinic of Baton Rouge.

    Dr. Broyles' relentless commitment to staying ahead of the curve in the field of joint replacement has led him to the SuperPath hip replacement procedure. The main distinguishing factors of SuperPath are a smaller incision, greater preservation of deep tissues with minimal dissection, and the ability to perform the procedure without the need to dislocate the hip joint. This is in contrast to standard techniques where the leg must be twisted to dislocate the hip and perform the procedure.

    REQUEST AN APPOINTMENT WITH DR. BROYLES

  • Jeremy M. Burnham, M.D.

    Dr. Jeremy BurnhamDr. Burnham is a fellowship-trained sports medicine orthopedic surgeon specializing in the diagnosis and treatment of sports injuries in athletes of all ages and competition levels. He has trained with internationally recognized sports medicine experts and has treated athletes from the NCAA, NFL, NHL, MLS, NBA, MLB, professional ballet, and more. He currently serves as team physician for several teams and sporting events throughout the region.

    Dr. Burnham is a Baton Rouge native and LSU Graduate. Dr. Burnham was a member of the 2005 LSU Football Team. During orthopedic surgery residency and sports medicine fellowship, he served as a sports medicine physician for high school, college, and professional teams and treated athletes from the University of Kentucky, Carnegie Mellon University, Dusquene University, University of Pittsburgh, the Pittsburgh Steelers, and the Pittsburgh Penguins.

    Dr. Burnham’s clinical and research focus has centered on ACL injury treatment and prevention. His specialties also include Meniscus Transplant and Meniscus Repair, Cartilage Restoration, Biologics, Stem Cells, and PRP. He has authored over 40 papers and book chapters and has presented research and instructional lectures at national and international sports medicine meetings.

     

    Request An Appointment with Dr. Jeremy Burnham

  • Arthur E. Hess, M.D.

    Dr. Authur HessDr. Arthur Hess is a board certified, fellowship-trained orthopaedic surgeon. His fellowship training in orthopaedic traumatology allows him to treat complex conditions in nearly every part of the body. Dr. Hess specializes in pelvic and acetabular (hip socket) surgeries, hip and knee arthritis and joint replacement, hip preservation, and complex reconstruction of knee, pelvic and acetabular fractures. 

    Dr. Hess performs periacetabular osteotomies, a surgery that reorients a dysplastic (I.e., shallow) hip socket to improve coverage, minimize pain, and delay or even entirely prevent the need for a hip replacement.  

    For those patients with end-stage arthritis, Dr. Hess, performs his minimally invasive hip replacements through the direct anterior approach, meaning the joint is accessed from the front.  This approach spares muscles, in contrast to conventional posterior hip approaches, that require dividing muscle groups to access the joint.  This approach may lead to smaller incisions, less muscle disruption, and a faster recovery.

    REQUEST AN APPOINTMENT WITH DR. HESS

  • Mathew J. Mazoch, M.D.

    Dr. Mathew MazochDr. Mazoch grew up on a beef cattle farm and is an avid outdoorsman. He is an LSU fan and a Baton Rouge native. He graduated Valedictorian from Catholic High School where he was an all-state wrestler for the Bears.

    Dr. Mazoch graduated Summa Cum Laude from LSU with numerous other awards and honors. He graduated at the top of his class in medical school at LSU, receiving Honors in all his clinical rotations and serving as president of the Alpha Omega Alpha Honors Society. 

    Dr. Mazoch is a Fellowship-trained orthopedic surgeon in arthroscopic surgery and sports medicine. He spent additional time after orthopedic residency working with many of the internationally recognized leaders in the field of arthroscopic and minimally invasive surgery to master complex procedures in the shoulder, knee, hip, and elbow.

     

    REQUEST AN APPOINTMENT WITH DR. MAZOCH

  • Gerard L. Murtagh

    Dr. Gerald MurtaghDr. Murtagh earned his BS Degree from Nicholls State University in 1978. He graduated Magna cum Laude and was a member of Phi Kappa Phi honor society. He received his MD from LSU in New Orleans in 1983 and was class president for three years. He completed an internship at LSU Medical Center in Shreveport and an orthopedic residency. He served as chief resident of Orthopaedic Surgery from July – October of 1987.

    He was certified by the American Board of Orthopaedic Surgery in 1990. He has served as Chairman of the Orthopaedic Leadership Committee and Chief of Orthopaedic Surgery at OLOL Regional Medical Center as well as a clinical instructor for LSU Medical School. Society memberships include the American Academy of Orthopaedic Surgery and the Arthroscopy Association of North America. Subspecialty interests include arthroscopic and minimally invasive surgical reconstruction.

     

    REQUEST AN APPOINTMENT WITH DR. MURTAGH

  • Julie Neumann, M.D.

    Dr. Julie Neumann

    Dr. Neumann is a Baton Rouge native who is excited to return home & treat patients of all ages & abilities with orthopedic conditions or injuries. She is dual fellowship-trained in sports medicine & foot/ankle.

    Dr. Neumann grew up in Baton Rouge and played just about every sport possible. As a student at St. Joseph Academy, she became more concentrated in soccer. She completed her undergraduate degree at LSU, where she was a scholarship student-athlete on the women’s soccer team. She graduated with Upper Division Honors Distinction from the LSU Honor’s College & was selected for Leadership LSU. She went on to earn her medical degree at LSU Health Sciences Center in New Orleans. She completed her residency at Duke University Medical Center where she received the 2016 Award for Excellence in Orthopaedic Research. During her time at Duke, she was a member of the medical team for the 2015 Duke Men’s Basketball National Championship team.

    Dr. Neumann completed her first fellowship in sports medicine at Kerlan-Jobe Orthopedic Clinic in Los Angeles where she helped care for the Rams, Kings, Dodgers, & Sparks. Then she completed an additional yearlong fellowship in foot & ankle at the University of Utah in Salt Lake City. She is a member of AOFAS, AOSSM, RJOS, & AAOS. Dr. Neumann looks forward to serving you & your family & friends when orthopedic conditions arise.

     

    REQUEST AN APPOINTMENT WITH DR. JULIE NEUMANN

  • David M. Pope, M.D.

    Dr. David PopeDr. Pope, a Baton Rouge native, attended Catholic High School where is starred on the football team. Team sports were always a part of his youth, and his passion for athletics drove him to pursue a career in orthopedics.

    Dr. Pope graduated Summa Cum Laude from LSU in 1989 with a Bachelor’s Degree in Microbiology. He received his Medical Degree from LSU School of Medicine-New Orleans in 1993, where he was the recipient of several distinguished awards, including the Louisiana Orthopaedic Association Award, the McGraw-Hill Book Award for the Highest Ranking Freshman Medical Student and the Urban Maes Memorial Award for the Most Outstanding Four Year Medical Academic Achievement.

    Dr. Pope completed his orthopedic residency in 1998 at the Lutheran Hospital in Fort Wayne, Indiana. He practices general orthopedic surgery with a subspecialty interest in knee arthroscopy, sports medicine, and knee joint replacement. He is a Diplomat of the American Board of Orthopaedic Surgery. Dr. Pope is an official finisher of the 2006 Detroit Marathon and the 2007 San Diego Marathon. He was recognized by Louisiana Life as a Top Doctor in 2015 & 2016.

     

    REQUEST AN APPOINTMENT WITH DR. POPE

  • Alan C. Schroeder, M.D.

    Dr. Alan SchroederDr. Schroeder is Board certified in Orthopedic Sports Medicine and one of the only Baton Rouge area orthopedic surgeons to have completed Fellowship training in Sports Medicine. His professional memberships include the American Orthopedic Society for Sports Medicine and the Arthroscopy Association of North America where he serves as an Associate Master instructor. He completed a dually accredited arthroscopy and sports medicine fellowship (extra subspecialty training) at MSMOC after orthopedics at UMMC. At LSU Medical School in New Orleans, his academic achievement earned AOA honors. Prior degrees include Health Systems Management and Biomedical Engineering.

    Dr. Schroeder treats athletes at all levels, with acute or repetitive injury, and people with shoulder pain during overhead activities find solutions to their problem. Conditions such as shoulder rotator cuff bursitis, shoulder dislocation, ACL tear, knee pain or instability, elbow pain, and hand numbness can all be treated conservatively or by minimally invasive methods when necessary.

     

    REQUEST AN APPOINTMENT WITH DR. SCHROEDER

 
  • Joseph E. Broyles, M.D.
  • Jeremy M. Burnham, M.D.
  • Arthur E. Hess, M.D.
  • Mathew J. Mazoch, M.D.
  • Gerard L. Murtagh
  • Julie Neumann, M.D.
  • David M. Pope, M.D.
  • Alan C. Schroeder, M.D.

Joseph E. Broyles, M.D.

Dr. Joseph Broyles MDDr. Broyles has been treating patients with knee cartilage loss with a procedure called Biologic Augmented Microdrilling (BAM) since 2011. BAM is a biologic treatment for regenerating cartilage, and it is applicable to patients with bone-on-bone and large area cartilage loss. As a leader in the cartilage regeneration field, Dr. Broyles started The Cartilage Regeneration Center at the Bone and Joint Clinic of Baton Rouge.

Dr. Broyles' relentless commitment to staying ahead of the curve in the field of joint replacement has led him to the SuperPath hip replacement procedure. The main distinguishing factors of SuperPath are a smaller incision, greater preservation of deep tissues with minimal dissection, and the ability to perform the procedure without the need to dislocate the hip joint. This is in contrast to standard techniques where the leg must be twisted to dislocate the hip and perform the procedure.

REQUEST AN APPOINTMENT WITH DR. BROYLES

Jeremy M. Burnham, M.D.

Dr. Jeremy BurnhamDr. Burnham is a fellowship-trained sports medicine orthopedic surgeon specializing in the diagnosis and treatment of sports injuries in athletes of all ages and competition levels. He has trained with internationally recognized sports medicine experts and has treated athletes from the NCAA, NFL, NHL, MLS, NBA, MLB, professional ballet, and more. He currently serves as team physician for several teams and sporting events throughout the region.

Dr. Burnham is a Baton Rouge native and LSU Graduate. Dr. Burnham was a member of the 2005 LSU Football Team. During orthopedic surgery residency and sports medicine fellowship, he served as a sports medicine physician for high school, college, and professional teams and treated athletes from the University of Kentucky, Carnegie Mellon University, Dusquene University, University of Pittsburgh, the Pittsburgh Steelers, and the Pittsburgh Penguins.

Dr. Burnham’s clinical and research focus has centered on ACL injury treatment and prevention. His specialties also include Meniscus Transplant and Meniscus Repair, Cartilage Restoration, Biologics, Stem Cells, and PRP. He has authored over 40 papers and book chapters and has presented research and instructional lectures at national and international sports medicine meetings.

 

Request An Appointment with Dr. Jeremy Burnham

Arthur E. Hess, M.D.

Dr. Authur HessDr. Arthur Hess is a board certified, fellowship-trained orthopaedic surgeon. His fellowship training in orthopaedic traumatology allows him to treat complex conditions in nearly every part of the body. Dr. Hess specializes in pelvic and acetabular (hip socket) surgeries, hip and knee arthritis and joint replacement, hip preservation, and complex reconstruction of knee, pelvic and acetabular fractures. 

Dr. Hess performs periacetabular osteotomies, a surgery that reorients a dysplastic (I.e., shallow) hip socket to improve coverage, minimize pain, and delay or even entirely prevent the need for a hip replacement.  

For those patients with end-stage arthritis, Dr. Hess, performs his minimally invasive hip replacements through the direct anterior approach, meaning the joint is accessed from the front.  This approach spares muscles, in contrast to conventional posterior hip approaches, that require dividing muscle groups to access the joint.  This approach may lead to smaller incisions, less muscle disruption, and a faster recovery.

REQUEST AN APPOINTMENT WITH DR. HESS

Mathew J. Mazoch, M.D.

Dr. Mathew MazochDr. Mazoch grew up on a beef cattle farm and is an avid outdoorsman. He is an LSU fan and a Baton Rouge native. He graduated Valedictorian from Catholic High School where he was an all-state wrestler for the Bears.

Dr. Mazoch graduated Summa Cum Laude from LSU with numerous other awards and honors. He graduated at the top of his class in medical school at LSU, receiving Honors in all his clinical rotations and serving as president of the Alpha Omega Alpha Honors Society. 

Dr. Mazoch is a Fellowship-trained orthopedic surgeon in arthroscopic surgery and sports medicine. He spent additional time after orthopedic residency working with many of the internationally recognized leaders in the field of arthroscopic and minimally invasive surgery to master complex procedures in the shoulder, knee, hip, and elbow.

 

REQUEST AN APPOINTMENT WITH DR. MAZOCH

Gerard L. Murtagh

Dr. Gerald MurtaghDr. Murtagh earned his BS Degree from Nicholls State University in 1978. He graduated Magna cum Laude and was a member of Phi Kappa Phi honor society. He received his MD from LSU in New Orleans in 1983 and was class president for three years. He completed an internship at LSU Medical Center in Shreveport and an orthopedic residency. He served as chief resident of Orthopaedic Surgery from July – October of 1987.

He was certified by the American Board of Orthopaedic Surgery in 1990. He has served as Chairman of the Orthopaedic Leadership Committee and Chief of Orthopaedic Surgery at OLOL Regional Medical Center as well as a clinical instructor for LSU Medical School. Society memberships include the American Academy of Orthopaedic Surgery and the Arthroscopy Association of North America. Subspecialty interests include arthroscopic and minimally invasive surgical reconstruction.

 

REQUEST AN APPOINTMENT WITH DR. MURTAGH

Julie Neumann, M.D.

Dr. Julie Neumann

Dr. Neumann is a Baton Rouge native who is excited to return home & treat patients of all ages & abilities with orthopedic conditions or injuries. She is dual fellowship-trained in sports medicine & foot/ankle.

Dr. Neumann grew up in Baton Rouge and played just about every sport possible. As a student at St. Joseph Academy, she became more concentrated in soccer. She completed her undergraduate degree at LSU, where she was a scholarship student-athlete on the women’s soccer team. She graduated with Upper Division Honors Distinction from the LSU Honor’s College & was selected for Leadership LSU. She went on to earn her medical degree at LSU Health Sciences Center in New Orleans. She completed her residency at Duke University Medical Center where she received the 2016 Award for Excellence in Orthopaedic Research. During her time at Duke, she was a member of the medical team for the 2015 Duke Men’s Basketball National Championship team.

Dr. Neumann completed her first fellowship in sports medicine at Kerlan-Jobe Orthopedic Clinic in Los Angeles where she helped care for the Rams, Kings, Dodgers, & Sparks. Then she completed an additional yearlong fellowship in foot & ankle at the University of Utah in Salt Lake City. She is a member of AOFAS, AOSSM, RJOS, & AAOS. Dr. Neumann looks forward to serving you & your family & friends when orthopedic conditions arise.

 

REQUEST AN APPOINTMENT WITH DR. JULIE NEUMANN

David M. Pope, M.D.

Dr. David PopeDr. Pope, a Baton Rouge native, attended Catholic High School where is starred on the football team. Team sports were always a part of his youth, and his passion for athletics drove him to pursue a career in orthopedics.

Dr. Pope graduated Summa Cum Laude from LSU in 1989 with a Bachelor’s Degree in Microbiology. He received his Medical Degree from LSU School of Medicine-New Orleans in 1993, where he was the recipient of several distinguished awards, including the Louisiana Orthopaedic Association Award, the McGraw-Hill Book Award for the Highest Ranking Freshman Medical Student and the Urban Maes Memorial Award for the Most Outstanding Four Year Medical Academic Achievement.

Dr. Pope completed his orthopedic residency in 1998 at the Lutheran Hospital in Fort Wayne, Indiana. He practices general orthopedic surgery with a subspecialty interest in knee arthroscopy, sports medicine, and knee joint replacement. He is a Diplomat of the American Board of Orthopaedic Surgery. Dr. Pope is an official finisher of the 2006 Detroit Marathon and the 2007 San Diego Marathon. He was recognized by Louisiana Life as a Top Doctor in 2015 & 2016.

 

REQUEST AN APPOINTMENT WITH DR. POPE

Alan C. Schroeder, M.D.

Dr. Alan SchroederDr. Schroeder is Board certified in Orthopedic Sports Medicine and one of the only Baton Rouge area orthopedic surgeons to have completed Fellowship training in Sports Medicine. His professional memberships include the American Orthopedic Society for Sports Medicine and the Arthroscopy Association of North America where he serves as an Associate Master instructor. He completed a dually accredited arthroscopy and sports medicine fellowship (extra subspecialty training) at MSMOC after orthopedics at UMMC. At LSU Medical School in New Orleans, his academic achievement earned AOA honors. Prior degrees include Health Systems Management and Biomedical Engineering.

Dr. Schroeder treats athletes at all levels, with acute or repetitive injury, and people with shoulder pain during overhead activities find solutions to their problem. Conditions such as shoulder rotator cuff bursitis, shoulder dislocation, ACL tear, knee pain or instability, elbow pain, and hand numbness can all be treated conservatively or by minimally invasive methods when necessary.

 

REQUEST AN APPOINTMENT WITH DR. SCHROEDER

Advancements in Knee Treatment in Baton Rouge

Stay updated on the latest advancements in diagnosing and treating the knee with the Bone and Joint Clinic of Baton Rouge.

knees-857441-edited
Knee Replacement Alternative: Biologic Augmented Microdrilling (BAM)

It may be called total knee replacement (TKR) or total knee arthroplasty (TKA), but no matter which name you use, the ultimate goal of knee replacement surgery is the same: Bring relief to those suffering debilitating knee pain. Most often, this pain is the direct result of osteoarthritis, or degenerative arthritis.

Read More
ACL Injury Baton Rouge
ACL Tears in Athletes: Risk Factors and Symptoms

Participation in sports is linked to many health benefits. Of course, athletes reap the benefits of physical fitness, but they are also more likely to make healthier choices, have higher self-esteem, work better in groups and perform higher academically. Still, there is also a certain amount of risk associated with athletics, including injuries such as tears of the ACL.

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ACL Injury Treatment Baton Rouge
An ACL Injury Overview

The anterior cruciate ligament, or ACL, is one of 4 major ligaments within the knee joint. Whereas collateral ligaments are located on the sides of the knee, the anterior and posterior cruciate ligaments are found in the middle, behind the kneecap. The specific function of the ACL is to connect the shin & thigh bones, maintaining their proper placement & promoting knee stability. Read more on ACL injury treatment here.

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BAM Cartilage Regeneration Baton Rouge
BAM Cartilage Regeneration Baton Rouge

Biologic augmented microdrilling (BAM) is an outpatient procedure that infuses damaged knee cartilage with stem cells derived from bone marrow to promote regeneration and improve symptomatic pain and stiffness. It is an alternative to total knee replacement surgery and is helpful for those whose age or condition may not yet warrant TKR.

Read More