Non-surgical biological treatments for sports knee injuries

By Ahmet Taş | Wise News Press

ISTANBUL, TURKEY — As the number of individuals engaging in sports increases alongside a growing awareness of healthy living, experts emphasize that non-surgical biological treatments are initiating a new era in healing knee injuries caused by incorrect movements.

Injections of PRP, stem cells, and hyaluronic acid—used for various problems ranging from meniscus tears and cartilage damage to early-stage osteoarthritis and chronic joint pain—significantly shorten the time it takes for patients to return to their daily lives and sports routines. Associate Professor Berkin TOKER, an Orthopedics and Traumatology Specialist at Acıbadem Fulya Hospital, notes that the knee joint is one of the areas most vulnerable to trauma due to its anatomical structure, adding that the success rate of these modern injection methods directly depends on correct patient selection.

The knee joint is one of the most weight-bearing and biomechanically active regions in human anatomy. High-tempo sports that require sudden direction changes, jumping, and rapid deceleration, such as running, football, and basketball, can multiply the load on the knees. Toker states that this excessive load and incorrect sports movements can cause severe destruction in the knee area, with the most common problems being meniscus tears, anterior cruciate ligament injuries, and cartilage tissue damage.

Non-surgical biological methods come to the forefront

Recent technological advancements in the medical world, particularly in orthopedics, have begun to delay or completely eliminate the need for surgical interventions in treating knee problems. According to experts, biological methods that externally stimulate and increase the tissue's self-repair capacity are finding more place in clinical practice.

Toker mentions that among the most frequently used applications in this context are PRP (Platelet Rich Plasma) obtained from the patient's own blood and hyaluronic acid injections that support the joint fluid. Pointing out that stem cell applications, which are considered revolutionary in the medical world, have also become widespread, Toker adds that the clinical use of these injection treatments is expected to become even more common in the near future.

Cellular renewal with PRP (Platelet Rich Plasma)

The PRP method, whose name is frequently heard in sports injuries, is fundamentally based on injecting platelet-rich plasma obtained from the patient's own blood into the problematic area. The main goal of this biological procedure is to externally stimulate and accelerate the body's natural healing and repair process at a cellular level. Underlining that PRP is a "reconstruction" treatment, Toker notes they aim to reduce the inflammatory process in the tissue, trigger tissue healing, and alleviate pain.

PRP treatment is mostly preferred for early-stage cartilage damage, patellofemoral pain syndrome commonly seen in athletes, mild to moderate knee osteoarthritis, and tendon problems like tendinitis. Stating that the method stands out as a very strong non-surgical option for load-related chronic knee pain, Toker advises that a miracle should not be expected on its own in patients with advanced mechanical deformity or full-thickness cartilage loss.

The application process is quite practical. The blood taken from the patient after the examination is separated in special centrifuge devices, and the obtained material is injected into the joint. This procedure, which takes only 10-15 minutes, does not require hospitalization. "Our patients can usually start doing sports after a week," says Toker, explaining that patients are discharged on foot the same day. The clinical effects of the treatment, usually planned as 1-3 sessions, begin within 2-4 weeks and last an average of 6-12 months.

A more complex repair: Stem cell therapy

Another powerful weapon in knee osteoarthritis and tissue loss is stem cell therapy, which mostly involves transplanting mesenchymal stem cells obtained from the patient's own bone marrow or abdominal fat tissue to the damaged area. The main purpose of the treatment is to support biological repair in damaged cartilage or soft tissues, suppress inflammation, and trigger the cells' self-repair process.

Stating that this method is a much more complex and advanced biological approach than PRP, Toker emphasizes that stem cells provide much longer-lasting protection compared to hyaluronic acid and PRP injections. The method can be used as supportive therapy in focal cartilage defects, early and mid-stage cartilage degeneration, and some meniscus injuries. Planned as an alternative to surgical operations, especially in young adults living an active life, stem cell therapy is not sufficient on its own in advanced bone deformations.

During the procedure, bone marrow aspirate or fat tissue taken from the patient is concentrated through special procedures under operating room conditions and injected into the lesion area. The effects of the procedure, completed in approximately 30-45 minutes, are felt within 4-8 weeks. The state of well-being can last up to 1-2 years in suitable patient groups.

Joint lubrication with hyaluronic acid

The quality of knee joint fluid is of great importance for joints to move healthily and painlessly. Hyaluronic acid naturally constitutes one of the basic components of this fluid. However, the quality and lubricating properties of this fluid decrease due to osteoarthritis or excessive load.

Experts state that hyaluronic acid injections applied in outpatient clinic conditions act almost like "joint grease," increasing lubrication and reducing mechanical friction. This method aims to reduce the patient's pain, increase joint range of motion, and boost performance capacity.

Preferred especially for chondromalacia patellae and joint pain due to calcification, the procedure takes only 15 minutes. The effect of the treatment, where most patients can return to their sports life within 2-3 days, begins within 1-3 weeks and continues for an average of 6-9 months.

Patient selection is the key to success

Despite these developments in medical technology, experts warn that a standard treatment protocol cannot be applied to every knee pain. Reminding that the most critical step in the success of injection treatments is making the right decisions, Associate Professor Berkin TOKER adds that the patient's clinical condition, age, activity level, and the degree of damage in the knee are vital factors that must be considered when creating a treatment plan.

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