Polyurethane foam injections or scaffold injections for knees?

Hello @nowforyou, Thanks for helping your friend. I have bone on bone in my left but so far I don't have any pain with it. My right knee is another story having torn the meniscus in my forties and had several steroid shots but no gel shots, I finally had a right knee replacement done in my mid 70s. I'm now 82 and still mobile without knee pain but a lot less mobility. I do struggle with walking but can relate to my friends that are struggling with knee pain. Before my knee replacement I looked into gel injections but my surgeon didn't think it was any better than a steroid shot so my only option was the replacement.

There seems to be a lot of research on your question but I don't think there are any doctors using polyurethane foam injections, or polyurethane scaffold injections. I think if there were, her age would also come into play in trying to get the procedure done. Hopefully you will get other responses if someone has more information on the procedure. Here's what I found using Google Scholar (https://scholar.google.com/):

-- Collagen/polyester-polyurethane porous scaffolds for use in meniscal repair
https://pubs.rsc.org/en/content/articlehtml/2024/bm/d4bm00234b
-- Evaluation of Porous (Poly(lactide-co-glycolide)-co-(ε-caprolactone)) Polyurethane for Use in Orthopedic Scaffolds: https://www.mdpi.com/1420-3049/29/4/766

I am in New Mexico and in taos I have been referred to the taos orthopedic institute.
read the bio for dr marvil

It's scary to wake up one day and not be able to walk. I barely made my trip to the Rochester Clinic last March, with all the walking on that huge Mayo campus. I could not get approved for Mayo Sports Medicine Orthopedics. My knee and hip joints were crippling me. The pain grew worse and I was a step away from permanent use of a walker at age 68. I've been studying nursing for 10 years and finally made it to a university level for a BSN, only to find out that I may not be able to walk. I blamed my last COVID & RSV combo shot for the deteriation of my joint tissue.

I did find a good treatment. It's nothing short of a miracle. It is not a cure, but its making a huge difference. I found a local Urgent Care Sports Medicine Clinic where I live. I explained that walking is important to complete my studies. I was determined not to have anymore injections since those COVID/RSV shots. But I accepted four injections for both knees and hip joints over a 10 week period. They consisted of Cortisol & lidocaine medicine. I'm back at the YMCA walking 2 miles on the treadmill and working on exercise equipment for muscles and joints. Hope this may help someone else.

I will say I have a young doctor who isn't afraid of over treating a senior.

Thank you so much for the information. Hopefully this clinic and doctor have provided relief for you. I will look into it further and pass along the information to my friend.

Dr Marvil has quite a long list of accomplishments, very impressive.

Thanks again.

Hello John, first off thank you so much for your volunteer work and input you give to so many people on this platform.

Thank you also for all of the information and links that you have provided. I will spend some time looking up this information, so far it seems to parallel the information that I researched and found as well.

I'm so glad that you were able to find relief with your knee replacement and still able to get around even though it may not be as far and as often. Wishing you the very best and thanks again for everything you do!

Hello Lynn,
Your condition and treatment and success does sound like it is nothing short of a miracle as you stated. So happy for you.

I will give this information to my friend and do some more research as well. Good luck with your program and wishing you success!

I would suggest that if your friend in in very good shape, that should consider all alternatives and advocate for what she feels would work best for her. If she is active and healthy, there should be few walls to climb to get care.
We live in a time when more and more people are living longer with chronic conditions- it does not mean that we should give up on seeking improvements.
An alternative for your friend could be engaging in physical activity. Silver Sneakers is an excellent and free program that is included with many medicare programs. You can also find free classes online. Work towards your ability. I also suggest water aerobics- even walking in a pool. It is easier on the joints but builds muscle.
I have worked with many adults up through Septegenarians (and a few over 100!). There are many possibilities, but clinical research and experience is only just starting with these age groups.

Might you have some literature citations for this treatment. I have a similar situation with right knee ( left already replaced) and a younger sports medicine doc who might be receptive. Thank you.

Didn't mean to imply that older orthopedic doctors aren't as good. I started out with a senior orthopedic doctor and he gave me diclofenac and told me to slow down, but the younger sports doctor gave me 4 shots and encouraged my nursing studies. Like you, I'm probably going to need a knee replacement at some point. Not looking forward to it.

Hello and thank you,
Right now I am out of the country and do not have access to the research and websites I saved on my PC in regards to the foam injections.
These results below using ChatGBT, a few months ago, I do have on my phone. This gives an excellent overview, but like any research from any site, details need to be looked into and further researched. Hope this helps!
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The foam procedure for knee pain, particularly in cases of osteoarthritis with bone-on-bone contact, is a relatively new and innovative treatment. It involves injecting a specially formulated foam into the knee joint to provide cushioning and pain relief. Here’s an in-depth look at this procedure:

Foam Injection for Knee Pain Relief

1. Procedure Overview:

Foam injections aim to reduce pain by providing a cushioning effect in the joint. The foam acts as a substitute for the lost cartilage, helping to reduce friction and distribute the load more evenly across the joint.

2. Mechanism of Action:

Cushioning: The foam creates a physical barrier between the bones, preventing the direct bone-on-bone contact that causes pain.

Shock Absorption: The foam absorbs impact and pressure, similar to how natural cartilage would function.

Lubrication: Some formulations also improve joint lubrication, reducing friction and further easing movement.

3. Materials Used:

The foam used in these injections is typically made from biocompatible materials, ensuring that it does not provoke an adverse immune response. Common materials include:

Polyurethane-based foams: These are flexible, durable, and can be formulated to match the mechanical properties of natural cartilage.

Hydrophilic polymers: These polymers can absorb water, swell, and create a gel-like cushion within the joint.

4. Benefits:

Minimally Invasive: The procedure involves a simple injection, making it much less invasive than surgical options.

Immediate Relief: Patients often experience pain relief soon after the injection.

Improved Mobility: By cushioning the joint, foam injections can improve joint function and mobility.

Temporary but Repeatable: While the effects are not permanent, the procedure can be repeated as needed.

5. Procedure Steps:

1. Assessment: The patient's knee is evaluated through physical examination and imaging (like X-rays) to determine suitability for the procedure.

2. Preparation: The knee area is cleaned and prepared for the injection.

3. Injection: Using ultrasound or fluoroscopic guidance, a needle is inserted into the joint space, and the foam is injected.

4. Post-Injection Care: Patients may be advised to rest the knee briefly and avoid strenuous activity for a few days.

6. Potential Risks and Side Effects:

Injection Site Reactions: Pain, swelling, or bruising at the injection site.

Infection: As with any injection, there is a risk of infection, though this is rare with proper sterile technique.

Foam Degradation: Over time, the foam may degrade, requiring repeat injections.

7. Effectiveness:

Clinical studies and patient reports suggest that foam injections can provide significant pain relief and improve joint function. However, as with any treatment, effectiveness can vary depending on the severity of the arthritis and the individual patient’s response.

8. Availability:

The availability of foam injections may vary by region and medical provider. It’s a newer procedure, so it might not be widely offered at all medical centers. Consulting with an orthopedic specialist or a pain management doctor can provide more information on local availability and whether it’s an appropriate option for the patient’s specific condition.

Conclusion:

Foam injections represent a promising option for managing knee pain in patients with advanced osteoarthritis. They offer a minimally invasive alternative to surgery and can provide significant relief for those who are not candidates for more invasive procedures. If you're considering this treatment, it’s important to discuss it thoroughly with a healthcare provider to understand the potential benefits and risks based on the patient's health profile and specific condition.