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VOL. 128 | NO. 31 | Thursday, February 14, 2013

Vic Fleming

Still Knee High

By Vic Fleming

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Few columns have drawn as much feedback as the one I wrote in May 2011 about the PRP (platelet-rich plasma) injection I had in my left knee – the knee that was on the list for replacement.

In that column, among other things, I wrote that at coimed.org, you could learn that PRP therapy is a non-surgical treatment used to treat sprains, cartilage tears, tendonitis and osteoarthritis. The injection of this concentrated mixture of one’s own blood “has been shown to relieve acute and chronic pain and accelerate healing of injured tissues and joints.”

Blood from one’s own arm is spun in a centrifuge, separating it into platelets and white cells, plasma and red cells. A platelet-rich solution is injected into and around the patient’s wound. The platelets release “growth factors that promote a natural immune response.” Special white cells (Macrophages) remove damaged cells and prepare the tissue for healing. “Stem cells and other cells multiply, repair and rebuild the damaged tissue. This accelerated healing response reduces pain, promotes increased strength, and improves joint function.”

Having had several injuries and a couple of surgeries to my left knee, I was a prime candidate for PRP therapy, which I had on May 5, 2011. A few days after my procedure, I drove in my car for several hours to a distant city. Each time I stopped and got out of the car, I braced for the pain of getting my left leg into walking operation. Each time: Nothing! For the first time in years.

In July 2011, I found myself at a hilly golf course, invited to join an old friend and his regular group of linksters. But he’d forgotten to tell me that they were walkers. Carrying my golf bag, I walked the 6,500-yard course, which was mostly uphill – something I’d not done in years. Next day, I hurt everywhere on my body – except my left knee.

In September 2011, I went to Yellowstone and hiked three to five miles per day, up and down hills and valleys, for a week. I iced the knee each night for 20 minutes. Very little discomfort, no noticeable swelling.

I’m writing this on Jan. 18, 2013. Swelling continues to be down, range of motion up. I can walk three miles in the neighborhood and work out at the gym on most of the machines. As long as I don’t try to fold my left leg completely to the point of the thigh and calf touching, I am virtually free of knee discomfort.

Perhaps the most telling thing about my knee is this: I am a compulsive leg-crosser when I sit down. Before the procedure, though, I could not cross either leg over the other and leave it in place for more than 60 seconds without a throbbing pain arising in my left knee. I now find myself from time to time saying, “Just how long have my legs been crossed?” That pain is gone completely.

I know it will not work this well for everyone. Moreover, I know and respect that I still have a significantly compromised knee joint. (I still don’t shoot right-handed lay-ups because of the push with the left knee that’s involved.) However, I have deep-sixed the notion that I’ll ever have to have the left knee replaced. And that, as they say, is good enough for government purposes.

Vic Fleming is a district court judge in Little Rock, Ark., where he also teaches at the William H. Bowen School of Law. Contact him at vicfleming@att.net.

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